Maryland’s 24 school superintendents face daunting decisions about when to bring back students in the coming weeks of the pandemic, and they have no clear benchmarks from the state or federal government to guide them.
New federal guidelines announced last week suggest there could be significant risks in having students return to school buildings in most Maryland districts unless more precautions — face masks, social distancing and cleaning — are in place.
The new guidelines from the U.S. Centers for Disease Control and Prevention, along with health metrics announced by the state late last month, are both broad, nonbinding advice to school superintendents.
Without prescriptive advice, officials in each school district will have to make a determination on their own — and take the political heat — as to when and how to reopen schools.
“The CDC should have issued direct and specific guidance — for example, a checklist of all the things that must be done to ensure safe school reopening," said Dr. Leana Wen, who formerly served as Baltimore’s Health Commissioner. "This would have provided clarity and empowered local school districts and health departments to best protect students, teachers, families, and communities.”
School superintendents had asked for guidelines similar to other states like West Virginia, which has created a chart with five categories that prescribes what a school system should do if the spread of the virus has reached a certain level in their county.
For instance, the chart says if there are 15 to 24.9 new daily cases per 100,000 people in a community, school districts should suspend all in-person classes immediately. A color-coded map indicates which of five categories each county in the state is in, shaded in hues from green for go to school to red for online only. Parents can look at the map and know precisely whether their children will be online or in a school building.
Maryland does not have such specific criteria for schools. In fact, it offers a sobering degree of choice.
Its guidelines say, for instance, that if a county’s testing positivity rate is greater than 5% and the number of new cases is 5 to 15 per 100,000 population, a school district can choose to hold some in-person classes or instead allow only online instruction.
Those guidelines, announced last month by Republican Gov. Larry Hogan and State School Superintendent Karen Salmon, fell far short of what Maryland superintendents wanted.
“We were disappointed that we didn’t get more specificity in terms of school openings,” said Mary Pat Fannon, executive director for the Public Schools Superintendents' Association of Maryland. “While it was helpful, we didn’t feel it was enough.”
She said superintendents aren’t expecting any more guidance from the state, and they will have to lean on local health officials to help them make reopening decisions.
Other Maryland school leaders are likely to experience the same range of reaction as they bring back students. Already, a number of school systems in the Baltimore region — including the city and Anne Arundel, Baltimore and Harford counties — have started to allow small numbers of students into buildings to take their online classes.
And that is expected to lead to bringing back larger numbers of students later this fall, including special education students, English language learners and those who don’t have the resources for online learning.
School superintendents had been asking for clear guidance from the state for more than three months, when Hogan and Salmon presented a set of criteria at an Aug. 27 news conference and declared all school districts were safe to reopen for some in-person classes.
Health experts interviewed by The Sun agreed with local school officials who called Maryland’s criteria too broad.
“I can understand why schools would want more … That is a pretty wide range,” said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security.
Michael Ricci, a spokesman for Hogan, said the state didn’t intend to dictate when schools should reopen.
State health and education officials “established metrics to help guide local reopening discussions, and not be overly prescriptive,” Ricci said.
The new CDC guidance is more detailed, said Meagan Fitzpatrick, an assistant professor at the University of Maryland’s medical school and a modeler in the university’s Center for Vaccine Development and Global Health.
According to the new federal bench marks, no Maryland county has reached the lowest level of risk of coronavirus transmission. And the state’s threshold to reopen — 15 new daily cases per 100,000 people — would represent a high risk of transmission in schools. While the federal guidelines don’t declare whether schools should remain closed with such transmission, they make clear it would be highly risky to open.
The CDC thresholds "are reasonable statements about risk,” Fitzpatrick said.
Watson also called the new CDC guidelines evidence-based and reasonable and said they should be helpful to local school officials, even though they are not prescriptive about what actions school districts should take.
While they come after many areas already have set their own thresholds, Fitzpatrick said she believes the new guidance is still valuable “for thinking about the next few months and next semester."
Of the state’s standard, Fitzpatrick said: “It’s less clear whether that is the right criterion for schools to be safe.”
New York State considers states with 10 cases per 100,000 population to have an uncontrolled epidemic and puts them on its travel advisory list. Massachusetts considers 8 cases per 100,000 to be a “hot spot” — while Maryland has labeled a rate of infection almost twice as high as “safe” for reopening schools.
The numbers in Maryland and individual counties, “seem high to me as a parent,” Fitzpatrick said.
Maryland and other states can’t draw on the experience of other countries that have reopened under national criteriabecause the U.S. rate of infection is much higher than when they opened schools.
“Our transmission has been so much higher than elsewhere in the world, it is hard to know what is safe,” said Meira Levinson, a professor at the Harvard School of Education.
Researchers also are developing tools that could help school districts assess risk.
A University of Maryland School of Medicine model uses the level of disease transmission in the community, the number of students and staff, and other factors to show the likelihood of at least one elementary student or staffer coming to school with a COVID-19 infection.
The model allows researchers to plug in a school’s population, rate of community spread and other characteristics, and then determines how likely it is that someone will come to the school with the coronavirus.
For instance, when researchers ran the numbers last week for the Baltimore area, they found the risk of finding a case in school ranged from 46% in Carroll County to about 64% in Baltimore City. Statewide the risk was about 61%.
“For my own kid in Howard County, am I OK with a 57% chance that someone in my child’s building will be infected? No, that probability does not make me feel very safe,” Fitzpatrick said. “Would other parents be OK with this? What about teachers? They should see the numbers for themselves and decide.”
The model does not show the likelihood that an infected person passes the infection to another student, teacher or staff member. However, Fitzpatrick said, evidence suggests that kids are about half as susceptible as adults to become infected.
Fitzpatrick’s model also does not attempt to determine what the spread would be inside schools with precautions.
But another model goes one step farther than Fitzpatrick’s, by taking into account the wearing of masks, social distancing and a variety of other precautions. That model, developed for the Pennsylvania Department of Education, predicts that schools can reopen with classes of 9 to 10 students even when there is a moderate level of the virus spreading in the community.
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The modeling, done by Mathematica, a public policy and analytics firm, says that when a community has 10 to 100 cases per 100,000 people during a week, students can return to classrooms with precautions without causing spread within the school community.
Brian Gill, a senior fellow at Mathematica, said the researchers assumed that some students and staff would come to school with the virus because it is in the community. Researchers assumed small class sizes because some students would stay home. They also assumed mask wearing and other precautions and that students would ride buses and move through buildings.
The researchers ran 200 simulations and found that schools wouldn’t cause more coronavirus spread at the level of community transmission currently in Baltimore City, and some of the surrounding counties, including Carroll and Howard counties where the levels are low or moderate. ButAnne Arundel and Baltimore counties come closer to the top limits of the threshold these researchers consider safe.
In other words, students and teachers would be unlikely to spread the virus within the school at that level. However, other counties in Maryland don’t meet that threshold, including a number of hot spots on the Eastern Shore.
Gill added that any school can get unlucky and have a student or teacher spread the virus and that schools need to be prepared to quarantine.
The models also show, he said, that if schools were to send all their students back in the current environment and not have precautions — such as masks — schools would become centers for spreading the virus.