Interview on COVID and return to schools from winter break — with pediatrician Dr. Adam Davis

SF Parent Coalition interviewed local pediatrician and SFUSD parent, Dr. Adam Davis, on how concerned we should be about returning kids to their schools after winter break given that we do not have complete testing access for every single SFUSD student, teacher, and staff.

Q: What do you think about SF Parent Coalition’s recent call for increased access to testing?

Dr. Davis: I think it’s great we’re advocating for increased testing, but I think it’s important to note that testing is no silver bullet. The UK probably has the best home testing program in the world and it hasn’t done anything to slow the spread there where the case rate has been astronomical.  Or we can look to the NBA where they do frequent testing and still see enormous spread. We’re going to have cases regardless of testing, but the vast majority will be mild for vaccinated people.

Q: What would you prefer to see right now that is not happening yet?

Dr. Davis: If I could move only one policy lever it would’ve been mandated vaccines for teachers and students. Luckily we’re in SF where over 90% of 12-17 year olds have completed their first two doses and over 60% of 5-11 year olds have had their first dose. It’s helpful to remember that in prepubertal kids, even when unvaccinated, COVID is closer in risk profile to seasonal flu than it is to COVID in adults.  In fact, even unvaccinated young children have lower risk than vaccinated adults over 50. When kids get vaccinated, as all SFUSD students have the option to, the risk drops even further. The calculus here is not that we’re going to be able to keep schools free of COVID, it’s that the importance of school is more beneficial to kids than the relatively minor risk of a COVID infection.

Q: Is there some amount of testing —every week, every day, 10 times a day?!— that would rid us of COVID?

Dr. Davis: The problem with messaging too strongly on testing is it maintains this idea that we can create a COVID-free environment and with omicron that looks extremely unlikely. But the risk profile of vaccinated people and even unvaccinated children in school is not such that it should cause us to close the schools. I know that’s a big shift in mentality for a lot of people that had been hoping to never be infected with COVID, but omicron makes that outcome much less likely. The best we can do is have our immune systems ready for when we’re exposed and to slow the spread so that we don’t have everyone get the virus at once. 

Q: What can parents who are very worried about COVID right now do to protect their families?

Dr. Davis: The number one thing by far is to vaccinate everyone in your family and get boosters if eligible.  Being fully vaccinated and boosted (if possible) still lowers the spread of the virus and makes infections more mild and safer.  Families also can upgrade to using N95 or KN95 masks when indoors outside of their own home during this surge.  I would recommend abstaining from large indoor group activities during this surge if quality masks cannot be worn. Testing prior to family gatherings or other group activities can lower the risk of spread within those events.

On the other hand, I don’t think there’s evidence that keeping kids from in-person school protects them.  In fact we’ve seen consistently lower rates of infections within our schools than within the community at large.  During the delta wave we saw virtually no in school spread of COVID. Kids have been much more likely to get COVID outside of school than during school since the beginning of the pandemic.  So even during this large omicron surge it’s clear that schools are a safe option and given the benefits that kids derive from schooling the strategy is clear, get your shots, mask up and go to school.

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Learn more about SFUSD’s Return to School Safely in 2022 guidance to the community here: https://www.sfusd.edu/announcements/2021-12-29-returning-safely-school-2022

SF Department of Public Health’s press release reaffirming their support of in-person learning despite presence of omicron variant can be found here: https://sf.gov/news/sfdph-reaffirms-support-person-learning-despite-presence-covid-19-omicron-variant