In the midst of the latest surge of COVID-19, an unlikely trend is taking shape in public schools in Massachusetts: a shift away from the most comprehensive virus mitigation measures, and from those straining the limits of school resources.
A vocal contingent of experts say the time has come for schools to prioritize pre-pandemic routines over arduous measures to contain an illness that has, so far, caused few children serious symptoms. And schools have begun to change their practices.
On Tuesday, Governor Charlie Baker announced schools can stop contact-tracing — the time-consuming work of identifying and notifying all close contacts of infected students — to ease the burden on staff, as long as they join a new state initiative that offers weekly rapid tests to willing students and staff. The move puts Massachusetts in line with Vermont and Connecticut, which also recently relaxed school contact-tracing efforts.
“The current state of the pandemic requires that we adapt our efforts to meet the times,” Baker said.
Newton schools already made a similar change at middle and high schools, after 30 students tested positive at one school in one day in December, creating a pool of 1,500 potential contacts for staff to determine how close the students sat to the infectious person and whether they were exposed, then asking parents for permission to test them. Now, schools send a general notice to parents when positive cases turn up in their child’s classroom or grade. Schools in Framingham and Swampscott made similar changes recently.
“Schools can’t sustain this over the long term,” said David Fleishman, schools superintendent in Newton. “When this surge is over, it’s critical that public health officials and education leaders get together and talk about the path forward.”
The push to move schools back toward pre-pandemic operations is escalating tensions between two impassioned groups: those who say that schools have done too much, for too long, to stop the virus, and those who maintain that not enough is being done.
More than 100,000 students and educators statewide have tested positive for COVID-19 since schools reopened in September, most coming since the Omicron variant began its rampage in mid-December. The staggering pace continued last week, with the state reporting last Wednesday more than 41,000 new student cases in the preceding one-week period. Experts have predicted caseloads will soon start falling.
In updated guidance issued Tuesday, the Department of Elementary and Secondary Education said participating schools will send two rapid tests home every two weeks to willing students and staff. In exchange, schools can stop contact tracing and end the test-and-stay program, which allows close contacts to attend school if they test negative. (Children who are vaccinated are excluded from test-and-stay, under state rules.)
The new protocols were based on a new review of school-based COVID testing data that found low rates of transmission inside schools, and supports a return to normalcy for students, said Dr. Westyn Branch-Elliman, an infectious disease specialist and associate professor at Harvard Medical School.
Data through mid-December — before the Omicron surge — shows that between 2 and 3 percent of unvaccinated students identified as close contacts later tested positive, she said. (Some may have been infected in the community, not at school.)
“We need to . . . find ways to make life feel more normal for kids,” Branch-Elliman said. “Health includes mental health, and living in stressful, fearful conditions has consequences as well.”
Now, children will be tested at home by their parents, instead of being pulled from class to be tested by school nurses and other staff. Officials said that will free up nurses to handle children who are sick and allow students in school to focus on learning, and let other staff concentrate on school duties.
The state’s latest changes sparked strong opposition from some parents, students, educators, and doctors who were already incensed by existing school procedures. Those include the state ban on large-scale remote learning; allowing students who test positive to return to school after five days if fever-free; and excluding vaccinated students from the “test-and-stay” program, even though they can still catch and spread the virus.
Hundreds of students in Boston walked out of classes on Friday to protest what they see as inadequate attempts to prevent illness. The group BPS Families for COVID Safety blasted Baker’s plan as having “serious problems” and poorly serving urban schools.
State leaders “are acting like it’s very much over,” said Suleika Soto, who has kept her two daughters home from Boston schools for most of January to protect her family. “But we need to be mitigating right now. This is the crisis point.”
Some said the state is providing too few tests under the new regime — one a week per student. Dr. Julia Koehler, an infectious disease clinician and assistant professor of pediatrics at Harvard Medical School, said weekly testing is insufficient because people infected with Omicron can become highly contagious within one to four days.
“By the time the infection has been detected four or five days later [after exposure], the virus has already been passed along to other children,” she said, adding that she knows many families where schoolchildren have spread the virus to babies or older relatives.
Lunchtime has emerged as a key concern for some parents since the state halved its isolation time recommendation last month, following new guidance from the Centers for Disease Control and Prevention. The revised state guidance says returning students must “mask for five additional days when around others.” But it does not account for lunchtime, when students remove masks to eat.
Dr. Cheri Weaver, an emergency physician at Beth Israel Deaconness Hospital-Milton, drives to her children’s school in Newton daily so they can eat lunch in her car. She said some returning students are likely still infectious, five days in, and she doesn’t feel the school is adequately addressing lunchtime risks. Weaver has another child at home who is too young to be vaccinated.
“It’s unfortunate DESE and school districts didn’t provide better guidance for what to do when we’ve got kids coming back into the building” with COVID, said Weaver, who spoke as a parent, not for her employer. “It’s great that we want to get them there; it’s unfortunate we didn’t have a better plan as to how to do that more safely.”
School leaders in Newton and elsewhere say they can’t segregate recently diagnosed students in a separate room for lunch because it would violate their privacy. In that case, some parents say, returning students should be tested first to ensure they don’t infect others.
A few districts, including Lexington and Hopkinton, have kept a 10-day isolation policy. Others, including Newton, have told families they are spacing students out in cafeterias for safety, and encouraging them to eat quickly.
Many medical experts are now giving more weight to the impact COVID measures are having on children’s mental health, given the availability of vaccines and the milder symptoms associated with Omicron. Some are even pushing to relax mask mandates in schools.
“In 2019, very high-risk people were at risk from influenza, but we did not subject children to masking and testing and the threat of school closures,” said Dr. Danny Benjamin, a professor of pediatrics at Duke University School of Medicine who has researched school COVID policies. “It makes very little sense, given the morbidity and mortality of the illness in childhood, to have children bear all the weight of this.”
In Vermont, the state chapter of the American Academy of Pediatrics endorsed the recent move away from contract tracing, calling it “no longer feasible or helpful” in a statement.
Some of the policy shift is driven by practicality. Contact tracing and related tasks have created an “unsustainable workload” for school nurses, driving widespread burnout and resignations, the Massachusetts School Nurses Organization said last week in calling for it to be sharply limited.
Yet many teachers say more protective measures are needed, not fewer. The Massachusetts Teachers Association says contact tracing should continue and has also pushed the state to provide extra staff support to help nurses, and to relax remote learning restrictions.
In many districts, said MTA president Merrie Najimy, COVID-related staffing shortages this month have forced “triage, rather than meaningful learning,” with students spending hours in study halls because of absent teachers.
Becky Slawson, a high school English teacher in Ipswich and president of her local union, said she understands the virus is here to stay, but due to the mystery surrounding long-term effects, “it does seem premature to say that we can treat it the same as the flu.”
Sean Furbush, a senior at Billerica Memorial High School, said the stress of the pandemic has clearly taken a toll on his peers.
“At what point do we get an answer, a certainty, that we can relax?” he said. “And is the stress we’re under as dangerous to us as the disease itself? I don’t know the answer.”