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San Francisco has the lowest coronavirus case rate of any major U.S. city. But its schools are among the last to reopen

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San Francisco’s public schools have only been virtual for almost a year, despite increasing pressure from parents and politicians to reopen for in-person instruction. Even the city attorney called on the school district to reopen elementary schools “immediately”.

The school district is expected to vote Tuesday on a plan that would allow schools to reopen in California’s second most restrictive red tier once staff are fully immunized.

But local politicians say this plan is still too restrictive, given vaccinations are progressing slowly due to lack of supplies.

Some have noted that other large school districts across the United States have opened up to some form of in-person schooling – despite higher levels of community transmission than San Francisco.

In New York City, where an average of 51 in 100,000 people test positive for coronavirus every day, elementary schools have been open on a hybrid schedule for months and colleges are reopening. Other large school districts, including Atlanta and Miami, have fully reopened to elementary, middle and high school students (with distance learning options), despite daily case rates higher than the current rate of 9 per 100,000 in San Francisco.

Supporters of San Francisco’s extended shutdowns have argued that keeping children and teachers at home is part of what explains the city’s low case rates, and that opening schools too quickly could result in transmission between students and teachers.

“We need a clear and coordinated state, county and local plan that prioritizes the health and safety of our communities and doesn’t take shortcuts to opening schools in person,” wrote the California Teachers Association in a letter to Governor Gavin. Newsom in late January as part of an effort to keep schools in counties below the state’s widespread purple level closed for 100 days.

The idea that keeping schools closed has kept the coronavirus count low is not supported by the evidence, according to many Bay Area health experts.

“There is no data to support this claim,” said Dr Jeanne Noble, chief of the COVID-19 emergency department at UCSF, said in an email. Noble cited a December study released by the CDC that found that among children under 18 in Mississippi, attending school or child care did not make students more likely to test positive. for the coronavirus. Instead, children who did not routinely wear masks or who had close contact with people outside their households were more likely to test positive.

In fact, Noble said, the study found that children who had attended school or daycare where masking was imposed in the previous 14 days were more likely to test negative for the coronavirus.

“In other words, not only did in-person attendance not increase the risk of acquiring COVID, but attending school with universal masking actually reduced the child’s risk of acquiring COVID.” , which suggests that schools can indeed be protective, ”she said.

In another recent study of 90,000 students and 10,000 teachers in the North Carolina school system, only 32 school transmissions occurred – all related to masking protocol violations, Noble said.

Carrie Byington, executive vice president of the University of California Health, said the coronavirus rate within a community remains an important factor in determining whether and how to reopen schools.

“Case rates and other indicators of community transmission are important considerations when planning for school openings or any in-person activity,” she said in an email.

But she agreed that opening schools probably wouldn’t increase San Francisco’s infection rates: “There is now evidence in the United States and other countries that the school itself does. is not the primary driver of community transmission of SARS-CoV2, ”she said.

Some experts have said case rates – a factor the CDC weighed heavily in its guide to reopening a school – shouldn’t even be considered when deciding to reopen.

“We’ve seen major cities across the country, including New York, Chicago, Dallas, Houston, Washington DC, Miami, Philadelphia, Atlanta and Boston, opening up to a face-to-face learning component (hybrid or full-time ) despite a much higher case rate than San Francisco without significant school transmission problems, ”said Dr. Mitul Kapadia, associate clinical professor of pediatrics at UCSF, in an email.

Kapadia pointed out that many public schools in Marin County have been open since October, with more than 17,000 students attending the school in person daily. With similar case rates – the daily rate of new cases in Marin County is 12 per 100,000 population – Marin found “minimal school transmission and zero student-to-teacher transmission,” he said. .

“The reopening of safe schools can take place despite high levels of community transmission,” Kapadia said. “The greatest predictor of transmission within schools is the consistent implementation of layered mitigation strategies, particularly the use of masks and physical distance.”

Susie Neilson is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @Susieneilson

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