After a dip in cases over the summer, COVID-19 numbers are trending upward.
“We have cases for people of all ages,” Dr. Barbara Ferrer, LA County Director of Public Health, said during a public online Q&A session on Monday, Nov. 9. “To date, 32,000 cases in the county have occurred among children under 18, which is sobering because people were under the impression that [those] people couldn’t get sick.”
According to Dr. Dawn Terashita, a public health specialist who also works for the county, coronavirus symptoms in children can present as nausea or vomiting, appearing similar to the flu.
Though many local cases in children were severe, not a single child has died of COVID-19 in LA County. But children can both get infected and infect others.
As the county continues to move forward with reopening some schools for the youngest and highest-need students, the county’s health and education departments have stressed to parents that they not only need to make sure their children are wearing their masks, staying six feet apart, washing their hands, eating outside and staying home when even feeling the slightest bit ill, but also educating their children on exactly why they need to do these things. “Children are very good about understanding what they need to do if we give them time and we explain to them why,” Ferrer emphasized.
Reopening guidelines are governed by the state, which has placed LA County in tier one (purple), meaning it has the most widespread level of transmission. The state has said that schools in tier one counties may apply for waivers for up to sixth graders, but LA County decided to cap its reopening waivers at second grade and below. Why? “We wanted to make sure we could do this well,” Ferrer said. “We decided to be cautious and go slowly.”
Reopening is based on the whole county, not neighborhoods or geographic areas. Malibu, for instance, is vastly different from other, more densely populated areas of LA. But Ferrer said that the state—“appropriately,” she thought—did not divide school reopening procedures along zip code or town lines due to unavoidable intermingling. Many students travel to attend school; many of their parents work in other neighborhoods.
“The state,” Ferrer said, “has really urged us all to understand that we are very much dependent on each other as a county.”
More than 74 schools—encompassing 8,000 TK-second graders and 1,600 staff—in the county have reopened already and 60 are in the pipeline. Once reopened, a school may have about 25 percent of its student body back on campus at a time, in stable cohorts that ensure the same group of adults and children are only ever exposed to each other.
Santa Monica-Malibu Unified School District is currently working on applications to reopen each of its elementary schools.
After each school completes its application and enters the countywide queue, the department utilizes “a formula that allows [it] to look at supervisorial districts and then rank those schools based on need for students who [live] in lower resource communities.” That formula takes into account a school’s eligibility for free and reduced price meals, giving schools that do qualify a higher chance of getting its waivers approved.
“But the goal is for all schools that apply, over time, to reopen,” Ferrer said, mentioning the county had extended the number of applications it is allowed to approve per week from 30 to 50 and saying that the county only has 233 applications in to date.
What happens when a school reopens—and then a student tests positive for coronavirus? Immediately, a “COVID team” from the LA Department of Public Health is notified. The team ensures that the individual student is isolated and sent home. Then, it interviews the student and identifies all contacts so officials can quickly identify if that student’s cohort has been exposed. If that is the case, all contacts are notified and told to stay home and quarantine. The COVID team looks for links between the students—do they share the same cohort? Were they together in the same bathroom? Were they sharing food? If the team finds a link, it can find more cases.
A negative test is not necessary for a student to return to school as long as symptoms have resolved. If a student tests positive but has no symptoms, they still must stay home for 10 days.
Three or more positive cases in a single school are deemed an outbreak. If officials can’t contain an outbreak, the entire school must close. If 25 percent of schools within a district are closed, then the entire district must close—but all of this is evaluated on a case-by-case basis to take into account multiple unique human and geographic factors, Terashita said.
Ferrer confirmed that the county has seen small outbreaks of three to four students at some schools but only one notable outbreak, amounting to nine cases.
“What happened there was, students on a baseball team went to Arizona … got infected … and came back and infected other people,” she explained. “This was not a school activity; it was an out-of-school activity. This is what I mean by ‘We all have to be careful.’”