This fall was supposed to mark a triumphant return to normal for K-12 schools, with children and teachers flooding back into classrooms. But the Delta variant of COVID-19 chewed up that idea and spit it out, and now districts are scrambling to figure out who can stay in school safely and who should go home to quarantine.
School leaders are walking a fearful tightrope, trying to find the right balance between protecting their students and staff from a hypercontagious virus, and delivering on their cherished goal of face-to-face instruction.
“Both choices have people on opposing sides, and nothing will 100 percent satisfy the masses,” said Lisa Herring, the superintendent of the Atlanta public schools. “It isn’t easy.”
In the last few weeks, as most schools reopened, tens of thousands of students and staff members across the country have been sent home to isolate because they’re infected, or to quarantine because they’ve been exposed to someone who tested positive.
Numbers have soared, in particular, in regions where mask-wearing is spotty or vaccination rates are low. In Hillsborough County, Fla., for instance, where the state forbids mask mandates, more than 10,000 students and staff were isolated or quarantined at one point soon after school opened.
But Delta casts an even longer shadow: In the last few weeks, nearly 700 schools in 25 states have delayed reopening, shifted temporarily to remote or hybrid learning, or shut down without offering any instruction, according to the tracking firm Burbio.
In an Aug. 27 briefing, Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said large outbreaks are occurring where schools don’t follow the agency’s advice to promote vaccination for everyone eligible, and to require universal indoor masking.
That’s a tall order in large swaths of the country. Nine states ban mask requirements in schools; four have stopped enforcing those bans, voluntarily or by court order, and five are now under investigation by the U.S. Department of Education for potential civil-rights violations stemming from the bans. But the ground under school leaders’ feet is still littered with landmines, as many local communities battle over key COVID protections such as masks and vaccines, and clash over whether school doors should be open, and for whom.
A tricky balance between safety and in-person instruction
If districts tilt too heavily toward quarantines as a safety measure, they could compromise students’ learning. If they let too many COVID-exposed people stay in school, it could compromise everyone’s safety.
So it’s “crucial for districts to get this balance right,” said Bree Dusseault, a researcher-in-residence at the Center on Reinventing Public Education, which has been tracking 100 districts’ reopening plans.
Some districts are sending home all “close contacts”—anyone who’s been within six feet of an infected person for a total of 15 minutes over a 24-hour period—as the CDC advised last spring. Most districts, determined to provide face-to-face instruction, are taking advantage of multiple exceptions to quarantine that the CDC outlined in its school guidance, such as for vaccinated people without symptoms.
But successive revisions in that guidance have put many schools behind the eight ball, either unaware of the shifts, or still struggling to decide which ones to embrace.
Originally, the agency recommended quarantine for any close contact, vaccinated or not. But in late July, it said that fully inoculated people, and those who’d recovered from COVID, no longer needed to quarantine if they showed no symptoms. The agency urged everyone, vaccinated or not, to wear masks indoors, and use as many other safety strategies as possible: vaccination, social distancing, hand hygiene, and good building ventilation.
Many schools don’t know about a key strategy that could keep more students in school
As schools reopen, though, most appear to be unaware of another CDC revision that could allow them to keep even more students in classrooms.
On Aug. 5, the agency said students who were three or more feet away from an infected person don’t have to quarantine if both people were properly masked. Slowly, districts are noticing this guidance, and a few are adding this exception to the list of those who can stay in school.
“It’s extremely important for school superintendents to know about this policy, and there is a compelling public need for it,” said Danny Benjamin, a professor of pediatrics at Duke University’s School of Medicine who co-leads a program that’s studying safe school reopening. Research that Benjamin and Duke colleague Kanecia Obie Zimmerman led earlier this year showed that universal masking can minimize spread of COVID in schools.
“It will keep kids in schools, which is what superintendents want,” he said, “and it incentivizes schools to enforce proper masking.”
But that calculus changes entirely in places where masks can’t be mandated, Benjamin said. Without that protection, he said, schools need to have quarantine policies that include all close contacts. “If you’re not masking, you should be quarantining,” he said.
Using all CDC-approved quarantine exceptions to keep people on campus
Atlanta is an example of a district that’s using all the CDC exceptions to minimize its quarantines. Between late July, when staff members returned to work, and Aug. 20, two weeks after children came back Aug. 5, the district quarantined 5,175 of its 58,000 students and staff members because of about 1,250 positive cases.
But Herring, the superintendent, notes that none of its 100-plus schools have closed, and only a few classrooms have had to flip to remote or at-home learning, a victory she chalks up to a combination of strategies, particularly an indoor mask requirement and surveillance testing of students and staff. As of next week, voluntary staff COVID testing will become mandatory, regardless of vaccination status.
Districts are increasingly changing policies to keep quarantines to a minimum.
Los Angeles Unified had been quarantining all close contacts, and as school reopened, it sent home about 6,500 of its 450,000 in-person students because of positive tests or exposure. But last week, the district narrowed that pool, deciding to exempt those who are fully vaccinated and asymptomatic. It does not, however, make an exception for students who fall under the CDC’s new “both-people-masked” guidance.
Little more than a week into the school year, the Hillsborough, Fla., schools, which include Tampa, had more than 10,000 students and 335 staff members—4.8 percent and 1.4 percent of each group, respectively—in isolation or quarantine. It already had some exemptions from quarantine: asymptomatic people who’d been vaccinated or recently had COVID. But in a bid to further reduce quarantines, it added the “both-people-masked” exception, only five days after the CDC announced it.
It also enacted a mask mandate on Aug. 18, despite the state’s since-suspended ban on such requirements. District spokeswoman Erin Maloney said in an email that quarantine numbers have declined since the most recent two safety measures were enacted.
Other districts find the CDC’s latest exemption unworkable, though.
The Rutherford County school district in Murfreesboro, Tenn., a state whose ban on mask requirements is being challenged in court, quarantined 1,600 students after 500 positive cases were discovered in late August, and did the same for 140 staff members because of 50 positive cases.
Those numbers could well increase, said district spokesman James Evans, because the district will no longer allow asymptomatic close contacts the choice of quarantining or staying in school. They’ll have to go home for seven days unless they were vaccinated or recently had COVID, he said.
The district knows about the CDC’s both-people-masked exception to quarantine rules, Evans said, and recognizes it could help keep quarantine numbers down, but ruled it out.
“Realistically, in a school setting, with the administration and nursing staff trying to contact-trace, it’s very difficult to determine, did they both have masks on at the time of exposure?” he said. “When you deal with schools that have 1,000 kids, it’s not very realistic.”
Is it time to shift from avoiding transmission to managing it?
Some medical experts think schools should abandon the prevailing approach of making quarantine exceptions for defined subgroups.
“All these loopholes are a little pre-Delta, if you ask me,” said David Rubin, the director of the PolicyLab at the Children’s Hospital of Philadelphia, which has advised the White House COVID Task Force and written reopening guidance for schools.
“People are still in the mindset of trying to eliminate transmission, and that’s not possible anymore. It’s about managing transmission. All these exceptions just lead to different interpretations of who you should quarantine, and when, and for what purpose,” he said.
It would be far simpler, Rubin said, if more districts used a “modified quarantine” approach in addition to standard mitigation strategies. Schools would regularly test students and staff, and when they discover a positive case, they’d require everyone who was a close contact to wear masks, he said.
Utah was the first state in the country to require schools to use such an approach. Last spring, when it outlawed mask requirements, the legislature also required schools to use a “test and stay” approach. Once there are 30 positive cases in a school, or 2 percent of students test positive in schools of more than 1,500, test-and-stay kicks in. Everyone who refuses to test, or tests positive, goes home, and those who test negative can stay in school.
A federal study of Utah’s pilot program last year found that it preserved 109,752 student-days of in-person instruction. This summer, Massachusetts announced its own version of test-and-stay, but it isn’t triggered by a caseload threshold. Instead, it uses daily, individual rapid-antigen tests to determine who can stay in school and who must quarantine.
