We don’t know enough about COVID-19 to send our kids back to school

The kids will be fine. 

That’s what many elected leaders and some school officials are telling us. Sure, they acknowledge, teachers and staff members in schools across the nation will have to accept some degree of risk when schools reopen for in-person learning. But kids only very rarely get sick from COVID-19, they say, and so it’s in the best interest of the children to get them back into the classroom. 

Yet we have absolutely no idea what the long-term consequences of COVID-19 will be for children who become infected. This should give us pause. 

To understand the unsettling magnitude of the unknown, it’s important to remember that viruses can be pernicious things. Most of us recognize that HIV, carried in the body long-term, can cause AIDS. We know that herpes viruses can cause outbreak after outbreak, for years and decades to come. And we know that even though we eliminated polio in the United States in 1979, post-polio syndrome still vexes survivors. 

Not all viruses are the same, of course, so our understanding of another coronavirus may be instructive. Nearly two decades after the initial outbreak of SARS in 2002, the full extent of the long-term damage is still being uncovered, but studies have revealed long-term bone and lung damage, altered metabolism and chronic fatigue. 

Our understanding of COVID-19 is limited by the novelty of this disease, but we’ve already learned quite a bit about what happens “post-recovery,” and what we are learning is not promising. Many COVID-19-infected adults go on to have serious side effects involving the heart, liver, gastrointestinal system and more, often altering their lives for extended periods (and for many, perhaps, permanently.) The fact that these associations are being found in adults, not children, should not give us relief; that’s simply where the research was focused. But it is beyond ignorance to argue that it doesn’t matter if kids get infected or that, if they do contract this virus, they will recover quickly, when we already know this is not the case with adults. It also does not follow that a mild case of a virus today portends mild long-term symptoms many years down the road. We simply do not know what will happen.  

Even more disconcerting, hundreds of studies from around the world have identified neurological symptoms in COVID-19 patients, from confusion to headaches to nausea to strokes, and it is now very clear that other neurological problems, such as “brain fog,” often persist months or longer after other symptoms have cleared. It is particularly important to understand that these symptoms continue even when the virus is no longer detectable in a person’s body. This is nothing short of evidence of brain trauma. 

Can neurological damage that is suffered during childhood resolve itself? It does seem this is possible in many cases; children’s brains are magnificently plastic. But we also know that many adolescents who experience brain injuries stemming from a variety of initial traumas will experience lifelong cognitive, emotional and behavioral problems as a result. 

Now, a word of optimism: Just as we cannot predict all of the bad things that might happen, down the road, to children who contract the virus that causes COVID-19, we absolutely cannot say that there will be any long-term effects. We certainly can and should hope that children infected once will never feel the effects of this virus again in their very long lives. 

But hope is not a public-health plan. It does not protect our children. Social distancing does. 

No one should be dismissive of the consequences of keeping schools closed. With lower transmission rates and functional test and trace programs in place, we can feel far more secure about sending our children back to school. In the meantime, however, the risk to our children’s long-term wellness is enough to exercise tremendous caution, rather than simply assuming that the kids will be fine.