A Multnomah County briefing on the COVID-19 pandemic Tuesday underscored schools’ struggles to remain open for in-person education while protecting students and staff from exposure.
Communicable Disease Manager Lisa Ferguson told county commissioners that school officials are, in some instances, turning to wide-scale quarantining — forcing entire grades or classes to move back to distance learning — because of the imperative to prevent exposures.
“That’s what we’re trying to limit,” she said.
Reynolds High School in Multnomah County closed for two days last week while shifting entirely to a week of remote learning. Ferguson told commissioners she has been working closely with schools to develop safe protocols that keep students in school.
“We’ve spent a lot of time talking about mealtimes. Lunch has been a big concern,” Ferguson said. “We ended up making some recommendations around outdoor lunches, and we have seen the schools work really hard to implement that and encourage outdoor eating.”
Most exposed students have not become sick with COVID-19. Public health measures like masks, distancing and increased ventilation are reducing the chances of a student contracting COVID-19.
Still, exposures are occurring. To keep kids in classrooms, schools need to determine exactly who was exposed — and that means keeping track of which students come into contact with other students. Ferguson recommended that schools use seating charts on buses, at lunch, and in classes to limit the number of close contacts each student has.
Once a student tests positive, parents are supposed to be notified by phone or by letter, and Multnomah County Public Health Department is to begin investigating exposures and looking for potential outbreaks. But that can be very time consuming, which can influence a school’s decision to simply go remote — like Reynolds High School did in Troutdale.
“That was a functional, operational decision. That’s not a public health intervention. It was purely based on staffing, and we learned about it from school leadership,” said Dr. Jennifer Vines, the lead health officer for Multnomah, Clackamas and Washington counties.
About one-third of students there were considered exposed, and Reynolds didn’t have enough teachers to administer classes both in person and online. To prevent another, similar closure, the school plans to implement stricter seating charts and limit contact between students. And the health department is ramping up its contact tracing.
“We’re working hard to get to that level of detail so we can keep more kids in school,” Ferguson said.
If there is an outbreak, it’s not clear at what point, if any, public health officials would make a decision to close schools.
“It may not achieve our goal of slowing spread,” Vines said, because students will gather or receive childcare outside of school, potentially exposing them in a less-controlled environment than schools.
Over a thousand students are in quarantine across Oregon, but it does appear that the delta wave of COVID-19 is beginning to slow, at least in Multnomah County.
“We’re at another pivot point,” said Jessica Guernsey, Multnomah County public health director. Getting cases lower will go a long way towards keeping schools open.
The volume of COVID-19 testing has gone up, and Vines would like to see it increase further. “I don’t think anyone in public health thinks it’s at the level that it should be to meet demand.”
The proportion of COVID-19 tests coming back positive in Multnomah County is still “in that danger zone” between 5% and 10%, Vines said. That indicates there is community spread that isn’t being detected in COVID-19 tests.
Vines emphasized the importance of lowering COVID-19 cases before winter comes — and with it, the seasonal flu.
“A bad flu season is already enough to squeeze our hospitals,” Vines said, urging people to get a flu vaccine. “As far as we’re hearing, there’s plenty of supply. It’s never too early or too late to get it.”
Flu seasons can be unpredictable. Last year, because of COVID-19 preventative measures, there was barely any flu season at all. But that means that people could be going into this year with little pre-existing immunity. Health officials say that means it’s particularly important to get vaccinated this year: many of the COVID-mitigating measures that slowed the spread of the flu are no longer in place.
There’s an exception to that rule: Schools remain one place where COVID-19 measures are supposed to be strictly enforced.
In a normal flu season, schools drive the circulation of influenza. That’s the opposite of what’s been seen with COVID-19, where schools have followed community trends, not the other way around.
It’s possible that COVID-19 mitigation measures in schools could help blunt the winter’s flu wave. The important thing is protecting hospitals from a double-whammy of respiratory viruses.