Anne Arundel County schools Superintendent Mark Bedell rolled up the sleeves of his white t-shirt outside of the Parole Health Center in Annapolis Sept. 29 and pointed to his shoulders.
“Can I get Moderna on the right and flu on the left,” he asked the licensed practical nurse administering his vaccines ahead of the winter season. “I have to do this, with all of the people I’m around.”
Bedell is among many school officials around the region emphasizing the importance of vaccinations and continued vigilance against the COVID-19 virus this fall. As Baltimore-area school systems have walked back most restrictions and mandates, the COVID-19 response is increasingly woven into familiar public health messaging about the approaching flu season or the common cold.
“[COVID] is becoming part of a norm,” Bedell said. “I think anytime you return to a norm after a pandemic, people lower their guards. We just have to do our part.”
Anne Arundel, Baltimore, Carroll, Harford and Howard county school systems have done away with masking mandates, quarantines and routine COVID testing this fall. Baltimore City is the only jurisdiction in the region to maintain a regular COVID testing program for students, though slimmed down from weekly testing last year to biweekly this semester as pandemic relief dollars dry up.
More than a third of the city’s approximately 78,000 students have turned in permission slips allowing schools to administer COVID tests as needed, and Cleo Hirsch, who leads the city schools’ schools COVID response, said more are rolling in each day.
“We really want families to consent to testing as we approach cold and flu seasons, so if our students have symptoms we can quickly give them a test,” said Hirsch, the system’s director of priority initiatives.
City schools leaders have yet to decide whether the program will continue into next semester — a decision that will partly depend on participation rates and continued funding from the Federal Emergency Management Agency, which reimburses the school system for 90% of costs.
Still, pushing vaccines remain a priority for Hirsch’s team, who are working with the city health department to set up vaccination clinics at schools within census tracks that have higher positivity rates.
The Maryland Department of Health on Wednesday updated the number of COVID-19 outbreaks in the state’s public and non-public K-12 schools. Schools in Baltimore County reported about eight cases and Harford County schools reported 101 cases. Howard and Anne Arundel counties’ public and private schools reported nine and six cases, respectively. Carroll County reported no cases.
The state defines an outbreak as two or more confirmed COVID-19 cases within a 14-day period spread among students or staff who are not household contacts. Hirsch said the city school system relies on an honor system for families who test at home to report their results to the schools, which must share those figures with the central office.
Meanwhile, public and private schools in Baltimore City reported about 62 cases to the state, according to Wednesday’s data. Hirsch said the school system’s case counts and early testing results this year are “reasonably good.”
Hirsch said the city schools’ testing also may turn up old infections that students had over the summer.
No matter the official reports, the number of COVID-19 infections in kids remains high, said Dr. Scott Krugman, vice chair of the department of pediatrics in the Herman & Walter Samuelson Children’s Hospital at Sinai in North Baltimore.
”In Maryland, there have been a handful of kids in the hospitals consistently, but it’s not a large outbreak like last December when the original omicron variant hit,” Krugman said. “But cases keep going and have pretty much been going since March when all the mitigation measures such as masking stopped everywhere.”
Krugman said most kids weather infections well, but a small percentage don’t. And as cases climb the number of really sick kids could rise. Those kids also continue to infect relatives and classmates. State figures show there were 8 children and 465 adults in the hospital with COVID-19 on Thursday.
The hospitals also are caring for a lot of children with other respiratory viruses. The U.S. Centers for Disease Control and Prevention reported this week that there was a rise over the summer in pediatric cases of rhinovirus and enterovirus, including a more severe type called enterovirus D68. They are normally expected in cooler months.
The Evening Sun
Krugman said the combination of COVID-19, flu and those other viruses could overrun hospitals. Further, with more children missing routine vaccinations, there could be outbreaks of measles or other highly contagious diseases.
Krugman recommends catching kids up on all vaccines. Flu and COVID-19 boosters can be given together. The new bivalent COVID boosters are available for kids ages 12 and older, though Pfizer/BioNTech is seeking authorization for children as young as 5 and testing doses for younger kids. He also said ventilation and masks were important to protect kids and vulnerable relatives.
Maryland has a relatively high rate of vaccination, with about 94% of the state population age 5 or older with at least one dose. Children have the lowest rates, however, with fewer than half of those ages 5 to 11 and less than 80% of those ages 12 to 17 fully vaccinated.
A big issue for most kids will be more missed school, said Krugman and Gigi Gronvall, a Johns Hopkins virologist and advisor to Baltimore schools. Gronvall praised Baltimore city schools for continuing to offer routine testing so infected students and staff can be sent home.
”I think this is a really great thing because we are seeing cases go up, and we are heading into fall/winter when we may see even more cases,” said Gronvall, a senior scholar in the Hopkins Bloomberg School of Public Health’s Center for Health Security.
She said incentives might help get more students vaccinated or boosted.
”Hoodies are expensive, about $80, and if you could give those out to vaccinated students, you’d get a lot of uptake,” she said. “I’d like to see more vaccine clinics for flu and for COVID. The most important thing we can do is keep students in school.”