Central Texas schools operating as sites of infection
Last week, Dr. Mark Escott of Austin Public Health shared some shocking Covid-19 positivity rates in school-age children. The positivity rates for elementary, middle, and high school students were 19.8%, 27.1%, and 20.2%, respectively; all of which were greater than the 17.8% positivity rate for Austin/Travis County. The numbers stand in stark contrast to the dangerously misleading and incessant claims that schools are somehow safe spaces during the pandemic.
Schools are not safe during the pandemic. Schools are where students, teachers, and staff come together indoors for extended periods of time. Masking and strict social distancing practices can help reduce the likelihood of transmission, but their effectiveness wanes the longer students are stuck indoors with others. When an infected student comes into school, other students, teachers, and staff members are put at risk of contracting the disease. If a highly infectious person comes into the school, a potential superspreader event is seeded. And the greater the level of community spread of Covid-19, the greater the likelihood that infected people are entering into the schooling environment. That likelihood is greater now than it has been any other month of the pandemic. And each person who gets infected in school then takes the disease back into the local community, and into their home. Schools are currently operating as sites of infection.
While in much of the United States “the rate of community spread of COVID-19 remains the primary benchmark that school and district administrators use to decide whether to move from in-person to hybrid or remote learning,” in Austin, TX, schools remain open despite high levels of uncontrolled community spread. Austin Public Health moved the county into risk stage level five, the highest stage of risk, on December 23rd. Since then, the 7-day averages of new confirmed cases and hospital admissions have increased by about 50%, while the numbers hospitalized, in the ICU, or on a ventilator have doubled.
At risk stage level five, Austin Public Health encourages everyone to avoid all gatherings with those outside of their household, to avoid non-essential travel, and to avoid in-person dining and shopping. Businesses are encouraged to close their doors to the public and operate only through contactless options such as curbside and delivery. In this pandemic context, schools are akin to businesses, and they should also close their doors and operate remotely during risk stage level five.
But because Austin Public Health has no authority to mandate that people follow their recommendations, and because individuals and institutions have largely ignored them, they occasionally make appeals for modified practices that can slow down the spread of the disease. Dr. Escott did that coming into the new calendar year, asking multiple times for middle and high schools to go virtual for two weeks following winter break. Every school district in Central Texas ignored the request. They also ignored requests to avoid using buses and carpools to transport students to and from school, and they even allowed indoor extracurricular sports to continue. Instead of committing to help fight the spread of Covid-19, Central Texas schools waived the white flag of surrender. They came to the point of surrender due to evolving societal pressures external to the school.
Three general responses to the pandemic
As the Covid-19 pandemic came to the United States early last year, and grew, we saw society breaking into three groups: the believers, the disbelievers, and the wait-and-see-ers.
The believers did not need to be convinced that a pandemic was afoot, and immediately began to take in as much information as they could. They watched the reports coming out of China, South Korea, Italy, and other places where the disease was popping up and quickly spreading. They read what governments, non-governmental organizations, and public health officials were putting out, and then they dove into the literature that was being published for journals when it began to trickle out. They focused on proactively planning and implementing practices that they could employ individually or institutionally to help limit the spread of the disease. The believers wore masks as soon as it seemed that they may help prevent spread, and they stayed home when possible. Those believers in charge of businesses, schools, and other places where people congregate shut down and waited for better guidance on how they could operate without putting public health at risk. The believers encouraged those in their communities to engage in safer practices such as hand washing, masking, physical distancing, and minimizing non-household interactions by staying home or forming dedicated pods. The believers skeptically observed the quick development and approval of vaccines, but read about the clinical trials and the approval process, and soon became proponents of vaccination as a quicker pathway to herd immunity and an end to the pandemic.
The disbelievers, on the other hand, accepted from the earliest days that there was nothing to be concerned about. Fueled by a malevolent President and his followers, longstanding attractions to conspiracy theories, or a distrust of the intentions or messaging of medical and governmental institutions, the talking points of the disbelievers shifted often. With an eye on Facebook, many of the disbelievers latched onto any contradictions they could find, even if the sources of the contradictions were outdated (e.g., CDC guidance on masks) or deliberately misleading (e.g., 99.97% survival rate). The disbelievers were not only those on the political right, they included plenty of progressives and libertarians who felt that healthier living was sufficient to fight disease, upper middle class and affluent folks who feared losing some of their privilege, and people who had a justified mistrust of government because of prior abusive responses to disease or crisis (e.g., Tuskegee Syphilis Experiment). Many of the disbelievers flooded social media with misleading posts that twisted or dismissed the truth about the sources of the pandemic, how the disease spreads, the severity of the disease, and the existence of miracle cures that justified not taking the pandemic seriously. The disbelievers argued that we must not live in fear — that the mental health and economic costs of fighting the pandemic were too great a burden to bear. The disbelievers not only demanded the right to go into public in ways that put people at risk of catching the disease from them, they demanded a full reopening of society to include no limitations on the manner in which people may congregate indoors in private or public spaces (e.g., restaurants, bars, schools). The disbelievers often mocked the believers who chose to stay home or wear masks, with plenty of them coming together for anti-mask rallies and protests (including forcing their way into private businesses unmasked).
The wait-and-see-ers, meanwhile, tended to recognize that Covid-19 was real, but felt that they could put their trust in the government and businesses to do what would be necessary to bring the pandemic under control. While the growth of the pandemic may have been concerning, normalcy bias led them to a state of inaction as they found themselves stuck in the middle between the believers and the disbelievers. They were not the most eager to implement safer practices that could protect others, but they were not going to go out of their way to act with a complete disregard to safer practices.
Schools as a battleground
Since the earliest stages of the pandemic there has been a fierce cultural battle between the believers and nonbelievers over how schools should respond to Covid-19, while the wait-and-see-ers played a crucial but underappreciated role in shaping the ways in which schools would contribute to the worsening state of the pandemic.
Last spring, the believers who initially had significant influence over the operations of many public school systems felt compelled to move quickly to protect their school communities and public health given preposterous statements being made by the President such as, “This is a flu. This is like a flu,” and “One day, it’s like a miracle, it will disappear.” Northshore School District in the State of Washington was the first large school district to temporarily close on March 5th. On March 12th, Ohio was the first state to shut down all schools for a two week period. And on March 17th, Kansas became the first state to shut down schools for the year. Over the coming weeks much of the rest of the country would follow suit. On April 17th, Texas finally announced that they would close schools for the remainder of the academic year.
As schools closed their doors, the debate over the role of schooling and the schools’ responses to Covid-19 began. Schooling, which had long been accepted as a necessary and immutable institution, suddenly came into sharper focus. More specifically, the purpose of schooling came to the fore of public conversation. Was schooling expected to be a place where kids went for the day for instruction, access to food (for kids in lower income families), or babysitting (for parents who worked)? Or was schooling a process applied to kids that could be done through classrooms, Zoom rooms, or personalized learning apps? The believers were all over the place in their conceptions of what the purpose of schooling was, while the disbelievers tended to focus on schooling as a place-based service. The wait-and-see-ers just waited while the debate that turned into an ideological struggle played out.
The debate over the decision to close schools evolved rather quickly. In a matter of weeks, without any meaningful training, educators were forced to try to figure out how to transition to online schooling. Because so much of conventional schooling is classroom management, too many teachers tried to manage children at home the way they do in school. Parents and guardians already struggling from job losses, or in fear of losing their jobs, felt they were suddenly forced into the role of teacher’s aide (or even teacher), expected to invest time and energy during the day to help their children navigate and comply with online schooling.
Initially, the closures had two distinct impacts on the perception of schooling by the general public. For one, it led to an initial lionization of teachers. Embedded in complaints about their children’s unwillingness to do schooling (during a pandemic), parents and guardians praised teachers for doing the seemingly impossible with kids. People celebrated teachers as vital essential workers; heroes even. For a moment, there were calls to immediately raise the pay of teachers. However, simultaneously, online schooling at home opened the eyes of many to woefully uninspiring content of schooling, and many of the disturbingly authoritarian and punitive practices of schooling. With many schools mandating dress codes for children at home, forcing kids to turn on their cameras for Zoomschooling, and punishing kids for not completing their schoolwork, many parents became concerned about the impacts of online schooling on their children, and many kids started to check out. While this could have led to a wonderful debate about what schooling could be, the disbelievers and most wait-and-see-ers just assumed that the fix to the struggles of online schooling at home was in-person schooling on campus. But most teachers did not want to go back. They justifiably argued that their health should not be sacrificed for the game of schooling. This led to attacks from disbelievers and many wait-and-see-ers. In the eyes of the public, they quickly went from heroic essential workers to selfish, lazy teachers. School leaders and administrators were blasted for kowtowing to the demands of teachers unions, and they received pressure from politicians at the local, state, and federal levels, as well as the business sector, to develop plans to reopen schools in September.
After the first wave in the spring, and a second wave in the summer, one would think that the ranks of the believers would swell while the ranks of the disbelievers and the wait-and-see-ers would shrink. But not in the United States. Pandemic fatigue compelled many believers to drift into the wait-and-see-ers camp, and the impatience of many wait-and-see-ers who longed for life to “go back to normal” started latching onto the disbelievers’ talking points. While the presidential campaign season moved many Republicans and Trump supporters firmly into the disbeliever camp, back to school season moved many nice white parents into the disbeliever camp, as well. Of particular note were the vocally anti-Trump, high earning, self-described liberal parents. They bemoaned the plight of children who would not have access to computers or reliable internet and would therefore suffer from online schooling. And the kids who needed school lunch for their daily sustenance. And all those Black kids and poor kids who were going to suffer from learning loss. The same Black kids and poor kids who were most likely abused at home, whose only refuge was the loving concrete arms of the school. It was remarkable how concerned they got about all those kids when faced with the prospect that their own kids’ affluent public and private schools might operate remotely.
Responding to the growing expectations that schools would be open in the fall, as well as concerns over funding (i.e., seat time for public schools, tuition for private schools), school administrators and educators worked furiously to make their schools Covid-safe for opening day, or at least to give the illusion that they would be. They bought hand washing stations, erected plexiglass barriers around desks, and they broke out the measuring tape and painter’s tape to make sure that each student would be no closer than 6 feet from any other student while seated in class (and then they shifted it to 3 feet when they ran out of space). It was an exercise in security theater, but it worked as intended. It gave politicians cover for arguing that schools were the one place where large numbers of people could congregate indoors for hours a day without fear of spreading Covid-19. So while different regions of the country debated whether or not shopping malls, restaurants, bars, and fitness centers could be open, usually debating along party lines, there was bipartisan support for the reopening of schools. The only people who objected to the school reopening plans were the believers and those pesky teachers who kept asking if the rhetoric about schools being safe for kids somehow erased them from the conversation.
When the schools reopened in the fall, the believers braced for an explosion in cases, while the disbelievers quickly pounced on a short-lived decrease as proof that schools were safe. That many school districts delayed their reopenings, and that many families refused to send their kids to school and opted instead for remote learning seemed immaterial to the argument of the disbelievers. The disbelievers eagerly spread opinion pieces saying that all schools must reopen immediately (for the sake of the children, especially the Black and poor children, or for the sake of the economy), and conveniently ignored steadily increasing cases, reports of outbreaks in schools, and teachers dying. The disbelievers jumped on articles about the lower rates of infection and spread among children, and as they did, more and more wait-and-see-ers became believers as they were convinced that schools were safe. The disbelievers’ constantly shifting standard for what qualified as “safe” was lost in the national debate. And in the eyes of the popular media it was settled: schools were safe, kids needed schools — especially those Black and poor kids, and that’s why the local affluent schools needed to be fully reopened (with a full slate of school sponsored sports, of course).
But as more and more schools reopened, and temperatures dropped, the cases continued to grow. Schools were having to periodically shut down because of outbreaks, sports teams had to cancel competitions because of infections, and in spite of the magical immunity of schools, teachers and staff kept getting sick. Schools could not continue to operate in-person under those circumstances, so the schools simply changed the standards for coming together. They raised the positivity rate cutoffs as local positivity rates increased, they allowed people to test out of quarantine and isolation, and they lowered education and training requirements for substitute teachers to stand in for those who were exposed. A willful ignorance rushed over the disbelievers and wait-and-see-ers as public health officials begged people to stop congregating indoors with others. The disbelievers dismissed the pleas, and the wait-and-see-ers did not even question if it was applicable to schoolhouse settings. And as the daily death toll in the country once again passed 2,000 (November 19th), and then 3,000 for the first time (December 9th), and then 4,000 (January 7th), OpEds and Facebook feeds continued to defend the practice of in-person pandemic schooling.
A lack of urgency, a lack of imagination
As we continue to suffer through the worst wave of the pandemic (new cases and hospitalizations are finally decreasing, and deaths have leveled off at around 3,000 per day) we must collectively choose to prioritize inconvenient but safer practices for the sake of public health. The refusal of Texas schools to remain closed post-holidays has and will most certainly contribute to new cases, hospitalizations, and deaths. What the disbelievers and the wait-and-see-ers too often ignore is that a single new infection can lead to tens of thousands of downstream infections thanks to the dispersion factor (k) of Covid-19, and even the “safest” schools are sites of infection. With vaccines finally available to help move us toward herd immunity, now is not the time to throw up our hands and say this is just too hard; now is the time to double down on our efforts in the midst of the worst phase of the worst pandemic in a century so that we can bridge the gap between now and then with minimal new infections and deaths.
Unfortunately, then is June, July, August, or later. And between now and then things could potentially get worse before they get better. One, too many disbelievers refuse to acknowledge the remarkable life saving benefits of the vaccines that are being rolled out, and will refuse to get vaccinated. Their refusals will help delay the point at which we hit herd immunity. Two, too many of those who will get vaccinated, including many believers, will act as though it is safe to revert to pre-pandemic type practices such as no longer masking, potentially leading to more, not fewer infections. What many do not get is that there is still a small chance that a vaccinated person can still get infected, and it may be possible that people can still spread the virus even if they do not contract the disease. Three, there is no approved vaccine for school-age children and adolescents, yet. Four, the B117 coronavirus variant that has done such harm in England, and that is more transmissible than prior strains, particularly in children, may become dominant in the United States. This is all to say that a fourth deadly wave is not necessarily out of the question (and people have been contracting the disease and dying in between waves).
Believing that it could be safe to open schools now, or within the first 100 days of the Biden presidency, conveniently ignores that we are still in the worst phase of the pandemic with uncontrolled community spread of the disease the norm across the country, that about 5% of vaccinated teachers will not be immune to the disease, and that placing teachers in classrooms with a bunch of unvaccinated students is the opposite of safe. Given the situation that we are in, and the potential that it can still get worse, schools should be closed right now and should stay closed for the rest of this academic year. But too many have given up the fight against Covid-19, becoming disbelievers or wait-and-see-ers who are willing to trade needless death and suffering for convenience. The people who are making the decisions to keep schools open fall into that category. As groups, they do not deem the benefits of just keeping people out of schoolhouses over the next several months worth the costs, even though the costs to society of doing so are miniscule relative to the costs of keeping schools open. It is a lack of urgency, and it is also a lack of imagination.
Schools across the country could have implemented two very simple practices that would have allowed them to bring students and teachers together without contributing to the growth of the pandemic. All they had to do was (1) mask up, and (2) leave the schoolhouse behind and meet entirely outdoors. It would have been that simple. Sure, it might have been frustrating to be outdoors in hot, cold, or rainy conditions, and they would have had to cancel school during inclement weather. And without a doubt it would have been inconvenient to secure space and to support the needs of the classroom outdoors (e.g., electricity, wifi). And yes, the schools would have had to figure out how to modify processes such as food delivery and transportation. But by simply decentering the schoolhouse as the place where schooling happens, they could have freed themselves to imagine better ways of being together during a pandemic.
Imagine how much better schooling could have been. Maybe schools would have been able to better define what constitutes a safe classroom, and maybe they would have come up with better solutions than having kids from the same household spend their days in different outdoor classrooms. Maybe they would have realized that the rigid curriculum they subscribe to would not take advantage of the opportunities to be outdoors, and is insufficient to support kids during a pandemic, and maybe they would have moved away from the curriculum. Maybe they would have made more time for exploration and free play under the sun, as well as time for relationship building.
And going outdoors is still the solution to pandemic schooling. It is not too late. If schools must bring students, teachers, and staff together they should do it outdoors. It is the best way to support kids during a pandemic, and the best way to prevent the trauma that comes from a student finding out that their teacher died from Covid-19 or that they brought the disease home to their family. Taking schooling outdoors is the best way to support the teachers who should not be needlessly risking their lives when there is a feasible and accessible alternative to in-person, indoor schooling. And taking schooling outdoors is the best way to contribute positively to public health. It’s also the one solution that would be workable for the believers who want to stop the spread of the disease, the disbelievers who want children out of the house and in school, and the wait-and-see-ers who continue to wait for something better.
Update 2/23/21: In the original essay I wrote “What many do not get is that a vaccine that is 95% effective means that it does not work for 1 in 20.” That was incorrect. Rather, with a vaccine efficacy rate of 95% (which is about what we have with Moderna and Pfizer vaccines) there is a 95% lower risk of getting Covid-19 (as determined by showing symptoms) with the vaccine than without (under experiment conditions). Further, the vaccines were 100% effective at preventing severe disease or death after the vaccine took full effect. This is all the more reason for everyone to get vaccinated if they can, yet we must still recognize that vaccinated people may be able to serve as vectors of the disease. Learn more about the calculation of efficacy in this recent The Lancet article.