Why COVID outbreaks are still a mystery in NYC schools

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Why COVID outbreaks are still a mystery in NYC schools


For many parents and teachers dealing with New York City schools, the last few weeks have felt like déjà vu.

Back in December, omicron broke COVID-19 records in classrooms. Its offshoot variants are now driving spread among students and teachers, based on both city data and individual reports from school staff. Yet limited action has been taken to contain the new surge.

And during this spring wave, case counts in schools are less reliable than at prior points in the pandemic, leaving parents and teachers in the dark about how much COVID-19 risk their students are actually facing. Increased popularity of rapid at-home tests, delays in reporting those results and a lack of reliable data from other city sources such as wastewater are all contributing to this uncertainty.

“It’s really scary and discouraging to see cases up again,” said Eva Roca, a public health researcher and mother of a kindergarten student in Queens.

In recent weeks, her text threads with other parents have often included reports of new COVID-19 cases — before she sees bulletins from school officials, she said. Sarah Allen, a public school teacher and parent in Brooklyn, similarly said she’s heard about outbreaks all over the city from her colleagues and on Twitter.

Data from the city’s Department of Education (DOE) back up these anecdotal reports.

NYC schools reported nearly 10,000 new cases in the week ending May 15th, double the number of cases reported two weeks earlier. The last time so many school cases were reported in one week was January 2nd, right as the winter omicron surge took off.

Even these lofty case numbers are likely underestimating the actual amount of COVID-19 spread in schools, experts say.

As at-home rapid tests have become increasingly available in New York City, the DOE is encouraging students and staff to use these tests frequently. Students receive four at-home tests each week, as well as extra tests after exposure to the coronavirus.

This week, the mayor’s office announced a new push to distribute 16.5 million at-home tests at schools and other community landmarks. About 37.5 million tests have been distributed at schools in total since December 2021, according to the DOE.

“From the beginning [of the pandemic], the number of reported cases has been a gross undercount,” said Dr. Jeffrey Shaman, an infectious disease expert at Columbia University’s Mailman School of Public Health who also has children in the public school system.

Omicron has amplified this problem, Shaman said, as more people have pivoted to relying on at-home tests over PCR tests. PCR test results are automatically reported to the government by the labs that conduct testing, while at-home test results are not — meaning these results aren’t captured in city data.

Parents are able to report individual at-home test results when a student is positive — but doing so isn’t required. This process can also take several days.

First, a parent must send the result to their school’s principal. The principal will then forward that report to the city Situation Room, a collaboration between education and health department officials that monitors the status of COVID in schools. The Situation Room decides whether to add the case to official counts.

This procedure may be especially slow when cases are reported on evenings or over the weekend, parents said. As a result, they may read about cases in Situation Room reports days after their children’s’ classmates have tested positive, potentially leading to further coronavirus spread as children continue going to class without knowing about their exposures.

In some cases, parents may be willing to report positive at-home tests at all, said Dr. Ayman El-Mohandes, dean of the City University of New York’s public health school. “There is now a bit of stigma to say, ‘I have COVID,'” he said, “and that might extend to children as well.” Parents may also avoid reporting positive results if they’re unable to stay home from work to care for their children.

The in-school PCR surveillance testing that started in fall 2020, meanwhile, is still occurring — but the system is spotty. Families need to opt into this testing, a policy that epidemiologists have often criticized. Citywide, about 340,000 of the district’s one million students have opted in as of January. Opt-in rates are far higher at some schools than others, causing the testing program to be more useful at schools where the majority of students are regularly tested than at those where a small fraction of students are swabbed

“The schools that have the most cases are probably just the ones doing the most testing,” Roca said. She pointed to a recent analysis showing that the Bronx High School of Science reported 152 cases on May 16th, far higher than any other individual school. Over 200 students at this school are tested each week, Roca said, but last week’s round of in-school testing only caught eight cases.

That’s despite this Bronx school swabbing way more people than, say, schools in Roca’s Queens neighborhood. There, only about 10 students are tested per week.

Roca and others wonder how many COVID-19 cases are going unreported.

“I remember the long lines of people getting tested” in January, she said. “Now, no one’s getting tested. What would the numbers look like if we were all standing in line again?”

“Unmooring” data landscape

Another common source of confusion for parents: data from different public sources often don’t match. In addition to the DOE’s dashboard and Situation Room bulletins, New York State shares schools data on its COVID-19 Report Card dashboard, including reports for private and charter schools which aren’t required to disclose their cases to city officials.

Keeping track of all these sources is “unmooring,” said Mary Ann Blau, a parent in Brooklyn. Sometimes city or state data lag behind the Situation Room’s reports, while sometimes there may be discrepancies between city and state data based on different disclosure practices that haven’t been clearly explained by the agencies. It’s “not a reasonable expectation” for parents to stay on top of these sources, Blau said.

Case reports for a particular school also may not include how many cases were identified in the same classroom and may be part of an outbreak, said Allen, the teacher in Brooklyn. Conversely, when parents receive an alert about cases in their child’s classroom, they may not know how many cases have occurred.

“The most effective surveillance has come from talking to other parents or asking your kid, ‘Hey, was anyone out?'” Roca said. “That’s really not an ideal way to have public health safety.”

As incomplete as case data for schools may be, this information is actually more reliable than the COVID surveillance for the city overall. The New York City Health Department does not track at-home test results, including those reported to the DOE by parents, meaning its undercounts are relatively worse than for schools.

Some experts have suggested data from wastewater surveillance can provide a substitute for case counts. In San Diego, researchers have designed a wastewater testing program specifically to measure COVID-19 in schools.

But in the five boroughs, “we’re still trying to figure out how to use that source,” Shaman said. Wastewater data for New York City has also been missing on the Centers for Disease Control and Prevention’s dashboard for several weeks during the current surge.

In Boston, parents can also monitor air quality in their children’s classrooms through newly-installed air monitors. But in New York City, such information is still limited.

America’s response to COVID-19 is shifting to an endemic phase, but the country isn’t there yet, according to health experts.

Part of this transition is learning to live with the virus, El-Mohandes said. During this period, he added, “We will need to exert good judgment and personal responsibility,” using tools like at-home tests to take individual precautions when COVID-19 risk is high.

But it’s difficult for parents and teachers to take this advice without reliable data, Allen said: “You can’t say, ‘It’s up to you as an individual,’ when the level of risk is being withheld from you.”

All recommended parents stay on top of the data sources they do, while frequently communicating with other parents, teachers and administrators at their schools. Gothamist’s COVID-19 dashboard and the People’s Dashboard from advocacy group Press NYC both use DOE data to show long-term trends, which are helpful for understanding the context of surges and lulls.

While at-home tests are a great tool to identify infections so people can quickly isolate at home, the results should be interpreted with caution, Shaman said. People infected with omicron may start showing symptoms days before they test positive, he said, and they may continue testing positive — indicating that they’re still able to infect others — for six or more days after symptoms have begun.

As a result, the CDC’s five-day isolation guidance is arguably too short to prevent transmission. But some parents have reported that the DOE encourages COVID-positive students to return to class at five days even when they are still contagious.

Shaman also advised that families mask up and avoid group settings. The city health department made similar recommendations when New York City reached a high COVID-19 alert level on May 17th. When asked how DOE is responding to this alert level, press secretary Nathaniel Styer forwarded a letter sent to families which recommends masking in schools, but does not require it.

“We will continue to follow the science and adjust if needed, putting the health and safety of our students and staff first,” said DOE associate press secretary Jenna Lyle in a statement about the current guidance.

“We can go to school [in-person] and also try to protect kids from getting sick,” Allen said. But that requires layers of safety measures such as masks, ventilation, and appropriate isolation for those who are infected — measures that are largely missing in New York City schools during this surge, she said.



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