COVID Question: School and Immuno-compromised edition

March 10, 2020 7:07 AM

Hey y'all. I need help coming up with guidelines/a litmus test/decision rule for when to pull my kids from school (Kindergarten and daycare respectively) in a city with about 30 cases including several in schools although not yet the ones my kids attend. We're approaching this with extra caution because I have a severe immune deficiency disease that especially impacts my lungs and puts me at higher risk for pneumonia. Assume that I have consulted with my immunologist who supports this in theory but doesn't have a lot to say about when. More below

If you think that pulling kids from school before schools officially close is ridiculous, please do not answer this question. Same if you think I have nothing to worry about.

My parents and husband are very concerned about my status and about school cooties despite rigorous hand-washing. My parents live in a rural area nearby and have invited us to come stay with them for the duration. We all get along well and this is actually a lovely option. However, it would require pulling my kids from school.

While it seems likely that schools will close on their own at some point, because of my compromised health we want to make sure we don't wait too long. (School criteria seems to be multiple officially diagnosed students.) I deeply understand why schools are trying to avoid closure-- especially in my community where many families depend on schools for food and are wage workers who can't stay home to take care of kids.

But. I think my family may need to have more conservative criteria given that by that time lots of kids will have been exposed.

So the question is..how do we know when it's time? Otherwise pulling kids from school just feels impossible. We've tossed around a number e.g. when there are 40 cases presumably exposure is getting high enough that we should scoot. Yesterday, the district next door suspended school which feels like maybe another signal. Maybe if another local district closes, it's time? At the same time life feels so normal and there is such pressure not to be 'hysterical' that it's hard to pull the trigger.

How would you know when it is time to go? Looking for clear criteria here rather than a gut check. Unless it is a very clear gut check....

posted by jeszac to Health & Fitness (26 answers total)

Best answer: Given the difficulty in even getting tested, it seems incredibly unlikely that your kids' school will close in time to keep you safe. By the time there are multiple officially diagnosed students the ship will have sailed and you will absolutely be exposed. One thing that makes this virus especially difficult is that it's very likely that carriers will be asymptomatic and therefore unwittingly spread it.

If I were in your shoes I'd pull the kids right now and head out.
posted by Tomorrowful at 7:22 AM on March 10, 2020 [35 favorites]

Best answer: Based on your info, I would go now.
By the time cases are diagnosed in your immediate neighborhood it will be likely you already have had contact with the virus.
I would also worry about infecting your parents so I'd also explore other options
posted by M. at 7:23 AM on March 10, 2020 [8 favorites]

Best answer: I'm sending my kids to school as long as the schools are open -- at least, that's my plan -- but if I had your risk factors, I would keep them home now. (I'm sorry I don't have any firm quantifiable rule to share with you.)
posted by The corpse in the library at 7:30 AM on March 10, 2020 [2 favorites]

Best answer: At the ages of your children there will be essentially no academic impact. I'd get in touch with their teacher for homework/catch up work, and go now, given your information. Consider it some world schooling, in your area of the world!
posted by warriorqueen at 7:33 AM on March 10, 2020 [15 favorites]

Best answer: I think there is no firm quantifiable rule. Most research suggests that closing schools/universities/churches can have a significant positive effect in limiting the spread of disease, but that it is almost always done too late.

I am not taking my kids out of school at the moment, but if they had regular contact with people who were immuno-compromised or older, I would be considering it now -- not for their heath (it seems like COVID-19 is mercifully mild in children), but for broader public heath reasons. And I live in a moderately rural area in a state where there is 1 confirmed case.

Given the statistics you've given for your locality, how easily the disease is spread, and the relatively high proportion of people (particularly young people) who can have the disease and be asymptomatic, I would assume that there are at least a couple of cases currently in your kids' schools. How does that affect your thoughts?
posted by Betelgeuse at 7:42 AM on March 10, 2020

Best answer: severe immune deficiency disease Pack the car. Buy some new board games, outdoor play stuff - badminton , maybe - get all the books from the school, and go. Ask the teachers to email lesson plans if they can. There are tons of lesson plans on the web, so you can educate your kids, which will help keep them occupied. I presume you have and use disinfectants as a regular practice. The potential downside of going is feeling sheepish about your reaction. Balanced against the potential downside of staying, and given that you have an excellent remote option, pack the car.
posted by theora55 at 7:47 AM on March 10, 2020 [10 favorites]

Best answer: in a city with about 30 cases including several in schools... I have a severe immune deficiency disease that especially impacts my lungs

I would go now.

For reference: I'm in a city with no confirmed cases yet. I have a condition that puts me at higher risk for pneumonia. This weekend I got sick and asked my doctor if I should spend more time at home recovering because of the risk of catching SARS-CoV-2 while already sick, and she said definitely stay home until the end of this week.
posted by medusa at 7:47 AM on March 10, 2020 [3 favorites]

Best answer: There is no harm in going too early. There is great harm in going too late.

I don't have your risk factors but I'm also considering pulling my kids from school before the schools officially close. Go spend some time with your parents, and stay safe.
posted by Winnie the Proust at 8:13 AM on March 10, 2020 [3 favorites]

Best answer: I cannot see a single concern with taking your kids out of daycare and kindergarten now. You can ask the kindergarten teacher if they can give you an idea of what you will miss so you can do it together at your parents' house, or google it, or use another ask for advice about how to temporarily homeschool. There is zero risk from taking them out now and non-zero risk from doing anything else.
posted by jeather at 8:46 AM on March 10, 2020 [1 favorite]

Best answer: Missing daycare and kindergarten will have no real impact on your kids development. Getting sick has real consequences. Pulling them now seems logical. I don't know if evacuating your house is called for at this moment.
posted by jclarkin at 8:51 AM on March 10, 2020 [2 favorites]

Best answer: Do you need another person to say "now"? Ok - "now".
posted by Mary Ellen Carter at 8:58 AM on March 10, 2020 [5 favorites]

Best answer: Agreed that there should be no harm academically taking the younger child out of daycare, but check with the school system about the kindergartner. We have truancy laws in our school district that are triggered at 10 days absence barring a medical reason (for the child). You may need to get some supporting documentation from your pulmonologist as to the medical necessity of keeping the child home to protect your health.
posted by tafetta, darling! at 9:51 AM on March 10, 2020 [2 favorites]

Best answer: As a teacher in Hong Kong who has been teaching remotely for weeks, I would be mortified if you felt you needed to keep your kids in class in your health circumstances, and I, too, would like to reduce my exposure to as many people as possible. A teacher's first obligation, even above education, is the safety of their students and families. My only concern is whether the rural area you're going to has the health care infrastructure you would want for your own existing health issues. If you think you're OK in that department, go with my blessing.
posted by mdonley at 10:14 AM on March 10, 2020 [2 favorites]

I'll also say that I would absolutely demand some sort of change in your favour to your school's/district's attendance policy in these circumstances - check the rules, of course, and inform the school of your decision if it makes sense for you. I feel like your own immunocompromised status will be of help here. Good luck.
posted by mdonley at 10:16 AM on March 10, 2020

Best answer: If there are (technically) 30 cases in your city now, there will be 300 in a couple weeks, by which time schools are going to close anyway. There is a tremendous lag in testing, which is causing this thing to spread quickly as people continue with their usual behaviors - life feels so normal, as you say. IAAD, IANYD.. but clearly in your case especially, every day counts. The time for you to protect your safety is definitely now.
posted by nemutdero at 10:46 AM on March 10, 2020 [1 favorite]

Home schooling is a thing. So are remote schooling options.
If neighboring school districts are closing, ask for lesson plans that can be emailed to you. You may need access to a printer and materials like crayons and scissors and glue, or you may be able to do things online. You may need alternative plans to meet objectives set by the state education department.
The school may have lesson plan packets that can be given to you and returned later for evaluation.
You may be able to continue with the regular curriculum and prove that the kindergartner is passing educational milestones prior to enrollment in first grade.
Ask about the guidelines for repeating kindergarten and about a transitional grade between K and first grade. Ask about additional tutoring next year for first grade students who withdraw early due to the current health situation.

Schools deal with students from other districts/states who have not met the same milestones all the time. Switch schools mid-year? Different classroom, different objectives. Lesson plan organization is subjective: as long as the state education department goals for the school year are met, a teacher can rearrange classroom objectives according to what works this year, with these students. Only a few subjects require a step-by-step approach (addition and subtraction before multiplication and division).

I would be shocked if school districts are not having meetings to consider the impact on next year's curriculum, following a shortened spring semester and parents withdrawing children from school early. Will students be held back a year (not recommended) or will the first month of fall semester be about reteaching the previous grade's curriculum?

Bottom line: if you have concerns for your family's safety, then take your children out of school now. Work with your education providers later to make up the difference.
posted by TrishaU at 11:06 AM on March 10, 2020

Best answer: Here is a recent report from the NYT, also reprinted on MSN that seems like a clear guideline:

The greatest concern is for older people, particularly those who have underlying conditions like diabetes, heart disease, lung problems and weakened immunity. “Don’t go to crowded places, think twice before a long plane trip, and for goodness sake don’t go on any cruises,” [Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases] said. For people who are particularly vulnerable, he said: “Don’t wait for community spread. Now is the time to do social distancing, whether there is spread in your community or not.” If community spread has already started, as in Seattle, he said, everyone should practice social distancing.

Also, you may want to review the information for People at Risk for Serious Illness from COVID-19 (US CDC)
posted by katra at 12:05 PM on March 10, 2020 [2 favorites]

Best answer: Go now. There's not a "too early" here, but there's definitely a "too late".
posted by bile and syntax at 1:03 PM on March 10, 2020 [2 favorites]

Best answer: A chance to go to the country and enjoy the first bits of spring? Sounds pretty sweet! You're not escaping or pulling your kids out of school, you're chasing spring. Enjoy your trip, and be safe!
posted by Geckwoistmeinauto at 1:59 PM on March 10, 2020 [2 favorites]

Best answer: Another vote for now, especially if you are in a city where a significant number of students rely on schools for essential services, like free or reduced breakfast/lunch programs. It will affect if/when school are closed. Good luck to you!
posted by wiskunde at 3:23 PM on March 10, 2020 [1 favorite]

Best answer: Hey y'all. I need help coming up with guidelines/a litmus test/decision rule for when to pull my kids from school (Kindergarten and daycare respectively) in a city with about 30 cases including several in schools although not yet the ones my kids attend.

Please appreciate that there is absolutely zero effort being made to test people proactively, so 30 confirmed cases means likely somewhere between hundreds and thousands of actual cases. Kids are the least likely to be tested, since they are the most likely to not have severe symptoms. Calculate what this means about the probability of someone at your school having it, given the total population of your area, and I suspect you won't like the outcome.

You're correct that some people will perceive you as hysterical. The decision rule is that you need to figure out what additional chance of death you are willing to accept in return for avoiding this, do the math, and behave accordingly. If I were you, I might suggest leaving instantly and then doing the math.

If it helps you feel good about the decision, you're also behaving altruistically by doing anything to slow the spread.
posted by value of information at 4:49 PM on March 10, 2020 [2 favorites]

Best answer: One other factor to consider is that some public schools may wait as long as possible before closing due to the fact that many children rely on schools for regular meals.

They are balancing a lot of difficult factors and will not be taking your personal best interests into account.
posted by jeoc at 6:40 AM on March 11, 2020 [3 favorites]

Best answer: You're not mentioning any reason NOT to go now other than pressure to avoid looking like you're panicking. You're leaving now so you don't have to panic! Send your husband to the store to load up your car with supplies, and enjoy your vacation.
posted by metasarah at 7:30 AM on March 11, 2020 [3 favorites]

Best answer: You are in control. Go with urgency, deliberation, and speed. Best of luck.
posted by ZeusHumms at 9:06 AM on March 11, 2020

I've been looking at the risks as a comparison to taking an hour long car trip without wearing a seatbelt.
posted by Sophont at 9:57 AM on March 11, 2020

Response by poster: We ended up heading to a cabin in New Hampshire instead to avoid exposing my parents. But all of your thoughts really helped us to pull the trigger before it was too late. So thank you!
posted by jeszac at 11:59 AM on March 17, 2020 [2 favorites]