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Utah doctor questions school plan, warns an outbreak could spread ‘fairly quickly’

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A renowned infectious diseases physician in the state fears that — “despite the best intentions” — Utah’s plans for reopening schools could lead to serious outbreaks and further spread of the coronavirus.

Dr. Sankar Swaminathan, chief of the Division of Infectious Diseases at University of Utah Health, said he particularly worries about the “modified quarantine” policy that the state announced last week. Under that plan, children and teachers who have been exposed to the virus can continue coming to class as long as they don’t show symptoms and no one in their house tests positive.

Having individuals quarantine at home for 14 days after they have been in close contact with a case of COVID-19, though, is one of the best ways of containing transmission, Swaminathan said during a virtual news briefing Tuesday.

“Quarantine is useful so that the person who was infected doesn’t infect other people,” he added. “That’s the whole principle behind controlling this outbreak. So I have concerns about the fact that an outbreak could spread fairly quickly in that [school] setting with what is essentially no quarantine.”

The state has proposed that the “modified quarantine” setup will allow more students to stay in class and focus on their education. It’s “modified” because they can go to school, but not participate in sports or other activities outside the home — and they have to wear a mask. Officials have said that’s what essential workers have already been doing in the state during the pandemic.

But Swaminathan finds it concerning because younger kids often have COVID-19 without any symptoms, though they still spread the disease. That means an outbreak may not be detected until an older teacher or adult in a child’s household, who may be at higher risk for serious complications because of their age or health conditions, gets sick.

“If kids are just going to go back to school, symptoms or a fever isn’t a particularly useful indicator,” he said, referring to the state’s plan.

Testing, too, isn’t always helpful because there’s a lag in getting results, as well as a delay in when someone will test positive after being exposed. And masks “aren’t 100%” effective, Swaminathan said.

That’s why he believes quarantine works best and health experts have been supporting it; but if only works if people actually stay home.

Most studies on children spreading the disease, he noted, have been done while school has been shut down, “so we don’t know how much a problem outbreaks in schools are going to be yet.” That’s especially the case as the number of new cases of the virus and transmission remain “fairly high in a few counties in Utah,” he said, putting kids, staff and their families at risk for when school starts later this month.

There have been nearly 42,000 confirmed cases in the state and currently just under 10% of tests are positive for the virus. Some states aren’t recommending schools reopen until that’s under 1%.

Dr. Adam Hersh, an epidemiologist at U. Health and Intermountain Primary Children’s Hospital who joined Swaminathan in the news briefing Tuesday, noted that the decision to quarantine under the state’s plan will be left to the parent. For now, he’s hopeful that many will choose to keep their kids home if there’s been close contact with COVID-19.

Meanwhile, other measures, Hersh added, such as face masks, hand washing and social distancing with desks should also be used together to help limit transmission in schools and make exposure less risky.

“This isn’t a free for all in the classroom,” he said, noting that the same protective measures can reduce community spread and make it safer for students to return.

Both Swaminathan and Hersh said it’s important for kids to learn in-person for social development, and it’s critical for schools to open for families who work or who may be disadvantaged. But they stressed teaching needs to happen in a safe environment.

The state released a manual for schools reopening Thursday, including the “modified quarantine” policy, after Utah Gov. Gary Herbert had previously ordered classrooms to welcome students back this fall. It also includes direction on how many cases it would take for a school or class to move online and how to effectively sanitize a building. And it pushes Herbert’s mandate that most K-12 students and staff wear masks.

But, in addition to health experts, teachers and administrators also have questioned Utah’s plan, as well as those drafted by local school districts.

The Utah Education Association, the state’s largest teacher union, had called for all schools to start the year online to be safe. It believes the state isn’t doing enough to protect educators from the virus, especially now with the allowance for those exposed to return to the classroom.

Teachers across the state have rallied against that, too. More than 150 educators picketed at the Capitol in July, calling for better ventilation and sick leave policies. Another 30 protested at Jordan School District last week.

And around 500 showed up outside Granite School District’s board meeting Tuesday night.

Many say that if they have to go back, they at least want students to be split into groups that come in on alternating days so there’s not as many people in a classroom at one time. But there’s no requirement for that from the state. And neither Jordan nor Granite district is planning to do so. Both are offering online options, though students are allowed to return mostly as normal if they choose to, for four or five days a week.

“There are a lot of teachers who are really worried about the safety of the current plan,” said Michael McDonough, the president of the Granite Education Association, which represents more than 2,000 educators in the district. “We want to go back. We just want to go back safely.”

McDonough said he’s heard from many teachers in the district who are worried about being able to spread students out enough to be socially distant. Many held signs Tuesday that said, “Open schools safely” and “Keep us safe” and “When students and teachers get sick and die, will you be able to sleep at night?”

They wore red, a color tied to education activism, and lined up across State Street. They said they fear catching the virus from a kid who may not have symptoms under the “modified quarantine” and bringing it home to their families. Some are quitting to avoid the situation entirely.

Ben Horsley, the spokesman for Granite School District, confirmed that 16 educators have resigned and 12 have retired. But he said the district doesn’t intend to change its plans for the upcoming year, which were finalized last month, “unless something significant occurs” with virus transmission.

“We will continue to monitor that,” he said, “though things are moving in the right direction.”