Experts question why New York City closed schools and not restaurants or gyms: 'Should parents drop their kids off at the bar?'

• New York City's schools are closed again indefinitely, since the city's test positivity rate for COVID-19 reached 3%.
• Experts and parents criticized the decision, especially since bars, restaurants, and gyms, which unlike schools are known super-spreader locations, remain open.
• Data has shown that school openings haven't affected community rates, and kids, especially younger ones, remain far less likely than older kids and adults to contract or spread the coronavirus.
• While keeping schools open isn't risk-free, closing them has graver consequences to kids academic, social, and physical development — and parents livelihoods.

New York City schools will be closed for the foreseeable future, Mayor Bill de Blasio announced Wednesday.

De Blasio said the decision was based on a strict policy decided months ago that once the city's rate of coronavirus transmission surpassed 3%, in-person classes would be suspended.

The move drew sharp criticism from infectious disease experts and epidemiologists, who questioned why the mayor had not followed his other strict rule: to shutter restaurants, bars, and gyms once the city's transmission rate surpassed 2%.

"To me, the fact that gyms and bars and restaurants are open is unfortunate," Dr. Preeti Malani, University of Michigan's Chief Health Officer and a fellow of the Infectious Diseases Society of America, told Insider. Eating, drinking, and exercising are riskier than going to school, particularly because mask-wearing in the latter situations is more difficult, he said.

She called a 3% threshold "pretty modest" as a benchmark to warrant closing schools, especially considering that much of the country is dealing with rates in the double-digits. What's more, the rate of transmission within New York City schools is much lower, at 0.17%, according to data cited by the New York Times, suggesting schools aren't big transmission drivers of COVID-19.

"Schools have been one of the successes," Malani said.

Throwing the towel in on that success isn't only a blow for local parents and politicians. New York has the biggest school district in the country and the first major city to reopen schools in the pandemic. As such, it could have implications for schools across the country, which have looked to New York City's seemingly successful COVID-19 strategy for guidance and inspiration.

Health experts reacted to De Blasio's decision

The move to close schools comes six weeks after they started reopening, bringing 300,000 of the city's 1.1 million students back into classrooms for face-to-face learning.

Now, they will be closed indefinitely.

Health professionals reacted on social media, many questioning how city officials are interpreting statistics.

Epidemiologist Jennifer Nuzzo tweeted, "Test positivity should not be the sole metric for making high consequence decisions about opening or closing businesses or schools."

Infectious disease specialist Dr. Amesh Adalja replied, tweeting, "Agree totally. The NYC schools decision was based on an arbitrary number and not reflective of transmission risk at school or the long term harm this decision will cause to children."

The US Surgeon General, Jerome Adams, weighed in, echoing another common thread: that schools are not much cause for concern, if handled correctly.

"One of the important lessons learned over the last several months is that kids (as well as teachers) appear to be as safe or even safer in school vs not. Limit bars/ indoor dining > schools," Adams wrote on Twitter.

It's complicated to keep schools open safely

Closing and reopening schools isn't simple, especially in a country like the US where the coronavirus has not been contained.

For schools that do reopen, it requires adherence to basic public health measures like distancing, mask-wearing, hand-hygiene, and good ventilation. Symptomatic kids need to stay home, and systems need to be in place to contact-trace and alert families if someone in the school tests positive.

Malani suspects that logistical fatigue, plus teachers understandably wanting to protect themselves, plays into decisions like what happened in New York. "You have to accept some risk," Malani said, "but it can't be reckless."

In her community, she said, schools require social distancing, hand sanitizer, masks, and kids don't necessarily go to class every day — but everyone is getting used to it.

"I describe it as you're trying to make a boat out of a car — it looks weird, but it floats," she said. "It's shifting our lens on what schools have looked like."

Kids don't seem to be particularly susceptible to contracting or spreading the virus

While schools may seem like a perfect storm for transmission, the evidence for it isn't there. "They seem rather to follow the situation than to drive it," Walter Haas, an infectious-diseases epidemiologist at the Robert Koch Institute in Berlin, told Nature in October.

A recent study tracking outbreaks in Spain came to the same conclusion. "What we found is that the school [being opened] makes absolutely no difference," Enric Álvarez, a researcher who's studying the spread of COVID-19 at the Universitat Politècnica de Catalunya, told NPR.

Kids can and do contract COVID-19, just at rates far lower than adults.

Kids may be less susceptible than adults in part because they seem to have a more tamped down immune response to the virus, and they're more likely to host and get sick from other viruses that compete with COVID-19, Dr. Tina Tan, a pediatrics professor at the Northwestern University Feinberg School of Medicine, said during a July media webinar.

Young kids seem to be particularly protected, with 5- to 11-year-olds experiencing about half the rates of 12- to 17-year-olds, according to a recent CDC report.

That makes elementary schools "comparatively safe for children," Dr. Rashmi Jain, a pediatrician and founder of BabiesMD: Online Pediatric Urgent Care, told Insider.

While it's possible kids play a role in child-to-child and child-to-adult transmission, it doesn't appear to be a key driver in the illness's spread. In this case too, little kids, or those under about age 10, seem especially unlikely to spread the disease, in part to their smaller lung capacity, which makes them less likely to "expel enough air to create as much spread of disease," Dr. Nathaniel Beers told WebMD.

That doesn't mean keeping schools open is risk-free. "What is a concern in the school setting is adult-to-adult transmission amongst teachers, staff, and administration," Jain said.

Plus, we don't know what the long-term impacts of COVID-19 in kids may be.

We know restaurants are a bigger problem for the pandemic than schools

Many experts bristling at the new rule pointed to a study released last week which, using cellphone data, found restaurants, bars, and gyms to be COVID-19 "superspreader" sites. For now, New York City still allows indoor gyms and dining to be open with limited capacity.

While the study did not address schools, other studies have found little evidence to suggest schools are a hotspot for outbreaks.

In most western European countries, lockdown measures implemented in the last two months have left schools open while closing restaurants. In combination with other measures such as mask-wearing and limits on indoor gatherings, epidemiologists are quietly hopeful that rates are starting to dip.

"Frankly, having the elementary schools open is a small incremental difference [compared to] bars and restaurants," Malani said.

Closing restaurants does more immediate damage to the economy, but closing schools isn't harmless

The city isn't just facing parents' ire with the decision to close schools. It could also cause long-term damage for kids, parents, and the economy.

Keeping schools open, Malani said, provides an "academic benefit, a social and emotional benefit, and there's an economic benefit because parents can keep working, and that's not a trivial thing."

One study published last week cautioned that delays in education are so closely linked with health that school closures could reduce the average life expectancy of US kids by three months.

Low-income children are also going hungry and facing unique mental health challenges, one recent study found.

Then there are the parents. Millions of them are out of the workforce, mostly mothers. As of September, there were 2.2 million fewer women in the workforce compared to the same time in 2019 — an historic drop, as Vox reported.

The irony isn't lost on parents and doctors alike that, outside of schools, life is rolling on as normal, despite the rising COVID-19 transmission rates — even if De Blasio expects indoor dining to close "in the next week or two."

As Dr. Craig Spencer, director of global health in emergency medicine at New York-Presbyterian/Columbia University Medical Center, put it on Twitter: "Should parents drop their kids off at the bar, indoor restaurants, or the gym — all of which are still open?"