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Health experts urge Md. educators to deepen plans for coronavirus cases

"If all you're getting from your school system is here's everything that we're doing to reduce the chance of infection, that's not enough," says Dr. Joshua Sharfstein of Johns Hopkins. "People should also know what should happen, when and if there's a case of coronavirus in the schools."(File photo)

“If all you’re getting from your school system is here’s everything that we’re doing to reduce the chance of infection, that’s not enough,” says Dr. Joshua Sharfstein of Johns Hopkins. “People should also know what should happen, when and if there’s a case of coronavirus in the schools.”(File photo)

School officials should be doing more to plan for potential cases of COVID-19, according to researchers with the Johns Hopkins Bloomberg School of Public Health.

The advice comes as school systems around Maryland prepare to pick up the new academic year in virtual classes, much the same as when the 2019-2020 year ended. The advice comes even as Maryland school leaders say they need more guidance from state public health officials to deal with the ongoing pandemic.

Dr. Jennifer Nuzzo, an associate professor and senior scholar at the Johns Hopkins Center for Health Security, said schools in Maryland and around the country need to do to more than have guidelines for social distancing, mask wearing and disinfecting.

“What we are seeing so far unfortunately is a cautionary tale,” Nuzzo said of schools in the U.S. and other countries that have opened classrooms.

“Schools need plans beyond just trying to assess what this means for the school if the level of infection is likely in the school at that moment,” she said.

One option, according to Nuzzo, is small groups of students and staff who only interact with each other and not other groups within the building.

“Hopefully with the cohorts they won’t have to close the entire school unless they find the infection has spread beyond that cohort or that there was a breakdown in who was exposed,” she said.

Maryland Superintendent of Schools Karen Salmon introduced a recovery plan in June meant to guide local school systems as they reopen for learning during the ongoing pandemic.

Salmon’s document establishes broad guidelines, with the goal of eventually moving all students back into the classroom, while stressing local flexibility rather than a one-size-fits-all standard. No health metrics are included that would guide a school system through the tough decisions of when to move from virtual to a mix that includes in-class learning or even a return to classes as they were pre-pandemic.

Broadly, schools must follow guidelines set by the Centers for Disease Control and Prevention as well as comply with state health orders. They must also be mindful of equity issues facing children in low-income families who lack technology and high-speed internet access.

Montgomery County Health Officer Travis Gayles said there is a trend of increased cases in people from infancy to 19 years old. Currently between 16-18% of all new cases in the county come from that age group.

There are also no guidelines for what happens if students or staff test positive.

Dr. Joshua Sharfstein, vice dean for public health practice and community engagement at Johns Hopkins, said plans should be developed for not only how to open schools but what to do if there is an infection in the school. Those plans, he said, should communicated to parents before classes start rather than after an infection is discovered.

“If all you’re getting from your school system is here’s everything that we’re doing to reduce the chance of infection, that’s not enough,” he said. “People should also know what should happen, when and if there’s a case of coronavirus in the schools.”

Children are believed to not be as severely afflicted by the virus as older adults who become infected.

“We are seeing consistent trends of a high percentage of cases in young folks,” Gayles told reporters during a conference call. “That’s consistent with what we’ve seen over the last month. This is on top of the national information that suggests that as more kids are being tested we’re actually catching more cases in the zero-to-19 age group as well as the 20-29 year old age group.”

Officials caution that low risk is not no risk. There is also concern that infected students in enclosed environments can transmit the virus to adults who could be more susceptible, including teachers and school staff as well as adults at home.

School officials told lawmakers a week ago that the lack of guidance from public health officials and a statewide standard are hindering their ability to open schools safely.

“Plan for cases,” said Nuzzo. “Even if these safety measures are in place, we have to think about what we do to further limit the spread. Schools should plan to reduce the numbers of people that any one person interacts with to reduce the probability that if an infection comes it will result in a school outbreak.”

Nuzzo said in-class offerings work best in communities with low incidence of the virus. She said those communities would have to remain vigilant about the cause of spikes and be prepared to impose restrictions in order to keep students safely in classrooms.

Parents and students would also have to show discipline outside of a school setting.

“What we’ve seen in other countries where they have reopened schools is that when cases have been found in the schools, they are not infrequently linked to social events that happen outside of school hours and outside of school settings,” Nuzzo said. “It’s one thing for schools to put all these measures into place, but if families and staff don’t take similar precautions in their lives then that will potentially dilute the impact of school planning.”


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