HOUSTON – The Texas Medical Center in Houston issued this open letter to the city on Friday.
An Open Letter to the People of Houston,
As CEOs of large hospital systems serving the greater Houston region, we are constantly asked for advice regarding the return of our children to schools. Therefore, in the spirit of working together as a community to achieve a common goal of safely educating our children, we offer the following letter with scientifically and medically backed advice for schools, parents, and the broader Houston community.
In ordinary times, back-to-school season is a time of hopeful anticipation. Milestones are celebrated. New shoes and backpacks acquired. Children look forward to reconnecting with old friends and meeting new ones. The new school year is full of promise and possibilities.
These are not ordinary times.
In the second year of our great pandemic, for parents the start of this school year has become a disconcerting blend of guilt, anxiety, and apprehension. It is time to go back to school. Virtual options are less available than last year. The pandemic education experience to date has left many behind academically and has taken a social, emotional, and economic toll on children and families. This year, most families do not have the option of virtual learning. Parents cannot stay home from work to home school. They have little choice but to return their children to school, and in doing so are asking themselves: Am I putting my child’s health at risk?
Even in the midst of the pandemic — and as the Delta variant surges — we have tools to provide a relatively safe school environment with an acceptable level of risk. However, creating safe schools will not occur by luck. It will require a thoughtful, unified collaboration between schools, parents, and our community. Each one of us has a role to play in ensuring a safe and healthy return to school for Houston students, even if you are not a parent, teacher, or student.
Let us start with the good news. We know children tend to have milder disease. We have experience across the country last year with safe school openings with appropriate safety protocols in place1 . Over the course of the entire pandemic, there have been just over 400 documented deaths in the United States of children under eighteen. One death is too many, and statistics are of little comfort if it is your child, but out of 73 million children in the US, the absolute risk is still very low.
However, if COVID-19 has taught us anything, it should be humility related to what we do not know. We cannot be complacent. Most of our documented, epidemiologically validated data to date comes from before the emergence of the Delta variant. Delta is clearly more infectious. Pediatric cases are on the rise, and in some areas of the country they are beginning to strain hospital ICU capacity. Although the risk to the overall pediatric population remains statistically low, some children do become critically ill. The Delta variant is different than its predecessors and needs to be taken seriously.
Another cause for caution. While the virus has changed, so have the schools. Where much of last school year was blended with lower than normal classroom density, there are less virtual options this year, and classroom density will almost certainly be higher, making effective distancing more difficult.
Parents and schools are in a difficult situation. We cannot wait until the pandemic is over to return to school. Our virtual school experience was a failure for many students, and not optimal for any of them. We have an incomplete and ever-evolving set of facts that change as we learn more about the spread of this virus and as the virus evolves. We need to go back to school, and we need to do so in the safest manner possible, based on our knowledge today.
The following guidelines will help to keep children safe, and we strongly encourage all schools, school systems and parents to work together to implement them as rapidly as possible:
Guidelines for schools and school systems
• Strongly encourage vaccination of your faculty and staff. Require vaccination if you can. At a minimum, strongly encourage vaccination. This is our single most powerful tool to protect ourselves, our community, and our children. Vaccines are safe, effective, free, and available.
• Implement masking for all people in school buildings – faculty, staff, and students. • Promote distancing. Maintain at least three feet of space between students, when possible, within the practical limits of your facilities. • Limit or eliminate outside guests/visitors to school buildings.
• Do everything possible to discourage teachers and staff members from coming to work if they are sick (fever, cough, breathing difficulty, fatigue, body aches, sore throat, congestion, loss of taste or smell, diarrhea, headache), or if they test positive for COVID-19.
Guidelines for parents
• Work to make sure your circle of friends and family – the people your child will see regularly – are fully vaccinated. Again, vaccines are safe, effective, free, and available.
• If your child is 12 years old or older, get them vaccinated. Today. Remember, they will not enjoy full protection until two weeks after their second dose. Start today, and they are still 5-6 weeks away from maximal protection. • Stress the importance of masking in public with your child, especially when indoors or in crowded environments.
• Do not send your child to school if they are sick (fever, cough, breathing difficulty, fatigue, body aches, sore throat, congestion, loss of taste or smell, diarrhea, headache), or if they test positive for COVID-19.
• Carefully evaluate extracurricular activities and social gatherings. Our experience to date strongly indicates most disease in students is contracted outside of the classroom and school. Make sure activities are designed to minimize the risk of exposure (vaccinate, mask, distance). If it does not feel safe, curtail after-school and social activities until the virus is clearly receding. Guidelines for the community
• Schools do not function in isolation; they are part of the community. We all have a role to play in maximizing the education and safety of our students and in protecting the people responsible for their education. Do your part to reduce the amount of SARS-CoV-2 in the community.
• Work to make sure you and your circle of friends and family are fully vaccinated.
• Wear a mask when indoors in public spaces. This will help protect teachers, students and their families and friends while they are out in the community.
One final recommendation is for everyone. Recognize that this is a difficult time for all. Teaching is a noble but difficult profession in the best of times. COVID-19 has imposed an incredible burden on schools and teachers. The pandemic has forced parents to make decisions that are uncomfortable and unavoidable. We all need to work together to promote an environment of mutual respect. Please be kind to, and patient with, each other.
We make these recommendations as health care leaders, guided by evidence, and bound by duty to protect the health of the public. Most importantly, we make these recommendations as mothers, fathers, grandparents, caregivers, and guardians who want to protect our children. Working together, return to school can still be a time of hopeful anticipation.
William F. McKeon
President & CEO
Texas Medical Center
T. Douglas Lawson, PhD
SVP, Divisional Operations & CEO
David L. Callender, MD
President & CEO
Memorial Hermann Health System
Paul Klotman, MD, FACP
President, CEO & Executive Dean
Baylor College of Medicine
Marc L. Boom, MD
President & CEO
Mark A. Wallace
President & CEO
Texas Children’s Hospital