Multnomah County health leaders documented about 100 school-based instances of students being infectious with COVID-19 while at a public or private school since Sept. 1, but thousands more have had to quarantine since school started.
"What I can say is that we're seeing very little evidence so far of transmission related to school activities," Lisa Ferguson, communicable disease manager for Multnomah County, said Tuesday, Sept. 21 during a briefing to the county's Board of Commissioners.
But while the actual transmission rates may seem relatively low, just a single case can trigger a quarantine for several students, regardless of whether those students test positive.
On September 15, Portland Public Schools reported nearly 700 students and staffers had to be kept out of school due to a positive case or potential exposure to someone with COVID-19. Specifically, during that reporting day, 109 people were isolating at home due to a presumed or confirmed case. Another 316 were quarantining due to being exposed to someone with COVID-19 while at school and another 270 were in quarantine due to off-site exposure, according to the district.
More recently, on Sept. 17, 789 students and staffers were in quarantine due to COVID-19 exposure and by Sept. 21, 435 were in quarantine, with 79 of them being in isolation with a confirmed or presumptive case.
Per county guidance, unvaccinated students and staff are recommended to stay away from school sites for 10 days following notification of a potential exposure to COVID-19. That quarantine period can't be cut short with proof of a negative test result.
Ferguson said the county hasn't adopted a test-out option, because it can't guarantee that every student has access to testing that would allow them to return before the 10-day period.
The county is actively working to expand COVID-19 testing sites, as is Oregon Health and Science University.
Lack of quick testing, combined with a high number of students in quarantine has posed a challenge to school districts scrambling to provide options for in-person learning, as well as hybrid or distance learning for those stuck in quarantine.
That challenge was manifested on Sept. 16, when Reynolds High School shut down in-person learning due to a large number of students in quarantine all at once.
As of Sept. 16, Reynolds reported 15 students and staff had tested positive, but 1,334 students and staff were in quarantine.
The high school didn't have enough staffing to cater to students on campus and at home, so school leaders decided to take the week of Sept. 20-24 off and focus entirely on distance learning with an anticipated return date of Monday, Sept. 27.
That decision was entirely a school-based call, not a county recommendation, county officials said.
Multnomah County health leaders also said that while schools have done a good job of providing a structured, controlled environment to prevent the spread of the coronavirus, school buses have proven more difficult to monitor. Kids don't have assigned seating on buses, and drivers aren't able to monitor students on buses the same way teachers in classrooms can.
"Expecting a bus driver to be able to pay attention to those details while they're driving a bus, I think is where the challenge comes in," Ferguson said.
What constitutes a school-based outbreak?
Ferguson said even a positive case of COVID at a school site doesn't mean others were exposed, despite the liberal quarantine protocols currently in place.
"For us to say there are school-associated cases, we have to see two cases in a cohort where we can't identify they were together outside of school or had some common exposure," Ferguson later clarified by phone.
What will it take for a school to shut down?
Dr. Jennifer Vines, public health director for Multnomah County, said the county has grappled with the question of when, and if to recommend a school closure due to COVID-19.
"We can keep kids out of school, but kids will need childcare," Dr. Vines said. "They'll get together with their friends. They're going to go somewhere, so we can talk about quarantine in hopes that people will stay home on symptom watch for two weeks, which is a long time, but I think when we talk about a public health school closure, we end up wrestling with, are they really any better off not in school, not learning, not in a structured environment with masking expectations and good ventilation and all those other prevention things?"
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