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Reopen K-12 - BostonCard - 10-11-2020

https://www.theatlantic.com/ideas/archive/2020/10/schools-arent-superspreaders/616669/

There doesn’t seem to be much spread in schools.  And while it is not a risk-free activity, the risk is low compared to the benefit.

BC


RE: Reopen K-12 - magnus - 10-11-2020

Many school districts around Seattle WA are welcoming kindergarteners back to school in the upcoming few weeks.   Testing percentage had been below 2% and 14 day cases per 100k was below 75 until a recent 200+ case UW Greek row outbreak.

WA Governor Inslee recently changed the youth sports guidelines so that most low to moderate risk sports (not including football,  basketball) are allowed to start scrimmaging again at the current levels. 

Hopefully that youth soccer study was accurate in showing that there was no noticeable infection increase with youth soccer participation.


lex24 - lex24 - 10-11-2020

Goes to the heart of a discussion the country can’t seem to honestly have.  The harm to low income kids that closing schools brings is obvious.  One would think with increased discussion on social justice issues that this would be at the top of the list.  But Trump was advocating for it.  Which means progressives must be against it.  Sadly where we are these days.


RE: lex24 - BostonCard - 10-11-2020

(10-11-2020, 09:53 AM)lex24 Wrote:  Goes to the heart of a discussion the country can’t seem to honestly have.  The harm to low income kids that closing schools brings is obvious.  One would think with increased discussion on social justice issues that this would be at the top of the list.  But Trump was advocating for it.  Which means progressives must be against it.  Sadly where we are these days.

I disagree that it is a reflexive reaction to the President.  Trump advocated for college football, and that has been allowed to restart, even in the liberal Pac-12 states.  I think this is about money.  K-12 education doesn't bring in any revenue, so there is no interest group whose business is entirely dependent on there being in person classes.  Thus, there is no interest group arguing loudly for restarting K-12 education (the teachers get paid anyways, and, at least in my kids' district, have been the loudest voices against restarting in person education).

Anyways, I have no compunction in saying that Trump is right on this.

BC


RE: Reopen K-12 - dabigv13 - 10-11-2020

Yes, it's about money. And plenty of Democratic led areas have in person schooling, so it is not a purely political issue. In areas where the prevalence is low, schooling should be able to proceed with appropriate safeguards. The problem is there is no one size fits all solution, and in the context of election season in a very polarized nation that necessarily scientifically informed nuance gets drowned out.


RE: Reopen K-12 - M T - 10-11-2020

Each individual family's risk tolerance (age, comorbidities, damage to family if things go bad) is different.  You might argue it is safe for 10%, 50%, 90% of the school families to send kids back to school (saying for them that your perceived likely health damage to them is less than your perceived marginal benefit for brick-and-mortar education over remote education), but I bet most of us want to make that decision for ourselves, given our own perceived risk and perceived positive/negative benefit.


RE: lex24 - akiddoc - 10-11-2020

(10-11-2020, 09:53 AM)lex24 Wrote:  Goes to the heart of a discussion the country can’t seem to honestly have.  The harm to low income kids that closing schools brings is obvious.  One would think with increased discussion on social justice issues that this would be at the top of the list.  But Trump was advocating for it.  Which means progressives must be against it.  Sadly where we are these days.

I work in the lowest income neighborhood in the Bay Area. Our zip code led the state in the rate of new Covid cases for several weeks recently. I have had positive Covid tests on over 30 kids in the last month. Most of their parents are sick as well. Several grandparents have ended up in the hospital. Although kids don't get as sick and they might not be as contagious, let's not fool ourselves into thinking there are no consequences for the poor. Their diets are of poor quality and their immune systems therefore are not of the same quality. One of our teen patients just barely survived a stay in the ICU. He has organ damage that may be permanent.

Every child in the Oakland School district has received a computer and I haven't met a family yet who hasn't found access to Wi-Fi. Sure, education is affected, but it is affected for everyone this year.


RE: Reopen K-12 - Farm93 - 10-11-2020

Wanna reopen schools (and keep them open)?
Wear those masks and treat COVID like a deadly, once in a century pandemic with the respect it has already earned.

Attending football games, going to beaches, hosting massive college house parties, and other similar things simply can't happen if schools are the priority.  Sadly, in the USA we have prioritized watching football, attending events in bars and restaurants, and a host of other activities that should be discouraged if we want a shot at keeping schools open.

The winter is rather easy to predict from here.   With schools open partially or not at all the working poor will need daytime childcare they can't afford.   In most cases that will mean the children will be at home on their own or will be with elderly family members in the area or they will cluster with friends possibly watching dozens of children.    Each method has problems for the children and/or the care providers and COVID will be one of the victors.


RE: Reopen K-12 - Goose - 10-11-2020

(10-11-2020, 10:39 AM)dabigv13 Wrote:  The problem is there is no one size fits all solution, and in the context of election season in a very polarized nation that necessarily scientifically informed nuance gets drowned out.
Absolutely correct, +1000. This is true of most of the public health decisions. That said, there is a lot of pressure to centralize these decisions. On this board, there are many people questioning why San Mateo County has different rules than Santa Clara County. Possibly a good question, but also possibly there are (many) good answers.


RE: lex24 - BostonCard - 10-12-2020

(10-11-2020, 07:21 PM)akiddoc Wrote:  
(10-11-2020, 09:53 AM)lex24 Wrote:  Goes to the heart of a discussion the country can’t seem to honestly have.  The harm to low income kids that closing schools brings is obvious.  One would think with increased discussion on social justice issues that this would be at the top of the list.  But Trump was advocating for it.  Which means progressives must be against it.  Sadly where we are these days.



I work in the lowest income neighborhood in the Bay Area. Our zip code led the state in the rate of new Covid cases for several weeks recently. I have had positive Covid tests on over 30 kids in the last month. Most of their parents are sick as well. Several grandparents have ended up in the hospital. Although kids don't get as sick and they might not be as contagious, let's not fool ourselves into thinking there are no consequences for the poor. Their diets are of poor quality and their immune systems therefore are not of the same quality. One of our teen patients just barely survived a stay in the ICU. He has organ damage that may be permanent.



Every child in the Oakland School district has received a computer and I haven't met a family yet who hasn't found access to Wi-Fi. Sure, education is affected, but it is affected for everyone this year.

While all of this is undoubtably true, the data provided in the original article suggests that kids are generally not becoming infected at school, and kids with hybrid or in person classes are no more likely to be infected with COVID-19 than kids who have a purely distant learning experience.  What appears likely is that the kids are getting sick from their parents, rather getting sick from each other and infecting their parents.

In the meantime, as you note, education is affected, as is the social/emotional development of kids.  Furthermore, a record number of (mostly) women have had to withdraw from the labor market altogether because a laptop and access to wifi is necessary but not sufficient to enable distance learning.

I am a firm believer in following the data.  If analysis of COVID-19 transmission to date had shown that there has been frequent spread of COVID-19 in in-person or hybrid school settings (and that the adult family members were getting sick from their kids), I would be much more hesitant towards endorsing in person classes, but the data is supportive of cautiously restarting in person classes.  The risks will never be zero, but in this case they are low enough and substantially outweighed by the benefits.

BC


RE: lex24 - JustAnotherFan - 10-12-2020

(10-12-2020, 08:24 AM)BostonCard Wrote:  
(10-11-2020, 07:21 PM)akiddoc Wrote:  
(10-11-2020, 09:53 AM)lex24 Wrote:  Goes to the heart of a discussion the country can’t seem to honestly have.  The harm to low income kids that closing schools brings is obvious.  One would think with increased discussion on social justice issues that this would be at the top of the list.  But Trump was advocating for it.  Which means progressives must be against it.  Sadly where we are these days.



I work in the lowest income neighborhood in the Bay Area. Our zip code led the state in the rate of new Covid cases for several weeks recently. I have had positive Covid tests on over 30 kids in the last month. Most of their parents are sick as well. Several grandparents have ended up in the hospital. Although kids don't get as sick and they might not be as contagious, let's not fool ourselves into thinking there are no consequences for the poor. Their diets are of poor quality and their immune systems therefore are not of the same quality. One of our teen patients just barely survived a stay in the ICU. He has organ damage that may be permanent.



Every child in the Oakland School district has received a computer and I haven't met a family yet who hasn't found access to Wi-Fi. Sure, education is affected, but it is affected for everyone this year.

While all of this is undoubtably true, the data provided in the original article suggests that kids are generally not becoming infected at school, and kids with hybrid or in person classes are no more likely to be infected with COVID-19 than kids who have a purely distant learning experience.  What appears likely is that the kids are getting sick from their parents, rather getting sick from each other and infecting their parents.

In the meantime, as you note, education is affected, as is the social/emotional development of kids.  Furthermore, a record number of (mostly) women have had to withdraw from the labor market altogether because a laptop and access to wifi is necessary but not sufficient to enable distance learning.

I am a firm believer in following the data.  If analysis of COVID-19 transmission to date had shown that there has been frequent spread of COVID-19 in in-person or hybrid school settings (and that the adult family members were getting sick from their kids), I would be much more hesitant towards endorsing in person classes, but the data is supportive of cautiously restarting in person classes.  The risks will never be zero, but in this case they are low enough and substantially outweighed by the benefits.

BC

Well we do not have good data on schools because many schools are not reporting, and many states are not collecting. The data that Oster uses is self reported, and I'm guessing the most irresponsible schools are not eager to fill out the survey. We also know that kids can catch and spread Covid. We know that many teachers and staff (and even some students) are at risk and even a low risk of infection is dangerously too high for them. We also know that most have families that they go home to. We know that when you mass people in indoor environments with stagnant or recycled air that the chance of spread goes up substantially. That there haven't been any documented superspreader sites at schools yet is hardly a compelling reason to reopen schools. Especially now, before flu season.

If we were to follow the data the schools would be operating outdoors.

Interestingly, a recommended article beneath the one from the OP was this one covering k: https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/

"Cevik identifies “prolonged contact, poor ventilation, [a] highly infectious person, [and] crowding” as the key elements for a super-spreader event."

Sounds like schools. Reopening schools at this point is playing with fire. Maybe Oster is right, and that schools only have some teachers and administrators dropping dead? Or maybe schools will become more frequent super spreaders, especially as more students come back to school and as complacency rises. Reopening the schools now us not a bet I want to take when playing with the lives of other people.


RE: lex24 - M T - 10-13-2020

(10-12-2020, 08:24 AM)BostonCard Wrote:  I am a firm believer in following the data.  If analysis of COVID-19 transmission to date had shown that there has been frequent spread of COVID-19 in in-person or hybrid school settings (and that the adult family members were getting sick from their kids), I would be much more hesitant towards endorsing in person classes, but the data is supportive of cautiously restarting in person classes.  The risks will never be zero, but in this case they are low enough and substantially outweighed by the benefits.

I don't know what you define as "frequent".   You mention data.  Can you please share that data?

Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities - Salt Lake City, Utah, April-July 2020
Quote:To better understand transmission from young children, contact tracing data collected from three COVID-19 outbreaks in child care facilities in Salt Lake County, Utah, during April 1-July 10, 2020, were retrospectively reviewed to explore attack rates and transmission patterns. A total of 184 persons, including 110 (60%) children had a known epidemiologic link to one of these three facilities. Among these persons, 31 confirmed COVID-19 cases occurred; 13 (42%) in children
...
Transmission was documented from these children to at least 12 (26%) of 46 nonfacility contacts (confirmed or probable cases). One parent was hospitalized. Transmission was observed from two of three children with confirmed, asymptomatic COVID-19.

The children were median age = 7 years; range = 0.2–16 years.

Of the 184 with links, half were asymptomatic & not tested.  I didn't see how many of the 110 children weren't tested. It is possible some cases were not detected.

13 of 110 children got infected, more than 10%.  R was approximately 1 for those children passing it on to others.

Contact Tracing during Coronavirus Disease Outbreak, South Korea, 2020
Quote:We analyzed reports for 59,073 contacts of 5,706 coronavirus disease (COVID-19) index patients reported in South Korea during January 20–March 27, 2020. Of 10,592 household contacts, 11.8% had COVID-19. Of 48,481 nonhousehold contacts, 1.9% had COVID-19.
... We grouped index patients by age: 0–9, 10–19, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and >80 years.
... We detected COVID-19 in 11.8% of household contacts; rates were higher for contacts of children than adults. These risks largely reflected transmission in the middle of mitigation and therefore might characterize transmission dynamics during school closure (3). Higher household than nonhousehold detection might partly reflect transmission during social distancing, when family members largely stayed home except to perform essential tasks, possibly creating spread within the household.
...We also found the highest COVID-19 rate (18.6% [95% CI 14.0%–24.0%]) for household contacts of school-aged children and the lowest (5.3% [95% CI 1.3%–13.7%]) for household contacts of children 0–9 years in the middle of school closure. Despite closure of their schools, these children might have interacted with each other, although we do not have data to support that hypothesis. A contact survey in Wuhan and Shanghai, China, showed that school closure and social distancing significantly reduced the rate of COVID-19 among contacts of school-aged children

Adolescent with COVID-19 as the Source of an Outbreak at a 3-Week Family Gathering — Four States, June–July 2020
13yo brings home COVID from a day camp.  Negative  Only symptom was a stuffy nose 2 days after a negative antigen test (4 days after exposure).  11 subsequent cases.  One hospitalized; another sought ER treatment.


RE: Reopen K-12 - BostonCard - 10-13-2020

From the article:

Quote:Since early last month, I’ve been working with a group of data scientists at the technology company Qualtrics, as well as with school-principal and superintendent associations, to collect data on COVID-19 in schools. (See more on that project here.) Our data on almost 200,000 kids in 47 states from the last two weeks of September revealed an infection rate of 0.13 percent among students and 0.24 percent among staff. That’s about 1.3 infections over two weeks in a school of 1,000 kids, or 2.2 infections over two weeks in a group of 1,000 staff. Even in high-risk areas of the country, the student rates were well under half a percent. (You can see all the data here.)

School-based data from other sources show similarly low rates. Texas reported 1,490 cases among students for the week ending on September 27, with 1,080,317 students estimated at school—a rate of about 0.14 percent. The staff rate was lower, about 0.10 percent.
These numbers are not zero, which for some people means the numbers are not good enough. But zero was never a realistic expectation. We know that children can get COVID-19, even if they do tend to have less serious cases. Even if there were no spread in schools, we’d see some cases, because students and teachers can contract the disease off campus. But the numbers are small—smaller than what many had forecasted.


It's not perfect data, but again, if school transmission were a major problem, we'd start seeing children in schools with a higher rate of COVID-19 than the surrounding areas, and teachers being infected more frequently than the general population.  It's not a reason to abandon all caution and declare that schools are absolutely safe, but it is a reason to cautiously reopen schools, particularly in areas of the country where the overall infection rate is low.

BC


RE: Reopen K-12 - M T - 10-13-2020

(10-13-2020, 03:54 PM)BostonCard Wrote:  From the article:


Quote: Our data on almost 200,000 kids in 47 states from the last two weeks of September revealed an infection rate of 0.13 percent among students and 0.24 percent among staff. That’s about 1.3 infections over two weeks in a school of 1,000 kids, or 2.2 infections over two weeks in a group of 1,000 staff.

BC, I suspect you must not have thought about those numbers.

They quote numbers like 0.13% and 0.24% yet those numbers aren't at the Qualtrics site.  The closest (but higher) numbers are for confirmed cases only.

The numbers in the data currently are (confirmed+suspected) 0.73% and 0.77%, 2-week periods).  COVID is infectious whether or not it is confirmed.

The Texas total numbers are muddied as the start dates vary per district.  Texas is only reporting test-confirmed cases. 

California defines its highest level of precautions (where schools may NOT open) as "widespread" (purple) with more than 7 daily new cases per 100K.

(confirmed, students) 0.151% for a 2-week period = 10.8 daily cases per 100K
(confirmed+suspected, students) 0.73% for a 2-week period = 52.1 daily cases per 100k.

(confirmed, staff) 0.28% for a 2-week period = 20 daily cases per 100K
(confirmed+suspected, staff) 0.77% for a 2-week period = 55 daily cases per 100K

Texas: (confirmed, students) 0.14% for a 1-week period = 20 daily cases per 100K.

Wow, that's high.


RE: Reopen K-12 - magnus - 10-15-2020

Here's a publication by several expert PH and epidemiologists with guidelines about risk assessment and testing protocols for K-12

https://www.centerforhealthsecurity.org/our-work/publications/risk-assessment-and-testing-protocols-for-reducing-sars-cov-2-transmission-in-k-12-schools

Haven't had a chance to read the whole thing so apologies for not highlighting


RE: Reopen K-12 - BostonCard - 10-15-2020

An article in Pediatrics showed that childcare centers (which is not the same as schools), but still shows that kids probably are not driving transmission to adult childcare workers.

https://www.latimes.com/world-nation/story/2020-10-14/preschools-and-daycares-dont-appear-to-drive-coronavirus-infections-new-national-study-shows

Quote:The study surveyed 57,335 providers serving almost 4 million children in two-thirds of the counties in the U.S., including Puerto Rico. It found that those who continued to work during the first three months of the pandemic were no more likely to have fallen ill than those who did not.

BC


RE: Reopen K-12 - magnus - 10-15-2020

(10-15-2020, 10:37 AM)BostonCard Wrote:  An article in Pediatrics showed that childcare centers (which is not the same as schools), but still shows that kids probably are not driving transmission to adult childcare workers.

https://www.latimes.com/world-nation/story/2020-10-14/preschools-and-daycares-dont-appear-to-drive-coronavirus-infections-new-national-study-shows

Quote:The study surveyed 57,335 providers serving almost 4 million children in two-thirds of the counties in the U.S., including Puerto Rico. It found that those who continued to work during the first three months of the pandemic were no more likely to have fallen ill than those who did not.

BC

So this means that if you are taking extra steps to avoid getting infected,  you should not send your child to school, right?


RE: Reopen K-12 - DocSavage87 - 10-16-2020

I just saw some recent data via talk that says: (1) viral load can be quite high in asymptomatic, even compared to symptomatic, and (2) viral load doesn't change much across age demographics, even at 1-10 yo category.  While #1 makes sense, #2 seems really odd to me given lack of transmission in schools as much as we'd expect.


RE: Reopen K-12 - M T - 10-16-2020

(10-16-2020, 12:40 PM)DocSavage87 Wrote:  I just saw some recent data via talk that says: (1) viral load can be quite high in asymptomatic, even compared to symptomatic, and (2) viral load doesn't change much across age demographics, even at 1-10 yo category.  While #1 makes sense, #2 seems really odd to me given lack of transmission in schools as much as we'd expect.
Where's the data behind your claim of "lack of transmission in schools"?


RE: Reopen K-12 - DocSavage87 - 10-16-2020

(10-16-2020, 12:43 PM)M T Wrote:  
(10-16-2020, 12:40 PM)DocSavage87 Wrote:  I just saw some recent data via talk that says: (1) viral load can be quite high in asymptomatic, even compared to symptomatic, and (2) viral load doesn't change much across age demographics, even at 1-10 yo category.  While #1 makes sense, #2 seems really odd to me given lack of transmission in schools as much as we'd expect.
Where's the data behind your claim of "lack of transmission in schools"?

You removed the "as much as we'd expect" part, which changes what I said.  There's definitely transmission, but you'd expect more super spreader events.  Totally possible there are plenty of those cases that are undocumented or I simply haven't seen because I'm not focused on this aspect of the pandemic.  I see you have posted data to counter BC, but given the conditions of these schools (indoor, somewhat packed, long duration, questionable ventilation) is transmission pattern same as we see in college populations or Rose Garden events?