How to reopen schools is one of the most pressing decisions facing political leaders. All children are being severely impacted by school closures, our most vulnerable children most of all.

The burdens imposed on children are particularly ethically unsettling. Although there are increasing concerns, it is still the case that school-age children rarely die or become seriously ill from COVID-19.

But what children lose by not being in school is enormous; school attendance is a life-defining experience that is critical for educational, social and emotional development. Children are being denied the benefits of attending school to protect the rest of us, particularly those at greatest risk of contracting the virus.

The biggest ethical challenge for decision makers is determining how to balance the interests of children and the interests of the rest of society. Factored into this moral calculus is the additional argument that school reopening is integral to economic reopening; parents need the full-day child care schools provide in order to return to their stores, offices and factories.

This big-picture trade-off decision does not, however, exhaust what is ethically at stake. Many difficult ethical decisions about exactly how schools should reopen need to be resolved.

COVID-19 will be with us in the fall; a vaccine will not. People at higher risk will likely be advised to continue staying at home, even as most return to work. Currently, about 474,000 teachers in grades 1-12 are over the age of 61 and over two million, mostly women, are under the age of 41. Among younger teachers, some will have high-risk health conditions or be pregnant.

What should schools do about teachers who fall into higher-risk categories? Should they be given a choice between returning to the classroom or working remotely? Even in the absence of choice, some high-risk teachers may decide to retire or quit. Given current teacher shortages, a sudden drop in the workforce of even 10% could be catastrophic. What about school staff in essential areas like sanitation and food services? Some of them will be high-risk as well.

Should parents be given a choice about sending their children back to school? Some parents may reject the risk calculus made by government that schools are safe for face-to-face instruction and keep their children learning virtually at home. Parents of medically high-risk children may feel they have no other choice. Other parents may be concerned about risks to family members.

About 10% of all children live with grandparents; they are more likely to be children of color, often from high poverty communities. The legal option of home schooling is a poor fit for the pandemic. For many parents, there will be no meaningful choice unless schools continue to provide the option of full-time home-based instruction.

Complicating these ethically complex questions are unsettled issues about how schools should institute social distancing practices as a condition of reopening. Several reports have raised options like reduced school hours, and prioritizing students’ return based on need or grade level. If Maryland schools will not return to full-time school days for all students this fall, how should face-to-face instructional time be allocated?

The Maryland State Department of Education’s Recovery Plan identifies several ways to reduce density in schools by limiting the in-classroom instruction for any given child. With any of the proposed options, once again, children of poverty and their families will be hardest hit, exacerbating background structural injustices that this pandemic has laid bare.

Given the disparate impact, an important ethics question is whether children from high poverty neighborhoods should be prioritized in the allocation of limited in-classroom instruction. Also, to the extent that at least some instruction will continue to be at a distance, the child care benefit of school reopening to the economy and to parents in need will be heavily compromised. Should the child care needs of parents who are essential workers or low income families factor into decisions about how to reduce density in our schools?

Deciding when and how to reopen schools entails trading off the needs and interests of different groups of people. A first step is being explicit about these trade-offs and what is ethically at stake in each.

Ruth Faden (rfaden@jhu.edu) is founder of the Johns Hopkins Berman Institute of Bioethics, Megan Collins (mcolli36@jhmi.edu) is a professor at Wilmer Eye Institute and co-director of the Hopkins Consortium for School-Based Health Solutions, and Annette Anderson (annettee.anderson@jhu.edu) is deputy director of JHU’s Center for Safe and Healthy Schools and a professor at the School of Education.