As school buildings in some states begin to reopen in various capacities, many teachers who are at higher risk for severe complications from COVID-19 are hoping they won't have to go back.
But there are big questions around who qualifies for a medical exemption from returning to the physical classroom.
People who are older than 65 are at higher risk for serious illness due to COVID-19, as are those who are obese, have serious heart conditions, or have Type II diabetes. The Centers for Disease Control and Prevention says that people who have immune deficiencies, have asthma, have Type I diabetes, are smokers, or are pregnant might also be at increased risk for serious illness, although the evidence is more limited.
Districts are now tasked with deciding which conditions to prioritize and trying to accommodate as many teachers as they can while still maintaining staffing levels for the students who are on campus. In some cases, that has proved to be impossible, and district leaders have had to either decide to keep school buildings closed or find alternate ways to accommodate teachers without keeping them home.
In the meantime, teachers who have a high-risk condition or are otherwise vulnerable, and those who live with someone who is high-risk, are left waiting anxiously to hear how they will be protected when they go back to school. So far, about half of the 600 districts in Education Week's database, which is not nationally representative, have opted to provide some form of in-person schooling this fall, including five of the 25 largest districts.
"I've been holed up in my house since March and have been very careful," said Margee, an 8th grade teacher in Colorado with asthma. "It just made me very, very nervous to think I'll be exposed to 120 students and their families."
Margee, who asked that her last name be withheld, got a doctor's note for her asthma and requested to work remotely. Her district, which plans to begin in-person instruction in October, approved her request. She will be working from home the whole year, teaching the students who opted to stay home. She'll be delivering instruction on a new platform, but she's relieved to not have to worry about potential exposure.
"I'd rather deal with unfamiliarity than feeling unsafe," she said.
Forty-three percent of teachers said they personally have a physical condition believed to make people more vulnerable to the effects of the coronavirus, a nationally representative Education Week Research Center survey found. And an analysis by the Kaiser Family Foundation estimates that about 1.5 million teachers-nearly one in four-have health conditions that put them at higher risk for COVID-19 complications.
In New York City schools, the nation's largest district that is set to welcome students back into school buildings on Sept. 10 for a few days a week, about 15 percent of teachers have applied for medical exemptions to work from home. The district is still finalizing staffing details.
For some districts, requests for accommodations have created staffing challenges. In Elizabeth, N.J., for example, more than 400 teachers-about a fifth of the district's workforce-reported that they needed special consideration for health-related risks and could not teach in person. The sheer volume of accommodations forced the school board to vote to begin the school year remotely.
"There would be insufficient staff to open safely in person with that many teachers unavailable for in-person instruction," said district spokesman Pat Politano in a statement provided to NJ.com. "It became a mathematical impossibility."
The Americans with Disabilities Act requires an employer to provide reasonable accommodations to qualified individuals with disabilities, unless doing so would cause undue hardship. Reasonable accommodations entail modifying or adjusting the work environment to allow the individual with a disability to perform the essential functions of the position or allowing the employee to take earned paid leave or unpaid leave.
For teachers who have a disability that puts them at higher risk for serious illness due to COVID-19, which could include conditions like asthma or diabetes, reasonable accommodations could mean smaller class sizes, receiving access to N-95 masks, being reassigned to a position that involves less contact with others, being given temporary leave, or working remotely altogether. What's reasonable will depend on what a teacher's individual condition requires, says the National Education Association, the nation's largest teachers' union, and for many high-risk teachers, remote work is the safest option.
However, employees aren't guaranteed to get the exact accommodation they request. If the requested accommodation would pose an undue hardship-defined in the law as an action requiring significant difficulty or expense-the employer must try to identify another way to accommodate the employee.
Kaitlyn, an elementary teacher in Texas who asked for her last name to be withheld, has a rare blood disorder and had her spleen removed at a young age, leaving her with a compromised immune system. Her school district is starting the school year remotely but plans to begin in-person instruction in September.
Due to health concerns, Kaitlyn requested to be in as little contact with students as possible, hoping to work remotely. But her partner teacher is also immunocompromised and requested to work from home as well. Administrators said both of them couldn't be remote, and since Kaitlyn's partner teacher submitted her paperwork first, she is the one who will be teaching remotely.
Instead, the district is giving Kaitlyn a teacher's assistant and an office. Kaitlyn will teach in person for half the day and teach via webcam from her office for the rest of the day, while the assistant will be in the classroom with the students to facilitate and manage behavior.
"It's going to be a little weird. ... I would prefer it if everyone was online for quite a while," she said.
Still, the district has "reduced our class sizes as much as they can, and they've been very accommodating," she said. "They're doing the best they can to help me be healthy, which I really appreciate."
In Georgia, where schools across the state have already started the year with mostly in-person learning, some districts have told teachers that letting them work remotely would be too great of a burden on their operations, said Lisa Morgan, the president of the Georgia Association of Educators, a professional group of teachers in the state.
"Educators are being asked to come back into the classroom in what is in many cases an unsafe situation-masks are not required, social distancing is impossible because class sizes have not been reduced, and the only option educators are being given when the accommodations are being denied is to resign," she said. "They are being asked to make the choice between their safety and their careers."
There are especially few options for teachers who have a high-risk family member, Morgan said. The ADA does not cover employees who live with someone who has a disability or high-risk condition. Forty-six percent of teachers said a member of their household has a physical condition that puts them at risk, according to the EdWeek survey.
District leaders say they will try to accommodate those employees if possible. Many districts have created tiered systems for requesting to work from home-priority is given to those who are at high risk, followed by those with high-risk family members. Teachers who feel uncomfortable returning are then given exemptions if there are still spots available.
Also, a health condition that puts a teacher at higher risk for COVID-19 complications isn't always the same as an ADA-recognized disability, which means it's often left up to the district on how to handle those requests for accommodation. For example, simply being older than 65 is not a disability.
Pregnancy itself is also not considered a disability, although conditions resulting from pregnancy, such as gestational diabetes or preeclampsia, may qualify as disabilities under the ADA. About 77 percent of teachers are women, and many are in prime childbearing years.
Much remains unknown about COVID-19 and pregnancy. One study found that pregnant women with COVID-19 were more likely to end up in intensive care units and need ventilators than non-pregnant women, but they were not more likely to die.
Dr. Aparna Sridhar, an associate professor of obstetrics and gynecology at the University of California Los Angeles' school of medicine, said in an email that at this time, all pregnant women, regardless of trimester, should take precautions to prevent infections. She said pregnant teachers who have additional risk factors should consult their obstetricians for accommodation guidelines, and those should be communicated to school management.
In some cases, teachers who have not been able to secure an accommodation are considering not coming back to work at all. Some are retiring early, resigning, or taking unpaid leave.
Some districts have also offered their teachers an unpaid, job-protected leave of absence. For example, the Springdale, Ark., school district offered any employee who was uncomfortable going back to school the opportunity to take an unpaid leave of absence. Forty-eight employees accepted that option, which guarantees them a job next fall. Of those, 26 were certified staff, including teachers. The district has 2,950 total employees.
The Family Medical Leave Act also allows employees who have been at their job for at least a year to take up to 12 weeks of unpaid, job-protected time off. This can be used if the employee has a serious health condition that makes it impossible to perform the essential functions of his job, or if the employee needs to care for a spouse, parent, or child with a serious health condition.
However, FMLA can only be used once in a 12-month period, so employees who already used it-or are planning to use it-to care for a new baby will be ineligible.
Employees who are quarantined based on either a government order or the advice of a healthcare provider and those who are experiencing COVID-19 symptoms are eligible for two weeks (up to 80 hours) of paid sick leave under the Families First Coronavirus Response Act.
That federal law also gives employees two weeks of paid sick leave at two-thirds pay if they need to care for someone who is quarantining. Employees can also take up to 12 weeks of paid leave at two-thirds pay to care for a child whose school or child-care provider is closed or unavailable due to COVID-19. (These leave provisions are set to expire on Dec. 31.)
However, the reduced pay will be a barrier for many teachers. Morgan said that in one Georgia district, more than 700 teachers initially expressed interest in the extended family leave, but when they learned the details, only one teacher chose to apply.
"Most people can't afford a 33 percent cut in pay," she said.
Teachers who feel like their request for an accommodation has been unfairly denied also have the option to file a complaint with the Equal Employment Opportunity Commission or with their local union, the NEA says, adding that there could also be grounds for possible litigation. The NEA has also recommended that local affiliates with collective bargaining rights add language to their contract about ensuring teachers' safety, and that educators in states without collective bargaining rights form health and safety committees to try to add similar language to school policies.