40.6 million U.S. adults living or working with school-aged children have medical conditions that raise their risk of severe COVID-19: New Harvard study

FOR IMMEDIATE RELEASE: August 21, 2020

Contact: Adam Gaffney, M.D., M.P.H., Harvard Medical School/Cambridge Health Alliance, PNHP president, agaffney@cha.harvard.edu
Steffie Woolhandler, M.D., M.P.H., City University of New York Hunter College/Harvard Medical School, PNHP co-founder, swoolhan@hunter.cuny.edu
Clare Fauke, PNHP communications specialist, clare@pnhp.org

As debate continues over the reopening of schools this fall, a new analysis from researchers at Harvard Medical School and the City University of New York’s Hunter College sheds light on the risks for adults who work or live in close contact with school children.

Researchers found that 2.3 million school teachers, and 28.6 million adults living with school-aged children, are either over 64 years in age or have chronic diseases that definitely put them at high risk of severe COVID-19. An additional 630,000 teachers and 9.05 million people living with children have conditions that may increase their risk. The study was published August 21 in the Annals of Internal Medicine.

To quantify these risks, researchers analyzed the National Health Interview Survey, examining conditions that the CDC has identified as “definite” or “possible” risk factors for severe coronavirus infection, such as chronic lung disease, heart disease, cancer, and obesity. They found that 39.8% of teachers were older than 64 or had one or more definite high-risk condition; more than half had a definite or possible risk factor. For instance, 8.0% of teachers have a serious heart condition, 5.8% diabetes, and 27.9% obesity.

The study did not include day care teachers or non-teaching K-12 school personnel, many of whom may also be at increased risk from school re-opening. Researchers also note that they could not evaluate several risk factors for severe COVID-19 identified by the CDC, such as chronic kidney disease. Hence, the number of school personnel and household members at high risk is very likely higher than they estimated.

Researchers also found that 41.0% of adults living in households with school-aged children (ages 5-17 years) had definite risk factors for severe COVID-19, and an additional 13.0% had a condition classified as a “possible” risk. 4.8 million of these adults have diabetes, more than 600,000 have cancer, and 2.5 million are 65 or older. Adults in low-income households, and those living with Black children, were more likely to have risk factors for severe COVID-19 compared to other adults living with school-age children.

“The benefits and risks of schools reopening are greatest for minority and low-income families,” noted Dr. Adam Gaffney, a pulmonary and critical care physician at Harvard Medical School who was lead author of the study. “On the one hand, in-person education is especially crucial for the education and development of disadvantaged children. On the other hand, the family members of these children face a particularly high risk of falling gravely ill from COVID-19 if their child comes home with an infection.”

“For schools that close, additional resources should be made available to vulnerable children, such as nutritional assistance, laptop computers, free broadband, and remote tutoring. For schools that reopen, federal investment to support testing, protective equipment for teachers, and smaller class sizes is critical,” Dr. Gaffney added.

“Fortunately, severe COVID-19 is uncommon in children,” noted study author Dr. Steffie Woolhandler, a primary care physician and Distinguished Professor at the City University of New York’s Hunter College and lecturer at Harvard Medical School. “But children can transmit the virus to others. As a parent, I know that kids need to be in school, but they need their caretakers to stay healthy as well. If we want to safely reopen schools, we need to be willing to close the bars, wear masks, test and trace, and do everything possible to stop the virus.”

“Risk for Severe COVID-19 Illness Among Teachers and Adults Living With School-Aged Children,” by Adam W. Gaffney, M.D., M.P.H.; David U. Himmelstein, M.D.; and Steffie Woolhandler, M.D., M.P.H., Annals of Internal Medicine, August 21, 2020. DOI: https://doi.org/10.7326/M20-5413

Physicians for a National Health Program (www.pnhp.org) is a nonprofit research and education organization whose more than 23,000 members support single-payer national health insurance. PNHP had no role in funding or otherwise supporting the study described above.