By RICHARD SKOLNIK
Los Alamos

Few things can be more important to our community than reopening schools as safely as possible for teachers, staff, students and those of us who live here.

It will be impossible to guarantee that no one gets infected with COVID-19 as our schools reopen. However, it is imperative that our schools and community engage in the best possible practices to avoid infection. This is especially so given the enormous costs of infection in days of lost schooling, days of lost work, hospital costs, and possible deaths.

In addition, we are learning more and more that infection alone, even sometimes without symptoms, can be associated with a range of short, medium and long-term neurological, cardiac, vascular, and kidney effects. Despite gaps in our knowledge, it is clear that the disease has much more profound effects and costs than most Americans realize or consider. It is also clear that we don’t yet know if children infected today might suffer longer-term consequences of such infection.   

The New Mexico Department of Health (NMDOH), the Public Education Department (PED), and the Los Alamos Public Schools (LAPS) have worked tirelessly, under extraordinary circumstances, to reopen schools safely. Many teachers and community members have also been involved in this effort. LAPS has a safety checklist that takes account of CDC and PED guidelines. Our School Board has said that a transition to the hybrid model will be contingent on schools meeting these important safety measures. This is good.

The next challenge, however, is to ensure that each school is actually ready, before reopening, to implement its checklist. The challenge after that will be to ensure that each school can continuously carry out the checklist activities. Doing this is fundamental, since the evidence suggests the importance in the school setting, among other things, of handwashing, social distancing, mask wearing, ventilation, having safe HVAC systems, and the rapid identification of school-related cases and follow-up contact tracing. It is hard to see how schools can reopen safely if they cannot fully implement their health and safety checklists. Plans are important. However, they don’t mean anything unless they can be operationalized.

It is also important that we have an objective basis for determining the readiness of schools to reopen, beyond the state’s epidemiological triggers. With this in mind, I want to suggest that:

• LAPS seek an independent party to verify that each LAPS school is ready to implement its safety checklist before the school is allowed to reopen for in-person instruction.
  
• That LAPS conduct a review at the beginning of each month, until safety measures are no longer required, of the extent to which each school has been able to effectively implement its safety checklist.

In suggesting the use of an independent party, I am not suggesting that any of the groups involved in implementing our school health and safety measures lack integrity. However, I am suggesting that:

• School systems are being asked to develop and implement many health and safety measures that go far beyond their normal realm of competence and experience, during an exceptional period.
• Various stakeholders have strongly held views about the “readiness” of schools to reopen. Independent verification of the health and safety measures the schools are supposed to take can help create a broader consensus around such measures than would otherwise be the case.
• Independent verification of health and safety measures by competent people from outside the system better protects the school system against claims of negligence than would the LAPS itself verifying readiness for implementation and actual implementation.
• There is extensive evidence that independent verification of matters such as our health and safety checklists provides more robust results than is the case when such verification is done by “insiders”.

In my involvement in health and education efforts internationally for many years, I also learned that independent verification on matters related to health and safety invariably produced better results that were more acceptable to all parties than alternative approaches.

We are fortunate to live in a community with a national lab that has a range of experts in safety-related issues. One possible approach to carrying out this work would be for the LAPS to ask the Los Alamos National Laboratory to provide several safety experts for this fundamental community effort. We only have seven schools in the county and such reviews could be done quickly. These “inspectors” could be supplemented with public health experts if needed or desired, such as former staff of NMDOH who are experienced in public health and safety or occupational health and safety.

Linked to the above, it will also be essential that the school system have an ongoing mechanism for reporting gaps in any school’s implementation of the health and safety checklists. The school system must encourage students, parents, faculty, and staff to report gaps when they see them and thank them for doing so. I have confidence that our community will do this and that we will not look like the community in Georgia, in which students had to report the remarkable disregard for health and safety when their school opened.

It would be nice if we did not need to worry about preventing infections in our schools. However, despite living in a community with relatively low transmission, we have no such luxury. Outbreaks occurring at other schools in the US, shortly after they opened, highlight the importance of reopening schools as safely as possible. I encourage our School Board to seriously consider the above approach to achieving both.

Editor’s note: Richard Skolnik is the former regional director for health for South Asia at the World Bank. He was the director of an AIDS treatment program for Harvard and taught Global Health at the George Washington University and Yale. He is the author of Global Health 101 and the instructor for Yale/Coursera’s Essentials of Global Health.