ARIZONA — Gov. Doug Doug Ducey this week pushed back any in-person school re-openings until August 17, giving school officials another two weeks to prepare for their plunge into the unknown.
The order came as confirmed cases of COVID-19 exploded and the state re-imposed an order to close non-essential businesses, lifted on May 15.
The stutter-step on reopening schools comes amid intriguing research showing that children are not only much less likely to get infected with COVID-19, but once infected they’re much less likely to develop symptoms.
On the other hand, research has also demonstrated that the abrupt shift to online learning last semester cost many students half a year of academic progress, with the worst effects on minority and low-income students. That includes many rural areas like Rim Country and the White Mountains, where half of the families qualify as low-income.
An earlier executive order gave school districts broad flexibility in reopening. Districts could return to near-normal, in-person learning, continue mostly online learning or embrace a blend of in-person and online approaches. Districts would still have to offer a place for students to study in the event of a blended approach. However, the order would insulate schools financially from a big drop in enrollment if parents kept their children home. It also eased standards for the amount of time students had to spend in class to get state funding.
The latest order spawned new uncertainty just as school districts were scrambling to lay plans for an August 3 reopening, while grappling with the suddenly overwhelming list of scheduling options.
Arizona Superintendent of Education Kathie Hoffman this week told the Arizona Republic “we were hopeful that schools could reopen and that with mitigation strategies that our schools could still offer in-person instruction. But more recently, it’s become more clear that’s not advised. We’re going to see a lot more online learning than we saw before,” she said.
The decision comes as confirmed cases of COVID-19 have risen from about 500 per day when the stay-at-home order expired on May 15 to about 3,500 per day in the past week. The rate of infection has increased eight-fold among younger people, but only doubled among high risk groups like those over 65. Only 11 percent of the confirmed cases have been among those under 20.
Even before the most recent surge, studies suggested 18 or 20 percent of parents have doubts about sending their children back into in-person classes. On the other hand, many parents support a return to in-person classes, especially those struggling to provide online learning tools at home or facing big problems providing care for children at home due to their own work demands.
Interestingly, recent studies suggest COVID-19 doesn’t pose a grave risk to children. Some doctors have documented a strange, potentially dangerous inflammatory response in children who have been infected, but the condition remains rare.
One international study found children are only half as likely to get infected when exposed to the virus as adults, according to the results published in Nature. Moreover, once infected only 21 percent of children show any symptoms at all. By contrast, 70 percent of people over 70 develop symptoms.
Much of the initial alarm about the impact of COVID-19 on children was based on the experience with the flu – a different respiratory virus. The flu hits the very young and the very old the hardest and spreads readily in school settings. However, COVID-19 has shows a very different pattern, with the odds of infection and the development of serious symptoms increasing with age.
The researchers concluded, “In countries with younger population structures — such as many low-income countries — the expected per capita incidence of clinical cases would be lower than in countries with older population structures, although it is likely that comorbidities in low-income countries will also influence disease severity. Without effective control measures, regions with relatively older populations could see disproportionally more cases of COVID-19, particularly in the later stages of an unmitigated epidemic.”
That’s bad news for rural counties in Arizona with generally older populations than urban counties like Maricopa. It also means that even if children don’t face a high risk of serious complications, they could get end up with a “silent” infection they pass along to parents. That’s especially alarming in places like Payson, where many grandparents are caring for their grandchildren.
The researchers said something in the immune systems of children apparently lowers their risk of first getting infected and then developing serious symptoms.
The human immune system has both an immediate response to an invader and an additional system based on an immune system memory of previously encountered viruses and bacteria. Children have a quicker immediate immune response, but less of an immune system memory of previous challenges that orchestrates a secondary immune response. Doctors speculate this difference in the immune system response might help explain the difference in reaction to COVID-19. The SARS-CoV-2 virus that causes COVID-19 first evolved in bats – which have a much faster-acting immune system and far less inflammatory response. The immune system’s inflammatory response in humans is behind many of the most dangerous complications of COVID-19.
The researchers in the Nature paper noted, “Understanding the role of age in transmission and disease severity is critical for determining the likely impact of social-distancing interventions on SARS-CoV-2 transmission, especially those aimed at schools, and for estimating the expected global disease burden.”
Other research has provided mixed results. Most studies have shown few infections and little serious illness among children. Some have shown children can get infected as easily as adults and spread the virus, even if they have few or no symptoms.
In Arizona, children account for 11 percent of infections and less than 1 percent of the deaths. By contrast, people older than 65 account for 12 percent of the infections but 74 percent of the deaths.
The enormous disparity suggests the greatest health risk in going back to school involves children with risk factors like diabetes and children likely to take the infection home to parents with risk factors or family members older than 55.
Some researchers have suggested this opens the door to a more nuanced approach when it comes to reopening schools. Mask wearing, temperature checks, spreading out children in classrooms, limiting the mixing of children during the school day and enhanced cleaning efforts could slow the spread of the virus on campus. In the meantime, improved distance learning for children with risk factors and family members at home with risk factors could limit the consequences of infections that do take place.
The latest governor’s order gives hard-pressed districts another two weeks to hash out a response.
Arizona percentage of infections and death by age
Age;Infections;Percentage of deaths
Under 20:;11 %;0 (6 deaths)
20-44:;49 %;6 (91 deaths)
45-54:;15 %;7 (107 deaths)
55-64; 12 % ;13 (219 deaths)
Over 65;12 %;74 (1,209 deaths)