{"id":29,"date":"2020-11-05T20:35:33","date_gmt":"2020-11-05T20:35:33","guid":{"rendered":"https:\/\/covidqanda.org\/?p=29"},"modified":"2020-11-30T09:50:38","modified_gmt":"2020-11-30T14:50:38","slug":"are-school-re-openings-leading-to-increased-community-spread","status":"publish","type":"post","link":"https:\/\/covidqanda.org\/?p=29","title":{"rendered":"Are school re-openings leading to increased community spread?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\" id=\"0458\"><strong>Question:<\/strong>&nbsp;Any thoughts of correlation of record high national cases and schools being open? I see a lot of schools are not spreading the virus stories but also that kids can be asymptomatic spreaders. It is confusing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"4075\"><strong>Answer:<\/strong>&nbsp;When reopened with appropriate risk mitigation measures, schools (K-12) seem to be low-risk transmission environments (see&nbsp;<a href=\"https:\/\/covidqanda.org\/?p=127\">Q&amp;A of 10\/13&nbsp;<\/a>#Reopening and recent research from Spain&nbsp;<a href=\"https:\/\/biocomsc.upc.edu\/en\/shared\/20201002_report_136.pdf\">here<\/a>). But we still don\u2019t have a good picture of schools and risk because we\u2019ve done a terrible job collecting, analyzing, and sharing comprehensive data on schools. In fact, my friend and public health expert, Dr. Nirali Chakraborty, wrote a commentary on this very issue published yesterday in the&nbsp;<em>Baltimore Sun, \u201c<\/em><a href=\"https:\/\/www.baltimoresun.com\/opinion\/op-ed\/bs-ed-op-1105-covid-data-private-schools-20201104-ucuvawgwmzftnfqoonzzaw22ry-story.html\">Private schools could teach public systems about COVID \u2014 if they\u2019re willing<\/a>.\u201d To further elaborate, let me start with three pieces of information that were unknown earlier in the pandemic:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Children can contract and spread the virus (some relevant research is&nbsp;<a href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/69\/wr\/mm6940e2.htm\">here<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/science.sciencemag.org\/content\/early\/2020\/09\/29\/science.abd7672\">here<\/a>, more background is in our&nbsp;<a href=\"https:\/\/covidqanda.org\/?p=245\">Q&amp;A for 9\/2<\/a>&nbsp;#Kids);<\/li><li>High-risk transmission settings are those that include closed spaces, crowded places, and\/or close-contact settings (see&nbsp;<a href=\"https:\/\/covidqanda.org\/?p=56\">Q&amp;A for 10\/30<\/a>&nbsp;#3 Cs); and<\/li><li>Most of the SARS-CoV-2 transmission occurs in the home among family units, however, these individuals are less likely to infect others outside of their homes. The bigger spread comes from bursts where one person infects many (e.g. super-spreader events) (see&nbsp;<a href=\"https:\/\/covidqanda.org\/?m=20201009\">Q&amp;A for 10\/9<\/a>&nbsp;#Overdispersion, and some relevant research published in&nbsp;<em>Nature<\/em>&nbsp;<a href=\"https:\/\/www.nature.com\/articles\/s41591-020-1092-0\">here<\/a>&nbsp;and&nbsp;<a href=\"https:\/\/www.nature.com\/articles\/s41467-020-18836-4\">here<\/a>).<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"7460\">Taking this information into account, we can surmise that schools as we knew them pre-pandemic \u2014 closed spaces, crowded places, close-contact settings \u2014 meet all the criteria of being potential high-risk transmission sites (e.g. super-spreader sites). So when we\u2019re talking about school reopening, we have to put it into context. Are we talking about reopening schools as they were pre-pandemic? If so, the transmission risk is high, particularly in areas with moderate to high levels of community transmission. But to my knowledge, that\u2019s not what we\u2019re talking about. We\u2019re talking about school reopening in the context of risk mitigation measures. Then the question becomes \u2014 in the context of limited resources, which risk mitigation measures are the most effective?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"3dd5\">And this is where we need better data across the country from public and private schools \u2014 on mitigation measures implemented, protocols adopted, case counts, school-based transmission, and more. Individuals are trying to fill the gap, but their data are limited and include only those schools that opt-in (<a href=\"https:\/\/covidqanda.org\/?p=127\">Q&amp;A of 10\/13<\/a>&nbsp;#Reopening). We need our local, state, and federal governments to help us make informed decisions! As Dr. Chakraborty wrote in her commentary about Maryland (but it\u2019s applicable to any state, in my opinion),<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p><em>\u201c\u2026 the state of Maryland should be leading the way for governmental data reporting standards, building the trust that is so needed among parents, teachers and school systems so that our children can be back in school, where they belong. Many parents are being asked to make the decision of whether to send their children back to a hybrid model, or remain virtual\u2026 parents, striving in an information void, to make the best decisions they can. Fill the void, and more children may return to school.\u201d<\/em><\/p><\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"2e05\">Finally, a&nbsp;<a href=\"https:\/\/biocomsc.upc.edu\/en\/shared\/20201002_report_136.pdf\">recent working paper<\/a>&nbsp;(not yet peer reviewed) written by scientists at Spain\u2019s Universitat Polit\u00e8cnica de Catalunya explored whether community infection rates were correlated with school reopening in Spain, concluding that school reopenings were not associated with increased incidence of community transmission. As described in a related&nbsp;<a href=\"https:\/\/www.npr.org\/2020\/10\/21\/925794511\/were-the-risks-of-reopening-schools-exaggerated#:~:text=8.-,A%20recent%20study%20found%20no%20link%20between%20coronavirus,school%20reopenings%20in%20the%20country.&amp;text=Despite%20widespread%20concerns%2C%20two%20new,the%20spread%20of%20the%20coronavirus.&amp;text=%22Going%20to%20school%20is%20really%20vital%20for%20children.\"><em>NPR&nbsp;<\/em>report<\/a>, schools in Spain reopened with numerous safety measures, including \u201cmask-wearing for all children older than 6, ventilation, keeping students in small groups or \u201cbubbles,\u201d and social distancing of 1.5 meters \u2014 slightly less than the recommended 6 feet in the United States. When a case is detected, the entire \u201cbubble\u201d is sent home for quarantine.\u201d These findings add to the growing evidence-base that when reopened with appropriate risk mitigation measures, schools (K-12) seem to be low-risk transmission environments.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" id=\"0ae3\">To conclude, I think that we\u2019re generally talking about schools and risk incorrectly. I see so many questions like, \u201cAre schools safe?,\u201d when we need to be asking, \u201cWhich mitigation measures should we mandate for schools to safely reopen, especially in the context of limited resources?; Of the schools that have reopened successfully, what have they done?\u201d Comprehensive, publicly available data are required to answer these key questions and ultimately get our children and teachers safely back into school buildings!<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Question:&nbsp;Any thoughts of correlation of record high national cases and schools being open? I see a lot of schools are not spreading the virus stories but also that kids can be asymptomatic spreaders. It is confusing. Answer:&nbsp;When reopened with appropriate risk mitigation measures, schools (K-12) seem to be low-risk transmission environments (see&nbsp;Q&amp;A of 10\/13&nbsp;#Reopening and [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":32,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[85,13],"tags":[15,14],"class_list":["post-29","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-children","category-school","tag-mitigation","tag-reopening","fallback-thumbnail"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/i0.wp.com\/covidqanda.org\/wp-content\/uploads\/2020\/11\/November-5.png?fit=621%2C539&ssl=1","_links":{"self":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/29","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29"}],"version-history":[{"count":4,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/29\/revisions"}],"predecessor-version":[{"id":874,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/29\/revisions\/874"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/media\/32"}],"wp:attachment":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}