As the nation mobilizes for the impact of the fast-spreading COVID-19 omicron variant, the federal Centers for Disease Control has announced recommendations to make the pandemic less disruptive for schools.
The CDC now says that instead of sending students with a close contact home, schools can repeatedly test the close contacts of a positive COVID-19 case.
This could drastically reduce the number of students who stay home for 10 days after a close contact, without increasing the odds of an on-campus cluster.
However, the recommendation assumes districts have rapid tests on hand, parental permission to give tests and someone to administer that test. Despite millions of dollars in federal aid for most districts and a year of pandemic planning — most districts don’t have the capacity to undertake the big increase in testing the policy envisions.
Fortunately, the Biden Administration has promised to make 500 million rapid tests available nationally for free — almost two tests per resident. Presumably, the program will prioritize test kits for schools. The Administration has also said it will deploy 1,000 Army doctors and nurses to help hospitals, with many overwhelmed by the latest surge in cases. Banner Health System — the largest hospital chain in Arizona — has said the surge has filled most of its beds and caused difficult staff shortages.
However, the CDC formulated the advice for schools based on studies in two large districts before the omicron variant came ashore. The variant has spread explosively and last week accounted for 2% of new cases in Arizona, according to a variant tracking program operated by TGen. Epidemiologists warn that omicron could become the dominant strain in the US in a matter of weeks. It took perhaps a month for omicron to displace almost all other strains in South Africa.
Research suggests that omicron spreads more than twice as fast as delta, which in turn spread more than twice as fast as the original strain. Doctors are scrambling to understand what that means. Some evidence suggests omicron can also more easily infect people who have been vaccinated as well as people who have recovered from an infection by another variant. Some very early evidence suggests omicron may also more easily infect children.
However, small-scale studies and very early evidence also suggests omicron might cause less serious illness — especially among the vaccinated. Those findings are still very preliminary, based on early data from South Africa, Denmark and Great Britain. However, it’s possible the seemingly less severe illness may mostly reflect the large number of vaccinated people in the population. In any case, variant can still cause very serious illness and death.
The US has so far suffered 800,000 COVID-19 deaths — a large share of the 5 million who have died worldwide. Arizona has suffered roughly twice the death rate as the rest of the nation. Moreover, the non-reservation portions of Navajo and Apache counties have suffered nearly twice the death rate as the statewide average.
Fortunately, test-tube studies show that a half-dose booster shot appears to restore nearly full protection from omicron, at least for the two-shot Pfizer and Moderna vaccines. This has prompted health officials to urgently recommend people get booster shots. Nationally, less than a third of the people who have been fully vaccinated have also gotten a third booster shot, according to the federal Centers for Disease Control.
In off-reservation portions of Navajo County, only 43% of the population has gotten at least one shot — including just 27% of those under 20. In the non-reservation portions of Apache County, 41% have gotten at least one shot — including 37% of those under 20. Statistics based on previous strains suggest the unvaccinated are five times more likely to get infected and 13 times more likely to die. It’s unclear whether the omicron variant will have the same effect.
The new CDC recommendation relies heavily on rapid testing and contact tracing. However, few districts in Northern Arizona have developed extensive testing programs — despite receiving millions in federal pandemic assistance. Most rural districts also don’t have mask mandates and have not invested in classroom air filtering systems, which studies show provide the best protection — second only to vaccination.
The new “Test to Stay” policy could enable many students to stay in class, with little risk of new clusters.
The CDC based its recommendations on the success of a testing program in Los Angeles and Illinois schools, prior to the arrival of omicron.
Los Angeles schools experimented with a “Test to Stay” pilot program between Sept. 20 and Oct. 31, then compared the results to students who quarantined when they had close contacts. The students in the automatic quarantine schools lost 92,445 more days of school. However, the infection rates remained about the same between the test-to-stay group and the automatic quarantine group.
Schools in Lake County, Illinois reported similar results when comparing automatic quarantine schools with “Test-to-Stay” schools between August and October. The automatic quarantine group lost 8,152 days of school compared to the testing group. Of the 16 students who did test positive for the virus within two weeks of an exposure in the test-to-stay schools, none appeared to have passed the virus along to other students at school.
However, those studies might not apply directly to local schools for several reasons. First, Navajo and Apache counties have very high infection rates. Second, both counties have a much lower vaccination rate. Third, most off-reservation schools lack a mask mandate — and few children or staff on campus wear masks. Fourth, the omicron virus may spread far more easily once it gets established.