School Daze: Omicron’s Spread Muddles In-Person Learning Debate

Whether children will be returning to schools today after the holiday break depends a lot on where they happen to be living. Today should be the first day back for millions of school children, but about 2100 school districts will be closed or conducting classes remotely, the school tracking website Burbio reports, thanks to unprecedented spikes in cases of COVID-19 in the United States brought on in part by the Omicron variant. The Johns Hopkins Coronavirus Research Center shows that as of December 30, 2021, there have been 300,866 new cases of COVID-19 causing 1546 deaths. About 63% of the US population has received 2 doses of a COVID-19 vaccine. What makes this COVID-19 surge particularly challenging is that there are 20% fewer health care professionals on hand to battle it than there were during the first surge in March 2020.

Esther Choo, MD, an emergency physician and professor at the Oregon Health & Science University, tells CNN that “our health system is at a very different place than we were in previous surges. This strain is so infectious that I think all of us know many, many colleagues who are currently infected or have symptoms and are under quarantine.”

In part because of staffing shortages, the Centers for Disease Control and Prevention (CDC) recently shortened the time health care workers exposed to COVID-19 have to spend in quarantine from 10 to 7 days. National Nurses United, a nurses union, protested the changed guidance, arguing that it puts nurses in more danger of being infected.

Linda Spauldling, RN-BC, CIC, CHEC, CHOP, a member of Infection Control Today^®’s Editorial Advisory Board (EAB), recently wrote in a a Viewpoint for ICT^® that patients—especially those who are unvaccinated—are acting out their frustrations with the health care system by being abusive to health care workers. In another ICT^® Viewpoint, Spaulding predicted that the US is not even halfway through the pandemic and that the health care system is on the verge of collapse.

Burbio notes that school districts in the Midwest, Northeast, and Sun Belt had been reopening during the autumn, driving the number of districts that continued to teach the children remotely down to 37%. But because of a spike in the Delta variant, that reopening slowed even before South Africa announced the discovery of the Omicron variant on November 24, and the first US case of Omicron had been discovered on November 29.

“As COVID rates rose around the country, we noted in our November 9th report that ‘introduction of in-person learning has slowed to an almost imperceptible level’ and districts across the Northeast and Midwest in particular began to signal issues around staying open for in-person,” Burbio states.

Keeping youngsters in school has become a major goal of public health authorities. On December 17, the CDC unveiled a program dubbed test-to-stay, in which the agency promotes the use of testing to ensure that children do not have to be quarantined to continue in-person school attendance. CDC Director Rochelle Walensky, MD, said at a White House briefing that day that test-to-stay will allow “unvaccinated children to stay in school even if they’ve been exposed to the virus.” However, Walensky at the same briefing urged parents and guardians to get their children vaccinated.

“We now have experience vaccinating children under the age of 17 and over 5 million of whom are under the age of 11,” Walensky said. “Looking specifically at vaccine safety data of over 50,000 children 5 to 11 years old, we found no evidence of serious safety concerns. The most common reported side effects include pain at the injection site, fever, tiredness and headaches and muscle aches, which we know are normal and are signs that the body is building immunity to the virus.”

Those sentiments were echoed this weekend by both education and health care officials.

Education Secretary Miguel Cardona said on CBS’ “Face the Nation” yesterday that “I still believe very firmly and very passionately, not only as an educator but as a parent, that our students belong in the classroom and that we can do it safely.”

Anthony Fauci, MD, the director of the National Institute of Allergy and Infectious Diseases and the chief medical advisor to President Joe Biden, told ABC News’ “This Week” yesterday that “it’s safe enough to get those kids back to school, balanced against the deleterious effects of keeping them out.”

The problem with making decisions about what to do in the face of Omicron is a continuation of the problem faced by medical experts and policymakers throughout the pandemic: There’s still a lot we don’t know about what we’re facing.

Kevin Kavangh, MD, another ICT^® EAB member, recently reported on a study that states that “Omicron can significantly avoid immunity created by both prior infections and vaccines, and younger people and people of ‘African ethnicity’ have higher rates of infection with Omicron than with Delta.”