School safety debate rages anew with Omicron

A debate over the pandemic safety of students in public schools, one that some health experts thought had already been resolved, has reemerged this winter with the rapid rise of COVID-19 infections due to the highly contagious Omicron variant.

In Chicago, where 272,000 students have been out of classes for almost a week because of teachers’ concerns around school safety, Mayor Lori Lightfoot has insisted schools remain open despite the city’s record coronavirus surge, arguing vaccines have made in-person learning safer and claiming the city has found little to no in-school transmission.

Those with safety concerns have responded by pointing to state data appearing to show that more than 40% of Illinois residents who were believed to be positive for COVID-19 had visited schools. Amplified by the Chicago Teachers Union and shared thousands of times on social media, the numbers added fuel to the fire in the argument over whether schools are sufficiently safe during this wave. But experts — and even state officials — now say there are many caveats with that data, including that the sample size is far too small for meaningful conclusions.

Many doctors have said sending children to school requires a careful risk-benefit analysis. While there is a detriment to students in remote learning falling behind in their studies and feeling social isolation, mitigation efforts such as masking, social distancing and screening need to be carried out with precision.

And the arrival of the Omicron variant, which has sent infections skyrocketing, has added to that to that calculation.

“It all kind of depends on what mitigation measures are put in place,” said Dr. Eve Bloomgarden, co-founder of a health provider advocacy group known as IMPACT. “There’s no reason to think schools are not sources of transmission.”

Chicago Public Schools officials say they have taken all those considerations, spending over $100 million on tests, masks, improved ventilation and more.

“Honest to God, it is an answered question in public health across this country whether schools significantly increase the risk of COVID transmission,” Health Commissioner Dr. Allison Arwady, a pediatrician and epidemiologist, told alderpersons at a City Council health and human relations committee hearing Monday.

On Monday Arwady provided data showing that less than 5% of CPS students quarantined because of potential in-school exposure this year ended up testing positive for the virus. She argued that’s because of the strict mitigation protocols put in place at CPS schools, which led to very low case rates in the district this fall.

Source: CPS

That data is largely from the Delta wave, however, and doesn’t account for the more contagious Omicron. Students and teachers in some schools across the city have also reported nonexistent social distancing, and inconsistent and undisciplined mask wearing, particularly when face coverings are removed for lunch periods. Communities have varying inoculation rates, and the majority of CPS students remain unvaccinated even though the district has held hundreds of vaccination events.

The latest argument made by the teachers union and its supporters has been around the Illinois Department of Public Health’s potential exposure location data, listed on a webpage and datagraph which appear to show schools as by far the top source of potential COVID-19 exposure.

But the numbers come with caveats and are an example of the incomplete and imperfect collection of personal information through a process known as contact tracing, which has had many challenges throughout almost two years of the pandemic.

While the high percentage of potential COVID exposures at schools statewide stands out, the data represents less than 15,000 cases while the state has reported nearly 2.4 million in total. That’s because contact tracers in the state and around the country have mostly failed to reach a larger number of infected patients to interview them about their whereabouts before they tested positive.

The data in question comes from local health departments, with the exception of Chicago, which feed their contact tracing information to a centralized state system.

Cook County identifies schools as its single-biggest source of potential COVID exposures among locations listed through contact tracing interviews. Schools made up nearly 60% of source locations with just under 3,300 cases identifying schools, compared with about 250 cases, or less than 5% of respondents identifying restaurants or bars. Cook County health officials declined to comment.

DuPage County, which among Illinois health departments provides one of the most granular explanations of COVID outbreaks, reports public schools account for the fourth-largest number of infections behind long-term care facilities, assisted living centers and skilled nursing homes. Almost 500 infections from 128 outbreaks were recorded at DuPage public schools. Private schools were next with 274 infections following 39 outbreaks.

Those figures detail actual outbreaks, not potential exposure locations. But here again, those numbers are a small representation of the total cases. Outbreak-related COVID-19 cases overall represent less than 10% of the total, according to the county health department.

DuPage health officials support “in-person learning with layered prevention strategies in place,” health department spokeswoman Kimberly Siebert said.

“The top priority is to ensure all children have access to in-person instruction this year in a manner that prioritizes the health and safety of the students, teachers, school staff, their families and the community,” Siebert said. Some school districts in DuPage have temporarily paused in-person classes this month to get a hold on the virus.

Even state health officials who publish the data caution the public not to misinterpret the numbers. The state data show “locations where COVID-19 exposure may have occurred, but is not definitive,” IDPH spokeswoman Melaney Arnold said.

“Children are our most unvaccinated population and are likely to list schools as one of the places they have been where they could have been exposed,” Arnold said. “Exposures do not confirm this is where they get COVID-19.”

The majority of infected or potentially infected state residents between 5 and 18 are likely to have been at a school, she added. “An individual can say they may have been exposed at a church, school, home and a restaurant,” Arnold said, and each of those locations would be listed in the dataset. But with health departments focusing contact tracing on schools and longterm care facilities, people who have been in those locations are sure to be overrepresented in the data.

Arwady, Chicago’s health commissioner, said in an interview with the Sun-Times that she told state officials months ago the city wouldn’t participate in this data collection.

“I think it has the potential to confuse people, which it has,” she said. “This is absolute nonsense, I’m just being honest with you. One of the reasons why [Chicago] data is not there is I think this data presented in this way does not help people understand risk.

“We track numbers of outbreaks in different settings, we track size of outbreaks in different settings, we share that information. … This is not the data that any epidemiologist anywhere in the country would use to assess the question that people are trying to incorrectly answer.”

Kids have to ‘go about their business’: U of C doc

A number of private doctors have said the risks of children being infected at school outweigh the negative impact of young people falling behind in their education and the depression and social isolation they may feel without access to in-person learning.

“A lot of steps have been taken. Does that mean there is no chance of transmission? Of course not. But they have reduced the chance,” said Dr. Daniel Johnson, head of pediatric infectious diseases at the University of Chicago.

It is imperative that all teachers are vaccinated and boosted and all children who are eligible — anyone at least 5 years old — get their shots, said Johnson, a strong proponent of keeping kids in school.

“We have to have kids be reasonably safe in the classroom but they have to go about their business,” Johnson said. “What is the business of children? It’s learning and socializing.”

Brett Chase’s reporting on the environment and public health is made possible by a grant from The Chicago Community Trust.