Analysis |

Israel Needs to Wise Up and Open Schools

COVID-19 serological surveys were poorly conducted, while actual school data shows how to manage the risk

Meirav Arlosoroff
Meirav Arlosoroff
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A classroom in Jerusalem's Gymnasia Ivrit high school undergoes disinfection following a super-spreader event, June 3, 2020
A classroom in Jerusalem's Gymnasia Ivrit high school undergoes disinfection following a super-spreader event, June 3, 2020Credit: Ohad Zwigenberg
Meirav Arlosoroff
Meirav Arlosoroff

A cabinet minister admitted this week that he envies ultra-Orthodox society. “All the pressure that I’m getting over the lockdown relates to restaurants, gyms or cosmeticians,” he said. “At least the ultra-Orthodox violated the lockdowns to open Talmudei Torah [the community’s religious elementary schools]. Their order of priorities is clear: Education ahead of everything.”

Can the education system be opened safely? That’s the issue that should have been the focus at the moment, because of the massive damage that’s being caused by shuttering schools. That includes immediate economic damage, because when children are home, their parents can’t go to work.

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The damage is disproportionately sustained by families of lower socioeconomic status and single parents. It involves long-term financial and societal damage, because the loss of months of schooling and social contacts damage children’s health, emotional well-being and educational advancement. Research around the world shows that the loss of three months of schooling by an entire generation results in sustained damage to a country’s GDP, and that extended periods in front of a screen leads to weight gain and depression among children.

Properly run countries have gone to great lengths to reopen schools, and they did it based on information and statistics. In Israel – being Israel – the data is at best partial, and therefore the risk of opening schools cannot be properly evaluated.

Over the past two weeks, the results of two serological surveys testing for coronavirus antibodies were published. They were designed to evaluate the extent to which the disease had spread through the population. But both surveys were partial and problematic, and instead of clarifying the extent of the spread of the disease, they mostly complicated things.

Resumption of studies at Gymnasia Ivrit high school in Jerusalem, June 24, 2020.
Resumption of studies at Gymnasia Ivrit high school in Jerusalem, June 24, 2020. Credit: Ohad Zwigenberg

The first survey, conducted by the Health Ministry among the general population, found that 5.5% of people had been infected, and contrary to expectations, it also found a high infection rate among children – higher than that of adults. This could be a warning that the rate of asymptomatic infections among children is actually quite high, and that schools should therefore not reopen.

But the Health Ministry survey was not conducted among a representative sample. It sampled people who had come to their health maintenance organizations for blood tests. In other words, these are people who already clearly showed signs of an illness. The sample included very few children, but reflected a high rate of infection among them, which is not so surprising. Children who come in for blood tests are typically sick, which would explain the finding.

On Monday, results of another serological survey were published, conducted by the Central Bureau of Statistics and the Gertner Institute, in accordance with all the principles of a representative sampling. But the survey focused only on the ultra-Orthodox Tel Aviv suburb of Bnei Brak. Furthermore, due to bureaucratic limitations that bar Magen David Adom paramedics from taking blood samples from children, the survey only included children ages 7 and up. Because the sample included a small number of children, those between 7 and 14 years of age were lumped together, even though previous research has shown that the chance of becoming infected with COVID-19 is lower among children who are 10 years old and younger than for older children. The survey found similar infection rates among children between 7 and 14 years of age and adults.

But that, too, teaches us very little, since patterns of infection in Bnei Brak are different from those in other Israeli cities. The Bnei Brak survey found incredibly high infection rates among large families – households of eight people or more – and among neighbors living in crowded conditions. That raises suspicions that most of the infections in Bnei Brak occurred within families or at home, and that children are much more likely to be infected at home than at school.

The researchers behind the survey believe that children under age 10 are less likely to be infected than adults. They think the infection rate is only one-third of that in adults, and that this age group is also only about one-half to two-thirds as infectious as adults. On the other hand, children have lots of in-person social contact, so even if they’re less infectious, they could still be a source of spread.

Students take matriculation exams in the midst of the coronavirus crisis, June 29, 2020. For illustrations purposes only.
Students take matriculation exams in the midst of the coronavirus crisis, June 29, 2020. For illustrations purposes only.Credit: Emil Salman

Jerusalem as an example

So is it safe to open schools? Given the lack of clear scientific answers, there’s no alternative but to work from observations in the field – which happen to be encouraging. Jerusalem’s education department, which oversees secular and ultra-Orthodox Jewish-sector schools as well as Arab-sector schools, has been tracking infection statistics at schools ever since the super-spreader event in the city’s Gymnasia Ivrit high school in May. The data is surprisingly encouraging.

Of course, the city’s statistics show a distinct problem of infections within ultra-Orthodox yeshivas. But aside from the ultra-Orthodox school system, and the one outbreak at the Gymnasia, there wasn’t much infection within the city’s schools. The infection rate among students of all age groups remained steady in the periods from May to June and July to August (when schools were on break) and in September until the lockdown. If anything, opening schools appeared not to have had an impact on the infection rates of the capital’s children.

In Jerusalem, they analyzed the few chains of infection that developed in schools. In 58% of cases in which an infected child attended school, no other infection chain was identified. In 35% of cases, the child infected another 1 to 2 children. In other words, in 94% of the cases, the child with COVID-19 infected at most two other children. In terms of age groups, children in first through third grades infected on average 0.5 children, while children in fifth through twelfth grades infected on average 1.08 children.

The main problem in Jerusalem was the large number of required isolations, imposed after a child or teacher came to school infected. A sick child would lead to one class or split half-class going into isolation, but a sick teacher would result in all the teacher’s classes being isolated. The implication is clear: Schools need to keep classes – or split half-classes – apart, and ensure that teachers not move from class to class. Teachers also need to keep their distance in the teachers’ lounge, so that one sick teacher doesn’t put the school’s entire staff into isolation and force the whole school to close for two weeks.

Resumption of studies following Israel's first nationwide coronavirus lockdown, for illustration purposes only, May 3, 2020.
Resumption of studies following Israel's first nationwide coronavirus lockdown, for illustration purposes only, May 3, 2020.Credit: Emil Salman

Schools as a priority

The Jerusalem findings reinforce recommendations from the Hebrew University’s School of Public Health: Schools need to be opened, because school is critical, more important than commerce, and they can be reopened wisely. Students need to be divided into subgroups that actually stay separate, with one teacher per class and regular use of masks.

The claim that children can’t spend all day in a mask is nonsense. They do it in other countries, and doctors work for hours that way. For teachers struggling with it, they can be given portable PA devices so they can speak more easily with masks on. This is safer, cheaper and less damaging than closing schools for weeks at a time.

In any event, Israel’s national evaluation of the risks needs to place the opening of schools at the top of its priority list. Even if infection rates increase as a result, it’s a risk that we need to take. It’s certainly more important and more justified than risking opening restaurants or other commerce.