AOC has the right idea but needs to move it outside

Rep. Alexandra Ocasio-Cortez (D-N.Y.) tweeted, “If it’s not safe enough for indoor dining, what makes it safe enough for indoor schooling?”   

A better question would emphasize moving out instead of closing in. “If we are facilitating outdoor dining spaces for restaurants, why aren’t we developing outdoor learning spaces to protect and educate our children?” This is an opportunity to decrease class size, improve ventilation, thereby reducing the likelihood of COVID spread, with a strong historical background dating back over a century. 

A study published two weeks ago in JAMA pediatrics reported that younger children with mild or moderate cases of COVID had higher virus loads than older children or adults. It is clear that even though children are less likely to be seriously ill with COVID, they remain reservoirs that can spread it to grandparents and other adults in higher-risk groups. In some cases, such as summer camps and schools, they can be what are called “super spreaders.” Schools are already reopening, and the minimization of COVID spread to and from children, especially in urban schools with limited opportunities to expand, should be a top priority if we wish to have in-person education.  

As recently as Aug. 1, the Centers for Disease Control (CDC) emphasized adequate ventilation as an essential part of preventing the spread of COVID in schools similar to what they, and the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) have recommended for workplaces.  Given that the same recommendations exist for schools and workplaces, it seems odd that schools are not afforded equal rights and encouragement of outdoor expansion as businesses. 

A recent study from the University of Minnesota outlined how COVID traveled in a classroom dependent on the ventilation system and suggested changes to diminish spread within the classroom. Unfortunately, a recent federal report acknowledged that over 50 percent of schools have inadequate ventilation and cooling systems. The changes in the position of students, teachers, ventilation outlets, etc., in the classrooms, are essential and should be a part of indoor schooling – but overall HVAC inadequacies indicate that it will not be implementable to the degree necessary to protect our children.  

In contrast, numerous studies in Japan and elsewhere have demonstrated that the chances of catching COVID are as much as 20 times greater indoors than outdoors, especially if coupled with social distancing and masks. This is not a new idea. During the tuberculosis epidemic in the early 20^th century, the open-air school movement was popular and effective. This movement largely atrophied in the 1940s with the discovery of streptomycin and other anti-tuberculosis medications. It might be time to revive it. 

We have the potential to do this even in crowded cities.  Departments of Education, particularly in urban areas, could make deals with local hotels and restaurants to use their outdoor spaces for education during non-peak hours. The same street and road narrowing and closures that have been provided to restaurants can make more space available for outdoor learning in even the most congested areas. Governments should evaluate the potential learning opportunities in every square inch of open outdoor space.  

Holding classes outside would not resolve the COVID pandemic. Students would still have to maintain social distancing and wear masks. There would be space, cost, and weather issues. School personnel may need help to supervise a more significant area, even if the number of students is smaller. New York City (NYC) has over 1800 public schools (and over 27,000 restaurants) plus many private and parochial schools. It is the prototype for a student rich and space poor urban area.  But, NYC comptroller Scott Stringer reported that NYC has almost 30 million square feet of available outdoor space. The provision of tents, blankets, or overhead heaters in the winter, etc., seems to be a very worthwhile investment. Substituting virtual learning on an occasional rain day does not seem too harsh a penalty for smaller, safer, classes.  

There are several critical flaws in what is currently available for remote mass learning and definite detriments to even short-term ablation of in-school education.  Socialization is a large part of education, especially for younger students, and it just can’t be created on a screen. There are clear disparities inability of internet access to remote learning. An April survey from the Pew Research Center reported that over six times as many low-income parents did not have access to at home high-speed internet and so their children would have to use public Wi-Fi or cell phones to go to school. Of course, using your cellphone for school generates a bill and also means that a parent can’t use it. Overall, students, especially Black and Latino students, will fall months behind as a result of remote learning. We just don’t have the technology as yet to meet our obligations to educate our children, and failure to make every effort to provide in-school education will significantly worsen educational disparities.  

Schools are opening. The American Academy of Pediatrics (AAP), American Federation of Teachers (AFT), National Education Association (NEA), and School Superintendents Association (AASA) have issued a joint statement outlining the superiority of in-school learning at so many levels. Optimization of opportunities for outdoor learning remains an underdeveloped resource to reduce class size, reduce COVID spread, and get a little sunshine in our lives at a time when we could use it.  

Dr. Michael Rosenbaum is a practicing pediatrician and a Professor of Pediatrics and Medicine at Columbia University Irving Medical Center in New York City.