Could schools become COVID-19 super-spreaders amid delta variant surge?
With the emerging delta variant posing a growing risk to unvaccinated individuals, health experts warn that schools with lax safety protocols could become COVID-19 super-spreaders.
"If masks are optional, they're not going to wear them," said Casey Pinto, a public health expert and professor at Penn State University.
Most York County school districts plan to start the school year with more relaxed safety protocols in place, keeping masks optional and holding in-person classes every day.
York City Health Bureau Medical Director Dr. Matthew Howie said he expects COVID-19 cases to rise countywide following the start of the school year based on national trends showing the spread of the delta variant.
Most experts endorse in-person instruction as a means of preventing students from falling behind in learning, but Howie said masking remains a critical step in controlling the spread of COVID-19.
Despite new federal guidance advising all individuals in K-12 schools wear a mask, regardless of their vaccination status, at least three local school districts confirmed they were not changing their optional mask policy.
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More recently, the Centers for Disease Control and Prevention advised all York County residents, even those who are fully vaccinated, to mask up indoors.
Pinto said keeping masks optional will do little to stop COVID-19 transmission.
York County, along with 27 other counties in Pennsylvania, moved back into the substantial transmission levels category this week. Howie said it is safer for schools to keep masks optional when transmission levels are moderate, but in a higher category school districts should consider strengthening their mask policies.
The CDC categories, from least transmission to most transmission, are low, moderate, substantial and high.
The delta variant is driving most of the recent pandemic concerns, with experts reporting the variant is more severe and more contagious than the original COVID-19 strain. Howie said about 80% of the COVID-19 cases circulating nationwide come from the delta variant.
Pinto said some experts believe the delta variant could be as contagious as measles among the unvaccinated, which includes most students. A COVID-19 vaccine has not yet been approved for children under 12. If just one student is infected, Pinto said, that could be enough to spread to an entire classroom.
The variant's impact is lower in Pennsylvania, which Howie said is likely due to the state's high vaccination rate. But York County's vaccination rate is lower than the state's overall rate, putting the county at a higher risk.
"Just because it's slow doesn't mean it's not going to show," Howie said.
In the last school year, more than 2,800 COVID-19 cases were recorded at York County schools. Many cases were linked to exposure outside school grounds. Howie said local schools did a good job employing safety measures last year.
But many of those measures, such as universal masking, remote learning and stronger social distancing, won't be in place during this school year. As each of the protective layers is peeled back, Howie said, the risk of greater transmission in schools increases.
Many teachers will have added protection in schools, after more than 100,000 state educators received the COVID-19 vaccine through a state initiative earlier this year. At least 2,300 of those employees came from York County. Howie said vaccinations remain one of the most important steps in slowing COVID-19 transmission.
While the initiative will help protect teachers from getting COVID-19, Pinto said students are still vulnerable. She said hospitalization rates are increasing for younger and healthier people. Between 70% and 90% of York County's recent hospitalizations for COVID-19 are unvaccinated patients, Howie said.
Vaccinated individuals are still at risk of infection from the delta variant, Pinto said, although most cases among the vaccinated are less severe. She said people who are vaccinated can spread the variant without realizing it, as they are less likely to show symptoms.
With less than one month left before the school year begins in York County, Howie said he would not be surprised if federal guidance changes again for K-12 schools.
"This is a moving target," Howie said.
Pinto said she hopes new federal guidance recommends universal masking in more areas. However, several York County school district officials have said they don't plan to require masks unless it is mandated by the state or federal government.
Without a mask mandate, Pinto said, social distancing is important for preventing transmission, but that is another area where local school districts relaxed their policies. Most districts are resuming full-time in-person instruction, and schools are only planning to implement social distancing when feasible, according to the districts' health and safety plans.
Pinto said hand-sanitizing stations, staggering lunch times and encouraging students to stay home when they are sick are other helpful practices that schools can adopt. Those are all policies that York County schools plan to keep in the fall.