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Oregon’s COVID-19 cases have never been higher: Here’s what your school should do to make in-person learning safer

Oregonian - 9/1/2021

A mixture of excitement and worry is descending upon Oregon parents, children and educators as K-12 students head back inside for full-time in-person instruction while COVID-19 cases are at an all-time high.

New known infections among children ages 0 to 17 are up 10-fold compared to a year ago, when most Oregon schools were shuttered and learning in front of a computer screen was most students’ only option.

But within the next two weeks, most Portland area classrooms will swell to full capacity — 25 students, 30 students or more in some cases. That’s in stark contrast to the half filled, physically distanced spaces of last spring.

Many parents are hungry for answers about the procedures their school will use to try to tamp down on spread. But with just days until the start of the school year, many Oregon districts are struggling to provide information, with some in the Portland area saying they’re still trying to nail down plans.

In their defense, many districts say they’ve been left to sort through a mountain of information from local, state and federal entities – and need more guidance.

Ginger Huizar, mother of a Portland middle schooler, told the Portland Public Schools board at a meeting this past week that she’s looking forward to the return to full-time in-person classes for the first time in 18 months.

“But I’m also concerned about the way that we come back,” Huizar said. “Because I want to stay back and not have to shut down and not have a lot of disruptions for kids.”

Huizar wants the district to create smaller class sizes, test all students who spent time in a classroom with a student who turned out to have COVID-19 and use federal coronavirus money to buy covered outdoor eating areas so hundreds at a time don’t crowd into lunchrooms indoors unmasked when it rains.

Already, at least four small, rural school districts have pushed back the start of fall classes because of surging numbers of COVID-19 cases in their communities or large numbers of employees who are quarantining. The 875-student Vale School District in eastern Oregon says it might have to temporarily shut down after more than 50 students and staff members were forced to stay home less than a week into the school year because they’ve been sickened by the virus or exposed to it.

“I really empathize with all these parents and teachers, ... you shouldn’t be in this situation where it feels like you’re having to choose between your children’s education and their health,” said Lucky Tran, a New York-based molecular biologist who was one of 25 public health and pandemic panelists who presented their best advice for reopening schools at an online “Speak Up America” forum this month.

No one knows for sure how delta will impact American schools this fall, since the variant was still rare in the U.S. when schools let out for the summer, said Kimberly Prather, the University of California San Diego aerosol scientist who organized the “Speak Up America” forum. But she said if districts follow the latest science on reducing transmission of the virus, in-person schooling can be made significantly safer.

“I say safer, not safe,” Prather told The Oregonian/OregonLIve. “With delta, it’s a roll of the dice.”

Prather has become a prominent voice in the fight against COVID-19. She has advised the Biden Administration and pushed for aggressive virus-fighting measures.

Chief among Prather’s and other experts’ advice: Ramped up ventilation systems that quickly replace exhaled air in classrooms, strict mask policies that not only focus on wearing masks but the quality and the fit, frequent rapid tests of all students and staff, and eliminating what might just be the most dangerous period of the day — indoor lunch. Experts say getting everyone vaccinated is also a top priority, but roughly half the K-12 population — everyone under 12 — isn’t eligible yet.

The Oregonian/OregonLive contacted a half dozen of the largest school districts in the metro area — Portland, Beaverton, Hillsboro, North Clackamas, Tigard-Tualatin and Gresham-Barlow, which together enroll more than 140,000 students — to learn how their plans stack up against recommendations from the Centers for Disease Control and Prevention and the panel of “Speak Up America” experts.

Most districts’ reopening plans lacked key details. The news organization followed up with all six to get more specifics. But even then, some districts couldn’t provide answers.

Prather told the “Speak Up America” panel that in this time of uncertainty, districts need to get the details to the public.

“One of the most important things for those of you dealing with this in schools is that you have to be transparent,” Prather said. “You have to tell the public what you’re doing to clean the air. Don’t just say ‘Oh, we’ve got this. Yes, we’re following CDC guidance.’ That’s just not enough to calm people down.”

VENTILATION

Prather said one of the most important steps districts can take is to address the way the virus is spreading: through the air.

One of the reasons delta is so much more contagious than previous strains is that people infected with it have 1,000 times more virus in their noses and throats, according to one groundbreaking study. Delta went from causing about 6% of U.S. cases at the beginning of June — just as the school year was about to end — to nearly 100% of cases today.

Prather said delta has dramatically increased the amount of virus that infected people are exhaling. It now might take just seconds to infect an unvaccinated person, Prather noted.

“The good news is we can clean the air,” Prather said. That, she said, will help prevent entire classrooms from being saturated with coronavirus in the hours that students spend together each day.

Experts say school building ventilation systems should be upgraded with air filters rated MERV 13 or higher, a standard that approaches the efficacy of a HEPA filter. Unlike air filters that have commonly been used in schools, MERV 13 filters can sift out the virus.

Airborne transmission experts also say classrooms with five or six air changes per an hour — meaning that the air in the room is replaced every 10 to 12 minutes — can significantly reduce the chance of viral spread. Many of today’s schools and ventilation systems might have been built to only conduct two air changes per hour.

“As a generalization, schools were pretty unhealthy before” in terms of air quality, said Richard Corsi, an outgoing Portland State University dean who has studied airborne transmission of COVID-19.

Using portable HEPA air purifiers in classrooms can significantly reduce aerosol particles, accomplishing the equivalent of several air changes per hour. In practical terms, Corsi said, adding a HEPA air purifier to a classroom is like upping a classroom’s air changes from two to almost six per hour.

He’s penciled out the cost of acquisition and maintenance to about $10 per student per year. That’s money well spent, Corsi said.

What’s happening locally: Portland Public Schools says it has upgraded all of its building filters to MERV 13s and purchased thousands of portable HEPA air purifiers to equip every classroom, as well as school buses. But Portland doesn’t have data on the number of air changes per hour in its classrooms or other spaces, said spokesperson Karen Werstein.

Beaverton has upgraded all of its buildings with MERV 13 filters and added HEPA air purifiers to special education classes where students might not be wearing masks because of mask rule exemptions, said spokesperson Shellie Bailey-Shah. The district also is considering whether to place HEPA air purifiers in its cafeterias. All of Beaverton’s classrooms and other indoor spaces have at least five air changes per hour, Bailey-Shah said.

In Hillsboro, the district has installed MERV 13 filters wherever the systems will allow, and all schools’ ventilation systems now perform at least six air changes per hour, said chief operations officer Casey Waletich. Waletich said Hillsboro isn’t using portable HEPA air purifiers unless six air changes per hour can’t be accomplished in a specific space.

Gresham-Barlow hasn’t upgraded its buildings with MERV 13 filters or every classroom with portable HEPA air purifiers, but the district has equipped 98 of its roughly 600 classrooms with the purifiers after teachers specifically requested them. Spokeswoman Athena Vadnais said all of the district’s classrooms have at least three air changes per hour.

Tigard-Tualatin spokesperson Traci Rose said the district couldn’t switch entirely to MERV 13 filters because the schools’ ventilation systems couldn’t handle it. The district, however, has begun installing bipolar ionization devices and expects to be done within the next several months, Rose said. But there’s little data outside the lab to prove such devices work, according to the U.S. Environmental Protection Agency. Rose said the district has discussed their effectiveness at length.

Tigard-Tualatin also isn’t making widespread use of HEPA purifiers. The district can’t say how many air changes per hour occur within its classrooms.

North Clackamas states in its ventilation plan that it’ll strive to install MERV 13 filters where possible and has purchased ultraviolet air purifiers for all of its classrooms. The district’s plan doesn’t state the number of air changes per hour in schools, and the district didn’t respond to questions from The Oregonian/OregonLive.

MASKS

There’s widespread agreement among experts that masks, when of high quality and worn properly, cut back on viral spread.

In a recent study published in the journal Physics of Fluids, researchers found that cloth and surgical masks only filter out about 10% to 12% of the aerosols exhaled from their wearers — mostly due to poor fit that allowed air to flow through the gaps. The study’s researchers found that KN95 masks in practice filter out nearly 50% of aerosols, but that percentage would be much higher if the masks were worn properly.

Experts advise parents to work with their children to wear the highest quality mask possible and to wear it right because the delta variant is far less forgiving than previous coronavirus strains. N95s aren’t made in children’s sizes, but the next best thing is a KN95 or KF94. Some cloth masks with insertable, replaceable filters also perform far better than cloth masks alone.

The CDC says masks should be made of tightly woven fabric that don’t allow light to pass through. An adjustable nose bridge provides a safer, snugger fit.

Experts widely agree masks are a necessity. Oregon is one of 13 states to require masks in all K-12 schools, and one of five states to require masks in all public indoor settings, according to The New York Times. On Friday, Gov. Kate Brown also made Oregon the first to require masks outdoors, although her mandate doesn’t apply to day-to-day operations at schools, such as recess.

Howard Taras, a southern California pediatrician who specializes in community health and preventing community spread, said an effectively worn mask filters out viral particles so an infected person’s breath won’t fill up a room’s air.

“If you get it at the source, you’re not going to have to deal with all of this air cleansing,” Taras told the reopening schools forum.

Taras said school districts should be careful not to automatically approve medical exemptions to mask mandates that parents submit.

“We have a huge number of children who are getting doctors’ notes saying they can’t wear a mask because of medical reasons,” Taras said. “We’ve found that probably 80% of those are bogus notes. The doctors have never tried a mask on them.”

One other important piece of mask advice from experts: People should remove masks outside and while distanced from others. Don’t remove your mask when you’re the only person in the room if others recently have been in the space because the virus can linger for hours. The same goes for bathrooms: Just because no one else is there doesn’t mean it’s OK to remove your mask.

What’s happening locally: Several of the Portland area’s largest six districts emphasize quality masks to varying degrees and strongly discourage single-layer cloth masks or gaiters. But not all of them are banning these lowest quality masks, though Tigard-Tualatin and Hillsboro have specifically said they are.

Monitoring for quality masks and good fit falls on individual school staff. But that could be a tall order, given that teachers and principals have a lot to do after more than a year of truncated schooling and are not mask experts.

TESTING

Even with universal masking, experts say stopping the spread of the delta variant isn’t a realistic goal. But trying to squash big outbreaks might be an attainable one.

Many experts believe that identifying outbreaks before they spiral out of control will require frequent COVID-19 testing of asymptomatic students and staff, with rapid results that arrive within minutes.

Prather, the aerosol scientist, said ideally schools would test everyone every day — including the fully vaccinated as well as the unvaccinated because it’s become clear that vaccinated people can be infected and spread the virus.

The CDC recommends that students or employees who show symptoms immediately quarantine regardless of whether they’ve been vaccinated. Then they should get tested. The CDC also recommends offering rapid tests to asymptomatic, unvaccinated students and employees (who Oregon says must be fully vaccinated by Oct. 18) at least once a week in areas of moderate, substantial or high transmission.

The Oregon Department of Education is using federal coronavirus funds to give districts the choice of offering weekly testing to any member of the school community, vaccinated or not, who wants to be tested. That means schools can test students and staff at no cost to the district.

What’s happening locally: The Portland area’s largest districts have embraced the idea of testing anyone with symptoms. But many districts haven’t decided yet whether or how they’ll offer testing to any or all asymptomatic students and staff.

Portland Public Schools and Tigard-Tualatin say they’re still in the process of developing testing plans for asymptomatic students.

Beaverton and Gresham-Barlow will test asymptomatic students and staff weekly upon request. Hillsboro also plans to have weekly testing available for asymptomatic people.

North Clackamas offered few details online about its testing plans, and the district didn’t respond to more specific questions from The Oregonian/OregonLive.

LUNCH

Last spring, as most students across Oregon returned to in-person learning part-time, many schools didn’t hold lunch. Instead, students attended only half days, which allowed them to eat their mid-day meal at home.

But with full-time, in-person school returning this fall, lunch is back on. Some experts say it could pose the greatest risk of the school day — because filling a room with scores or hundreds of unmasked, chattering students could quickly saturate the air with virus.

Alex Huffman, an aerosol scientist at the University of Denver, said it’s dangerous to go maskless indoors, even if it’s just for 10 or 20 minutes at lunch.

“We need to treat indoor eating really seriously at school,” Huffman said. That means “small numbers, be quick, don’t talk, ventilate (with HEPA purifiers), but also give some time to flush out the air before another group comes in.”

Staggering lunch groups with 15 minutes between them — or better yet an hour — can ensure that large amounts of virus laden aerosols from the last group don’t linger for the next group to breathe in. But separating lunchtimes by an hour is unrealistic in most schools. Spacing students at least several feet apart lessens the risk, but experts are still concerned.

Huffman said the best solution is moving lunch entirely outdoors. Then as long as students are spaced away from each other, longer lunches, talking and a much-needed break from their masks all become much safer.

What’s happening locally: Portland Public Schools is the only metro area district to announce it’s moving lunch outdoors for at least the first six weeks of the school year. But that’s weather permitting. It remains to be seen how often fall rains move lunch indoors.

Werstein, the district spokesperson, said the district can’t specify the numbers of students who will occupy a cafeteria at one time, until school meal plans are turned in Tuesday, the day before school starts.

Beaverton, Hillsboro and Gresham-Barlow intend to have lunch indoors for the most part. Beaverton’s spokesperson said her district will strive for 6 feet between students but “admittedly, that kind of spacing is difficult in a cafeteria.” Both Beaverton and Hillsboro plan to assign seats to elementary students to make contract tracing easier for students who ended up sitting near an infected classmate.

Tigard-Tualatin said schools will spread out students during lunch indoors and are working on plans to allow lunch outdoors with rain shelters.

North Clackamas didn’t post its lunch plan on its website and didn’t respond to questions from The Oregonian/OregonLive. But the district has said online that it strives for 3 feet of physical distance between students.

OTHER ‘HIGH RISK’ ACTIVITIES

Other especially risky times, experts say, are music, theater or band classes where students sing or play wind instruments. The CDC recommends canceling singing and band classes altogether when an area is experiencing “high” COVID-19 transmission, unless all participants are fully vaccinated. In the Portland area, about 50% to 60% of 12- to 17-year-olds are fully inoculated.

The CDC also recommends the same for “high risk” sports, which includes football and wrestling or other “exercise” that is held indoors. The CDC’s recommendation doesn’t include “low risk” outdoor sports such as cross-country, softball and baseball.

Although Gov. Kate Brown is requiring masks in all public indoor settings and outdoors where physical distancing can’t be maintained, she’s made exceptions for students who sing or play instruments and athletes who are practicing or competing.

What’s happening locally: None of the six large metro area districts has canceled high risk sports, choir or band classes.

Portland Public Schools says its plans are still “developing.”

Hillsboro spokesperson Beth Graser said it’s “unknown at this time” if high risk sports and music activities will be canceled. “We are awaiting additional guidance from state and local public health,” she said.

Beaverton, Tigard-Tualatin and Gresham-Barlow say they’re going forward with all of these activities. Tigard-Tualatin and Gresham-Barlow will require students to wear masks while singing, though not at performances with physical distance.

“Student participation in sports has occurred for several months now, and we have not seen any transmission of the virus through our sports and activities,” Gresham-Barlow’s spokesperson, Vadnais, said in an email.

And, she said, like with so much related to the pandemic and the return to school, “if the relative risk increases, we will reevaluate this decision.”

Aimee Green; agreen@oregonian.com; @o_aimee

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