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What Health Data Says About Safely Reopening Schools

RACHEL MARTIN, HOST:

Schools aren't virus superspreaders - that was the conclusion of a recent study out of Brown University. Economist Emily Oster led that research, and I asked her to explain the data that makes her so sure.

EMILY OSTER: I mean, I think the import of the piece is really to try to start to bring together what we're seeing from schools, which now, in some places, have been open for, like, eight weeks, and to put some context around, I think, these fears that people had early on that when we opened schools, there would be these huge outbreaks and that schools would be a source of, like, giant spread in the community. And as we have opened schools, I think we haven't seen that. And you know, we're - it's not that we're not seeing cases in schools. We are definitely seeing some cases in schools, but we're not seeing these kind of large outbreaks that would suggest that schools themselves are at fault for spreading the virus a lot.

So Texas posts a dashboard where they have reported infections and they have counts of enrolled students, which is, of course, very important. And a lot of what I'm talking about here is really needing to understand how many kids are in school. So Texas has got, you know, some number of cases in a given week in a number of students. And their rate sort of implies something like, you know, 1.5 student infections in a school of a thousand in the week. You know, that actually translates to a case rate that's probably a bit lower than the case rate overall in Texas. And at least in that case and in general, we're seeing mostly kind of one, two, three cases in a school, not 50 cases in a school - again, pointing to the idea that people are coming to school with COVID. There are some people at schools with COVID, but we're not seeing these large clusters in most cases.

MARTIN: What about outbreaks or positive COVID tests for teachers and other school staff members? I mean, are you taking that into account in your data?

OSTER: Yeah. So in our data, we can also see those cases. And in the Texas data, they also see those cases. And again, you see a sort of - similar kinds of patterns where it looks like the rates are mimicking or maybe a little lower than the overall case rates in the area, which suggests, again, this idea that, you know, people may be acquiring COVID elsewhere and then, you know, being at a school or being affiliated at a school but maybe less that the cases are spreading around the school.

So for example, in our data, we can see that, actually, the staff COVID rates are very similar in - maybe even a bit higher in schools where the students are not in person and the staff are to the schools where the students are in person, which does really suggest this is just reflecting the community rate the same way, you know, if you looked at infections in any other setting, you'd see kind of rates similar to the overall population.

MARTIN: But just because schools aren't superspreaders, as you just pointed out, there can still be a community outbreak. At what point do schools need to respond to that and shut down?

OSTER: That's a sort of second question, and part of that is going to be about the capacity of the school to deal with cases. And, you know, I think a lot of schools have struggled, for example, with the need for additional substitute teachers. That is an important consideration, although I think it is not a consideration that's unique to schools, right? So if we're in a position where we're saying, OK, there's a community outbreak; we need to limit what we're doing, I feel like a lot of people are talking about it like, OK, the first thing we're going to do is shut schools, as opposed to saying, maybe the first thing we should do should be limit our indoor dining, limit our bars, limit the other things that we're doing. And given the social benefits of schools, that maybe is something that we should try to preserve longer than some of these other things.

MARTIN: I mean, isn't the problem that this is still a deadly disease, right? And there's just not a lot of clarity. You don't know exactly who's going to get a mild case or who could end up in the ER. And even one severe case is really frightening to schools, and they just don't want to be responsible for that.

OSTER: I think that's right. And I think that is - that kind of fear is where a lot of this is coming from. But one of the things we're not thinking enough about is the issues on the other side that, in fact, you know, keeping schools closed has very significant consequences for kids, which include learning consequences but also mental health consequences - depression, anxiety - physical health, food insecurity. You know, not having school is not good for kids. I think we're kind of very hyperfocused on COVID, you know, as we should be. It is a deadly disease. But on the other hand, we don't want to forget that there are risks in the other direction as well.

MARTIN: I mean, if your data are right, why aren't more schools open? (Laughter). What are they looking at? What other data or metrics are school districts using?

OSTER: There's a couple of issues. I think one is just simply there's a lot of fear, and there's fear among parents and fear among teachers. And I think it's been hard to understand the size of the risks, in part because mostly what we've been doing is just looking at cases and not looking at the denominators, not looking at how many kids are in school. And it's scary, as you say, when you say, OK, there's three cases. It's like, oh, my goodness, there's three cases, until you realize, you know, that's a school of 600 kids and, you know, 200 staff. And so actually, as a rate, that's - you know, that's still relatively low. So I think that's one piece.

I think the other piece is that schools don't have the resources they need. Right? So when we're seeing, you know, successful openings, they are more likely to be in places that are well-resourced, where people are wearing masks, where they're able to enforce some distancing and limited group sizes. And schools are struggling with how to do that. And so I think that there's really been a fall down on resources here, and districts need more help to be able to do this.

MARTIN: Information is conflicting, though, isn't it? I mean, just this week, the CDC published two papers, one about a case of a 13-year-old who was exposed to the virus at a camp and then she got a whole lot of her family members sick and another paper suggesting that toddlers are efficient vectors for the virus. How do you integrate that into your analysis?

OSTER: I think that in both of those cases, their, you know, papers are kind of arguing that kids can spread the virus. That is true. I think our question is really, when we open schools, are we going to see large amounts of virus spread as a result of that? And that's actually - it's both not - it's not sufficient to see evidence of how much spread there is or a single example of one kid who got people sick. That is neither concerning in some ways nor is it reassuring because, of course, schools are many kids and many adults and have a lot of other contacts. We really need to be looking at data on schools. In the case of toddlers, you know, we need to be looking at data on child care settings and actually trying to look at the things that we're actually trying to do as opposed to trying to sort of piece together tiny pieces of information that are only tangentially related.

MARTIN: Emily Oster is an economist at Brown University. Her most recent piece outlining her research on COVID and school reopenings appeared in The Atlantic magazine.

Emily, thank you.

OSTER: Thank you so much.

(SOUNDBITE OF HADOKEN'S "CLOUD RULER TEMPLE") Transcript provided by NPR, Copyright NPR.