PHOENIX -- As COVID-19 infections surge in Arizona schools, sickening thousands of students and staff and forcing thousands more into quarantine, parents—and the public at large—have been left without a comprehensive picture of where Arizona students and educators are contracting the virus.
A patchwork of outbreak and quarantine notifications from school districts has sown confusion among families about the scope of on-campus exposure. And while districts report infection data to county health officials, who in turn submit it to the state, that information is seldom relayed back to the public in an accessible, thorough way, an analysis has found.
Just 30% of Arizona’s 215 traditional school districts provide public-facing dashboards that track outbreaks by school, according to an Arizona Center for Investigative Reporting review of their websites. Of the state’s 15 county health departments, only Pima County publicly monitors active COVID-19 cases by district.
The state, meanwhile, does not specifically show where school- and day care-based outbreaks are occurring. It offers only county-level totals and a running tally of infections among Arizonans 19 and under.
The lack of public disclosures detailing how the virus is affecting Arizona schools comes at a time when the rate of COVID-19 transmission among children is poised to surpass that of older age groups for the first time, research conducted by the University of Arizona’s Dr. Joe Gerald shows.
Though severe infections are less common among children than adults, they do happen, as do pediatric deaths from COVID-19. And in a state that recently topped 1 million cumulative cases, medical experts said the consequences of school-based outbreaks aren’t limited to kids.
As Arizona debates the merits of a statewide ban on school mask mandates, schools have reported increasing outbreaks of COVID cases since August.
As state and local officials continue to debate the merits of a statewide ban on school mask mandates, Arizona school districts have reported more than 2,000 confirmed COVID cases since in-person learning started in August.
Sending students back to classrooms without consistent mask requirements, school-based testing or high overall vaccination rates has the potential to accelerate COVID transmission statewide, according to Gerald, who oversees UA’s public health policy and management program.
Arizonans under 15 now represent about 25% of COVID-19 cases, up from 10% during the winter 2020 spike, his analysis of state data shows. The overall percentage of Arizonans testing positive for the virus also continues to climb.
“With continued K–12 in-person instruction, plus opening of our major universities, there will be additional pressure on transmission among children and young adults” in the coming weeks, Gerald wrote. “If transmission in these groups spill over, then another surge of cases and hospitalizations similar to that of the summer of 2020 remains possible.”
Dr. Chris Beyrer, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said having a “more systematic,” more transparent strategy for preventing and tracking school-based cases would go a long way toward curbing the spread of the virus.
“What we have is a patchwork—a great deal of variability in policies and practices,” Beyrer said. “While local nuances are important, there’s nothing like rational statewide and national planning to get this right. And we’re just not there.”
Frustrated parents turn to each other
A 2020 emergency measure from the Department of Health Services requires Arizona schools and child care establishments to report COVID-19 outbreaks to local county health departments within 24 hours.
County officials must share the information with the state using Arizona’s Medical Electronic Disease Surveillance Intelligence System (MEDSIS), but they are not required by law to post it online.
Most don’t, with the exception of Pima and Maricopa counties. Pima alone pinpoints where outbreaks are occurring; Maricopa County reports only numbers of active and resolved school outbreaks.
In counties without comprehensive school-outbreak dashboards, the decision to publicize school-level case and quarantine data is left to individual districts. The Arizona Department of Education said in a statement that it “has urged all public schools to communicate transparently about school-related outbreaks with staff, students and families” since the onset of the pandemic.
“Now, as cases, particularly in children, are rapidly increasing, families need the best information possible to stay safe and slow the spread of the virus,” ADE spokesperson Morgan Dick wrote in an email. “ADE recognizes this can be incredibly challenging for some school communities, given limited resources and capacity. Nevertheless, robust, transparent communication is vital to keeping our schools safe and healthy, and ultimately able to operate and provide in-person instruction.”
While school officials don’t have to notify the public about cases or exposures, they do have to alert parents if their child was in close contact with a known COVID-19 case, typically via email or letters sent home. As of late August, some schools were sending home advisories daily or almost daily.
The nearly 150 advisories submitted to AZCIR’s school-based outbreak tracker in August indicate the level of detail provided in school notifications varies. Some letters tell parents that their child could have been in contact with someone on campus who “may” have tested positive, for example, while others confirm numbers of new cases and specify the last day a COVID-positive student or staffer was at school.
The resulting confusion is palpable on social media platforms, where parents have flocked in an attempt to piece together how the virus is hitting their kids’ classrooms, bus routes and after-school programs.
Many have uploaded alerts from schools or reported outbreaks, seeking to compare notes.
“There is a covid outbreak at Franklin Elementary East campus,” one Mesa Public Schools parent posted on Twitter on Aug. 13. “How many other @mpsaz elementary schools are experiencing outbreaks?”
A few days later, a BASIS Charter Schools parent posted that parents in that school system “are sharing covid+ case announcement emails with each other, since our schools only update trackers 1/week.”
“Every single day the past 1.5 weeks has been stressful,” she wrote.
Some families have formed private Facebook groups to jointly track outbreaks and exposures as they navigate an uncertain school year. Others are logging numbers on their own.
Queen Creek dad John Flowers, for instance, used Chandler Unified School District data to calculate that about 2% of the student and staff population at his sons’ high school, Casteel, had been infected with COVID-19 during the first month of school.
He said he suspects the total is higher given the number of students not in class.
Like many other school districts, Chandler Unified does not isolate new cases on its daily dashboard, listing only “active” and “resolved” counts, nor does it quantify the number of students and staff being quarantined following exposure to the virus. The district also erases past dashboard entries, which makes it difficult to track patterns over time, according to Flowers.
“You can get to the information, but it’s not being honest with people,” Flowers said. “I mean, you should be able to see every day how many new cases are showing up in your school, how many new cases are showing up in the district.”
Chandler Unified spokesman Terry Locke said the primary goal of the dashboard is to “let parents and staff know when a school is approaching thresholds that may lead to additional mitigation,” and officials “update the number of active cases daily to allow the public to review trends.”
“We are limited in manpower to compile additional data, so compiling quarantine numbers (is) not feasible,” he wrote in an email.
Epidemiologist: Those under 12 at heightened risk
Frustration over the lack of comprehensive outbreak information comes on top of ongoing tensions related to a law signed by Republican Gov. Doug Ducey in June that prohibits school districts from requiring masks.
Though the law doesn’t take effect until Sept. 29—assuming a pending lawsuit seeking to block it does not succeed—the majority of school districts in the state have opted not to mandate face coverings. More than 30 districts and several higher education institutions have, though some have broad opt-out policies.
Beyrer, the Johns Hopkins epidemiologist, argued inconsistent mask coverage has left Arizona students of all age groups unnecessarily vulnerable to infection upon returning to classrooms.
Those under age 12, who cannot yet get vaccinated, are at particular risk, he said, with “an increasing number of kids of this age in the hospital.”
Among August COVID-19 hospitalizations in Maricopa County, about 6% were children, with kids under 12 representing one in six COVID cases overall, according to county health officials. Before the school year began, children constituted about 3% of Maricopa County’s COVID hospitalizations.
While those 12 and up are eligible for the Pfizer vaccine, vaccination rates among that population remain low nationwide. The age group also tends to be more autonomous and more social, mixing in different ways than children do, which makes them “more important in community spread,” Beyrer said.
And kids of any age can get so-called long haul COVID-19—where symptoms such as fatigue, headaches, dizziness and shortness of breath can persist indefinitely—even if they have a relatively mild case, Beyrer said.
“We’re not really sure how to treat that in children,” he said.
This story was originally published by The Arizona Center for Investigative Reporting, an independent, nonprofit media organization dedicated to statewide accountability journalism in Arizona.
Maria Polletta is an investigative reporter for AZCIR, focused on covering inequities in education. Shaena Montanari is an investigative reporter for AZCIR, focused on covering health disparities.