How schools should look as they reopen despite the coronavirus pandemic, according to the CDC and education experts

• As schools weigh how best to reopen with the coronavirus at hand, the CDC recommends keeping classes small and isolated.
• They recommend staggering pick-up and drop-off times, and encouraging telework for coronavirus-exposed students and teachers.
• Education experts stress that there are some aspects of schooling that cannot be mimicked online, especially social interactions.
• There are also critical interventions some students receive only when they're physically at school, like free breakfast and lunch, health services, special education, and child abuse protection.

Nearly every child in America has skipped some time at school this year.

As coronavirus cases surged in hotspots around the US this spring, 55 million kids were sent home, to avoid spreading more infections through their classrooms.

While instruction in reading, writing, and arithmetic ("the three r's") continued for many on laptops and tablets, there are some aspects of schooling that cannot be replaced with a screen and an internet connection. That's why many doctors and education experts are stressing that US elementary schools must reopen this fall.

"What kids get from school isn't just the three r's, the kids get a lot of social and emotional development," former US Food and Drug Administration Principal Deputy Commissioner Dr. Joshua Sharfstein (now a public health professor at Johns Hopkins) said in a recent conversation with the editor in chief of JAMA, about what the doctor called the "urgency and challenge" of reopening K-12 schools across the US this fall.

In addition to lots of social interaction and education, many kids also get some much-needed sustenance, through free breakfast and lunch programs at their schools nationwide.

"20 million kids rely on that, and we know that hunger among kids has really zoomed up as a result of the coronavirus," Sharfstein said. "That's a very serious problem, and it affects child development and suffering in all kinds of different ways."

Schoolkids may have suffered a "COVID slide," impacting everything from nutrition to test scores

Sharfstein said he's worried that the US' coronavirus school closures have prompted a "COVID slide," impacting not only nutrition, but also leading to regression in children with learning disabilities, letting cases of child abuse go unchecked, and even hitting some kids' math scores.

Reopening schools will not be one-size-fits-all, because not every family or teacher's coronavirus risk is the same.

Though cases of the coronavirus in children tend to be rather mild, kids who live with vulnerable grandparents, or teachers who are over 60, may not feel as comfortable coming back to the classroom as quickly as their peers and colleagues do, knowing there are people in their households at higher risk of potentially fatal coronavirus complications.

"There's no activity, including staying home, that is perfectly safe," Sharfstein said. "So the question is how do we create an environment which is as safe as is reasonably possible for kids and for teachers and for others, while respecting the fact that there may be some people who view that amount of risk as too much?"

Here is what the US Centers for Disease Control and Prevention recommends schools across the country keep in mind, when weighing the risks of reopening their classrooms:

Experts warn schools should be prepared for a "hybrid" approach of virtual and in-class teaching if there is another spike

Reopening considerations are going to vary widely, depending on the location and size of a school, the ages of the children who attend it, and how well pupils can truly learn at a distance. Keeping student cohorts segregated will become an important disease prevention technique.

"It's not like you're going to English with one group of kids, and math with another group of kids," Sharfstein said. "They need to stay together, so if there is an infection, it's a relatively small group of kids that are exposed."

Holding classes outdoors could also help reduce viral spread, and the CDC recommends opening windows and doors when possible to increase the circulation of fresh air through classes. Realistically, though, not every student is going to be great at social distancing, or wearing a mask.

"You can have all the social distancing guidelines in the world, and you keep desks two meters (more than 6 feet) apart, but good luck getting 6- and 7-year-olds not to want to hug their teacher, and touch their face, and hug their friends," Christopher Morphew, dean of the Johns Hopkins School of Education, told JAMA. "It's going to be nearly impossible, if not impossible."

That's just one of the reasons why the education expert stressed that even as schools reopen their doors, they should also improve distanced learning tactics, and be fully prepared for the possibility they may need to take everyone back online.

"The need to reopen schools physically is very important, but there also needs to be the preparation for the very significant reality that we may need to go to hybrid or remote learning at some point during the academic year, if there's a spike," Morphew said.