Let’s Use Evidence-Based Criteria to Decide When (or Whether) It’s Safe to Open K-12 Schools

“School season is rapidly approaching. A huge public health policy question out there is ‘how do we decide when school can start this Fall (if at all) and under what circumstances?’  Thus far, the governor [of Arizona] has been talking about when schools would be allowed rather than under what circumstances. 

“A couple of weeks ago, he postponed the start of school until August 17, a date that he described as ‘aspirational.’  Setting a date for school to start is arbitrary if it’s not linked with evidence-based public health metrics. It makes a lot more sense to tie school openings to evidence-based performance criteria.

“There are two categories of criteria that should be used to make the school opening decision:

• The quality of school district mitigation plans & their ability to execute those plans with fidelity; and
• Evidence-based criteria that measure community transmission. 

“Both these factors should be in place before considering setting a date for in-person instruction to begin.

“While many school districts have quality mitigation plans to lower the risk of spread, community transmission is too high right now to adequately protect kids and staff, even if they have good plans. Testing capacity is inadequate, sample turn-around times are insufficient, contact tracers get tardy data, public health laws are inadequate and unenforced, and testing & infection control are inadequate in care homes.  All the above issues are fueling community spread and need to be improved before schools open this Fall. But, how would we measure success?

“Fortunately, we can come up with evidence-based performance measures to help determine whether community transmission is low enough warrant opening our K-12 schools for in person instruction.

“Let’s explore the possibilities.  Consider the four bullets below as the criteria that would need to be met to set a date to open schools for in-person instruction:

• A 30-day reduction in the number of new COVID cases in the community measured by a 7-day moving average;
• A community percent positive rate of less than 5% for 2-weeks measured by a 7-day moving average;
• Eighty percent of case and contact tracing investigations completed within 96 hours of sample collection over a 21-day period; and
• Community hospitals open for elective procedures.

"When a community meets all these criteria, the district could be free to set a date for in-person instruction (if their county health department has validated their mitigation plans).  County personnel could conduct periodic on-site validation of school’s mitigation plans.  If community transmission rebounds and the above criteria are no longer met, then districts would need to suspend in-person instruction.

“Another advantage to this evidence-based performance criteria approach is that members of a community would have a common goal to work toward, as nearly everybody agrees that in-person school instruction is important and worthy of trying to achieve.  Having measurable criteria in place to make that happen can build additional community motivation to achieve and maintain the important mitigation measures that reduce transmission of the virus” (Arizona Public Health Association).