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Community Physicians Question the Safety of Elementary School Reopening Plans

cloroxThis letter was shared with Scarsdale10583 by a group of Scarsdale mothers who are doctors.
Dear Scarsdale School District Administration,

We are writing to you as concerned mothers and physicians on behalf of our children in the Scarsdale elementary schools. We write to you with several goals in mind. First, we want to emphasize the importance of following evidence-based risk mitigation. Second, we would like to raise concerns about the disinfection methods that the district plans to employ, particularly during the break between the AM and PM cohorts. Third, we would like to offer suggestions for how to make the elementary schools as safe as possible for both students and teachers. And lastly, we would like to offer our gratitude and assistance.

To our relief, young children do not appear to be major vectors of COVID19, however we know that sending our children to school during a pandemic involves some degree of risk. Fortunately that risk can be heavily mitigated with good ventilation, masks, and basic hand hygiene. We believe that the Scarsdale elementary schools can reopen safely, and we support the American Academy of Pediatrics in their recommendation for children to be physically present in school as much as possible.

Having reviewed the Scarsdale School District's re-start plan, we are concerned about the proposed disinfection process and the absence of a ventilation plan. Many popular disinfection practices create an illusion of safety but can actually pose significant risks to children, who inhale, ingest and absorb these products at much higher levels than adults due to their smaller body size, increased respiratory rate, higher body fat composition, and their tendency to put fingers and other objects in their mouths. In addition, children are still developing physiologically and are more subject to the effects of toxic substances. We have reviewed the disinfection products listed in the restart documentation and are aware that some of the ingredients are known to increase the risk of asthma. We are also concerned that some of the ingredients pose risks to other developing organs and systems. If we understand the current plan correctly, the PM cohorts may be entering classrooms shortly after the cleaning/disinfection process finishes.

Unlike many other viruses, COVID is spread primarily through the air, not via surface contact. Healthy lungs are our first line of defense against COVID. We risk undermining that barrier if we expose our lungs to irritants. Wiping down high touch surfaces like door handles is prudent, but the obsessive disinfection of most or all surfaces is unnecessary and potentially dangerous. Additionally, while this should go without saying, cleaning products should be kept under lock and key at all times to prevent accidental ingestions. Statistically speaking, a young child is far more likely to be sickened or killed by accidental poisoning than by COVID19. Early data already shows that accidental poisonings have increased along with the increased use of disinfectants during this pandemic.

Good ventilation appears to be key in preventing COVID19 transmission. Fortunately, good ventilation is inexpensive and easy; it involves opening the windows and turning on a fan to help circulate the air. Leaving a classroom idle with the windows open and a fan blowing is the safest, easiest way to disinfect a classroom. Doing so is certainly preferable to dousing a school building with industrial chemicals. Outdoor learning and play is also an easy way to keep everyone safe as COVID19 appears to fare poorly outdoors. We request full transparency with regards to the School District’s plans for ventilation and disinfection in the elementary schools so that families can better assess the risk benefit ratio of sending their children to school.

As parents, we are entrusting the Scarsdale School District with our most precious, vulnerable assets during unprecedented times. As physicians, our first duty is to do no harm. We ask that the elementary schools take the same approach. We are concerned that under the AM/PM model, the PM cohort would suffer disproportionately in terms of their exposure to industrial disinfectants. In theory, the PM cohort may also face a higher risk of exposure to COVID19 if the classrooms are not properly ventilated between cohorts. None of us wants our own children to be in the PM cohort, and we feel an ethical obligation to advocate for all of the children in our district. Unfortunately the full day AA/BB model employed by other districts comes with its own set of limitations and challenges. For example, young children (and some adults) are unlikely to tolerate masks all day. Children and adults are less likely to tolerate the climate extremes inevitable in having open windows in the classrooms if the school days are long. Lunch time presents a logistical challenge. And having two days of school punctuated by five days without school seems undesirable for kids and hugely problematic for parents.

While we acknowledge that no model is perfect, we believe that a preferred elementary school model would involve a single cohort of students in the school per day (this could be any of multiple A/B plans, including a 6 day model of 3 on 3 off, alternating weeks, etc.). We believe that this plan is advantageous for the teachers as well because it would eliminate the need for teachers to evacuate buildings in the middle of the day while the buildings are being cleaned between cohorts, it would also reduce their exposure to disinfectants, and it would reduce their likelihood of being exposed to COVID19. These teachers are going to be the ones teaching our children. We believe that it is our fundamental responsibility to prioritize their safety as well.

We know that our children will have unusual school experiences this year because of COVID19, but we are also confident that the Scarsdale community can rise to the occasion. We want to offer our assistance to you as physicians, parents, and in some cases, Scarsdale alums. We realize that now is an extraordinarily challenging time to be a teacher and administrator. We are truly grateful for everything the School Board, the administration, and the teachers are doing on behalf of our children.

We of all people empathize with teachers who are fearful. As physician mothers, we never imagined that we would be asked to put our own lives at risk while also caring for and educating our children during a pandemic. Like millions of other essential workers, we have made tremendous sacrifices, and we will continue to do so. To that end, we ask our school district to partner with us: We are here to assist you in any way possible.

Respectfully,

Dr. Deborah Hemel
Dr. Beth Rapaport Pass
Dr. Leah Blank
Dr. Suzanne Arinsburg
Dr. Hope Stephens
Dr. Doreen Chung
Dr. Monika Desai
Dr. Oksana Lekarev

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