But the state is not publicly reporting any outbreaks in school settings. And while the state is publishing a weekly dashboard of reported cases, schools and public health officials are not investigating all cases — making it impossible for the public to identify outbreaks and raising concerns among parents, who are trying to monitor potential exposures themselves.
“Based on widespread community transmission and the number of daily positive COVID-19 cases and close contacts, the Department of Public Health is unable to investigate, contact trace or issue quarantine orders for all positive cases and close contacts,” Dr. Karen Landers, of the state Department Public of Health, said in September.
Leah Dueffer, a parent in Vestavia Hills where masks are now optional, says her district’s decision not to contact trace means she never knows whether she’s sending her children into a safe environment.
“Every day I ask my kids: is there anyone out in your class? And how many kids are out in your class? Basically, all I have to consider is what I hear from my kids or what I hear from my friends about what their kids have told them,” she said. “And if you don’t happen to know other families in your class, you may not know what’s going on.”
School Superintendents of Alabama Executive Director Ryan Hollingsworth questions why ADPH still does not have the ability to effectively contact trace cases, 18 months into the pandemic.
“It should be the responsibility of the Alabama Department of Public Health to contact trace a communicable disease, period,” Hollingsworth said.
Lack of data
School and health officials have speculated that children are spreading the virus at school, and have sometimes used the word “outbreak” when talking about decisions to close schools or require masks. But they haven’t specified whether any case increases have met the official public health definition of an “outbreak,” defined as at least three cases that are found to be linked in the school setting or school-sanctioned extracurricular activity.
It’s unclear if state officials are even collecting and analyzing that information.
Because COVID-19 is a disease that must be reported to the Alabama Department of Public Health, school officials report known cases to ADPH online through the “Novel Coronavirus Report Card.” Outbreaks can be reported in two ways: on the online “Communicable Disease Report Card” or called in to the Infectious Diseases and Outbreak Division.
In addition to reporting all cases directly to ADPH, school nurses are required to report the number of new cases their district has learned of each week for the Alabama State Department of Education’s K-12 COVID Dashboard, published every Thursday. That form does not require the name of the child’s or teacher’s school.
In response to AL.com’s request for the number of COVID outbreaks that occurred in schools during the 2020-21 school year, ADPH attorney Dana Billingsley wrote: “School COVID data is included in the data that is reported to the Department, but it is heavily commingled with other data and is not readily producible or always identifiable as such. Such data is not maintained by schools and would have to be extracted with special programs or report forms.”
Further questions to ADPH about whether they are tracking school outbreaks have gone unanswered despite repeated requests.
Other states — including Colorado, Georgia, Louisiana, Minnesota, Mississippi, North Carolina and Virginia — report school outbreaks to the public, though with varying levels of consistency and detail. Others, such as Tennessee, embroiled in battles about masking in public and in schools, have decided not to track school cases at all.
For their part, the Alabama State Department of Education said ADPH officials have helped school officials make decisions in some places when an outbreak has occurred, but the volume of COVID cases this year has made that difficult.
When asked if the education department is keeping track of where school outbreaks have occurred, head nurse Jennifer Ventress said it hasn’t been possible for them to do so.
“Due to the high numbers and the hybrid operations of schools in the past 24 months,” Ventress said, “we have been unable to monitor the logistics or where and when the outbreaks occur.”
School districts are reporting new cases weekly to publish on the COVID-19 K-12 dashboard, and department officials are monitoring those numbers, she said.
School officials are also monitoring the ADPH dashboard that shows the spread of COVID by county, she added.
Some school district officials are publishing the number of new cases on their websites, in daily or weekly school or district-level updates.
“We’ve got some districts that took the initiative,” Hollingsworth said, “because I guess nobody else was doing it, and they wanted to do that for their parents.”
The lack of available data on where outbreaks are happening frustrates Hollingsworth. Before the start of the 2020-21 school year, superintendents asked ADPH to share case data by zip code to help them make decisions about whether in-person school was safe to do.
“We were told we couldn’t get that information,” he said.
That leaves school officials making health decisions, Hollingsworth added, which they are not fully equipped to do.
Rep. Terri Collins, R- Decatur, chairs the House Education Policy Committee and said she hasn’t asked for any information from ADPH about school outbreaks. School districts in her area are publishing school-level COVID data, she said, providing parents with transparency about what is happening in their children’s schools.
“They seem to know their data is what I’m hearing,” she said.
Last year
In addition to complaints about a lack of analysis and sparse information this school year, officials wonder why Alabama apparently didn’t conduct a large-scale review of last year’s cases, and then use that information to inform their current response.
The Alabama Department of Public Health or other agencies haven’t conducted a large-scale review of cases in schools during the 2020-21 school year to assess whether masking was effective or if any school outbreaks could occur, as other states have.
As a condition of returning to in-person learning, North Carolina required schools last year to submit data on COVID transmission in schools to the ABC Science Collaborative, which is run through the Duke Clinical Research Institute.
The collaborative collated, analyzed and interpreted the data from 100 participating school districts and 14 charter schools, representing 864,515 students who attended in-school instruction, and 160,549 staff members. The study found that there was very limited in-school transmission and that proper masking was an effective mitigation strategy, with less than 1-percent transmission occurring even without social distancing.
This school year, researchers from the collaborative have held regular, monthly meetings with superintendents to discuss strategy. They expanded their research outside of North Carolina to work with 200 districts across 18 states.
“Our research has shown that masking is the most effective mitigation strategy to prevent transmission in schools. This will be true regardless of geography,” said Dr. Michael Smith, an associate professor of pediatrics at Duke. “However, we encourage districts in Alabama to partner with us as they can take advantage of our data visualization tools to track cases over time.”
Alabama schools also have the option to partner with ADPH and the University of Alabama at Birmingham to conduct free, voluntary testing of students and staff in order to maintain in-person learning with minimal disruption.
However, UAB researchers are only collecting aggregate data to evaluate the program, rather than to draw conclusions about outbreaks in schools or the effectiveness of mitigation measures.
Moving forward
Last year, Alabama school officials were expected to keep track of seating charts and to notify parents if students were exposed to a positive or suspected case of COVID. This year, schools have been told they don’t have to do that.
“The expectation has been going into both school years, well the first year especially, that ADPH is going to [contact trace],” Hollingsworth said. “And [ADPH] didn’t have the capacity to do it. So it went down to the school level. And there’s a lot of frustration among superintendents that we are just having to do it because nobody else is.”
Hollingsworth said officials he speaks with also are frustrated with the pressure to make decisions about masking and school closures, which could better be made by healthcare professionals or with advice from ADPH about specific metrics to use. ”In the absence of any parameters from ADPH, local districts, boards and superintendents are developing their own,” he said. “That’s why you’re seeing differences across the state.”
Districts might require universal masking for two weeks, he said, and then promise to re-evaluate based on case data school officials are collecting. But Hollingsworth reiterated those are really healthcare decisions that school officials need more help with.
“[School officials] are doing the best they can,” he said. “And they’re trying to communicate that but there’s no consistency at all because it’s all at the local level, between that superintendent and that board of education.”
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