School & District Management

‘You Can’t Follow CDC Guidelines': What Schools Really Look Like During COVID-19

By Sarah Schwartz — March 31, 2021 13 min read
Guntown Middle School eighth graders walk the halls to their next class as others wait in their assigned spots against the wall before moving into their next class during the first day back to school for the Lee County District in Guntown, Miss on Aug. 6, 2020.
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Since the fall, research has shown that schools can operate safely during the ongoing pandemic—as long as schools take precautions such as universal masking, distancing, and contact tracing to stop the virus’ spread. And while most schools doing in-person instruction have put these protocols in place, teachers say that the reality on the ground is that strict adherence to them can be next to impossible.

In interviews with Education Week, 15 teachers across seven states described how the conditions in their classrooms are often far from the ideals outlined by the Centers for Disease Control and Prevention and other public health experts: Kids take off their masks, classrooms and hallways are too crammed for distancing, and windows don’t open for ventilation.

This group of teachers does not comprise a nationally representative sample. But other research suggests that some of these breakdowns in mitigation measures are occurring across a subset of schools. In a survey of students conducted in October by the CDC, just 65 percent of students said that their peers wore masks “all the time” in classrooms.

Several of the teachers interviewed by EdWeek taught in states that don’t require, or explicitly ban, collective bargaining with teachers’ unions. They said that the kinds of contentious battles going on between big-city school districts and teachers over safety precautions aren’t happening in their districts. Many have been teaching five days a week in person since the beginning of the school year, with little or no input in decisions about classroom conditions.

“It seemed like there were a flurry of studies that came out in January that said school spread doesn’t happen … as long as these guidelines are followed,” said Betsy Hobkirk, an elementary school art teacher in Knoxville, Tenn. “But who has those conditions?” How could it be possible to extrapolate that all schools are safe, when not all schools meet the same criteria as those that are studied, Hobkirk asked.

Most teachers said they didn’t fault their school administrators, who they said were trying to keep everyone safe with scarce resources and amid competing mandates, guidance, and community priorities. But the gulf between what public health experts are recommending and the conditions in teachers’ classrooms left them wondering: Is what we can manage to do good enough?

It’s hard to know from the research we have now, many experts said. The schools that have been the focus of research on spread during the pandemic may differ from others in significant ways, said Justin Lessler, an associate professor of epidemiology at Johns Hopkins University’s Bloomberg School of Public Health. “The schools, by the mere fact that they’re being studied, are going to be more on the ball.”

“Doing the really careful work takes time, and we haven’t had it,” said Kimberly Powers, an associate professor of epidemiology at the University of North Carolina-Chapel Hill’s Gillings School of Global Public Health. “Some of the really careful looks at how schools have contributed to this pandemic may come later. We may be through this.”

For now, even as more educators receive the vaccine, the way forward isn’t for schools that have operated with few mitigation strategies all year to assume that precautions aren’t necessary, Lessler said. COVID-19 variants continue to circulate, and though their spread hasn’t been shown to weaken the effectiveness of the vaccine, they are more transmissible. Instead, schools need to double down on the strategies they are able to execute, Lessler said: “Just because you’ve dodged it so far doesn’t mean you’re not at risk.”

‘You can’t follow CDC guidelines’

Education Week spoke with teachers in Florida, Iowa, Michigan, Nebraska, South Carolina, Tennessee, and Texas—all states with a high proportion of their school buildings open five days a week.

About half of the teachers said they couldn’t enforce social distancing, either at the 3-foot or 6-foot marks, because they had too many students in class to separate them further. These teachers said their classrooms were filled to normal or almost normal capacity, with 20 to 30 kids. Several said they were able to distance until their school, or in some cases, their state, mandated a full, five5-day- a- week return to school.

Walt Caves, the dean of students at a middle school in Okeechobee, Fla., said there wasn’t enough room to distance in classes after the state required that schools adopt a five-day, in-person schedule to maintain funding, and most of their students came back to campus. “When you say that, you can’t follow CDC guidelines,” Caves said.

One elementary school teacher in South Carolina, who asked not to be named, said that she preferred a full-week schedule over hybrid learning. On remote instruction days, many students go to alternate child-care settings, where they can be exposed to more people, she said. That’s a concern that public health experts have raised about hybrid schedules.

The other half of teachers said they could maintain distancing, some at 6 feet and some between 3 feet and 6 feet. But most of these teachers said that they were only able to meet this standard because so many students had chosen to stick with remote learning.

“I teach in a science classroom. It’s one of the largest classrooms on campus. I could not achieve social distancing if all my students showed up,” said Richard Lines, the science department head at a high school in Garland Independent school district, in Texas. The state has required all schools to offer on-campus instruction five days a week, but only a handful of his students have chosen the in-person option, Lines said.

Asked about mask-wearing, about half of the teachers said that most of their students wore face coverings properly and regularly. But almost all of these teachers said they had a handful of students who had to constantly be reminded to pull their masks back up from under their chins to cover their faces, or refused to wear them. Several of these teachers also said that mask-wearing varied from classroom to classroom by how strictly each teacher decided to enforce the policy.

The other teachers described different scenarios: Mandy Lloyd, a high school chemistry teacher in Greenwood, S.C., said that only half of her students will wear masks in some of her classes. Other teachers said they had to remind students multiple times every class period to wear their masks properly, even though their schools have mask mandates. One teacher, who requested not to be named, works at an elementary school in Iowa where masks are not required, so no students and very few staff wear them, she said.

If it’s systemic, that no one’s wearing their mask, or hardly anyone is wearing their mask, and there’s basically no other measures in place to stop spread, then it’s going to be a huge problem.

While that Iowa elementary school has been mask-optional since it opened for in-person instruction in August, some other districts across the country have recently started lifting mask mandates—the Comal school district in Texas, Lake Pend Oreille school district in Idaho, and North Butler schools in Iowa all decided in March to pull back requirements for mask-wearing in schools. (At the same time, studies that support less physical distancing in schools—showing that 3 feet may suffice—assume that students are wearing masks.)

The teachers Education Week spoke with knew less about their schools’ ventilation systems. Some said they weren’t aware of any changes made, while others noted upgrades to air filtration or portable HEPA filters provided for their classrooms. Five teachers specifically mentioned that their windows didn’t open, that they didn’t have windows in their classrooms, or that they didn’t feel comfortable opening windows due to safety concerns, weather, or noise.

The CDC’s ventilation guidance suggests circulating as much outdoor air as possible throughout a room, ensuring that HVAC systems are maximizing ventilation, and using portable air filters and cleaners.

But whether these holes in mitigation strategies are contributing to in-school spread of the virus, the teachers said, is hard to know. Most said that their schools did not have school-based testing programs, so they relied on students and staff to seek out testing and, in some cases, self-report results to the school. Two teachers said that students often come to school with cold-like symptoms.

One middle and high school special education teacher in Iowa, who asked for his name not to be used, has heard students try to persuade their peers not to get tested, in attempts to avoid a quarantine of their class or sports team. He also thinks some students are hesitant to test because they don’t want to disrupt parents’ work schedules. “Kids feel like they’re a burden when they have to go to quarantine,” he said.

The CDC recommends that individuals quarantine for 14 days if they have been within 6 feet of an infected person for 15 minutes or more over a 24-hour period.

Several teachers said their schools saw spikes in case counts between Thanksgiving and the new year, but noted that these numbers mirrored trends in their communities. Most said that they still have teachers and students out of the building in quarantine on a regular basis, though the numbers are lower now than they were in the winter.

Along with lower case counts, some teachers said they felt more comfortable in schools now that they had received their first dose, or both doses, of the COVID-19 vaccine. Still, said Lines, the Texas teacher, “it’s important that we’re clear that it’s not a game-changer yet for the students and their families.” Most middle and high school students aren’t likely to be vaccinated before the end of this school year. Experts say that mitigation measures will remain necessary in schools while some in communities aren’t yet vaccinated, and new, more contagious variants of the virus circulate.

Which leads to what Hobkirk, the elementary art teacher in Tennessee, called “the million dollar question”: Are school systems missing spread within their buildings? Or can they be assured that imperfect adherence to guidance is good enough?

Most of the studies on COVID-19 and schools haven’t asked this question

The vast majority of research on schools during the pandemic suggests that schools can open up without causing outbreaks and driving up community transmission as long as mitigation strategies are in place and adhered to.

In situations where these strategies are not in place, or are followed more loosely, the data are less clear, said Mario Ramirez, an emergency medicine physician who previously served as the acting director for the Office of Pandemic and Emerging Threats at the U.S. Department of Health and Human Services during the 2015 Ebola outbreak in West Africa.

“There have been random and sporadic outbreaks that have led to clusters,” said Ramirez, who is currently a managing director at Opportunity Labs, a consulting group that works on education issues. While some of these clusters occurred in schools that weren’t taking precautions, there are also examples of schools that took imperfect protective measures and didn’t see any outbreaks, he said.

I teach in a science classroom. It’s one of the largest classrooms on campus. I could not achieve social distancing if all my students showed up.

There may be undetected asymptomatic spread in these schools, said Dominique Heinke, an epidemiologist in North Carolina. School numbers are “heavily dependent” on testing, so if schools aren’t testing, or students aren’t electing to test, they’re likely to miss cases, she said. But it’s also possible that schools not following precautions, and not seeing a high number of cases, might be protected against spread through other means.

If students are staying home most of the time they’re not at school, for example, it’s less likely they’ll bring the virus into the building. Conversely, if most students at a school have a lot of exposure to the community, either because parents are working in person or for other reasons, it could be that the majority have already been infected, and the virus has fewer possible additional hosts, which could limit spread, Heinke said.

On the other hand, “it’s entirely plausible that the combinations of these many measures, though imperfect, are keeping in-school transmission to very low levels in many schools,” said Powers of UNC.

In its guidance for schools, the CDC has emphasized layered mitigation, sometimes talked about as the “Swiss cheese model,” said Greta Massetti, a senior scientist at the CDC and co-lead of the Community Interventions and Critical Populations Task Force for the organization’s COVID-19 response.

The idea is that no one strategy—like distancing or masking—is infallible; each has holes like a piece of Swiss cheese. Layer the slices, or the strategies, on top of each other, and the holes in one strategy will hopefully be blocked by another. It’s less likely the virus will slip through.

“When some of those strategies fail, the others are there to sort of step in and provide protection,” Massetti said.

Schools can focus on what’s in their control

But just how many of those strategies can fail before the stack is all holes and no cheese? Again, it’s unclear, said Ramirez.

“All of these questions that we’re asking are experiments that are taking place in an imperfect scenario,” he said. In an ideal world, he said, researchers would be able to isolate one variable at a time. If they wanted to see how well a certain ventilation strategy worked, for example, they would compare two schools where adherence to every other mitigation measure was exactly the same. But researchers don’t have that option right now, he said.

“What you have is thousands of schools around the country that each have 10 to 20 different variables that are changing site to site. … It’s impossible to ascribe disease spread to any particular intervention, or lack thereof. What we are stuck doing is making broad strokes about how much transmission there is in schools,” said Ramirez.

Still, it’s likely that a few small breakdowns in an otherwise well-adhered-to policy is less of an issue than ongoing habits, said Lessler. If a couple of students in the school refuse to wear masks, but everyone else does, “that’s probably not going to be a huge problem,” he said. “If it’s systemic, that no one’s wearing their mask, or hardly anyone is wearing their mask, and there’s basically no other measures in place to stop spread, then it’s going to be a huge problem.”

There’s always the possibility that people—teachers, children—will make mistakes, or resist mandates. That’s why Donald Milton, a professor of environmental health at the University of Maryland, argues that districts should be focusing more on modifying the school setting, rather than human behavior—especially when they’re having trouble enforcing guidance that requires students and staff to follow new rules.

The concept is known as the “hierarchy of controls,” a framework used in occupational health and safety. “What you want to do first is controls that don’t require behavioral changes, that don’t require people to individually do anything, but are rather built into their daily environment,” Milton said. For example, effective ventilation is key. So are administrative choices—like moving lunchtime, one of the riskiest parts of the day as students aren’t wearing masks, to an outdoor location.

As Education Week has reported, at this stage in the pandemic and at this point in the school year, many schools aren’t considering making costly, large-scale infrastructure updates as a COVID-19 mitigation strategy. But enacting smaller changes—purchasing portable air filtration systems or asking teachers to take students outside for lunch—doesn’t have to be prohibitively expensive, Milton said.

While this may be an option some schools choose going forward, it still doesn’t leave teachers or school leaders clear answers on how much adherence to how many mitigation strategies they need to achieve the same results as the schools studied in reopening research.

“I think that this pandemic has highlighted a lot of inadequacies in the funding and support for education, for public health, in terms of our data systems,” said Powers, the UNC associate professor. “It’s been my hope that coming out of this, we will build things back in a way that’s informed by all of the challenges we’ve faced.”

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A version of this article appeared in the April 14, 2021 edition of Education Week as ‘You Can’t Follow CDC Guidelines': What Schools Really Look Like During COVID-19


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