Idaho schools did not know about, or report, more than half of COVID-19 cases among students in the last school year, according to an Idaho Capital Sun data analysis.
More than 16,000 school-aged children in Idaho had COVID-19 between the first week of September and May 22.
But the statewide summary of COVID-19 cases linked to each school since September shows just 8,660 known cases — a number that includes students, teachers and school staff. The state will issue one final report for the school year on June 7.
The Idaho Department of Health and Welfare began publishing the school-by-school tally in the fall.
The findings suggest that schools don’t have complete information to make their plans for the fall, said Dr. David Pate, a pandemic adviser to Gov. Brad Little and to some Idaho schools.
The 16,270 cases of COVID-19 among Idaho’s school-aged children during the school year are “likely significantly underreported,” he said.
As the school year winds to a close, Idaho children aged 5 to 17 now make up a growing share of the coronavirus cases in Idaho, as more adults get vaccinated.
Children are unlikely to become seriously ill from the coronavirus. State figures show that 158 of Idaho’s 8,600 hospitalized COVID-19 patients were under 18, and none died. But children can infect higher-risk adults; more than half of Idaho’s adults remain unvaccinated.
The apparent underreporting of cases to schools also adds a new dimension to Lt. Gov. Janice McGeachin’s executive order last week. McGeachin, who is running for governor, tried to block school boards from requiring masks to prevent disease transmission. Little repealed her order the next day.
After the COVID-19 test, an honor system breaks down
The pandemic exposed what happens when Idaho’s public health systems are underfunded and understaffed, and when people defy rules and guidelines.
Every part of the public health system — from testing to contact tracing — falls apart. Outbreaks spin out of control, making it impossible to accurately track them.
When it came to schools, there were even more challenges, Pate said.
There was another layer of privacy concerns. There wasn’t enough COVID-19 testing. (Republicans in the Idaho House of Representatives rejected $40 million of federal aid to help school districts with that.) Children were often asymptomatic, and parents were forced to make tough choices.
When a child tests positive for COVID-19, health care providers and laboratories notify the local public health department just as they would for an adult with an infectious disease. But those Idaho doctors and labs aren’t required to notify schools, just as they’re not required to tell a person’s employer.
“And many physicians would actually be concerned to report that to schools without parental permission,” Pate said. “What gets reported to schools is largely parents being forthcoming, or kids telling the school, ‘I tested positive.’”
Or, they share the school information with the health department workers who called to follow up on their positive test.
They didn’t always do that.
“The information collected from the health departments was limited to what parents shared during (their contact tracing) interview,” said Niki Forbing-Orr, public information manager for the Idaho Department of Health and Welfare. “Not all families were able to be reached for (that) interview, and of those who were reached, not all were willing to share the name of the school that their child attended.”
It’s also possible that some parents or students chose not to seek coronavirus testing, to avoid a diagnosis or the quarantine of their sports team, Pate said. He doesn’t know if that happened in Idaho, but he suspects it did based on what other states have seen.
Some parents with sick or exposed children may have sent them to school, instead of keeping them home for two weeks. For working parents, it may have been a choice between keeping a job and sending a potentially infected child to school.
“No doubt that happened,” Pate said.
Federal law required some employers to offer paid leave to parents with children who had COVID-19. The Families First Coronavirus Response Act didn’t cover all employers, though. And it only guaranteed two-thirds of the employee’s normal salary, for two weeks.
“Spreading disease is always a concern, and parents make those decisions on a daily basis, not just for COVID,” Forbing-Orr said. “We would hope parents would do the right thing and keep sick children home, and that employers would make it possible for them to do that without jeopardizing their employment or their pay. But that’s why getting vaccinated is so important, and why we are eagerly anticipating a vaccine approved for children younger than 12.”
Why don’t the data for schools and school-aged kids match?
The Department of Health and Welfare relied on some schools’ public COVID-19 data dashboards to track the schools’ cases. Even then, some schools did things their own way.
“Some counted only students and staff that were infectious while at school (at school within 48 hours of symptom onset or, if asymptomatic, within 48 hours of receiving positive test result),” Forbing-Orr said in an email. “Other schools counted all confirmed and probable cases among students and staff whether or not they were at school while infectious.”
Starting in January, the West Ada School District only counted people who tested positive and who were infectious at school, according to Char Jackson, West Ada’s chief communication officer.
West Ada, the state’s largest school district, gathered its COVID-19 case numbers from school nurses, who got information from parents, guardians or Central District Health, she said.
“When we have a positive case in our schools, with close contacts, we notify the parent/guardian via letter and/or phone call,” she said in an email to the Sun. “CDH has access to our data, and they cross reference to the lab reports they receive. We are in constant communication with CDH about our case numbers, and our Health Services Supervisor does a weekly call with them as well.”
The state has been transparent that its school-by-school case numbers are incomplete. They’re based on reports from local public health agencies, media and schools.
As a result, the numbers for dozens of schools are imprecise. For example, there were “122+” cases linked to Eagle High, meaning the number was more than 122, but the state didn’t know how much more.
The tally also excludes the number of cases at online or virtual schools, and at schools with fewer than 50 students or an unknown number of students.
Why does it matter if Idaho schools had uncounted COVID-19 cases?
School districts around the nation have been operating in accordion style, with virtual and in-person learning, for almost a year and a half.
They have shifted rules for masks, social distancing and other mitigation measures.
And now, they’re charged with preparing for another school year with many unknowns.
It is possible that children of all ages will be eligible to get coronavirus vaccines in the fall. Pfizer and Moderna trials are now underway for children 6 months to 11 years old.
Will parents choose to vaccinate their children? Will vaccines be required for students, staff or teachers? Will children be harder hit by COVID-19 variants than they have been in the past?
“I told the state — I think back in January — that we really need to follow these younger kid numbers very closely,” Pate said. “And the reason is with the ‘wild type’ virus, and the variant that we dealt with the majority of last year, those forms didn’t seem to have very high attack rates in children, so it was true back then that children are less likely to become infected; and if infected, they are more likely to be asymptomatic … and less likely to transmit the virus if they are infected.”
That isn’t necessarily true of the new variants, though, he said.
“I tried 100,000 times to get the West Ada School District to understand: stop thinking about the virus like we did last year,” he said.
The variants now spreading fastest in the U.S. spread faster among children, and one of them may hit young children especially hard, he said.
“These are the kids who cannot get vaccinated,” he said.
It is important for school boards, and public health officials, to “understand the limitations of their data. What they’re being shown, what they’re being told.”
He looks to summer camps for a preview of the school year.
“I do hope that schools don’t waste this summer,” and instead invest in ventilation, windows and other things that can also limit the spread of flu in schools, he said. “Even if they aren’t worried about COVID, this won’t be our last pandemic.”