As students return to the classroom after winter break, Idaho health officials are concerned that with few mitigation protocols in place, schools could contribute to an increasing spread of COVID-19 and added strain on hospitals.
Before winter break, most school districts in the Treasure Valley removed their mask mandates as cases declined and vaccines became available for kids between the ages of 5-11. The Boise School District is one of the few in Idaho that still requires masks in the classroom.
Across Idaho, about 15% of children 5-11 years old have received at least one dose of the vaccine, 40% of kids 12-15 years old and 45% of those 16 and 17 years old, according to the Idaho Department of Health and Welfare.
With the spread of omicron – a highly contagious variant – coupled with low vaccination rates among kids, health officials have warned that schools could see higher numbers of infections and could even ending up having to close temporarily if large numbers of teachers test positive.
“It’s a concerning set of circumstances to be sure,” Dr. Kenny Bramwell, system medical director for St. Luke’s Children’s Hospital, told the Idaho Statesman. “And as kids go back to school in large groups for long periods of time, that’s a setup for a lot of spread of this disease.”
Schools lack mask mandates, quarantine protocols
Many school districts in the Treasure Valley have not had mask mandates or quarantine requirements in place since the start of the school year. Over the past few months, the West Ada and Caldwell school districts, which previously required masks, removed the mandates.
In December, the Boise School District’s board met and was expected to consider changing its mask policy. But after hearing from health care professionals who pointed to the omicron variant and high levels of virus transmission in the Treasure Valley, the board kept its mandate with plans to revisit it mid-February.
The trustees acknowledged during the meeting it was a decision that would upset many families, but said they would continue to listen to experts and make decisions they felt would keep the community safe.
“I’m frustrated. I know all these people are frustrated. I know our staff is frustrated and I know our students are frustrated,” Board President Dave Wagers said. “We do pay attention, and it is heart wrenching from both sides. … There is no perfect answer, and anything we do we will make half the people mad.”
When the West Ada School District removed its mask mandate – a change that took effect after Thanksgiving – trustees pointed to the availability of vaccines for kids aged 5-11 as a primary reason they felt comfortable lifting the requirement. At the time, the district was also reporting fewer positive cases among students and staff.
“Before the winter break cases were decreasing. But we are monitoring for what impact the variant may have on schools,” Tracey Garner, the district’s health service supervisor, said in an email this week. “We continue to stress our mitigation measures, especially staying home when sick.”
Mask mandates have stirred tension in school districts for months and divided parents. Many parents have argued they should have a say in the health protocols their kids follow, while others have said masks are a key way to keep their kids and the community safe.
Doctors said school districts could be in for a difficult time if they continue with few or no mitigation protocols.
“It doesn’t make sense to decrease your mitigation measures when you’re facing something that’s more transmissible,” Dr. David Pate, former CEO of St. Luke’s, told the Statesman.
Bramwell and Pate said they have seen some school districts relying less on information from health experts. Both said they are still happy to help any district that asks, but fewer have been consistent in getting medical expertise.
Could schools have to shut down?
Experts warned schools could face closures going forward.
“The history, even in our own state, of schools having to shut down because of being overwhelmed by COVID were significant in the fall,” Bramwell said. “So I would expect that, sadly, to be worse now that we’re starting a new semester with a more contagious variant.”
When students returned to school in the fall, several schools across the statetemporarily closed, including schools in Nampa, Kuna and Emmett. Districts and schools said at the time that the closures were due to high numbers of absences among students or teachers, or large outbreaks that forced students and staff to quarantine.
With the more transmissible omicron variant and low vaccination rates among kids, Pate said he’d similarly expect to see more kids getting the virus.
“We’re certainly in a situation where most kids are going to be vulnerable,” he said. “There’s going to be less mitigation measures in place and I would expect we would see many more of them infected.”
Several school districts in other states across the U.S. have temporarily moved students to online learning due to COVID-19.
‘There’s still a lot we don’t understand’
Most kids experience milder symptoms if they get the virus. But some have to be hospitalized. In Idaho, 285 people younger than 18 have been hospitalized with COVID-19 since the start of the pandemic, according to the Department of Health and Welfare.
Kids are also at risk of multisystem inflammatory syndrome, or MIS-C, a condition connected to the coronavirus that can cause can cause inflammation in the heart, lungs, brain, kidneys and other organs. Doctors aren’t yet able to predict the children who are susceptible to MIS-C, which typically develops a few weeks after an infection. Children could also be at risk for long COVID-19.
“There’s just still a lot we don’t understand, and I think we would be overstating it to say that, ‘Well, COVID is no problem for kids,’” Pate said.
Health officials warned even if kids don’t have severe symptoms, they could get the virus at school and spread it to family and friends who are immunocompromised or more vulnerable.
“Children are really effective catchers and spreaders of illnesses,” Bramwell said.
He added that schools are one of the best places for viruses to thrive, because so many people are together in an unprotected setting.
“If you have a disease that’s four times as contagious as the initial COVID virus, and kids are around each other all the time, it stands to reason that more kids are going to get admitted to the hospital,” Bramwell said. “And by inference, either directly or indirectly, more adults are going to get admitted to the hospital.”
Bramwell said St. Luke’s hasn’t seen an uptick in the number of children coming in with COVID-19 over the past few weeks. But he said the St. Luke’s Children’s Hospital is near capacity with other viruses, which is typical for this time of year.
“This is respiratory season. It’s when people get together and breathe on each other – and flu, and RSV, and paraflu, and all of those very common viruses get spread a lot and affect the youngest kids the worst,” he said.
It’s a change from last year, when across the country, flu activity was “unusually low,” according to the Centers for Disease Control and Prevention. Health officials attributed that in large part to people wearing masks, washing their hands and distancing from others.
This year, with the combination of flu, RSV and COVID-19, health officials worry it could put even more strain on hospitals and health care workers.
Officials encourage vaccinations, masks in school
The Department of Health and Welfare said in an email the recommendations for schools and families are unchanged, even with the spread of omicron.
Those recommendations include getting vaccinated, physical distancing, hand washing, staying home when sick and getting tested if symptomatic.
“The best protection from spread is universal indoor masking for all teachers, staff, students, and visitors to K-12 schools regardless of vaccination status,” spokesperson Greg Stahl said in an email.
Pate pointed specifically to kids who are immunocompromised or have family members who are.
“In this kind of fervent desire for everybody to not wear masks, we have just made schools much more dangerous for those kids and for those family members who have particularly concerning medical conditions,” Pate said.
Health officials also emphasized the importance of getting vaccinated for people of all ages. Those under 18 continue to have the lowest rates of vaccination in the state.
The CDC late last month released a study relating to vaccines for kids 5-11. It found that after administering about 8 million doses of the vaccine to kids in that age group, serious adverse events were rarely reported. The study identified 11 verified cases of myocarditis. Seven of the children had recovered, and four were recovering at the time of the report.
“You are, in essence, choosing between having a significant illness or at the very least spreading a very significant illness to other people,” Bramwell said.
Pate also recommended, in addition to encouraging masks and vaccines, that schools pay attention to the ventilation in classrooms and look for opportunities to improve it.
“I’m concerned that that we’re in for a really long winter,” Bramwell said.
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