As children and teachers started returning to classrooms over the past few weeks, new cases of COVID-19 emerged, forcing some schools to temporarily shift to online-learning only and hundreds of students to quarantine at home until their health was assured.
While those developments have been well-documented, it’s what remains unknown that has been more troubling for some parents and educators.
Information that schools, health officials and state agencies share about known cases varies substantially, leaving some stakeholders to wonder how safe they or their children may be when new cases emerge.
In Gainesville, Florida, where several staff members working at an in-person summer program contracted the coronavirus, the absence of a community-wide notification protocol allowed rumors and fear to spread. Despite assurances from district officials that they will share as much information as they can about cases this fall, some parents and teachers remain skeptical that they will learn enough soon enough to feel safe.
“Are you going to tell us what’s going on? How are we going to find out about cases?” asked Janine Plavac, a nurse and teacher who is director of the Academy of Health Professions at Gainesville High School. “Right now, I have no faith in transparency in this district.”
Melissa Tines, a mother of three children attending classes in Evansville, Indiana, said it is important that communication not be limited only to people with known exposures. She wants to know how many COVID-19 cases emerge in those schools – even if they don’t involve her kids.
“I would be able to discuss with my kids how to be cautious,” she said. “If it was something that became a problem where the number was creeping up, then I may be able to make the decision that school isn’t a safe option, and we may have to bring them home.”
Federal law prohibits the disclosure of personal medical records by health providers, and no one is asking that people who contract the virus be identified on local news broadcasts. Yet in many cases, school leaders have prioritized personal privacy over the public right to know, even though HIPAA, the medical privacy law, does not apply to schools, and FERPA, the educational privacy law, does not bar schools from releasing case information so long as people aren’t named.
Most schools already practice balancing privacy and public health notifications. Principals send letters home alerting parents to cases of lice or providing guidance on meningitis symptoms when someone in the school has become ill. If attendance drops below normal because of the flu, schools sometimes advise parents to keep their kids home when ill and reinforce good hygiene habits.
The U.S. Department of Education released additional guidance this spring specific to the novel coronavirus, a global pandemic with risks and scale unmatched by the typical public health challenges managed by schools.
In some cases, the agency said those extraordinary circumstances might mean that schools would even need to share details that could identify a person with the coronavirus so others can “take appropriate precautions.”
Yet over and over again across the country, new cases emerge and some schools choose to notify only people who’ve had prolonged direct contact with the patient. No notice to others in the school building. No alert to parents. No answers for reporters seeking to confirm or deny local rumors.
In a recent case in Naples, Florida, school officials refused to say how many people had to quarantine at home after an exposure. An emailed statement from the school district read in part, “It is not appropriate for us to disclose sensitive medical information, which if we did, would otherwise conflict with our obligations under FERPA and HIPAA.”
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In other parts of the country, school officials have opted for as much transparency as possible. Several superintendents said that it not only is the right thing to do but that it will help build trust in the community during a time of anxiety and uncertainty.
“The greater good and the greater need for community health knowledge is superseding our usual complete and total protection of individual privacy,” said Michael Lubelfeld, superintendent of North Shore School District 113 in Highland Park, Illinois. “I don’t want to shield them from the truth. We’re all in this together. They have a right to know – especially because we’re a public school district funded by the public and they’re entrusting us with their kids.”
To better understand how local and state governments are balancing personal privacy with the public’s right to know, USA TODAY surveyed the state health departments and education departments in every state and interviewed officials from dozens of schools across the country.
Reporters found that decisions about how to communicate about positive cases among students or staff have largely been left up to individual school districts, sometimes in coordination with local health departments, because state leaders often have not provided any guidance.
“That’s been nonexistent,” said Marlon Styles Jr., who is superintendent of Middletown City School District in Ohio. “We’ve had limited communication from a state level, from our governor’s office to the state health department. … The primary source of anything health related has been from our city’s health commissioners.”
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‘We want parents to be aware’
Some parents and teachers say their faith in future decisions has been harmed by limited communication about positive cases this summer.
In Alachua County, Florida, a paraprofessional working with students in several classrooms tested positive. A few weeks later in a separate outbreak, several bus drivers became ill and one died. Football players and cheerleaders who attended summer conditioning also contracted the virus.
Alachua County Public Schools Communication Director Jackie Johnson said district officials notified people with known exposures and provided a schoolwide notification about the paraprofessional. In the case of the bus drivers, she said all active transportation staff members were notified, adding that the driver who died was “case zero” and had not gotten ill because school officials failed to notify employees about other cases.
“There was a lot of misinformation floating around,” she said, brushing off critiques by some teachers and parents that the district was being secretive and ignoring staff members who disputed the official story at school board meetings. “I’ve heard the same rumors you have.”
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She pointed to a draft reopening plan published on the district’s website as proof the district planned to be transparent this fall. The document generically says parents will be notified about new cases, which Johnson said includes the entire school and not just an affected classroom.
“We want parents to be aware when there is a case on their campus even if their child did not have significant exposure,” she said.
School officials have similar plans in Martin County, Florida. And they’ve already had to put them to the test.
On the second day of school, nine students were sent home to quarantine after a student exhibited signs of the virus. Within less than a week of classes resuming Aug. 11, the total number of students in quarantine reached 136. Only the parents of the students who were in close contact were notified by the district.
District spokeswoman Jennifer DeShazo said it was standard epidemiological practice to not notify anyone else about cases, pointing to contact tracing guidelines from the Centers for Disease Control and Prevention.
But the district’s strict focus on contact tracing procedures ignores guidance from the federal departments of health and education that says it is legally allowable and recommended to notify the entire school community about cases of a communicable disease so families can watch for symptoms and manage personal risk factors.
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Indian River School District, another school district on Florida’s east coast, plans to do things differently, district spokeswoman Cristen Maddux said.
If there’s a positive case on campus, she said, those in close contact with the student or staff would be notified with a direct phone call. In the interest of transparency, others on campus who were not in contact with the presumed positive case would still be notified, but via a robocall from the district.
“We didn’t think it was fair” to tell only a select few, she said. Many district officials and administrators are parents, and “we all agreed that if there was someone on our child’s campus (who tested positive), regardless if our kid was near them, we’d still want to know. We made the decision to say, ‘Hey, this has happened,’ and parents can make the choice to send their child to school or keep them home. It gives them the option to do that.”
‘It’s better to be open’
Some states have provided recommendations to school leaders.
Lubelfeld, the superintendent from Illinois, said he has appreciated the general guidance from state health and education officials but has been particularly grateful for his county health officer. For instance, she provided him with copies of form letters that can be used to notify parents and staff members about positive cases, including variations for known contacts, people in the same classroom and a more generic notification for the broader school.
“It’s better to be open, authentic and transparent. That will help build trust even if it does create some anxiety,” he said. “This is a pandemic like we’ve never seen. We owe it to them.”
The letters also provide another opportunity to remind families about precautions and school rules. He worries that if schools keep their cases secret, students, parents and teachers might have a false sense of security and be less likely to comply with safety protocols.
In Texas, the state education department did not make specific recommendations about how to handle communication, but Dallas Independent School District Superintendent Michael Hinojosa said it received general encouragement to be transparent.
His district has written a playbook for principals on what to do when they learn of a positive case so there is consistency about who receives what kind of information, when and how.
Keeping parents in the loop is important, he said, to empower them to make informed decisions rather than basing them on rumors or fear.
“They’re going to find out about it anyway, and then they’re not going to trust you (if you didn’t tell them). They’re going to wonder what you’re trying to hide,” he said. “People are so emotional and scared right now, and rightly so. … The less we communicate, the more terrified people become.”
‘We don’t share that information’
In the absence of state guidance specific to the coronavirus – the most common situation across the U.S. – local districts have had to develop their own plans. And that has resulted in stark differences even within a single state.
In school districts that have reopened classrooms in Indiana, USA TODAY Network reporters have tallied at least 158 cases among students and staff – numbers that state officials are not sharing with the public.
Given a week to answer emailed questions from USA TODAY, the Indiana State Department of Health did not reply.
At the district level, communication policies have varied substantially.
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When asked last week to clarify whether a staff member who tested positive had been in any school buildings the week before the result, a Plainfield Schools spokesperson declined to answer, saying only that “individuals considered to be close contacts” will be notified when new cases emerge.
Just 50 miles away, South Madison Community School Corp. Superintendent Mark Hall wrote more than 350 words in response to questions about positive cases over the summer involving student athletes, a choir singer and four staff members.
Other Indiana districts have chosen not to release any information.
For instance, Zionsville Schools declined to clarify whether a positive case involved a student or a staff member out of concern for community stigma.
In an email, Janet Mann, spokeswoman for the district, said children and adults are already experiencing stress and could feel shamed or pressured to consider self-harm because they view contracting the virus as letting others down or contributing to the disruption of a program or sport.
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Jason Woebkenberg, spokesman for the Evansville Vanderburgh School Corp., said it relies heavily on the Vanderburgh County Health Department for the guidance it seeks – and the health department is opposed to publishing school-specific COVID-19 data.
“It’s like with a business. If there’s a restaurant out there that has two employees that work at the restaurant (who test positive for COVID-19), we don’t share that information because it’s their information, and it’s the employer’s information,” said Joe Gries, the department’s administrator.
But Gries knows it isn’t up to him.
“If there’s guidance that comes down from (the state education or health departments) that says they feel people need to know how many cases within a school, then they’re going to work with the school corporations to develop that,” he said.
Uncertain times ahead
First-grade teacher Alyssa Fisher isn’t sure whether her school in Mesa, Arizona, will return to in-person instruction. As the possible opening date in September grows near, her frustration with state officials grows.
“Gov. (Doug) Ducey shut down schools in March when we had 12 cases. Now, we’re a hotbed, and he’s letting the school boards decide,” she said, sympathizing with local school boards and principals scrambling to decide what’s best in the absence of state leadership.
She is particularly nervous about how local districts will decide to handle communication. In a previous job, she was scolded for telling parents that an unnamed student in the class had a chronic lice problem after two girls became infested.
“We had a staff meeting about how telling parents about lice is a violation of HIPAA and they likened it to HIV. To me, that was a stretch,” she said. “Now with COVID, all of us are like, what the heck will happen? Are we going to get a kid test positive and not be able to say anything?”
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The 28-year-old said she is not overly worried about her health but is concerned for colleagues – like the 68-year-old who taught her decades ago as a child – and for parents who have to send their kids to school so they can work even if it creates risk for grandparents living with them.
“If anything can be an exception to the rule, it should be COVID because we don’t have information on it,” she said. “It’s not like HIV, where we have so much data about how it’s not easily transmittable among children. Lice isn’t a life-or-death type of situation.”
Fisher acknowledges she’s not an expert on privacy laws or health care. She just wants to know what local leaders decide for the fall so she can prepare for the inevitable conversations with parents – whether that involves sharing basic school-approved information or not being able to say anything at all.
“It would be great to start getting an idea about how to navigate those obstacles,” she said. “But apparently mum’s the word on that, too.”
Contributing: USA TODAY Network reporters CD Davidson-Hiers, Duane Gang, MJ Slaby, Annysa Johnson, Kimberly Moore, Louise Oleson, Laura Testino, Skylar Rispens and Meghan Mangrum
This article originally appeared on USA TODAY NETWORK: COVID in schools: Information about new cases varies widely by state