“No close contacts were identified within the school district”
That’s what it says on today’s email from my district reporting that two elementary staff and one student tested positive for COVID-19.
That’s what it said on Tuesday’s email about a different elementary staff member testing positive.
And the email from last Sunday about two elementary staff, and last Monday about a middle school staff member, and the one from Nov. 19 about an entire Kindergarten class and its teachers being quarantined.
Actually, that last email said the outbreak was limited to the Kindergarten class and teachers – that no close contacts were identified beyond its doors, in the building or the wider district as a whole.
However, considering that at least five more elementary teachers and another student tested positive later, I’m not sure I believe it.
All of which prompts the question – how accurate is contact tracing?
How Contact Tracing Works
Let’s say a little girl, Ava, gets COVID-19.
Where did she get it from?
Let’s do some contact tracing to find out.
We ask Ava to think back two days before she showed symptoms up until now. Who was she in close contact with (within six feet for at least 15 minutes)? She doesn’t remember much, but she gives us a list of two or three people who may fit the bill.
We call them, find that none of them are sick, none have been out of the state or country, ask them to quarantine and that’s it.
So where did Ava get the virus? Who did she get it from?
We don’t know.
And contact tracing rarely produces an answer to that question.
In fact, that’s not really its point.
Contact tracing is a key strategy for preventing the further spread of an infectious disease. Its goal is to limit spread beyond this point.
We already know Ava has the virus (or is suspected of having it). We’re trying to find out who she may have spread it to – as much as, if not more than – who she got it from.
In the process of doing that we may be able to trace the spread of the virus back to its source before Ava. But probably not.
Why Does Contract Tracing Often Fail to Lead Us Back to the Source of an Outbreak?
If we had rapid and ubiquitous COVID tests, perhaps we could achieve that goal. But we don’t.
Moreover, we’re relying on individuals to voluntarily cooperate with contact tracers and to provide detailed information about who they came into contact with over a wide period.
At best, people are scared and not as specific as they might be. At worst, they refuse to participate at all.
Michael Huff, Pennsylvania’s director of testing and contact tracing efforts, said that more than 34,000 new cases were reported over the past week, but case investigators were only successful in reaching about 8,332.
And of those they did reach, ninety-six people refused to quarantine.
“Why? Because people don’t want to answer the phone. Because people do not realize how important it is to give the information we need to make certain we can control disease.”
To make matters worse, most children who get the disease (especially those younger than 10) are asymptomatic or have only mild symptoms, according to the Centers for Disease Control (CDC). Though they are still capable of spreading the disease, they go undetected by contact tracing entirely.
So it is entirely disingenuous to claim contact tracing proves much of anything about how the virus is spread. It’s usefulness is in stopping COVID-19 from going any further.
How Contact Tracing is Used to Make Wild Claims
Students, teachers and other school staff have come down with the virus in significant numbers.
More than 1 million children have been diagnosed with Covid-19 according to a report by the American Academy of Pediatrics released last week.
No such estimate exists for school staff, but about 1 in 4 teachers – nearly 1.5 million – have conditions that raise their risk of getting seriously ill from Coronavirus, according to the Kaiser Family Foundation.
And though many thousands of school staff have contracted the disease, more than 300 district employees have died nationwide from the virus according to the Associated Press.
Where did all these people get COVID-19?
Contact tracing provides no definitive answer, however, policymakers are pretending that means something.
Since contact tracing has rarely been able to identify the source of an outbreak to a particular person in school, they assume that means the virus isn’t spreading much in our schools.
First of all, there have been significant contact tracing studies that have found these direct links.
In fact, the largest contact tracing study ever conducted shows that children and young adults are potentially much more important to transmitting the virus than previous studies had identified.
The study of more than half a million people conducted by researchers at Princeton, John Hopkins and the University of California at Berkeley suggests the role of schools in the spread of the virus is much greater than previously believed.
However, many policymakers overlook this evidence as contrary or inconclusive.
They insist that contact tracing’s inability to consistently find the causal link is enough to disregard the existence of that link.
That’s like sniffing the air and claiming with absolute certainty that there is no leak of carbon monoxide. The gas is odorless and colorless. A sniff test will never tell you if it’s present. You need special equipment.
The fact is Ava has only been to two places in the last two weeks – home and at school.
At home there’s just Ava, her three brothers and her parents.
At school, there are hundreds of students and 8-9 staff she comes into contact with every day.
She is probably in closer contact with the people at home than at school. But the sheer number of people she is in contact with at school multiplied by the number of hours and then days – is tremendous!
The likelihood that Ava caught the virus at school is quite high – no matter how good the precautions being taken.
Taking Advantage of Our Ignorance
It is ludicrous to assume that the lack of a direct causal link after only a few months of schools being open to reduced capacity means much of anything.
Add to that the absence of a standard national database of school cases, and it’s beyond absurd.
States don’t compile COVID cases at schools. The federal government doesn’t either. In fact, no one really does.
A few self-proclaimed experts have tried to put together what data they can – and used that data to make extreme claims.
Economist Emily Oster has used a mere two weeks worth of data in September to argue that the virus isn’t spreading much in schools.
And policymakers have jumped on that bandwagon all across the country including director of the CDC Dr. Robert Redfield.
Oster is now trying to have it both ways – defending her argument but chiding anyone for taking it too seriously.
Her Website incorporates data that school districts publish voluntarily, along with some data reported directly to the site. However, Oster says it’s far from complete, and she was surprised Dr. Redfield was citing it as fact.
She told CNN:
“It is totally bananas. I think we are doing as good a job as we can. This is not my field. It’s crazy.”
She later clarified in a series of Tweets, “…it is bananas that there isn’t a better federal effort to get these data….”
“Our data is, I think, the best available. It’s not perfect, and I’ve said that elsewhere many times…”
Besides the case of COVID-19 in schools, Oster is best known for making outrageous and often disproven claims such as that drinking alcoholic beverages during pregnancy is safe.
What About When Outbreaks Happen?
But it’s not just Oster who wants to have it both ways.
Policymakers say kids aren’t getting COVID at school and then walk back such claims when outbreaks happen in communities with high levels of infection.
Salt Lake City, Utah, had one of the biggest outbreaks in schools in the nation. However, that happened as infection rates reached more than double the level at which the state recommended distance learning.
“You can only open your school safely if you have COVID under control in your community,” said Benjamin Linas, an associate professor of medicine and epidemiology at Boston University School of Medicine who has advocated for opening schools under strict safety measures.
The sheer number of people she is in contact with at school multiplied by the number of hours and then days – is tremendous!
Which kind of disproves his position.
If COVID doesn’t spread much in schools, the infection rate in the community shouldn’t matter. If it does, then the virus can and does spread significantly in schools.
The situation in Utah has been partly attributed to community resistance to safety precautions like mask wearing and social distancing. When parents won’t take precautions, neither will children.
Keeping Schools Open During a Pandemic Increases Reckless Behavior
However, this highlights another danger of keeping schools open while infections are high.
Even if viral spread was low in schools, keeping buildings open minimizes the danger of the pandemic.
If Ava can see her friends in school, why shouldn’t she get together with them after school, too?
In-person learning enables more in-person extra-curricular activities, sporting events, parties and other social gatherings outside of school.
Under normal circumstances, this would be great. When there’s a raging pandemic – not so much.
With kids, it’s not always what you say. It’s what you do. And if it’s safe enough to have in-person schooling, kids aren’t as likely to social distance outside of school.
The point isn’t that school cannot exist during a pandemic.
In communities where infection rates are low, even in-person classes can be conducted in relative safety with proper precautions and adequate funding.
However, if the community infection rate is moderate to high, classes should be conducted remotely.
We have not been doing that.
Helen Bristow, MPH, program manager of Duke’s ABC Science Collaborative, which guides schools on COVID-19 safety, cautions:
“We’re nine to 10 months into a brand-new disease. We’re regularly learning something we didn’t know before.”
We have to stop pretending that the partial data we have is enough to make broad and reckless decisions about keeping students and staff safe during this crisis.
Decisions should be made with an abundance of caution.
We need a national database of COVID cases in schools for students and staff.
We need free, quick and ubiquitous viral screenings done frequently for all students and staff.
And darn if a working and safe vaccine wouldn’t be helpful, too.
But in the absence of all of these things, we should not be rushing to open schools to in-person classes.
The virus definitely is spreading in our schools.
In most communities, it’s not where the contact tracing leads. It’s the sheer number of cases, the quarantines, staffing shortages and, yes, even funerals.
For all its faults, remote learning is far preferable while the virus runs free.
Gadfly On The Wall