For School Outbreaks, It’s When, Not If

The coronavirus is unpredictable, but one thing seems certain in this back-to-school season: Outbreaks will appear in many K-12 schools as they reopen.

“It’s not a question of if, but when outbreaks will occur,” said Dr. Leana Wen, an emergency physician and the former health commissioner of Baltimore.

“We have to be realistic,” said Dr. Benjamin Linas, an associate professor of medicine and epidemiology at Boston University. “If we are opening schools, there will be some Covid.”

That inevitability can feel frightening. But a case at your child’s school does not mean you should panic. And a classroom in quarantine, or a school forced to switch to remote learning, does not necessarily mean a district has failed. In fact, if your school is following an established pandemic procedure, it might mean things are working as planned.

Here are a few questions and suggestions to help you calibrate your concern and weigh contingencies, based on our conversations with epidemiologists and public health experts.

If there’s a case, where did that person get exposed?

“It’s important to distinguish between Covid in your school, which is bad, but not exactly the same thing as Covid being transmitted in your school,” Dr. Linas said. “People have lives outside of school. It’s very likely that people will get infected somewhere else.”

A few unrelated cases at a school does not necessarily mean there’s an outbreak. If community transmission rates are high, students are most likely getting infected outside of school, where the environment is less controlled. (Most experts agree that students shouldn’t return to school if more than 5 percent of people in their community test positive.) Effective contact tracing is essential to help families and classrooms assess risks and make a plan.

How transparent is your district?

Just because there’s a case in your child’s school, it doesn’t mean that your child has been exposed. “By just passing a kid in a hallway, your kid is extremely unlikely to get Covid-19,” said Dr. Megan Ranney, an emergency physician and assistant dean at Brown University. “It’s really about being in a classroom with that other person for a significant period of time.”

If your child hasn’t been anywhere near the infected child, she said, “it would not be appropriate for your kid to quarantine.”

But transparency about cases varies across districts. Some, citing privacy concerns, are only releasing limited data — if any at all. But that might be because they’re interpreting HIPAA incorrectly. Either way, dashboards and trackers are slowly popping up across the country, under pressure from parents and doctors. Detailed, reliable information about outbreaks can keep learning as uninterrupted as possible and may save lives.

What about testing?

Pediatric tests have been hard to get in some places, but they are available. Try to find a center that turns around results quickly.

If there’s any chance your child may have the virus, don’t send them back to school without a negative test, because research suggests they can be asymptomatic but still contagious. And if they have symptoms — even sniffles or an upset tummy — play it extra safe.

“This is not the year to just send your kid to school,” Dr. Ranney said. “This is the year to respect the community and get your kid tested before sending them back.”

Outbreaks and responses

• Michigan: For weeks, the state dragged its feet on releasing detailed information about outbreaks to parents and teachers, citing privacy concerns and sluggish computer systems. On Monday, the state released a list of all schools with coronavirus cases, from K-12 through college.

• Connecticut: A number of schools had temporarily switched to online learning after a few positive cases. (Many students in the state are back in classrooms full time.) Gov. Ned Lamont challenged that approach as overly cautious because each classroom functions as a pod. “If there happens to be an infection in that one class, it’s just those 20 students and that teacher who would have to quarantine — not the entire middle school or not the entire school,” he told WNPR. The state’s test positivity rate has consistently hovered around 1 percent.

• Minnesota: School leaders spent the summer making plans for contact tracing and pivots between in-person and distance learning as cases pop up. A rapid-response team is now trying to implement those procedures and protocols.

• Germany: In the first week of school, the country reported 31 clusters, and 150 total cases. But The Washington Post reports that there have been few documented cases of transmission within schools, and while national cases have been rising, the schools have not been “identified as a driver of infections.” Officials said that’s because of low community transmission rates, more than any school-specific policy. “This is where the United States will have problems,” one doctor said.

The Big Ten calls an audible

The athletic conference, which said on Aug. 11 that it would not hold any football games in 2020, abruptly reversed its decision after coming under intense pressure from coaches, parents, players, fans and even President Trump.

Football for teams like Michigan, Nebraska, Ohio State, Penn State and Wisconsin will now resume as soon as Oct. 23, with safeguards including daily coronavirus testing and enhanced cardiac screening. (In a recent small study out of Ohio State, 15 percent of athletes who tested positive for the virus showed signs of cardiac inflammation. )

Reinstating the season is likely to provoke new outrage from those who believe the league is prioritizing profits, entertainment and public relations peace over the health and safety of student-athletes.

Back in August, Kevin Warren, the Big Ten commissioner said: “There’s a lot of emotion involved with this, but when you look at the health and well-being of our student-athletes, I feel very confident that we made the right decision.” Later that month, he said the decision “would not be revisited.”

College football conferences that have returned to play, like the Atlantic Coast Conference and the Big 12, have found it tricky to navigate the epidemiological perils of the pandemic. A handful of games have been postponed, some teams have held out players because of positive tests or contact tracing, and stadiums are operating with fewer spectators in the stands or none at all.

The coach of Louisiana State’s football team, the reigning national champions, said on Tuesday that most of his players had already contracted the coronavirus, including “about three or four guys” who had active cases, The Baton Rouge Advocate reported.

Around the country

College updates

K-12 updates

• In New York City, a small army of school chefs and cooks fed millions throughout the summer. Now, they’re gearing up for students eating in schools, which are set to open next week. But much is still uncertain.

• In Massachusetts, students who may have been exposed to an infected student still came to class.

• The chief executive of Baltimore schools told WYPR that only 65 percent of students are logging on every day without interruption, one week into the school year, according to a tweet from Alec MacGillis, a reporter at ProPublica. “That means 27,000 students are not reliably present, despite the district’s considerable tech & outreach efforts,” he wrote.

Around the world

• The United Nations projects that at least 24 million children will drop out of school because of the pandemic.

• Students in Denmark are learning outside, using nature as their classroom and staying at a social distance.

• Israel will close schools on Thursday, a day earlier than planned, after new cases surged to a record: 5,523 in a single day.

Listen: Inside quarantine dorms

Today on The Daily: What life is like for one University of Alabama sophomore under quarantine. Zoie Terry, 19, spoke to our colleague Natasha Singer about her life in isolation.

She had tested negative before she returned to campus and was thinking “there was no way I could have had the virus because I was following every guideline — I was doing nothing, I was in my room 24/7,” she said.

But Terry still tested positive. Her story might be indicative of how cases are spreading on college campuses.

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