As the coronavirus that causes COVID-19 evolves, school leaders’ work to track and mitigate outbreaks in schools will have to adapt to keep up.
The Centers for Disease Control and Prevention earlier this month relaxed its guidance for physical distancing in schools, advising that elementary schools and some secondary schools can separate students and staff by three feet instead of the six feet previously recommended, as long as schools maintain universal mask-wearing and other protective measures. (The CDC kept 6-foot spacing recommendations in place for middle and high schools in communities with high infection rates, unless the students remain in small, isolated cohorts during the school day to limit infection risk.)
However, the CDC did not change its recommendation that schools track and potentially quarantine any student or staff member who comes within six feet of an infected person for 15 minutes or more during a 24-hour period. In fact, experts say close contact tracing and a willingness to quickly adapt learning modes in response to signs of an outbreak will become even more important this spring and summer, as more contagious strains of the coronavirus come to dominate U.S. cases.
“We really don’t have infection studies in the school setting, looking at what would occur with these new strains,” said Tina Tan, a pediatric infectious disease doctor at Lurie Children’s Hospital in Chicago and a coronavirus expert with the Infectious Disease Society of America. “I think one of the things that’s going to be really important is that the school district leaders need to continue to monitor the amount of disease that’s occurring in the community, because if there’s a surge of disease … They have to be flexible enough to quickly go back to hybrid learning or go back to e-learning, etc.”
Higher transmissibility will affect children
Viruses are constantly mutating, and the SARS-COV-2 virus, which causes COVID-19, has gone through many permutations since the first strain—called the L-strain—was identified in Wuhan, China, more than a year ago. However, a handful of recent variants have contained mutations in parts of the virus that make it more easily spread, or that make some therapies less effective against it. So far, the CDC has identified five so-called “variants of concern,” meaning variants that cause faster infection, more severe illness, and/or reduce the effectiveness of treatments or vaccines:
- B.1.1.7, also known as the U.K. variant, and B.1.351, the South Africa variant, both have been found on average to be 50 percent more transmissible than the standard COVID-19 strains;
- Two new variants identified in California, B.1.427 and B.1.429, both are on average 20 percent more transmissible; and
- P.1., first identified in Japan and Brazil, is no more infectious, but may reduce the effectiveness of some antibody treatments against the disease.
Studies of school infection rates—including newly released studies in Florida, Missouri, Utah, and New Jersey—have looked at the effects of physical distancing, mask-wearing, and other mitigation measures in schools with varying community infection rates, but so far school studies have not been conducted in communities where new variants had already become entrenched.
It means that school and district leaders should be on alert for what could be rapid spikes in community infection rates as more infectious strains of the virus become dominant in the United States; the U.K. variant, for example, already accounts for more than 1 in 5 new COVID-19 cases in the United States.
“We know that masking and hand hygiene and all these mitigation strategies work for any one of these strains,” Tan said, “but you have to make sure the amount of disease in the community is not so high that you are running an increased risk of bringing more disease into the school setting. … The amount of disease in the community is what needs to drive how they decide to use in-person learning or some other method of learning, and they need to have protocols in place so they are not scrambling when all of a sudden there’s a surge in their community.”
Tighter control on teen masking needed
Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said that children are more likely to get infected and to see more severe illness if they contract some of the variants, such as the U.K. strain, but he noted in a briefing on the pandemic that “that might relate not to anything specific about children but that it is just in general more easily transmitted.”
CDC Director Rochelle Walensky agreed. “While these variants are concerning, it is in fact the same disease and the same mitigation strategies—the masking, the distancing—work just the same with the variants as they do with the wild-type [meaning unmutated] disease,” she said in a White House briefing on the pandemic.
Tan agreed, adding that schools should not consider reducing physical distancing from six feet to three feet unless they can ensure all adults in the school are vaccinated—as vaccines for students likely will not be available until this fall for secondary students and potentially 2022 for those 12 and younger—and strictly implement other safety measures, such as universal masking for all students and staff, even in states where broader mask mandates are being lifted.
“If you look at populations where COVID cases are surging,” such as in Texas and Florida, Tan said, “it’s in the teenage population, and it’s surging because kids are tired of doing what they should be doing and they’re just like, forget it, I’m just not doing this anymore.”
School leaders and educators can help improve teenagers’ safety efforts through better and more communication with them, she said. Recent studies by the JED Foundation and others have found high school students surprisingly have higher rates of anxiety about health risks to themselves and their families from COVID than about isolation from friends, so framing safety measures like mask wearing and hygiene as a way to both reduce the risk to friends and relatives and shorten the length of the pandemic can be helpful, particularly in the run-up to spring break, when teenagers may be more inclined to break distancing and mask safety measures.
