If South Carolina fails to tamp down the latest surge in coronavirus cases before most school districts resume classes in mid-August, the state risks greatly exacerbating the outbreak, according to a leading local infectious disease doctor.
Conditions in K-12 classrooms, where few students are vaccinated and masks are not required, are ripe for transmission of the highly contagious delta variant, which is driving the current spike in cases and likely accounts for more than half of new cases in South Carolina.
“It’s clear that kids transmit this and this variant that is shifting to the younger, unvaccinated population can make children symptomatic, which increases transmission,” said Dr. Helmut Albrecht, director of the University of South Carolina’s Center for Infectious Disease Research and Policy.
Albrecht said South Carolina need look no further than Great Britain and Israel, where large delta outbreaks started in schools, to get a sense of the variant’s potential course in the Palmetto State.
“We will see this here as well,” he predicted. “And that’s why one of the masking efforts now is to get the numbers back down before the schools open. Otherwise, this will be an unmitigated disaster.”
The U.S. Centers for Disease Control and Prevention updated its masking guidance Tuesday, amid a nationwide spike in coronavirus cases, to recommend universal masking in schools, regardless of vaccination status. The agency previously had said fully vaccinated students and teachers need not wear facial coverings.
But until more people are vaccinated — only 44.4% of eligible South Carolinians are fully inoculated — delta is likely to continue to spread, state health officials said.
“This has turned into a pandemic of the unvaccinated,” State Epidemiologist Linda Bell said Wednesday. “Our recent analyses show that more than 90% of cases and deaths in South Carolina, and 86% of hospitalizations are among those who are not fully vaccinated.”
The threat of delta transmission in schools is especially acute because most students in the state are not fully dosed.
COVID-19 vaccines are not currently authorized for children younger than 12, and only about 24% of South Carolina residents ages 12 to 19 have received a single shot to date, according to state Department of Health and Environmental Control data.
Coronavirus transmission in schools was minimal last year, but changes in school mask policies, the return of full in-person learning, and the evolution of the virus could lead to increased spread this fall.
Recent outbreaks at children’s summer camps, where at least 150 COVID-19 cases were reported in South Carolina between June 1 and July 15, may be an early indication of the problems delta could pose for districts this school year.
Delta variant poses risk to school operations this fall
Perhaps most concerning to health experts about the return of K-12 classes in a few weeks is the prohibition on face mask requirements in South Carolina schools.
Masking in schools, which federal and state health officials strongly encourage for students, staff and visitors, regardless of vaccination status, can no longer be mandated in South Carolina following the passage of this year’s state budget, which included a proviso prohibiting districts from using any state funding to impose mask requirements for students or staff.
Some lawmakers have argued that districts would not be prevented from using local funds to enforce mask mandates, but the state Department of Education disagrees with that interpretation.
After consulting with state budget writers and their staff, Education officials concluded that the budget proviso prohibits mask requirements in all school facilities and has conveyed that message to local districts, spokesman Ryan Brown said.
The state Department of Education, which dropped its own mask requirement for students and staff in May, does not plan to challenge the proviso and would not reinstate a mask mandate this fall even if it had the authority to do so, he said.
That’s not to say education officials support abandoning all COVID-19 mitigation measures or dismiss the threat of the delta variant.
Brown said the agency strongly encourages masking in schools, adherence to the latest federal guidance on physical distancing, hand hygiene and contact tracing, and vaccination for eligible students, teachers and staff.
State education officials, who touted schools as a relative safe haven from COVID-19 toward the end of last school year, are very concerned about the impact delta could have on school operations this fall, he said.
“We thought we’d be able to have a much more normal year with fewer interruptions,” Brown said. “But as cases spike and the delta variant spreads like wildfire ... it could definitely cause some disruption.”
He said the agency was closely monitoring COVID-19 cases in districts where classes already have resumed, but had seen no major issues thus far.
A matter of personal responsibility
Gov. Henry McMaster, who earlier this year called it “ridiculous” for schools to require children to wear masks in the classroom and later issued an executive order preventing them from doing so, this week reiterated his belief that masking decisions should be left up to a child’s parents.
“The delta variant poses a real threat to South Carolinians. However, shutting our state down, closing schools and mandating masks is not the answer,” the governor tweeted Tuesday. “Personal responsibility is.”
The amount of personal responsibility students and teachers exercise in the classroom remains to be seen.
When the state lifted its school masking requirement in mid-May, as case counts were dropping, roughly half of students continued wearing face coverings, Brown estimated.
With COVID-19 cases now surging statewide and parents fearful of the delta variant, student masking rates may increase. On the other hand, those turned off by the CDC’s recent reversal on masking in schools may continue doing without them.
“I think it’s going to be very difficult,” to achieve compliance with masking in schools, Brown said. “We’ll continue to encourage it, but it’s hard for people to change once they’re used to something.”
In addition to encouraging mask usage, all districts have created plans for returning to in-person instruction safely. The plans, which are posted online, align with CDC guidance on COVID-19 mitigation and mostly resemble the protocols schools had in place last year, Brown said.
There will be more students in classrooms this year, however, and not all districts will use plexiglass barriers for when distancing is not possible because doing so can be difficult in a full classroom.
The availability of COVID-19 testing in schools will expand this fall and districts are likely to test students and staff more frequently to identify nascent outbreaks and curtail their spread, Brown said.
State Education officials also are working with DHEC to provide more education about COVID-19 vaccination in communities with high levels of hesitancy, and to encourage more eligible students and teachers to roll up their sleeves.
“It’s the strongest tool we have,” Brown said of vaccination.