20 Utah schools reopened when COVID-19 rates were soaring, but only saw 5 new cases. Here’s how they protected students and teachers.

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Elementary school students walk to classes to begin their school day in Godley, Texas, Wednesday, Aug. 5, 2020.

  • Only 5 school-associated COVID-19 cases were detected among students and teachers exposed and tested across 20 schools in the district.
  • The rare school-associated infections were attributed to poor mask usage or close lunch seating.
  • Schools can reopen safely even when seating is 3 feet apart if other measures like masks are heeded, the CDC says.
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Rates of COVID-19 transmission were high in Salt Lake County, Utah, this past December and January, but in one school district, they remained very low thanks to mitigation measures like mask-wearing, a March 19 report out of the Centers for Disease Control and Prevention found.

Specifically, only 0.7% of teachers and students who’d been in close contact with an infected peer or colleague contracted COVID-19 from them at school. None of the 20 schools analyzed experienced a coronavirus outbreak.

The authors say the report demonstrates how mitigation measures like mask wearing and restricting extra-curricular activities can make school reopenings safe – even, as was the case in the schools studied, kids can’t always sit a full six feet apart.

In accordance with this report and other studies, the CDC changed its physical distancing guidance for K-12 schools Friday, saying 3 feet of space is enough between students, in most circumstances.

The school-associated cases were traced to improper mask wearing or close seating at lunch

To conduct the study, CDC researchers looked at 20 K-6 schools in one Salt Lake County school district between December 3, 2020 and January 31, 2021.

They identified 1,041 students and teachers susceptible to COVID-19 who, while at school, were in close contact with 51 of their COVID-positive peers and colleagues. “Close contact” meant they’d been with the infected person, while contagious, for 15 minutes or more in a classroom, cafeteria, school bus, or at recess.

After testing 735 of the 1,041 contacts, the study authors found only 12 had contracted the disease, and only five had contracted it at school. In those school-associated cases, transmission seemed to occur because the infected person wasn’t wearing their mask properly or was sitting near someone at lunch.

Wearing masks and staggering breaks can prevent transmission even if some students and teachers are COVID-positive

The study authors credit the school’s mitigation strategies with preventing higher rates of spread and outbreaks in schools.

For example, students were put in cohorts where possible, and most schools staggered lunch, gym, and other activities like library use and art classes. They also limited, or made virtual, in-person extra-curriculars and events like sports, assemblies, performances, and field trips. 86% of teachers reported that their students always wore their masks, except when eating and drinking.

Such strategies proved successful, despite the fact that kids were spaced a median of 3 feet apart, and teachers often had closer than 6-feet interactions with their kids in small group settings without any plexiglass or other barrier.

Even when the school district loosened its quarantining guidance in mid-December – only requiring a close contact of an infected person to quarantine if one or both hadn’t been wearing masks – rates of school-associated COVID-19 cases didn’t change. That guidance shift led to over 1,200 student in-person learning days saved, the report says.

This could be a model for other schools

The study had some limitations. For one, the genome-sequencing technology to differentiate school-based transmission from community transmission wasn’t always available. Plus, some contacts of infectious people could have been missed, and some identified contacts may have already been unknowingly immune to COVID-19. The findings also can’t be applied to new COVID-19 variants that weren’t circulating in the Utah community at the time.

But the study authors say the Utah schools can serve as a model for others looking to resume in-person learning safely.

“When ≥6 ft distancing is not feasible,” they write, “schools in high-incidence communities can still limit in-school transmission by consistently using masks and implementing other important mitigation strategies.”

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A 15-year-old dancer with long-haul COVID-19 now has COPD, ‘a disease of the elderly’

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(Delaney DePue not pictured.)

  • Delaney DePue, 15, got COVID-19 last summer and still struggles to catch her breath. 
  • She was diagnosed with COPD, which is “considered a disease of the elderly.” 
  • She joins an increasingly visible group of young people that appear to have long-hauler symptoms. 
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Delaney DePue, a 15-year-old in Fort Walton Beach, Florida, used to train 20 hours a week for competitive dance. Now, even running errands can leave her short of breath, Kaiser Health News’s Carmen Heredia Rodriguez reported

Her downturn began after contracting COVID-19 last summer, a condition from which she still hasn’t seemed to recover. Doctors have diagnosed her with chronic inflammatory lung disease, a condition researchers say is “considered a disease of the elderly” and is usually caused by smoking

While young people tend to fare well if exposed to the coronavirus, some do get seriously ill, and fewer die. And others, like DePue, are among a growing pool of so-called long haulers, or COVID-19 survivors who continue to battle wide-ranging symptoms, including fatigue, mental fog, severe body aches, heart palpitations, and even delirium. 

Health professionals don’t know exactly why these symptoms develop, or why some people with COVID-19 recover quickly and others are unwittingly it for the long haul.  

COPD gets progressively worse over time

COPD is an incurable, progressive disease that makes it difficult to breathe. People with it can experience wheezing, chest tightness, coughing, respiratory infections, and fatigue due to lung damage. 

It’s unusual in children because their lungs haven’t had the time to be damaged to that extent; typically, kids with COPD symptoms have asthma or cystic fibrosis, not COPD

But DePue’s case suggests COVID-19 may accelerate lung damage in some kids, as it does in some adults with the virus. One imaging study of people who’d died from COVID-19 found “persistent and extensive lung damage,” helping doctors better understand long haulers, Reuters reported

“The findings indicate that COVID-19 is not simply a disease caused by the death of virus-infected cells, but is likely the consequence of these abnormal cells persisting for long periods inside the lungs,” Mauro Giacca, a professor at King’s College London who co-led the work, said.

Severe illness is rare among children, but more data is needed

As of February 25, nearly 3.17 million children have tested positive for COVID-19, according to a report out of the American Academy of Pediatrics and the Children’s Hospital Association. That’s 13.1% of the total cases among states who report by age. 

Most have no or mild symptoms, but around 2,000 have developed multisystem inflammatory syndrome in children, a potentially deadly issue involving a high fever and inflammation. Black and Hispanic kids represent most cases of serious illness or death from COVID-19. 

Enough of a subset of children have developed long-hauler complications that some hospitals are erecting clinics to help manage their symptoms and rule out other potential causes, Rodriguez reported. Clinics and “bootcamps” for adult long-haulers are opening up too

In both cases, patients and clinicians have more questions than answers. 

“There is an urgent need to collect more data on longer-term impacts of the pandemic on children,” the AAP and CHA report writes, “including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.”

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