The Register Citizen (Torrington, CT)
How schools and Phase 3 contributed to CT’s second wave
When Gov. Ned Lamont announced in late September that the state would move into Phase 3 of its reopening on Oct. 8, there was a seven-day average of 155 new daily coronavirus cases in Connecticut.
That was below the national rate. In an attempt to to find balance between shutting down and staying open, the governor believed that Connecticut was safe to expand the size of events, allow more people inside restaurants and keep schools open.
Two weeks or so later, when the state did allow an increase in capacity at indoor restaurants, arts venues and hair salons, the average number of daily cases had nearly doubled to 287
ess than a month later, on Nov. 6, Lamont moved the state back to what he called “Phase 2.1.” By then, the average number of daily COVID-19 cases in Connecticut had grown to 988. As of Wednesday, Connecticut was averaging nearly 1,200 new coronavirus cases every day.
Is there are link? Experts say that the two data points may be connected, that the relaxation of restrictions — and perhaps in-person school — contributed to Connecticut’s second wave of COVID-19 infections.
Even one infection that resulted from a relaxation of restrictions could be viewed as “contributing” to the latest outbreak. The question is how significant that contribution has been among the many factors contributing to Connecticut’s sharp rise in infections.
There are many more tests being conducted in the state, potentially uncovering asymptomatic cases that might have gone unnoticed. Many informal social gatherings are not covered
under any state orders, and the entire nation is seeing a COVID-19 surge, all of which are “contributing factors,” as well as in-person school and a move to Phase 3.
“I don’t believe that the transition to Phase 3 was the initial cause of the second wave, although it was likely a contributing factor,” according to Pedro Mendes, of UConn’s Center for Quantitative Medicine. “My conclusion is that the reopening of schools was possibly the first factor that started the wave. That increase then picked up speed around Oct. 24, which then means Phase 3 also contributed to this wave, but did not start it.”
As for schools, many in Connecticut have moved back to all-remote schedules in the face of rising infections and, in some cases, hundreds of staff and students in quarantine. Superintendents, though, by and large insist that COVID-19 transmission is happening outside of schools.
In Shelton, interim Superintendent Beth Smith made the decision this week to move the entire district to a remote learning model, but she said it was an operations issue — a problem of too many teachers in quarantine — not one of disease transmission.
“From a statistical standpoint, if schools were going to be superspreader locations, and it’s mid-November, we should have had many more positive cases than we actually have had and we just haven’t seen it,” she said.
Data: Public event bans lower rates
A study of COVID-19 data from 131 countries published late October in the journal Lancet showed that as restrictions were put in place — like school closures, travel bans, and limits on movement and crowd size — cases and hospitalizations fell.
Similarly, as those restrictions (called non-pharmaceutical interventions, or NPIs) were lifted, transmission rose. The study suggested a direct link between the relaxation of NPIs — school closures in particular — and an increase in COVID-related cases and hospitalizations.
“That study’s results “seem to be in line with the intuition that most researchers [myself included] already had,” Mendes said by email. “It is nice to have this solid data now to back that up.”
The data shows when you put a restriction in place, the transmission rate drops a week later. Lift that restriction and, three weeks later, the transmission rate increases.
Specifically, the study showed that school closures and limits on crowd sizes had the largest impact.
“As a single NPI, banning public events resulted in the greatest reduction in [transmission rates],” the study says. “This finding is unsurprising because a ban on crowded activities could prevent super-spreading events, which were commonly reported at the beginning of the COVID-19 pandemic.”
Lamont spokesman Max Reiss said the governor and state public health experts have said from the start of the pandemic that “as more residents participated in more activities, that inherently contains more risk.”
“The state’s initial reopening phases happened at a time when more residents were able to participate in activities, eat at restaurants, and attend sporting events outside, Reiss said. “These activities continued into the Fall when key metrics like positivity rate, total cases, and hospitalizations began [to rise] as more interaction happened indoors. There were also many instances of people letting their guard down with small gatherings and a lack of mask-wearing.”
Reiss said that increases in cases and hospitalizations “are trends seen all over the country and all over the world,” and that “Connecticut residents must continue to take the rules seriously by wearing masks, keeping a safe distance, and limiting their contacts outside their immediate families.”
In school or out of school
School districts are grappling with a logistical nightmare, too many teachers in quarantine and not enough substitutes to go around, but Fran Rabinowitz said disease transmission is “happening in the community and being brought into the schools.”
Rabinowitz, executive director of the Connecticut Association of School Superintendents, said the virus is being passed around at sporting events and within households.
“They’re bringing those COVID cases into the schools which is causing the quarantines to happen,” she said. “If it were being transmitted in the schools you would see it transmitted across schools, and we’re not seeing that.”
According to data maintained by CT Insider, there are 11 COVID cases in Weston public schools. But Weston Intermediate School Principal Pattie Falber announced Wednesday in an email to parents that the school had seen their first case of in-school transmission.
“We learned Wednesday morning that two fifth grade students have tested positive for COVID-19,” Flaber said. “This appears to be our first case of within-school spread.”
What counts as “community spread” and what counts as in-school transmission may be a bit of a question.
Rabinowitz called transmission on local sports teams cases of community spread, for example, and Smith said a Shelton teacher may have caught COVID from another teacher while they shared lunch in an office after school.
“We had an early release schedule. Staff was eating lunch after students were dismissed from school, not in front of students,” she said Wednesday. “From the first day of school until yesterday, we’ve had 31 cases in our school community. We believe that 29 of those were positive from community spread.”
‘Not a stretch’
According to that Lancet study, “closing schools alone could decrease transmission by 15 percent on day 28 and reopening schools could increase transmission by 24 percent on day 28,” but of course schools aren’t always either open or closed.
Though she acknowledged that she doesn’t have quantitative data to prove it, Rabinowitz said “schools are seeing more of an outbreak in some cases with students that are hybrid.”
“I’m not at all sure that students who aren’t at school are safer at home,” she said.
And according to Mendes, the realities of transmission are complex enough that a direct link is difficult to establish.
But the virus spreads through human-to-human interaction, so it’s probably not if relaxation of restrictions is a cause of increased transmission, but how much.
“It is not really possible to be sure that the school reopening and Phase 3 were the main causes,” he said. “But since the cases have to be tied up with an increase in human contacts — as that’s how the virus spreads — it is not a long stretch to believe this.”