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Scott County School District 1 in Austin, Indiana reopened for the fall semester with optional face masks, less distancing in classrooms and no remote option.

District leaders quickly realized they had relaxed the Covid safety rules too soon.

Within the month of August, the district would record 65 Covid-19 cases among students — more than the number of cases recorded in the entire 2020-21 school year, according to Deana Broadus, the district’s lead nurse.

The cases weren’t confined to just one or two classrooms, Broadus said. Some outbreaks seemed connected to school buses. She suspected that many cases may have originated from social contact outside of school, or were the lingering vestiges of summer break infections.

One week into the semester, the district shut down in-person learning for two weeks in order to get the situation under control. When students returned to classrooms on August 23, they faced Covid safety protocols similar to those of the previous spring: distances between desks were back to six feet and masks were required whenever a student was not actively sitting at their desk. School staff “reinforced the basics of hand hygiene, staying home if you’re sick, testing, covering if you’re coughing, being careful when you’re eating,” Broadus said.

P.S. 705 administrators, teachers, and staff used winter holiday decorations to boost morale towards the end of a tough fall semester. Here, Principal Valerie Macey poses in a hallway decorated with paper snowflakes. Credit: Betsy Ladyzhets for The Hechinger Report

There was a “little bit of pushback,” she said, but the community was supportive overall: In-person school with some Covid safety measures was preferable to more weeks of remote learning.

Scott County School District 1 was one of the lucky ones last school year. Most children attended school in person for most of 2020-21, but the rate of Covid cases among children remained well below the national rate.

Not this year.

The delta variant changed the equation for schools and districts that stayed mostly Covid-free in the first 18 months of the pandemic. The virus has reached rural and suburban areas that were relatively insulated in the earlier days, as relaxed mask policies and exhaustion with pandemic restrictions helped fuel the spread, and highly contagious Covid variants have overcome the defenses of even the most vigilant schools.

Related: 11 lessons from schools that kept Covid cases low

Earlier this fall, the Covid-19 Data Dispatch and The Hechinger Report examined reopening strategies in five school communities — four districts and one New York City elementary school — where the majority of children returned to school in person in 2020-21 but the cumulative rate of Covid infection stayed below 5 percent of the student population. (Based on CDC and census data, about 5 percent of school-aged children in the U.S. contracted Covid-19 between the start of the pandemic and early August 2021.)

As the third year of the pandemic dawns, the Hechinger Report returned to these five communities, to learn how their earlier successes and current challenges can inform schools everywhere as they try to cope with new waves of disease and disruption this school year and beyond.

In Indiana, the rest of the fall 2021 semester in Scott County School District 1 became more manageable, once prior protocols were revived. There were 30 student cases of Covid in September, six in October, and nine in November. But the decline has come at a price: numerous quarantines, staff shortages, pandemic fatigue and no end in sight as vaccine rates among students remain low — even though vaccinated students are not required to quarantine after exposure to Covid.

Still, said Broadus, “we’ve started to maybe find a balance, as far as how to live with this [Covid], and how to still be cautious about it.”

Learning from past pandemic semesters

Even with in-person classes and new, more contagious coronavirus variants circulating in recent months, schools are still not typically the primary vector of virus spread in communities. Transmission in school settings tends to be similar to or lower than transmission in the surrounding community, especially when safety measures are in place, according to the CDC.

Masks and vaccinations continue to be the two most effective safety measures to keep Covid cases low in schools, according to experts who spoke to The Hechinger Report. But other layers of mitigation — such as ventilation updates in school buildings, easily accessible testing and screening students for Covid-19 symptoms — also helped reduce transmission.

The five school communities covered earlier this fall used a combination — or in some cases all — of these strategies. In Indiana, Scott County District 1 borrowed lessons learned during the HIV/AIDS epidemic, including partnering with the public health department, to prepare schools for Covid.

Garrett County Public Schools in rural Maryland relied on community partnerships, school task forces and extensive communication with parents to keep cases down. Last school year, the district reported under 30 total cases.

P.S. 705, an elementary school in Crown Heights, Brooklyn, also communicated extensively with parents. It relied heavily on surveillance Covid testing, too. Last year a total of eight students and three staff members tested positive at the school of 300 kids.

Port Orford-Langlois, a tiny district in coastal Oregon with just over 200 students, relied on its close-knit community during a step-by-step reopening. The district did not report a single Covid case last year.

Andrews Independent School District in Texas made personal responsibility its top priority, communicating Covid information to parents and allowing families to make their own choices about their children’s safety. But, in the early days, school officials also worked with the local health department, held classes outside and improved building ventilation. Last year, Andrews reported 167 cases in students and 76 in staff, in a district of about 4,000 students.

This fall, most of these districts either continued or reverted to prior safety measures and, as a result, have at least kept case numbers at a lower level than their surrounding communities. For example, Garrett County Public Schools in Maryland followed “all the safety protocols that were in place” in spring 2021, said Nicole Miller, chief academic officer at the district.

But distancing in classrooms was a challenge for the Garrett County district, which transitioned from about 15 percent of students learning remotely in spring 2021 to entirely in-person instruction in the fall. The district, with about 3,600 students and 600 staff, reported between 20 and 50 cases per week from early September to late November.

“We’re doing everything that we can in schools, but we cannot do anything in the community,” said Rebecca Aiken, the district’s school health services manager. About half of the county’s eligible residents are fully vaccinated, according to CDC data; the county’s case rate has been well above the CDC’s threshold for high community transmission throughout the fall semester.

Michael Smith, a North Carolina pediatrician and professor at the Duke University School of Medicine, said districts that required masks had lower case numbers, even as the delta wave led to an increase in pediatric Covid-19 patients at his hospital.

“Districts that went mask-optional when delta came, didn’t stay mask-optional very long,” said Smith, who is also a member of the ABC Science Collaborative, a program that collaborates with school districts on Covid-19 safety strategies. “They had lots of secondary transmissions. They had lots of kids quarantine.” He said that “well over 90 percent of school districts in North Carolina had masking required” within a couple of months, though some have since returned to mask-optional policies, according to local reports.

Quarantine and testing challenges

As cases rise, staff in schools and districts that managed well last year have often been overwhelmed by the job of contact tracing for the larger number students learning in person this year. Leah Rowland, a pediatrician affiliated with Children’s Hospital of the King’s Daughters in Norfolk, Virginia, said the extra work “can be very burdensome for the school and the health department.”

“Not every school has a school nurse,” Rowland said.

In December, parents and other visitors of P.S. 705 were greeted in a main office decorated for a variety of winter holidays. Parents could also communicate with teachers and administrators though a virtual office run on Zoom. Credit: Betsy Ladyzhets for The Hechinger Report

The New York City school district has a surveillance testing program intended to help identify cases, but only a small proportion of students are tested. Each week, the district attempts to test 10 percent of unvaccinated students who opt into the program, excluding kindergarteners and pre-K. In the spring, the city program tested a higher share of students.

This school year, the vast majority of cases at P.S. 705 in Brooklyn have been identified outside of the city surveillance program, said parent coordinator Melissa Graham.

And, even with a district-wide “situation room” like the one in New York City, it can sometimes take several days to alert students and their families to potential Covid-19 exposures. At P.S. 705, administrative staff took it upon themselves to contact-trace internally due to lags in the New York City system, said principal Valerie Macey.

Testing programs may help cut down on quarantines by enabling students to return to class if they’re exposed to Covid-19, but test negative. Yet these programs are logistically challenging and expensive, giving an advantage to wealthier districts — and to those in states with state-wide programs, said Smith, the pediatrician

Beyond the administrative burdens, quarantine policies mean students have missed weeks of school. “At one point, we had two students who were out for three weeks, not because they had Covid, but because somebody in their family had Covid,” said Krista Nieraeth, principal at the tiny Port Orford-Langlois district in Oregon.

Last year, quarantined students may have kept up with their classes through remote learning. But in fall 2021, “some of the schools have really dismantled their virtual platforms,” said Tina Tan, professor of pediatrics at Northwestern University’s Feinberg School of Medicine. Without virtual platforms, she said, “kids don’t have an option for catching up and learning.”

Schools are “still in a pandemic” while communities push back

Many teachers and school staff say the stress of keeping up with cases — and trying to help kids keep learning when they’re sent home — is leading to burnout, and contributing to staff shortages in schools. They say their frustration is exacerbated by communities that fail to acknowledge their efforts to keep students safe.

At Andrews Independent School District in Texas, the fall semester has proceeded largely without safety protocols: masks aren’t required, nor are quarantines. School staff rely on parents to identify when students are sick and keep them home; attendance rates in fall 2021 were closer to 90 percent than the pre-pandemic standard of 95 percent, said superintendent Bobby Azam.

The Texas district had reported about 160 Covid-19 cases among students, out of a total enrollment of 4,200, as of December 5, according to state data. Due to limited surveillance, however, it’s likely that the district’s true case number is higher.

“We have had a few [teachers] notify us that they will retire at the end of this year,” Azam said. “I can’t help but think that Covid helped speed that along.”

In Maryland’s Garett County, mask mandates and other safety requirements within the school district coupled with a lack of such restrictions at other local institutions has led to a strange dichotomy. “The community thinks the school system still has a pandemic, and the pandemic is over everywhere else,” said health services manager Aiken. This contradiction has taken a toll on school staff, especially the nurses who face the most direct contact with parents on health issues.

“There are many times when I’ll get a telephone call, and [the nurse is] saying, ‘I’m quitting, I’m not doing this again,’” Aiken said. The district is able to provide its nurses with mental health support, clerical support, and frequent acknowledgement of their efforts, which helps with retention.

Nurses across the country are facing similar challenges, said Robin Cogan, legislative co-chair for the New Jersey State School Nurses Association. “We’re exhausted,” she said, describing her job as “having to keep all these plates spinning in the air without things crashing down around us.”

Cogan said she has “never felt this way” in 21 years of serving as a school nurse.

The intense politicization of masks and vaccines is a major driver of burnout. “It’s extremely difficult to operate and try to do the best practices for your schools, when you have such great political pressures,” said Rowland, the Virginia-based pediatrician. She expressed concern that Virginia seems likely to end its statewide mask mandate soon; the state’s newly elected governor, Glenn Youngkin, promised to do so when he takes office in January. In Virginia and other states, state mandates helped take pressure off individual districts, Rowland said.

Related: Relying on personal responsibility to prevent Covid spread in schools

This has been true in Oregon, where the governor enacted a statewide school mask mandate last summer: “I think, by having the state say, you have to [require masks], it makes it easier for us to say, we’re just doing what the state wants us to do,” Nieraeth, the principal at the Port Orford-Langlois district said.

Even in places with broad support for Covid-19 precautions, pandemic fatigue has taken a toll. Crown Heights, like most of Brooklyn, was hard-hit by the pandemic. Many students lost loved ones or faced financial hardship. Still, staff and parents alike are feeling the challenge of maintaining Covid-19 safety, said principal Macey. “People are going and going and going and going, and now it’s like, when does this stop?” she said.

Macey said that she tries not to take criticisms personally, and to remember that “you have to remain structured” in order to keep students safe. At the same time, she and other P.S. 705 staff try find joy where they can — such as at a school-organized fall festival event or with extensive holiday decorations.

Trying to get shots into arms

Schools have taken on an added role in many places this fall: as vaccination sites. At P.S. 705, one in four students received their first doses at a vaccination event held at the school on November 15, Macey said.

Student vaccination can help limit quarantines and protect the entire school community. But school officials elsewhere are finding it challenging to convince many parents to inoculate their kids.

In Scott County, Indiana, the local public health department has assisted the school with vaccine clinics, while the state has opened a new health clinic — with free Covid-19 testing — close to the school campus, Broadus said. Still, Broadus estimated that only about 29 percent of high school students and 18 percent of middle school students were vaccinated as of early December.

In Maryland, the Garrett County district has organized vaccine clinics in schools through collaboration with the county public health department. But the responses to these clinics “haven’t been overwhelming,” said health services manager Aiken. At one November clinic for children in the 5 to 11 age range, Aiken estimated that around 30 kids got vaccinated — out of a district total of 1,630 elementary school students.

Some experts are optimistic about the capacity of the health and education communities to build upon Covid-19 lessons. “This work has shown me that academic science, academic institutions, academic medical centers, and school districts and superintendents can work together to improve the health and safety of kids,” said Smith, the Duke professor.

In future public health crises, he said, communication networks built during the pandemic will be “critical” for gathering data and sharing knowledge.

Still, polling data suggest that the majority of American parents with children under age 12 either want to wait and see how the vaccines perform — or don’t want to get their kids vaccinated at all. As of December 29, about 23 percent of children ages 5 to 11 had received at least one dose of a Covid-19 vaccine, according to federal data.

“Until we can get these vaccine numbers up,” said Tan, the Northwestern pediatrician, “it is way too early to talk about relaxing mask mandates or any other protective protocols.”

This story about Covid safety was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for Hechinger’s newsletter.

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