NBCT Teacher Justin Parmenter and microbiologist Dr. Nan Fulcher write here about North Carolina’s reliance on limited studies to justify reopening schools.
A Warning for Governor Cooper: the burden of COVID-19 in NC is far higher than in countries that struggled with school outbreaks after reopening
On Tuesday Governor Roy Cooper announced that North Carolina students will return to school for in-person instruction in August. Schools will be expected to follow distancing protocols and symptoms screenings will be done as students and staff enter school buildings. Also on Tuesday, North Carolina set new records for single day death totals and COVID hospitalizations.
On Saturday we wrote about the COVID-19 data that North Carolina school officials are mulling over. In analyzing the specific points presented by the North Carolina Department of Health and Human Services (NCDHHS) to the NC State Board of Education, we noted the scarcity of information on COVID-19 spread in schools, and the potential for misinterpreting the few studies that do exist.
In our article, we only addressed the studies cited by the NCDHHS that supported the statement “schools do not appear to have played a major role in COVID-19 transmission.”
We did not address the fact that the NCDHHS failed to include other data in their report — information about countries that had already reopened their schools prior to the end of the 2019-2020 school year.
To shed more light on reopened schools, we now highlight a recent New York Times (NYT) article, which was published the same day as our last blog article.
The NYT outlines critical considerations for reopening U.S. schools, citing much of the same research we analyzed — and identifying the same flaws.
In addition, the authors discuss what happened when countries reopened their schools following initial closure due to the first COVID-19 cases. Information about reopened schools was absent from the NCDHHS’s literature review. This data could have greatly helped to inform discussion about North Carolina’s plan for the upcoming school year.
The NYT article cites the report entitled “Summary of School Re-Opening Models and Implementation Approaches During the COVID 19 Pandemic, which was distributed by the University of Washington Department of Global Health (updated 7-6-2020).
To set the stage for analyzing the UW report, we generated some values that reflect the COVID-19 burden in each country at the time they reopened their schools. Because the studies had different methods for determining transmission rates, direct comparison of each country’s infection data was not possible.
Therefore, to illustrate the prevalence of COVID-19 in each country, we determined the number of new daily cases expressed as a fraction of the country’s total population. (For example, Denmark had 198 new reported cases the day schools reopened; that value divided by the total population of 5.8 million equals 0.34 cases/10,000 people)
Table 1. COVID-19 infection data from six countries on the date that schools reopened.
New daily cases on reopen date per 10,000 people
Denmark 0.22
France 0.01
Germany. 0.15
Israel. 0.1
Norway. 0.07
S. Korea. 0.01
In the UW report, the authors considered Denmark and Norway to be among the European countries with low community transmission, while Germany was considered to be “higher”. This conclusion doesn’t track with our calculations, but high variability among the number of new daily case reports at the time could account for the discrepancy.
As for the outcome of reopening schools, the UW report presented the following results: [*NOTE: each country employed different mitigation measures and different strategies for grouping students and determining which ages returned to school.]
Denmark and Norway – These two countries reopened schools gradually, starting with preschool and then all students six weeks later. This approach did not result in an increased rate of growth of COVID-19 cases in either country.
Germany – The return of older students later in the reopening process was accompanied by increased transmission among students; staff infection rates were equivalent to that of the general population. Individual schools were closed for quarantine as outbreaks occurred. Recently, Germany closed a small number of schools preemptively in response to local community outbreaks.
Israel – Schools adopted fewer social distancing measures due to crowding. After reopening schools, over 300 children and staff were infected within a month, with over 130 cases at a single school. Around 200 schools out of 5,200 were closed for quarantine during June, others remaining open through the end of the month.
South Korea – Soon after reopening, schools near a warehouse facility outbreak were closed and other schools postponed reopening. Other closings have occurred in response to other small community clusters. No reports of school-related infections have been reported to date.
France – There were no publications on the outcome, but news accounts indicate that, despite a small number of cases (70 per 1.2 million students) after gradual opening in mid-May, cases have subsided and schools have fully reopened with no additional outbreaks.
The overall conclusion from UW was that reopening schools in countries where community transmission was low did not increase overall spread, but opening schools in countries where community transmission was higher correlated with school outbreaks and subsequent school closures.
To consider how reopening U.S. schools will compare to the other countries’ experiences, we looked at the current data for new daily cases for the entire country and for North Carolina (Table 2).
Table 2. Current COVID-19 infection data (7-11-2020) for the United States and North Carolina.
New daily cases per 10,000 people, 7-12-20
United States 1.87
North Carolina 2.35
It’s clear that none of the countries that reopened schools in late spring had anywhere near the extent of COVID-19 that’s present in the U.S.
Further, the value for new daily cases from each country that reopened schools (with the exception of Israel) continued to decline after school was back in session.
With transmission rates continuing to rise in the U.S. and in North Carolina, the number of daily new cases in both places could double by the time school starts on August 17th.
If the experience of other countries holds true — that COVID-19 spread in reopened schools reflects the prevalence of the infection in the community — reopening schools where the number of active cases is high would present an enormous risk for students and staff in those areas.
Even if children don’t pass along SARS-CoV-2 as easily as adults, there could still be a significant increase in spread among students and their families in communities hardest hit by COVID-19.
NC school officials urgently need to consider the lessons from other countries’ school reopening experiences, and look at the pace at which the virus is spreading right now … and where it’s predicted to be this fall and beyond.
Nan Fulcher earned her Ph.D. in Microbiology and Immunology from the University of North Carolina, specializing in infectious disease research. She’s involved in science and outdoor education programming for children and does freelance graphic design.
Diane Ravitch's blog 
Screenings?
Those who have temperatures?
Those who have the sniffles?
On any given day, 20 percent of the school would be turned away at the door–of the students, of the teachers, of the staff, of the administrators.
And what about those who are asymptomatic but spreading the virus like crazy?
The conversations about this topic are ridiculous. Until we have N95 is insane to reopen. It makes sense only if you are OK with large numbers of students, teachers, and others connected with our schools dying or having long-term consequences, such as neurological problems, from having had Covid-19.
Two months in, everyone will be backtracking, but by then we will be in the midst of the school-caused massive surge in infections and deaths.
OBVIOUSLY
Just received a note from my brother in Indiana. Teachers in Greenfield were called to a meeting and told that school would reopen as usual in four weeks. On the back of that notice was a waiver that they were required to sign, saying that they would not sue the district if they got sick. Two of the thirty teachers in attendance signed it. The rest refused to do so.
MORE OF THIS!!!!
Of course, Mitch McConnell, who represents one of the poorest states in the Union, has already announced that he will refuse to allow to move forward any second stimulus package that does not include a blanket waiver of responsibility for employers. You can always count on Mitch to look out for the interests of the ownership class.
Has anyone asked these states, cities, school boards what they will do when they don’t have enough teachers willing to risk theirs, their students’, support staff and families lives?
Haven’t school districts already been facing teacher shortages? If you have children, are you willing to take the risk? Are you willing to send your children into a dangerous situation with a teacher with no experience and little training – who may not stick around when they discover just how hard the job is?
This is dangerous. This is irresponsible. It’s unlikely there will be additional federal dollars. This makes no sense. This is wrong.