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Malia Jones and James H. Conway: Respect social distancing — and keep your kids home from school ASAP

Malia Jones and James H. Conway: Respect social distancing — and keep your kids home from school ASAP

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We are infectious disease specialists at UW-Madison — one an epidemiologist and mother of two boys at Van Hise Elementary School, the other a global health pediatric infectious diseases physician. Out of concern for the safety of our community during this critical moment of the COVID-19 pandemic, we ask all parents (who have the means to do so) to please voluntarily keep your children home from school, starting on Monday.

We work together to study human contact patterns and infectious disease epidemics. Like many of you, we’ve been following the COVID-19 pandemic extremely closely. At this point, it is very clear that the time for action to prevent further community spread of COVID-19 is upon us — and has been for weeks, probably.

When we say "upon us," we mean right now. With the delays in providing widespread testing, we don’t even know exactly which communities are most affected. But the more we test, the clearer it becomes that there are COVID-19 cases scattered throughout the state.

The time to stand in crowded supermarkets and wonder if you’re overdoing it was last weekend. The time to ask your elderly loved ones to stay at home was last Tuesday. The time to cancel events was Wednesday, and the time to close schools, universities and high-contact gatherings was yesterday. Madison is now at the beginning of an epidemic curve of disease spread, and we’ve already seen where that curve goes from watching it unfold elsewhere.

We were relieved to hear the announcement that Gov. Tony Evers has shuttered schools, but dismayed to learn that statewide closure would not take effect until Thursday, and that the Madison Metropolitan School District in Dane County — where we have several confirmed cases and dozens more tests pending — will not close until Wednesday.

We were relieved because even though most children are not at particularly high risk for poor outcomes when they get COVID-19, in all likelihood they are central to the spread of this disease. Children are bringing home the microbial by-products of hundreds of close contacts every day that they go to school. And they are coming into regular, unavoidable close contact with their high-risk parents, grandparents, great-grandparents, caregivers, immunocompromised and otherwise high-risk friends and siblings. Those adorable little goobers are the connective tissue of the disease transmission network.

While COVID-19 is not influenza, the two diseases share similar transmission characteristics, and we have a lot of data for influenza that we can use to make good decisions in this pandemic. When we look at incidence rates for influenza, we can detect the dampening effect of a single snow day — that’s how important kids are in the epidemic process. So we heartily agree that school closures are necessary.

That’s also why sending kids back to school for any more days delays our ability to interrupt one of the most important transmission networks this virus uses. We have canceled international flights. We have canceled our beloved college and professional sports. We have agreed to limit large public gatherings, and are canceling performing arts and religious events across the country.

We understand that the people who made the school closure decisions are balancing many competing needs, and that we’re beyond good solutions right now. We also understand that closing down schools is a major disruption for working parents. And we know that countless children in our society depend on all sorts of services provided by our schools.

But allowing the contact patterns within schools to continue to play out for even one more day, let alone several more days, will contribute to additional infections and additional stress on our health care system. There are an unknown number of untested, undiagnosed cases circulating and growing across Dane County. Sending kids back to school on Monday and risking further transmission to other families is all but guaranteed to make things worse.

Here’s what we know: the scientific community has never responded so quickly to a health crisis. Reliable research is coming out daily on this new disease. The latest evidence this week suggests that COVID-19 is spreading quickly across the world for two reasons:

- Many cases have mild or no symptoms, but they are still contagious.

- Infected people can be contagious before they show symptoms.

Taken together, this means that an infected person could be feeling just fine or have only a mild runny nose and be infecting a lot of people. In addition, we have seen disappointingly slow testing, so finding and isolating just those with the disease is just not possible at this time.

School closures represent a disproportionate burden to the most vulnerable students in our community, and we need to help those kids. There are kids whose parents cannot be at home with them, and kids who won’t get enough to eat. There are kids who have no homes. We are worried about those kids. But we’re also very worried that kids could spread the disease to the vulnerable members of their families, and that families will be crippled by hospital bills from COVID-19.

So here is our ask. We ask that all parents who can do so keep their children at home from school starting on Monday. Sparse school attendance will help, even without a total closure for the first few days of this week. MMSD has already said it will excuse absences on Monday and Tuesday.

In addition, we ask that we all work together as a community to mitigate the effect of this crisis on vulnerable families.

Second Harvest Food Bank is gearing up to meet increased demand as people’s lives and economic welfare are disrupted. Consider sending a cash donation, 94% of which is used to purchase food. The school district and safety net organizations will need other supports such as funding, volunteers or supplies. When those calls come out, we ask that you to respond. Please.

Things may improve some as the weather warms and spring comes. Social distancing will slow it down. But in the meantime, immediate community-wide action is the fastest path back to normalcy and economic recovery. We need broad social distancing, now. Closing schools (or at least making attendance sparse) is an unfortunate and unavoidably important part of that.

We’re not promising that it will happen quickly, but we can defeat this threat to society. We will get there sooner if we all act together.

P.S. Get your flu shot. It’s not too late!  Influenza is still around. We need to free up the hospital beds that flu patients are using right now.

Malia Jones, Ph.D., MPH, is a Van Hise Elementary mom and assistant scientist in health geography at UW-Madison’s Applied Population Laboratory. James H. Conway, M.D., FAAP, is a professor of pediatric infectious disease and associate director of the UW-Madison Global Health Institute.

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