Can we safely reopen our schools?
That question has barged to the top of the list of pandemic priorities, with Payson schools set to start distance learning on Aug. 3 and the state-mandated in-person classes starting on Aug. 17.
Epidemiologists say safe reopening of schools depends on two things.
First, is the spread of the virus in the surrounding community under control?
Second, can schools provide enough masks and tests to detect infections quickly?
Alas, Arizona and Gila County in particular haven’t come close to meeting either of those criteria.
For starters, the virus is widespread and still spreading.
For weeks, Arizona has led the nation in documenting new cases. Moreover, Gila County has gone from being a quiet COVID-19 backwater to infection rates approaching the statewide average.
There’s one slender sliver of good news on that front. The relentless rise in new cases may have eased in the past two weeks. On national databases, Arizona has moved from “rapidly rising” to “staying about the same.” Florida, Texas and even once-safe rural states like Idaho have now surged ahead of Arizona.
So how do we determine the spread has slowed enough to open schools?
Fortunately, epidemiologists have come up with one rough benchmark, based on the safe and successful reopening of schools in other countries.
The experts say schools should hold off opening as long if more than 5% of the COVID-19 tests come back positive.
That’s still a fuzzy standard, since it depends in part on who you’re testing. If you’re only testing people with symptoms, a high percentage will test positive. That’s because somewhere between 30% and 50% of people infected will never develop symptoms and so won’t show up for testing based on symptoms. For months, Arizona restricted testing to people with symptoms.
So how do we fare with positive tests?
Not so good.
Statewide in the past week, 14% of the swab tests to detect an active infection have come back positive. That’s one of the highest percentages in the country and a possible indication the virus is still spreading.
In Gila County, about 9% of the tests have come back positive — a big increase from the average of less than 5% before Gov. Ducey lifted his stay-at-home order on May 15.
Gila County so far has 479 confirmed cases and 12 confirmed deaths, many of them in a Payson nursing home. In the past four months, the labs and doctors’ offices and test sites have done 7,100 swab tests in the county of 52,000. About 5.7% have come back positive. But the rate of positive tests has risen sharply in the past two weeks.
Back in April, the state’s positive test rate was on the decline — despite the continuing rise in deaths and new cases. Gov. Ducey cited that decline as the reason to change the stay-at-home order. The percentage of positive tests has risen sharply since then.
At one point, Arizona’s positive test rate rose to 27%. At that point, we had the national record — with Florida at 19% and Texas at 14%. By contrast, New York’s rate had declined to just 1.1%.
Only about five states currently meet that positive-test percentage criteria for re-opening schools — especially when it comes to protecting teachers and high school students. Research shows elementary school students are less likely to get infected and much less likely to develop serious symptoms. High school students face a much greater risk, although not as great as their teachers, their parents or their grandparents.
State health officials hope the rapid spread of the virus after the economy partially reopened may finally be starting to slow. That means it’s possible the state’s percentage of positive tests may subside before the state-ordered restart of in-person classes on Aug. 17. Some educators hope Gov. Ducey will put off the mandatory start of classes for another month or more.
But that brings us to the second problem — performing enough tests to quickly detect an infection on campus.
One national database shows Arizona has one of the lowest per-capita test rates in the country. Even when you can get a test, people routinely wait for a week or two for the results. That makes the test close to useless if you’re trying to stop a potentially infected person from creating a cluster of cases in someplace like a classroom with 30 students all sharing the same air.
The COVID Tracking Project estimates that the U.S. is doing an average of 634,000 tests per day, but would need to do 1.6 million tests per day to adequately identify new cases and their potentially infected close contacts. That estimate’s based on studies done at the Harvard Global Health Institute.
Nationally, we’re testing 193 people per 100,000 people — about 39% of the targeted number of tests, according to a July 10 snapshot of the data. About 8% of those tests were coming back positive.
Arizona’s numbers looked much worse. We were doing 181 tests per 100,000, about 10% of the target rate, based on confirmed cases. The lack of sufficient testing was reflected in the 27% positive rate for tests.
The Harvard researchers said each state should have enough tests to check everyone with flu-like symptoms, plus 10 close contacts for each positive test. Only about 18 states are at least close to the recommended level of testing, by that criteria.
Public school advocates nationally have appealed for more resources to enable schools to safely reopen. That includes money to add teachers to reduce class sizes, more money for cleaning, more money for testing and a host of other resources. Some estimates suggest it would cost $200 billion to implement all those measures to protect some 50 million students and their teachers. The CARES Act included about $13 billion for schools, but only a portion of that money has so far been distributed.
Arizona District 1 Congressman Tom O’Halleran said he doesn’t think schools in Arizona are ready to reopen — based on the continued spread of the virus and the lack of masks, protective gear and tests.
“I think most school officials will tell you they’re not ready. They don’t have enough money to do everything they need to do,” he said.
He noted that Congress has passed the HEROES Act, with an additional $95 billion for schools as well as a $85 billion infrastructure bill, which could include things like improved ventilation systems for school buildings. He’s hopeful that negotiations in the U.S. Senate will result in a bipartisan bill that will provide schools with the resources they need to reopen.
“We need to move as fast as possible. I have the highest hope a bipartisan approach will work. We need to find common ground as we found common ground to help business. We’ve spent more than $3 trillion so far and to not follow through and waste all that makes no sense. People in Arizona are highly concerned. We’ve had about 26,000 emails and letters in the past two months. A lot of people are concerned and they have a perfect right to be concerned.”
O’Halleran concluded, “I don’t understand magical thinking that says, it’s just going to go away. It’s not going to go away. We have to give the schools the resources they need for an extended period — we can’t have them open and close and open and close. We have to stop making political decisions and start making decisions based on what the experts are telling us.