The Problem With Opening Schools

Mortality and morbidity are the two most common measures of disease impact ( Zylke & Bauchner, 2020).

Mortality is usually assessed as excess deaths attributed to the specified disease.

Morbidity concerns lasting health impacts, particularly with respect to newly acquired disease(s) and syndromes among survivors.


The disease, Covid-19, caused by the virus SARS-CoV-2 is still little understood but one issue is crystallizing:

The emphasis on mortality is distracting from morbidity generally and specially SEQUELAE.


What are sequelae? They are the pathological conditions caused by a disease or other hazard.

SARS-CoV-2 is able to invade cells lining blood vessels and colonize organs beyond lungs.

That colonization may not be evident until later.

The pathological conditions caused by this terrible virus include damage to the heart and central nervous system.

It is still not clear to me whether most people can even clear this virus entirely. I fear it lurks hidden and may only be revealed by down-regulated T cells and other immune anomalies that make individuals more susceptible to other insults (see Wang, et al, 2020).

Potential immunological susceptibilities to this virus have caused experts to worry we might get it over and over again as it mutates, particularly if it can persistently down-regulate T cells (see Kirkcaldy, 2020).

This aggressive virus is occurring in an existing context of environmental degradation and declining human reproductive health and longevity - see my discussion here.

These conditions remind me of bee and bat colony collapse. Entire colonies collapse when weakened by pesticides, fungus, mites, etc and then exposed to opportunist pathogens - such as a virus. The pathogen destroys enough of the population that the colony ceases to exist.

STUDENT -  COMMUNITY COLONY COLLAPSE RISK

Several months ago I set up a search alert for news coverage of "Covid-19 and sick workers." Everyday I get notifications from mostly local news sites on hundreds of workers at a particular site testing positive after several had developed symptoms.

Most people think that if you're asymptomatic you are good to go but that may be very deceptive if the virus is hiding out, colonizing your cells. Although not necessarily contagious, asymptomatic carriers are likely to have significant and imminent health problems.

Every type of congregated workplace is getting hit - from oil refineries to agricultural workers, from grocery store workers to Amazon distribution centers. Masks aren't the golden ticket to disease freedom. They may help but they are not alone sufficient, based on the skyrocketing cases among health care workers in the most advanced economies, such as the US.

Requiring students to return to classrooms will test my hypothesis that this virus has the capacity to produce rippling disease eruptions that worsen across time, endangering social networks as the virus and other pathogens are shared in primary sites and subsequently circulate to vulnerable populations.

Vectors of contagion are clear: Toilets in most US schools that I've seen do not have lids. Many school bathrooms have blowers that have been proven empirically to simply spread bacteria around bathrooms.

Bathrooms will be a primary site of transmission unless all sorts of extreme measures are put into place.

PLEASE: Let's make sure that SARS-CoV-2 is not capable of producing human colony collapse BEFORE we open classrooms and further endanger our critical workers and most vulnerable populations.

Never before has the importance of the PRECAUTIONARY PRINCIPLE been so obvious.


REFERENCES

Kirkcaldy RD, King BA, Brooks JT. COVID-19 and Postinfection Immunity: Limited Evidence, Many Remaining Questions. JAMA. Published online May 11, 2020. doi:10.1001/jama.2020.7869

Román, G. C., P.S. Spencer, J. Reis, et al. (2020), The neurology of COVID-19 revisited: A proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries, Journal of the Neurological Sciences (2020), https://doi.org/10.1016/j.jns.2020.116884

Varga, S., Andreas J Flammer, Peter Steiger, Martina Haberecker, Rea Andermatt, Annelies S Zinkernagel, et al. (April 20, 2020). Endothelial cell infection and endotheliitis in COVID-19. Nature Correspondence, 395(10234), P1417-1418.https://doi.org/10.1016/S0140-6736(20)30937-5

Wang, X., Xu, W., Hu, G. et al. SARS-CoV-2 infects T lymphocytes through its spike protein-mediated membrane fusion. Cell Mol Immunol (2020). https://doi.org/10.1038/s41423-020-0424-9

Zheng, M., Gao, Y., Wang, G. et al. Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cell Mol Immunol 17, 533–535 (2020). https://doi.org/10.1038/s41423-020-0402-2

Zylke JW, Bauchner H. Mortality and Morbidity: The Measure of a Pandemic. JAMA. Published online July 01, 2020. doi:10.1001/jama.2020.11761