If you got your pediatric COVID news from New York Times science and public health correspondent Apoorva Mandavilli, you might be under the mistaken impression that (as Mandavilla asserted Monday) "the reopening of schools has fueled the [recent] surge," and that "children are as likely as adults to transmit the virus to others, and more likely to do so than adults older than 60."
Neither of these claims are supported by the evidence.
According to the Centers for Disease Control and Prevention (CDC), the rise in U.S. COVID hospitalizations began on June 28 (when the rate was at 0.56 per 100,000 residents), or precisely when most schools were closed for the summer. The rate then steadily climbed to 3.73 per 100,000 on August 27, at which point three-quarters of K-12 schools had flung open their doors. Now that the remaining 25 percent of schools have started the 2021–22 school year, hospitalizations are steadily sinking, down to 2.94/100,000.
As for children being "as likely as adults," and more likely than senior citizens, to transmit the virus, that sentence would be balderdash even after inserting the woefully missing qualifier "infected." As the CDC lays out in its school recommendations, students, proportionately, are not the ones spreading COVID inside school buildings: "staff-to-staff transmission is more common than transmission from students to staff, staff to student, or student to student," the agency noted. "Findings from several studies suggest that SARS-CoV-2 transmission among students is relatively rare."
Mandavilli's shoddy article, dissected at hyperlinked length in this Twitter thread, deployed such pediatric scaremongering in the service of adding outside pressure to the Food and Drug Administration process of approving under-12 vaccinations. But a more accurate depiction of COVID and schools could be used to fix a policy error that's negatively affecting families right now: excessive school quarantine policies.
As has been clear since August, the single most important dataset involving kids and COVID would be coming out of the Los Angeles Unified School District (LAUSD), which is testing a half-million combined students and staff each week, regardless of vaccination status, at a cost of $350 million in 2021–22. Far from fueling any surge, let alone showing evidence of "superspread," these numbers overwhelmingly indicate that schools are safe and being overcautious.
The "baseline" rate of infection, taken from the two weeks before school, was 0.8 percent for students, 0.6 percent for staff. From that low starting point it has inched steadily down, as have pediatric hospitalizations and overall community spread. No fuel, no surge.
To the contrary. A study released on September 16 by Los Angeles County contains two remarkable findings: 1) Students, most of whom are not vaccinated, have a lower positive rate than teachers and staff, most of whom are. And 2) the positive test rate among students who are quarantined because a classmate tested positive is a microscopic 0.2 percent. Here is the relevant section:
In K-12 school settings countywide, between August 15 and September 13, 7,995 student cases and 1,193 staff cases were reported, with the vast majority occurring at LAUSD, which tests everyone weekly. With more than 1.5 million students and 175,000 staff countywide (by last year's counts), 0.5% of the student body and 0.7% of staff have become infected since school districts reopened. This is slightly higher than the 0.4% rate of infection experienced overall in the County. Given the massive testing of asymptomatic individuals at schools, this very low rate of infection affirms the safety provided to students and staff at schools.
Close contacts that are not fully vaccinated, are subject to quarantine for up to 10 days after exposure to a case. Between August 15 and September 13, 15,655 student contacts and 1,056 staff contacts have been reported, with an additional 22,650 close contacts of unknown status reported, most of them suspected to be students. In total, nearly 2% of all staff and students countywide have been identified as a close contact of a case. Data to date indicates that very few of the identified close contacts have subsequently tested positive. As of last week, among the almost 30,000 people quarantined, 63 tested positive; this amounts to an overall secondary attack rate of 0.2%.
(Note: L.A. County, with its 88 cities, is home to 10 million people, 4 million of whom live in Los Angeles proper. The LAUSD includes some kids from outside city limits, and educates a bit more than 40 percent of the county's students overall. Also, Southern California governance is a confusing mess.)
In response to this overwhelmingly good news, the county has announced a "modified quarantine" system, whereby potentially exposed students can stay in class if they are asymptomatic and test negative twice within the ensuing seven days. This "test to stay" protocol treats quarantining as a problem more of information than infectiousness, while acknowledging the educational inadequacies and familial disruptions of remote learning.
Such insights, perhaps coupled with anxiety over declining (albeit aggressively unreleased) enrollment numbers, prompted New York City Mayor Bill de Blasio to announce Monday that unvaccinated asymptomatic kids will no longer have to automatically quarantine after exposure, in part because testing of the non-vaxxed will be ramped up to weekly. "We saw enough quarantining that we thought this is something we want to get ahead of, and make sure that only those who really need to quarantine are quarantining," de Blasio said.
In both NYC and L.A., the biggest critics of the test-to-stay policy change are the same who did the most to keep public schools closed for most of 2020-21: teachers unions.
"We strongly disagree with the mayor's plan to limit the quarantine process only to some children rather than an entire classroom," New York's United Federation of Teachers tweeted yesterday. "Children—particularly the youngest who are most vulnerable to the Delta variant—need more protection than the Mayor is offering with this recent, ill-considered decision."
United Teachers Los Angeles, meanwhile, has not indicated whether it will agree to L.A. County's modified quarantine policy, even though the district is alone among all big-city systems in mandating vaccines for all eligible students.
It is astonishing, at this very late date, that so many Americans are unaware what an outlier the United States is on school reopening and masking young children. It is appalling that people who certainly know better, such as the University of Minnesota's Center for Infectious Disease Research and Policy Director Michael Osterholm, are saying such scaremongering nonsense as "the fact of the matter is that this is killing kids right now at a rate much, much, much higher than our worst severe influenza years." (The 2017–18 flu season killed an estimated 172 children in five months; COVID has killed 146 children since April.)
And it is a miserable reality, if no longer quite surprising, that some elite journalists have done such a piss-poor job of giving families and policymakers usable, contextual, and numerate information on which to base crucial decisions. At some point this school year, test-to-stay policies will replace excessive quarantining in all but the most union-dominated of districts. When our kids' 18-months-and-counting nightmare finally comes to a close, here's hoping a whole bunch of adults take a good long look in the mirror.