Recently, teachers contacted Utah Physicians for a Healthy Environment, concerned that schools will open without sufficient COVID-19 precautions. The American Federation of Teachers may authorize a strike nationwide unless school safety is prioritized. We examined the issue and agree with the teachers.

While transmission research is still quickly evolving, it appears that children 10 years and older are as likely to spread the virus as adults, even if they are at much lower risk for a serious outcome.

We have seen that premature opening of the economy in many states only served to create crisis level spread, and Utah has been, and still is, very close to crisis stage. In a federal report from the president’s own coronavirus task force, only one state, Vermont, was in the green zone. Utah was one of 18 states considered to be in the red zone, triggering more restrictions, not less. States in the red zone are recommended to adopt various policies like statewide mask mandates, close bars, limit restaurants to to 25% indoor capacity, and prohibit public gatherings of more than 10 people. How can opening up schools be consistent with that activity level?

A core tenet of infectious disease management is: a pandemic anywhere means a pandemic everywhere. That’s why a national control strategy was needed, not the fragmented, “every state for itself” strategy that the White House forced upon the 50 governors. That’s why multiple health experts pleaded with Gov. Herbert to declare a statewide mask mandate, rather than leave it up to cities and counties. It’s why opening up schools without statewide, consistent, careful and extensive precautions not only threaten teachers and staff, but is likely to ignite a new wave of infection throughout the entire community.

Some Utah hospitals are already once again facing a shortage of critical PPE like N95 masks. An infection resurgence threatens everything we know is needed to achieve control of the infection — adequate testing and rapidly available results, contact tracing, and enough PPE for healthcare workers, essential workers, and now teachers and school staff.

Unless detailed and strict plans are drawn up for optimizing the safety and protection of children and school employees, opening up schools will only accelerate the spread of the virus throughout the community, potentially greatly so, forcing a recycling of school shutdowns and worse.

If precautions are inadequate and halfhearted, teachers will be unable to be effective if they are constantly in fear of contracting a potentially serious or deadly disease. Furthermore, if many teachers feel their work place is unsafe, understandably, they will not go back to work at all, which will lead to even larger class sizes, an even more dangerous work environment, and a vicious cycle eroding the very foundation of public education.

State leaders may balk at spending the money needed to make schools safe. But we really have no choice. The extensive recommendations from the Harvard School of Public Health should be followed as much as possible, but at a minimum Utah schools should adopt the following:

1. Mandatory masks for all students, teachers and employees, in addition to face shields for all employees that interact with students. Very few medical exemptions are legitimate.

2. Increase outdoor air ventilation. Open windows for all class rooms where possible, classes outside where possible, especially music and physical education.

3. Upgrade ventilation systems. Filter indoor air, including adding stand alone air purifiers for every classroom. This is long overdue. Studies show air pollution impairs students learning ability both acutely and long term. Purifiers will also help reduce virus particles in the indoor air, whether they are attached to particulate matter, or carried in droplets or aerosols.

4. Enforce class size limitation and desk positioning consist with social distancing.

5. Ensure adequate supply of hand and surface disinfectants. Strict policy of hand hygiene repeatedly in all classes.

6. Sports and activities that require close proximity to other students, like football, soccer, wrestling, basketball, choir and dance should be temporarily suspended.

There is no way to make school activity completely COVID-19 safe, and the best time to have settled this was back in March. But the second best time to establish the necessary safety plan is right now.

Dr. Brian Moench is president of Utah Physicians for a Healthy Environment. Wendy Moss is a local elementary school teacher.

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