Despite the tireless and persistent efforts of school superintendents, principals, nurses, and teachers, statewide data show that 27 percent of K-12 students and 41 percent of staff have reported positive test results during the 2021-22 school year alone. State leaders must grapple with the immensity of the impact of COVID-19 infections on students, staff, and educators.
These figures certainly understate the true rate of infection. They are drawn from district-level data, which is taken from what local and school-based health officials are able to count and report. Because testing is inconsistent between districts, so is reporting. For example, some districts continued their pool testing program this year while others did not. Despite the provision of rapid tests to parents by DESE and districts, restrictive opt-in rules made universal access to tests more challenging.
Reducing the number of new cases is important for several reasons. It is vitally important in lowering the risk of new variants. New cases also create havoc at day care, schools, and workplaces. With children and staff averaging five missed school days for the 2021-22 school year, we estimate the loss of 1.5 million lost class days for students, 1 million workdays for their parents, and more than a quarter of a million lost work days for educators and staff.
It is also important to look honestly at hospitalization and death data, which have often been used to suggest new variants are less serious. Even though Omicron brought lower incidence of severe disease than earlier variants, it still caused an enormous spike in deaths simply by infecting far more people. Schools played a role in this. We now know that school children spread COVID both to one another and to other high-risk individuals.
Among the youngest children, infection rates have been especially high. In our separate review of district dashboards totaling 393,000 Massachusetts children last week, elementary school children were 260 percent more likely to be infected with COVID than middle school students and 180 percent more likely than high school students.
This adds urgency to boosting vaccination rates. Unfortunately, vaccinations for younger children have stalled at levels far below what would be needed for adequate protection. In 182 of 351 Massachusetts communities, fewer than half of children ages 5 to 11 are fully vaccinated against COVID-19. Places with lower vaccination rates tend to be communities of color, rural areas, and places with more white working class and politically conservative residents. The number of new shots in arms for 5- to 11-year-olds appears stuck in place. In the past three months, only 15,000 children in Massachusetts or about 42 children per community have had their first COVID-19 vaccine.
School-based mitigation measures, such as masking and social distancing, have fallen by the wayside in nearly all districts. Testing regimes have also slowed dramatically. Rapid antigen testing, in principle, holds much promise as a backup, but there are major disparities in access to the tests. A recent poll from the MassINC Polling Group found upper-income households far more likely to report using rapid tests during the Omicron surge than lower-income households.
Looking ahead, the state is not prepared to deal with current Omicron subvariants nor new and more pernicious subvariants should they continue to arise. What’s more, we can predict where impacts will be most severe. We can see where vaccination rates are lowest, mitigation is lightest, and testing is irregular.
So what can be done, both in light of these figures and keeping in mind the weary public?
One promising proposal would involve expanding successful wastewater surveillance as a new public health tool at the school building level. UMass Amherst has piloted this approach through wastewater testing at 40 buildings on the UMass Amherst campus over the past year. This would allow communities to detect not only COVID but also other pathogens like seasonal flu.
Making rapid antigen tests available is essential as in-school testing programs decline. Another recent survey by the MassINC Polling Group of Massachusetts K-12 parents found that providing rapid tests for families to take home was supported by 91 percent of Black and Asian American parents, 89 percent of Latino parents, and 85 percent of white parents. There’s no reason income should be a barrier to rapid tests, though evidence shows it has been in the past.
As for masks, the same survey showed a strong majority of Massachusetts parents of color are in favor of requiring mask use in school — 80 percent of Black parents, 71 percent of Asian American parents, and 67 percent of Latino parents compared with 50 percent of white parents. While mask rules may not be possible or appropriate in every case, when transmission rates are high and parents are supportive, they will help keep kids and staff in school.
Finally, the state shouldn’t be satisfied with the very low vaccination rates among young children in many of communities. All studies agree that vaccines protect against severe disease among children ages 5 to 11. Boosting rates may involve educating vaccine-hesitant parents who want more 1-on-1 conversations with their doctors and more educational initiatives from the state. There have been numerous successful community-based efforts to improve COVID-19 vaccine uptake across the general population with lessons applicable to parents and young children.
It’s incumbent on all of us to work together to find ways to keep kids and staff safe in school and minimize the spread of COVID in the community. Taking a hard look at the data and then planning for the future will help us do just that.
Alan Geller is a senior lecturer at the Harvard T.H. Chan School of Public Health. Steve Koczela is president of the MassINC Polling Group.