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When will it be safe to reopen schools? Carroll County health officer outlines key stats to watch

While guidance from the state could be coming soon, Carroll County’s top health official briefed Board of Education members Wednesday night on what measures he believes should be taken into account when they are deciding whether to reopen schools. He also gave them some homework.

The school board voted at its previous meeting, on July 29, to open the school year online-only for students, but with the option of reassessing on or before the board’s Oct. 14 meeting, perhaps getting students back into buildings by the start of the second quarter.

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Board President Donna Sivigny noted that she had been emailing county Health Officer Ed Singer for his guidance about when conditions would be right for reopening.

Singer joined Wednesday night’s board meeting via video conference and explained to the the board and Superintendent Steve Lockard the three metrics he considers to be the most important indicators of when it would be safe to return to traditional schooling: the weekly total of new cases of COVID-19 among community members not living in congregate living facilities, in relation to Carroll’s population; the number of intensive care unit beds in use at Carroll Hospital; and the number of weekly community fatalities from COVID-19, the disease caused by the novel coronavirus.

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Singer said he and his staff had researched successful and unsuccessful school reopenings, and found that, generally, communities with one to three coronavirus cases per day per 100,000 residents had a far greater chance for success than communities with higher rates. Carroll County has a population of nearly 170,000.

“I would suggest we’d be looking for two weeks of 35 new cases [or fewer],” Singer said. “Right now we’re above that.”

The number of Carroll’s new community cases — a statistic that does not include those who live or work in congregate living facilities, such as nursing homes and group homes — was 62 last week after hitting a high of 109 the previous week and 97 the week before that. (A health department spokesperson said Thursday that two cases announced this week had lab reports dated back to last week, retroactively raising the total to 62.) For the seven weeks prior, however, the county averaged about 28 new community cases each week.

“It’s certainly something that’s achievable and a place we could end up being,” Singer said, in reference to his stated goal of no more than two weeks of 35 new cases. “In general, this would be a good guideline ... we were there, late May through June. ...

“I wouldn’t be surprised if we wind up there again in September and October. It may be very appropriate to be considering school reopening at that point.”

It was just a guideline he was providing, though, and he recommended that the board members do their own research, seeking out reputable sources and looking at how various school systems around the world have done with reopening. In Europe, there have been many success stories, he said. He pointed to Israel’s as an unsuccessful reopening.

“I think what we really need to be considering is those community cases,” Singer said.

Board member Kenneth Kiler said he was reluctant to commit specifically to 35 new cases.

“I’m not sure we want to lock in to a certain number,” he said, noting that if there are 40 cases for two weeks in a row, for example, “we should talk about it.”

Regarding his second metric, Singer said he and Carroll Hospital President Garrett Hoover look at hospital data on a daily basis. He said that what concerns the hospital most is intensive care unit capacity. The hospital is normally staffed for seven ICU beds and can push it to 10, but going beyond that level would potentially become an issue. The number of emergency department patients and the overall number of patients are also statistics to consider, but ICU capacity in particular was the one Singer asked school board members to consider.

The hospital has not seen the number of ICU beds in use rise above 10 for a couple of months, Singer said. A health department spokesperson said more data on ICU hospitalizations related to COVID-19 is planned to be released next week.

“Right now I think the hospital is in really good shape. It’s been really steady for probably the last couple of months,” Singer said. “Barring something significantly changing, I don’t think that’s going to be a problem for us.”

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Finally, while Singer said he didn’t have a firm number, he said he would be concerned if Carroll began seeing multiple deaths from community coronavirus cases per week. “If we’re seeing two to three deaths a week to [COVID-19], that would be very concerning and would have to enter into the discussion of schools reopening,” he said.

A total of 15 fatalities have resulted from community cases to date, according to Carroll County Health Department data. Only one community death has been announced since June 17.

Lockard said he speaks to his fellow superintendents across the state and they would all like to be getting this type of guidance.

“We’re very appreciative of the ongoing partnership and collaboration,” he said.

Lockard was one of Maryland’s 24 school superintendents who voted unanimously Friday to request that state health officials create benchmarks for deciding when students could safely return to school buildings, saying it is imperative that there be common rules across the state. Some states have set tiers based on a ratio of new cases to the district population.

Kelly Griffith, president of the superintendents association, made clear that every school system won’t be in he same phase at the same time. She also said superintendents will ask the state health department for protocols for personal protective equipment and contract tracing.

Maryland Department of Health spokesperson Charles Gischlar said in an interview, “We are in the process of finalizing school guidance and look forward to working with our health officers on next steps.”

Sivigny said Wednesday she had suggested via email looking at other measures, such as positivity rates, but Singer said positivity rates are perhaps not the best measure because so many people are being tested for a job, or prior to going to college or on a trip, or just because they are curious — these people were not sick and were never expecting to test positive, he said, and that can skew the numbers.

“Our positivity rate is going down a lot. That’s a good thing, but I don’t really think that tells the story,” Singer said.

Singer also reminded the board that Centers for Disease Control and Prevention recommendations state that if a student is sick — with a runny nose and a sore throat, he used as an example — that student would be considered positive for COVID-19 unless and until a negative test result or a signoff by a doctor that the student has a different illness is provided. Not only would that student have to isolate in the interim, but so would any other student who had come in close contact (within 6 feet for at least 15 minutes).

With that in mind, Singer suggested that schools consider rotating teachers, rather than students, to different classrooms throughout the day, thereby keeping students at the same desk, if possible.

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Singer reiterated that the metrics he suggested were the ones he thought were right, but that it’s important the members of the board learn about other communities’ successes and failures before deciding on the parameters necessary for reopening in Carroll.

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“You don’t have to make a decision on these numbers tonight, whether they’re the right numbers or the wrong numbers,” he said, recommending that, “by the next meeting, everyone does their homework.”

Baltimore Sun reporter Liz Bowie contributed to this report.

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