At least one key question still lingers as students, parents and educators prepare for a return to school next month: What happens if someone in a school building tests positive for COVID-19?
School districts are planning to coordinate with local county health departments to trace an infected person’s contacts and determine who else needs to isolate and get tested. But those determinations will be driven largely by the specifics of individual cases, according to the Schenectady County health officials working closely with area districts.
“This is where people want there to be an answer: Who would be exposed?” said Claire Proffitt, supervising public health nurse with the Schenectady County Public Health Department in charge of the communicable disease program. “It really depends on so many things.”
Proffitt said county contact tracers will work with school administrators and nurses to determine who the infected person came in “close contact” with since the 48 hours before they were symptomatic or received a positive test result. Typically, tracers would be looking for anyone who the infected person came within six feet of for 15 or more minutes. But the school environment complicates that equation.
Finding those close contacts, Proffitt said, will come down to a litany of factors, including what role the person had, how well they adhered to mask-wearing and other precautions and how well ventilated the spaces they interacted with other people were.
“Who gets isolated and quarantined is going to be very, very situationally dependent,” Proffitt said, noting classroom-level details could influence how health tracers approach particular cases to determine who was potentially exposed.
State Department of Health and Education Department guidelines grant school districts and local health agencies a good deal of flexibility in managing the complex decision tree that follows a positive COVID-19 case in a school, but many educators, parents and lawmakers are seeking greater clarity around how districts should handle cases – and just when school buildings should be closed.
The state’s two major teachers unions on Wednesday pressed for a more stringent statewide standard, calling for a mandatory two-week closure of any school building after a student or staff member tests positive for the virus. Beyond broad regional benchmarks – keeping positive test rates below 5 percent in the region – current state guidelines don’t specify any positive case threshold that would automatically result in a school closure.
“The unions believe that if districts are to move forward with reopening their school buildings, they must err on the side of caution at all times,” New York State United Teachers and the United Federation of Teachers said in a joint statement Wednesday.
The unions also called for “clear statewide directives” outlining how school and county health agencies should conduct contact tracing and the precautionary quarantining of people who may have been exposed to possible infection.
“This is not time to take risks,” NYSUT President Andy Pallotta said in the statement. “If the state allows school buildings to reopen, districts must be prepared to close them in the event of a positive case.”
A tricky balance
State senators on Wednesday met virtually with state health and education officials, relaying concerns they have about the timing of testing results, the potential of asymptomatic spread in school and whether schools will be consistent in public health approaches.
Lawmakers also urged health officials to establish an online portal or help-line, where parents and educators can ask questions or report concerns.
Delays in COVID-19 testing are another complicating factor in reopening schools. While state officials do not require or mandate universal testing of students or staff before schools returns, parents, educators and lawmakers have expressed concerns delays in testing results – as much as a week or more for tests processed through national lab companies – will make it impossible to stamp out a potential outbreak in schools.
State Sen. James Seward, whose sprawling district includes Schoharie County, asked about the likelihood of the state ramping up widespread rapid testing – like the tests used to return results in under an hour.
“I don’t see us getting there soon,” state Commissioner of Health Howard Zucker said in response.
Throughout the virtual discussion, Zucker emphasized the importance of keeping students home from school if they don’t feel well and repeatedly highlighted the importance of giving districts the flexibility to tailor plans to their specific circumstances.
“These things have to be tailored to each school,” Zucker said. “The schools themselves know what the challenges are.”
But lawmakers also highlighted the deep anxiety among parents and educators and the risk of confusion if parents think their school district is handling a situation far differently than other districts. Some of them called for more detailed guidance from state officials about how schools and county health agencies should handle positive cases, defining close contact and what level of risk would necessitate a closure.
“There may be issues where we require stronger guidance from DOH on what is proximity and how should the evaluation of risk be handled,” said state Sen. Shelly Mayer, who represents portions of Westchester County and chairs the Senate education committee.
Districts leaders are also asking for more specific health guidelines to ensure consistency and detail the best public health advice at the time. Bob Lowry, who analyzes state policy for the New York State Council of School Superintendents, said district leaders have faced inconsistent advice from local health department and many are looking for more state health guidance on how to respond to positive cases and when to close a school.
“We are normally folks clamoring for more flexibility, but on some things it helps to have one clear answer, this is the way it has to be done,” Lowry said. “These are educators not public health experts.”
‘We are going to be there’
County health departments have been leading local health responses to the pandemic since March, leading teams of health tracers and coordinating with other local agencies, including school districts.
Montgomery County Public Health Director Sara Boerenko said her agency plans to approach contact tracing for cases in schools they same as they have other cases in the community.
“We will treat a case in a school no differently than what we have been doing all along with tracing, isolation practices in the community,” Boerenko said in an email response to questions. “I hope state DOH gives some further guidance but we have to remember, this is not a one-size-fits-all. Some schools have very small class number and what works for a large city school may not make sense to a small rural district.”
Jennifer Tonks, a Schenectady County supervising public health nurse and the county Health Department’s preparedness coordinator, as well as a former school nurse, leads a regular conference call with district leaders across the county. Recent discussions have centered on the health logistics of re-opening plans, Tonks said, including how to set up isolation rooms, what equipment nurses should wear, how to manage students on buses and how to clean classrooms.
Tonks and Proffitt said they have been in consistent communication with state health officials throughout the pandemic and are confident the agency will consult with local health departments making decisions about isolating students and staff or closing schools.
They are both the parents of area schoolchildren and acknowledged the difficult choices that families face in deciding whether to send their kids to school.
“I don’t think there is any right or wrong answer as a parent for making that decision,” Tonks said.
They said it was possible more state health guidance would be forthcoming but also emphasized the importance of treating each case based on its own specifics.
“I hear firsthand the angst coming from parents and educators, and I appreciate the desire for their to be an answer,” Proffitt said. “This is a once-in-a-generation crisis we are all facing for the first time … and it’s incredibly difficult to give these answers.”
“I don’t have the answer,” she continued, making at least one promise: “I can guarantee that when these situations arise, we are going to be there and help you through it.”