"in feb, i thought the failure to act was slowness. in april, i thought it was incompetence. i dont know how to process that it was malice," tweeted Prof. Ellie Murray.
These words have hung heavily with me over the past few days. I agree with these words. I struggle with these words.
I would add that, in the months since the novel coronavirus pandemic began largely shutting down our communities, we have also squandered the opportunity to plan for how to safely resume some of the most critical aspects of society.
Since many schools closed in March, there has not been nearly enough discussion of how to reopen them in a safer fashion this fall. If we truly wanted schools to open, we would have collectively worked to lower community transmission and allocated the money and resources needed to reopen schools as safely as possible.
If the community transmission in my area remains low, my wife and I have made the calculated decision that we will send our children to school. I am comfortable with this decision because I understand and support the mitigation factors our children's school has put in place.
My children also understand the importance of masks, distance and how their interactions with others increase risk of infection.
But I recognize and have to admit to my privilege. My children attend a private school with the resources to reopen in a manner that will maximize the chance that they, their classmates and the staff at the school will remain infection-free.
Even with the resources on hand, the teachers at my children's school are nervous for their health and safety. And rightfully so -- if you have kids and you don't have nerves about schools restarting, then you aren't fully appreciating the situation that teachers, staff and your household are facing.
Teachers in public schools understandably have the greatest level of anxiety, based on conversations I've had with them.
I am somewhat sheepish in admitting to the following, but one of the other factors that helped in our decision to send our children to school is my knowledge of the link between socioeconomics and infection.
The families that send their children to private schools fall into demographic groups that are less likely to be badly affected by the pandemic. We have long-known that there is a wealth disparity with the infection rates.
From the early days of the pandemic, public health officials recognized how the virus was deepening American inequality. The financial inequality rife throughout the US drove some families directly into the path of the virus while allowing many with means and office jobs to isolate themselves at home, continuing to work but remotely and away from this plague.
The wealth disparity is not unique to the US. A similar phenomenon has also been observed in Canada. In a beautifully written piece, the Toronto Star clearly highlighted the difference in infection rates between the 20 lowest income neighborhoods and the 20 highest income neighborhoods in Toronto.
The number of weekly new Covid-19 cases in the lower income neighborhoods, at peak, was as much as 6 to 8 times higher than that of the wealthy neighborhoods.
We can speculate as to why there is a wealth disparity with infection rates in our communities: More people in lower income neighborhoods may have been essential workers, providing more opportunities for exposure; often the housing density in those neighborhoods is high, increasing the ease of transmission between households once infections have penetrated the neighborhood; and often within households there are more people in less space, enhancing within-the-home infection rates.
These disparities in infection rates should alarm us all. Not just because they highlight how fractured society has become, but because they provide us with a forecast of what is to come in the rest of the US when schools resume in-person teaching.
When there are people mixing in the workplace and those workers come home to a family, the spread of the virus in the community paves the way for transmission in the home.
Children throughout the US were pulled out of school in the spring semester to finish the school year remotely and have largely been staying home due to lockdown measures. But they will be assembling in groups when the school restarts in person.
The infection rates we have seen among lower income essential workers and their families could now become the infection rates we see in children attending school. And those infected children will come home to their community and mix with each other in neighborhoods and sports. And they will spend many hours with their parents, siblings, and extended family.
We now know that children can be infected. While the evidence is currently mixed on how easily they can be infected -- ranging from half as likely to as likely as adults (especially for those children over 10 years old) -- the data is robust that children can be infected.
However, we can take some comfort in the data showing that children are much less prone to severe outcomes from Covid-19. Lower severity of disease gives many people the justification they need to send their kids to school.
This fact alone, coupled with my family's overall good health, does give me some comfort in our decision to send our kids to school.
But we must appreciate that children also harbor as much virus in their noses as adults. This is important because the nose and the mouth are the primary locations by which the virus tries to leave your body and find a new host.
If children touch their nose or mouth and then touch another child or a shared surface, or they cough or sneeze, the virus could be easily released into the school environment.
Given that many children do not develop as severe Covid-19 symptoms as adults, it's possible that their ability to transmit the virus could be lower. But that transmission risk is still, of course, present. And when we consider there are 56 million school-age children in the US, that risk is nothing to take lightly.
Some parts of the US have started going back to school, with one Indiana school closing days after it opened due to an infected staff member. Other schools may get a little bit of breathing room before the first infections are revealed.
But make no mistake, if there is community transmission in your local area, once schools resume there will be infected children and staff within those school walls. And once they are in the school, you are relying on the mitigation efforts the school has put in place -- masks, physical distance, ventilation and filtration of air, outdoor teaching -- to stop within-school transmission.
What is your school doing to prepare? Every parent, teacher and staff member should be asking critical safely questions. If the answers you receive don't align with your risk profile, then you need to demand more of your school and your local government.
At this stage the most important thing we can do is to focus our attention on reducing community transmission -- because once schools resume in-person teaching, children will be interacting with larger group of friends and we will be giving the virus mobility and the susceptible hosts it needs to spread in our community.