Reopening Primary Schools During the Pandemic
An important perspective published in the New England Journal of Medicine. Indiana is one of the earliest states to start the new school year. However, school districts around the country are struggling with the task of protecting students, faculty, and staff (and their communities) while safely reopening. What follows below are recommendations for how to view and provide support for primary schools that can apply to all school districts. According to the authors:
[W]e would argue that primary schools are essential — more like grocery stores, doctors’ offices, and food manufacturers than like retail establishments, movie theaters, and bars. Like all essential workers, teachers and other school personnel deserve substantial protections, as well as hazard pay. Remote working accommodations should be made if possible for staff members who are over 60 or have underlying health conditions. Adults who work in school buildings (or drive school buses) should be provided with PPE, and both students and staff should participate in routine pooled testing.” (citations omitted)
Whether (and how) to reopen primary schools is not just a scientific and technocratic question. It is also an emotional and moral one. Our sense of responsibility toward children — at the very least, to protect them from the vicissitudes of life, including the poor decision making of adults who allow deadly infections to spiral out of control — is core to our humanity. Our expectations of school personnel are equally emotionally and morally fraught. It is not incidental that the majority of primary school teachers are undercompensated women who are expected to sacrifice themselves “for the sake of the children.” School closures have also brought social, economic, and racial injustice into sharp relief, with historically marginalized children and families — and the educators who serve them — suffering the most and being offered the least. For all these reasons, decisions about school reopenings will remain complex and contested.
But the fundamental argument that children, families, educators, and society deserve to have safe and reliable primary schools should not be controversial. If we all agree on that principle, then it is inexcusable to open nonessential services for adults this summer if it forces students to remain at home even part-time this fall.
Is Telehealth Here to Stay?
The New York Times asks whether this intervention that has rapidly expanded in use during the epidemic will stick around once the emergency passes. Telehealth has been a significant benefit for those seeking treatment for substance use disorder and mental health services during the Covid-19 epidemic. And this week, the Center for Medicare and Medicaid Services proposed rules that would expand Medicare reimbursement beyond the public health emergency.
Covid-19 Vaccine Policy
The news that one vaccine in development has moved into Phase 3 testing has increased the public discussion about:
(a) ensuring the vaccine’s safety and efficacy; (b) ensuring adequate engagement and health communication to maintain public trust in the vaccine’s safety and efficacy (see this piece and the associated summary from the Johns Hopkins Center for Health Security); (c) the distribution of the vaccine, including how to prioritize what populations receive the vaccine when supply may be scarce; as well as (d) whether or not states should require that certain populations receive the vaccine.
For a discussion of many of these issues, see Ensuring Uptake of Vaccines against SARS-CoV-2, a piece I coauthored in the New England Journal of Medicine.
The expiration of federal protections against eviction (as well as expiring protections against foreclosures and utility shutoffs) raises significant concerns about the near-term and long-term health-harming disruption to the lives of hundreds of thousands in the midst of the ongoing public health crisis. Governing magazine has a piece discussing recent policy steps states have taken to protect renters.
Contact tracing efforts have been failing in many states, here’s why.
Law & Ethics During the Covid-19 Epidemic: Webinar Series
This summer, the American Society for Bioethics + Humanities has held a webinar series with leaders in the fields of public health law and bioethics on issues arising in the Covid-19 Epidemic. Full videos of these talks are linked below:
- Nursing and the Law with Prof. Emily Largent of the University of Pennsylvania
- Public Health Law (Part 1 & Part 2) with Prof. Lindsay Wiley of American University
- The Changing Terrain of Healthcare on the Front Lines with Dr. Michael Stephen of Jefferson Hospital in Philadelphia
- Crisis Standards of Care and Liability Shields with Prof. Valerie Gutmann Koch of the University of Houston
- The Ethics of Immunity Based Licenses (“Immunity Passports”) with Prof. Govind Persad of the Sturm College of Law
- Covid-19 Research Law & Ethics with Prof. Kayte Spector-Bagdady of the University of Michigan School of Medicine
- Health Equity & Justice in the Covid-19 Pandemic (Part 1, Part 2, Part 3) with Prof. Ruqaiijah Yearby of St. Louis U. School of Law, our own Prof. Seema Mohapatra from IU McKinney School of Law, and yours truly.