Modified Quarantine

When the elementary schools went back to full day, in-person this autumn, they obviously had to have a plan for what would happen when a student tested positive for COVID-19. In our case, that first happened less than a week into the year. Other schools here in Alameda also saw cases in the first few weeks of school. Previous guidelines for those who may have been exposed were to quarantine at home for 10-14 days, and get tested at the end of that period (and, of course, should any symptoms appear during the quarantine). However, for this school year the state has created a new scheme called modified quarantine, which is not really quarantine at all in my opinion.

Modified quarantine allows the children exposed to somebody who tested positive to remain at school, and even to commute to and from school on public transit, if necessary. The only thing they cannot do is activities outside of school, as if, somehow, doing activities at school makes them safer.

The reality is that this plan was not put in place to ensure the safety of the children, nor to manage the spread of COVID-19. The document on the California Department of Public Health site makes it very clear what their main priority was: “The foundational principle of this guidance is that all students must have access to safe and full in-person instruction and to as much instructional time as possible.” They even put it in bold text, right near the start of the document. In simpler terms, the main goal is to keep the kids in school unless they are actually sick.

What Could Possibly Go Wrong?

That first case we had was quickly followed by a second student in the same class testing positive. Obviously, it is impossible to prove that the transmission happened at school (and the school was quick to point out they could not confirm the cases were related), but the timing would follow. That student’s sibling then developed symptoms a few days later, resulting in an exposure of another class. Amazingly, modified quarantine allows the sibling of a student who has tested positive to continue attending school as long as they show no symptoms, and have not themselves tested positive.

The timeline was something like this:

  • Class was notified of the first case on Tuesday morning.
  • Second student tested on Wednesday, with the whole class that was exposed.
  • Second student develops symptoms by Friday morning & tests positive with a home test (which the school does not consider valid, even when accompanied by symptoms and when the student was part of a close contact group, but that’s another issue).
  • Second student’s PCR result from Wednesday arrives late Friday, and is negative.
  • Second student tests again on Saturday (the second of the required three tests during modified quarantine).
  • Third student (second student’s sibling) develops symptoms on Sunday.
  • Second and third students have positive results from Saturday’s test, delivered on Monday afternoon/evening.
  • Tuesday morning the first class is notified of a second student testing positive (and quarantine period is extended); second class is notified of close contact and starts their modified quarantine.

The problem is clear: both the first and second students were contagious before showing any symptoms, and before receiving a positive test result (the latter partly because of the 48 hour delay on the PCR tests). By leaving these children in the school longer, they put more students at risk, unnecessarily. The chain was broken because student #3 was most likely contagious on the Friday/Saturday, and was not at school on those days, and because the school has above average mitigation processes in place.

Mitigation

The school has done more than most in the way of mitigation. They have a mask policy that includes all outdoor time as well as indoors. They have the classroom doors and windows open. They added filters to the HVAC, and standalone air purifiers in each classroom as well. They eat outdoors, and they ask the kids to replace their masks while they chew. They have hand sanitizer everywhere, and insist on its use when entering and leaving the classroom.

As we go into the rainy season though, some of that becomes less possible. In particular, what is perhaps the highest risk time of the day for the students, lunch, will need to move indoors. When that happens, we will see. Hopefully, by that point, we will have delta under control, and the children will be at least partially vaccinated.

Four cases in the elementary school, in two and half months, but only one case that could be considered in-school transmission, is a good result in the circumstances.

Bringing it Home

Also worth noting, that CDPH priority to keep the children in school even after exposure completely fails to take into consideration the risks to others in their household. In the case of student #2 above, it was not only the sibling who was infected – both parents, who were fully vaccinated, also caught it and were symptomatic. Children with immunocompromised adults, or indeed siblings, or even just elderly grandparents at home could easily put them in grave danger.

If there’s one thing any parent can tell you, schools are great at sharing infections. Whether it is common colds or other infections, like pink eye, once one has it, it spreads through all the kids. Why anybody would think that COVID-19, and especially the current variants that spread more aggressively, would not also spread in a school environment is beyond me. Another thing parents can attest to is that they also catch some of those colds when they’re brought home. Children can, and do, spread infections to adults at home quite easily.

Alternatives: Contract Study Option

This week, on Monday, was the fourth exposure, in our eldest’s grade. As we did with the first one, we pulled both kids out of in-person school immediately. The school was somewhat reluctant about the sibling, but accepted our argument that it was both safer for our children, and lower risk for the school since if the first did test positive, the second was very likely to, and that would expose another class again. Our priorities are not well aligned with CDPH: the safety of our children comes a long way ahead of their presence in a classroom, followed by the safety of the others in the school, both students and teachers.

Both children have been given contract study packets, both have access to the online tools they use in the classroom, and they both have their assigned homework (which was assigned on the Monday when they were at school anyway). There is zero reason why the standard quarantine protocols could not be followed always. The schools have the necessary tools, and if it was the whole class, could even switch to video classes for 10 days. They have the experience to do it having done it all of last year. For those students who cannot easily stay at home, they could operate the small pods scheme that worked well, and had zero cases, last year.

If we want to stamp this thing out for good, we need to be willing to deal with proper quarantine. “Modified quarantine” is not quarantine at all, and telling parents their kids can continue going to school, but they cannot do anything outside of school is simply not going to work.

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