Schools can mostly reopen safely, providing they take precautions like ensuring everyone wears masks, gets tested frequently and quarantines when they’re infected, the federal Centers for Disease Control has concluded.

The studies suggest schools can prevent on-campus infections by altering schedules to avoid mixing in large groups and preventing things like sporting events from turning into super-spreader events, the CDC concluded.

However, the advice hits Arizona just as one of the nation’s biggest surges in new cases has peaked and amidst a worrisome increase in the number of children hospitalized with the virus.

Moreover, epidemiologists nationwide are alarmed by the spread of several new strains of the virus that appear more easily spread among both children and adults. Experts worry the new strain could cause a third peak in infections before the slow-moving vaccine rollout can contain the pandemic.

The new CDC recommendation says studies show that schools operating with proper safeguards have not driven clusters of new cases. The cases that show up on campus mostly stem from cases in the community, rather than triggering new clusters.

But the advice hinges on both controlling the spread of the virus in the community and on avoiding things like crowded sports events that can trigger outbreaks, the CDC concluded.

On the other hand, hospitals in Arizona report a surge in admissions of people under 18 with serious symptoms from the virus. Most of the hospitalized teens recover and the death rate among teens and children remains far lower than among adults — especially adults older than 65. However, hospitals in Arizona have also reported the admission of a relative handful of children with a still mysterious inflammatory response after recovery from an infection. This inflammation can prove lethal.

The conflicting trends leave school districts in a quandary about reopening schools. Many have continued with distance learning only since the holiday break due to the ongoing spread of the virus in the community, with Arizona ranking as a national hot spot. About half the nation’s schools currently remain in distance learning mode.

Payson schools have a big advantage over most, since Gila County put teachers at the head of the list for vaccinations. About 75% of the Payson schools faculty will receive their second dose of the Moderna vaccine this week. Most teachers statewide haven’t even received the first shot yet.

On the other hand, a quarter of the staff decided not to get a shot — which means they can still get infected on campus — since children don’t yet qualify for a vaccine.

The latest CDC advice relies on studies of the spread of the virus in schools that have resumed in-person classes since last spring. Last spring, virtually all the school districts in the country shut down when the pandemic first hit. Studies showed that students lost months of academic progress and suffered a rise in mental health problems, including depression and suicide. Experts fear the loss of contact with teachers and peers may have long-term impacts, including a big increase in drop-out rates and a decline in college attendance rates.

During the fall term, roughly one-quarter of districts remained in distance learning mode and another quarter resumed in-person classes. The rest relied on some hybrid system — with a mix of in-person and online classes to reduce the number of students and faculty mingling on a daily basis. About half of all school districts resumed their sports programs, according to figures compiled by the CDC.

Payson schools resumed in-person classes in the fall, but had to shut down the high school and middle school campuses for an extended time when reported cases forced so many teachers to quarantine the district couldn’t find enough substitutes. The school board opted to remain in distance learning mode until Feb. 9, when the staff who opted for a shot will have 95% protection from infection. The vaccination apparently can reduce the severity of the symptoms, even for the 5% of cases in which someone who has the shot still gets infected.

The CDC bulletin included the results of two different studies — one alarming and one mostly reassuring.

In one study, a high school wrestling tournament in December in Florida turned into a super-spreader event, leading to 79 infections and one death. The tournament brought together 10 schools and 130 athletes and coaches. Nearly a third ended up infected. Thirty-eight of those infected transmitted the virus to 41 other people not at the tournament. The event led to the loss of 1,700 in-person school days as people and their close contacts went into quarantines of between 10 and 14 days.

On the other hand, a study in Wisconsin concluded normal, on-campus classes in the fall did not result in a noticeable increase in transmission, the CDC concluded.

The researchers analyzed the patterns of spread in 17 elementary and secondary schools in rural Wisconsin, where students and staff routinely wore masks on campus. The infection rate in the schools was actually lower than the infection rate in the surrounding community. Not only are children less likely to get infected or spread the disease once they are infected, but the students and staff were more likely to wear masks on campus than off campus. The analysis found that during 13 weeks in the fall of 2020 there were 191 infections detected in the 17 schools. Only seven of those were a result of in-school transmission.

Those results proved reassuring — but data from Arizona hospitals has sounded a countervailing note of caution.

Arizona hospitals filled up in the weeks after the holidays, treating a record number of COVID patients. At the peak of the surge, about 93% of the hospital beds in the state were full and many rural hospitals ran out of beds altogether. The rate of admissions has gone down in the past week.

The surge in patients included a worrisome number of children. Banner Health Systems reported a fourfold increase in pediatric admissions — a total of 795 teens and children younger than 18 since Oct. 1, according to a report in The Arizona Republic.

A University of Minnesota study looked at pediatric COVID-19 hospitalizations in 22 states with a total population of 29 million for the period from May 15 to Nov. 15. The study found a dramatic increase in Arizona’s pediatric hospitalizations in that time. Arizona and South Dakota had the highest rate of pediatric hospitalizations in the country, according to the research letter published in JAMA Pediatrics, a peer-reviewed medical journal.

Arizona hospitals also report an increase in a rare condition called MIS-C (multisystem inflammatory syndrome), which can occur in children months after they’ve recovered from a COVID-19 infection — even if they had few symptoms when infected. Doctors suspect that the virus triggers a potentially lethal immune system reaction. Banner has treated more than two dozen children with the condition.

So far the state has reported 1,323 hospitalized COVID-19 patients younger than 18 and 19 deaths — most of them older teens.

Those younger than 20 still constitute just 2.7% of hospitalizations for COVID and just 0.16% of deaths, making them the lowest possible risk group for the pandemic.

The Biden administration has urged schools to “reopen as quickly as possible” and vowed to provide schools with additional resources to vaccinate staff, do frequent testing, hire extra staff to reduce class sizes and the mixing of students, sanitize facilities, provide masks and operate safely.

The surge in new cases coupled with the slow rollout of the vaccination programs that has left most teachers and staff unvaccinated has complicated that call for action. Moreover, the Moderna vaccine hasn’t been fully tested in those younger than 18 and the Pfizer vaccine hasn’t finished testing for those younger than 16. If the tests show the vaccines also protect children with minimal side effects, they’ll become eligible for a shot — but that will likely not happen until late in the current school year.

Teacher groups across the country have also been resisting a return to in-person classes without a vaccine for staff or other protective measures — like testing, masking and schedules that keep children in “pods” to minimize their mixing during the day. Studies show that elementary schools can operate much more safely than middle schools and high schools, but most districts have tended toward an all-or-nothing model — either all grades in person with normal schedules or everyone in distance learning mode.

The just-passed second COVID-relief package includes about $52 billion to provide ongoing help for schools districts. The Biden administration is pushing for a third installment, which would include another $130 billion for schools — which amounts to several thousand dollars per student. However, prospects for passage of the full package appear dim at the moment.

Contact the writer at paleshire@payson.com

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(1) comment

Steve Brule

I'm 41 and got covid last February. It took me months to get back to normal and my lungs are permanently scarred. My wife is immune compromised so we were able to get our first dose of Moderna's vaccine and it we have lived to tell the tale so please for the sake of your community and your loved ones get the darn vaccine. It's 3 days of feeling kind of crummy then you're back to normal trust science not the fool rambling in a facebook group.

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