Future of learning unclear
Doctors: Schools aren’t spurring spread, but reopenings uncertain
NORFOLK — As COVID-19 cases skyrocket, more students and staff are getting sick.
As of Friday morning, Chesapeake schools had reported 101 coronavirus cases in the last two weeks. The Virginia Department of Health has reported 1,007 cases in the city in roughly the same time frame. But so far, there’s only a handful of cases in Hampton Roads in which people contracted COVID-19 at a public school.
A number of local pediatricians and health care professionals say that in-person learning isn’t driving climbing case numbers.
“The data supports that they are not,” said Dr. Douglas Mitchell, medical director of the Children’s Hospital of The King’s Daughters Medical Group. “There are plenty of published studies and published examples that indicate that the risk of spread in the schools is less than we would have expected.”
Dr. Mitchell and Dr. Leah Rowland, a CHKD pediatrician, say that there’s increasing evidence that a multilayered approach to COVID-19 mitigation — based on masks and social distancing, supplemented with other measures — makes in-person learning significantly safer.
“That’s why these other states have changed course and pivoted away from looking at absolute numbers and looking more at transmission,” Dr. Rowland said. “They’re saying, look, where schools are staying open, we’re not seeing spread like we thought.”
K-12 schools represent a small fraction of COVID-19 outbreaks, where two or more cases are connected to a single place. For example, a student getting COVID-19 from a classmate would count as an outbreak, but not if two teachers who contracted it from different places showed up to work.
Out of 1,657 outbreaks VDH has reported on its dashboard, only 76 were from K-12 schools. And among those, the largest outbreaks have happened mostly
“Stress is through the roof. The amount o mental health issues that we’re having to deal with, that families are dealing with on a daily basis, is very concerning.”
— Dr. Douglas Mitchell
at private religious schools: 21 cases at Gate City Christian School in Scott County, 19 at Grace Christian School in Staunton, 19 at Richmond Christian School.
The two largest Hampton Roads school outbreaks were at private schools in Chesapeake. Twelve cases were connected to an outbreak at Great Hope Baptist Church School that started last month, and 10 stemmed from an outbreak at Stonebridge School in September.
Dr. Rowland, who is also the chair of the Virginia Chapter of the American Academy of Pediatrics’ school reopening task force, said that many of those schools shared common themes in their COVID19 plans.
“You go to that school and see that masking was optional,” Dr. Rowland said. “There were really big mitigation pieces missing.”
The outbreaks at public schools in the region haven’t reached those scales.
Matoaka Elementary School in Williamsburg closed briefly after an outbreak in late October. The district’s COVID-19 dashboard reported three staff cases at the school around that time. At Crestwood Intermediate and Truitt Intermediate, several classrooms switched to all-virtual after outbreaks were reported among a handful of staff.
Dr. Rowland said that research from other states so far suggests that when outbreaks happen, it’s because of a gap in the school’s measures. About a third of cases in other states have been related to sports teams, not classroom instruction.
“Spread in school is very low, but when it does occur, it is sometimes through a hole in the mitigation that’s too great, such as staff eating together,” Dr. Rowland said. “I’d still say the spread is low.”
Guidelines from the Virginia Department of Health and Centers for Disease Control and Prevention recommend schools consider a number of factors in reopening decisions. The three primary ones are the number of cases per 100,000 residents, the percentage of tests coming back positive and school’s ability to implement mitigation measures like masking and contact tracing.
Even for schools at the highest risk in several categories,
VDH guidelines from October leave the door open for schools to offer in-person schooling to their youngest and most vulnerable students. The CDC categories are “the starting point.”
If a school can effectively implement mitigation strategies, VDH says they can consider more in-person instruction. Mitchell and Rowland say that given the limited spread in schools; it might be time to weigh the community metrics less heavily.
“That’s a pivot,” Dr. Rowland said. “It’s just difficult for people to look at the changing data.”
In Norfolk, a group of doctors, nurses and other medical professionals are pushing the School Board to change its thresholds for in-person learning at its next meeting. Currently, the city would need to be in the “lower” or “lowest” risk of transmission category under the CDC guidelines in both the three core indicators that the VDH recommends using and five “secondary indicators.”
Dr. Sharon Sadr, a primary care physician at Norfolk Internal Medicine PC and a parent of two Norfolk students, said there’s little indication that the city will make it to those levels in the near future.
“There are many journal articles that have shown that when schools have been in session recently, the spread has not been coming from the schools, that the kids are not the spreaders of this virus,” Dr. Sadr said. “It really replicates what’s happening in the community.”
The group, Medical Professionals for In-Person Education, want the board to consider some in-person instruction in the “moderate” risk category, which is in line with the VDH guidelines. They also want the board to abandon the secondary indicators, which VDH guidelines say, “should not be used as the main criteria for determining the risk of disease transmission in schools.”
MPIPE doesn’t want an immediate return with cases as high as they are in Norfolk. Rather, Dr. Sadr says, they want a clearer plan.
“The restrictions are fine for the time being,” Dr. Sadr said. “We just don’t feel like there is an attainable goal for the future. We just don’t feel like there’s a plan in place that’s based on evidence-based medicine, on data.”
There’s little to suggest that the
state is going to take any action soon to push schools either way.
At a news conference Thursday, Gov. Ralph Northam said the decision to open or close remains in the hands of local school boards, a tactic the state has followed since it first announced reopening guidelines in June. Schools are exempt from the new gathering limits Northam announced Thursday.
“This does not change anything about schools or colleges and universities,” Northam said. “Across Virginia, local school boards and school superintendents are working very hard to make thoughtful and responsible decisions at the local level.”
The Virginia Education Association, which represents thousands of teachers across the region and state, issued a call for schools to switch to all-virtual instruction until mid-January on Thursday.
In a statement, VEA President James Fedderman said that rising case numbers would inevitably put students and staff at risk, and that schools should take every step to minimize risk.
“Public schools are attempting an unprecedented balancing act. We must ensure that our students are learning — but we cannot take actions that put the health and safety of students, or educators, or Virginia families at risk when safer options are available,” Fedderman said. “Learning losses will be made up, but loss of life cannot be.”
There are more factors at play in reopening than just whether COVID-19 is spreading in schools.
Increasing community cases has led to more and more staff having to quarantine. In York County, school officials say that principals and assistant principals are having to cover classes because of shortages of substitute teachers.
WVEC reported that Chesapeake has had about 1,000 quarantines this school year, and WAVY reported that some staff from other schools were called into help at Butts Road Intermediate due to quarantines.
Many districts are dealing with staffing shortfalls. Too many teachers are in high-risk categories and have documented health concerns. Hampton walked back a broader reopening plan last month after it became clear that 65 classrooms wouldn’t have teachers.
But there’s increasing consensus, both among educators, families and medical professionals, that virtual learning is straining students. A Christopher Newport University poll released earlier this week found 75% of Virginia voters fear their children are falling behind in school.
Dr. Mitchell cites increasing emergency room visits for mental health emergencies from children as a sign of the strain on young people.
“Stress is through the roof,” Dr. Mitchell said. “The amount of mental health issues that we’re having to deal with, that families are dealing with on a daily basis, is very concerning.”