Why Washington State's Guidelines to Open Schools Are More Cautious Than Others

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The numbers seemed "incredibly low."

That's how high schooler Adeline Roza felt when she learned in August that her school would use Washington's recommended thresholds for determining when to resume classes in person.

Her private school's decision fit with guidance from Washington's top health officials. But Roza, a senior at Seattle Preparatory School, wondered what was behind the numbers. So she started pulling public health documents from West Coast states and a handful of others.

What she found surprised her: States are using vastly different metrics to gauge when and how to reopen schools, and Washington seemed to be among the most cautious.

Roza's findings were supported by a national study: Nearly half of states have no clear health benchmarks to guide reopening, the Seattle-based Center on Reinventing Public Education (CRPE) found. Washington was one of the few to provide clear guidelines that tied case counts to in-person classes. And Washington's guidelines are far more careful than what a panel of national researchers has recommended.

"That's when I realized ... that it doesn't really look like I'm going back to school any time soon," she said.

A majority of Washington's students have been away from classrooms for more than half a year, though some large districts, including Bellevue and Tacoma, are considering a partial return. They're making decisions based on a reopening road map Gov. Jay Inslee and state health officials released in August:

--Schools shouldn't open, they recommended, if they are located in "high risk" counties, which they defined as having more than 75 cumulative cases per 100,000 residents over a two-week period.

--In areas with fewer cases, considered "moderate risk," districts could consider bringing back elementary schoolers and those with disabilities; in "low risk" areas, older students, who are more prone to being infected by coronavirus, could come back under a hybrid of in-person and remote learning.

When they first began to consider reopening guidelines, Washington officials convened teachers, advocacy groups, school leaders and others. They weighed the academic and mental health consequences of keeping children away from school buildings against the risks of spiking infection rates and harming school employees by opening classrooms too early. Officials then looked at what happened when other countries reopened schools. They asked disease modelers. And they checked to see what neighboring states and those further afield were planning.

Washington state's metrics are in the middle compared to its West Coast neighbors: more cautious than California, looser than Oregon. It appears much more careful when compared with some Midwest and Eastern states such as Connecticut, where the bar for restarting some in-person classes -- fewer than 25 daily cases per 100,000 residents -- is roughly five times higher than Washington's.

"The fact that Washington state is more conservative is not a bad thing -- the goal is to get lower and lower new cases per day," said Dr. Thomas Tsai, assistant professor of health policy and management at Harvard University's T.H. Chan School of Public Health.

But what went into the state's risk calculus in deciding when school should resume as usual? Unlike most other corners of public life -- business, transportation, religion -- schools were left out of Inslee's four-stage reopening plan. When to reopen schools has been left up to each county and school district, unlike Oregon and California, where the benchmarks are legally binding.

"We've always felt this is really a local decision," Dr. Kathy Lofy, the state's health officer, said in an interview. "This is one of the hardest decisions we've all had to consider during this pandemic."

Other states have also deferred authority on reopening for schools, which have a long history of local control by school boards, said CRPE's Ashley Jochim, the lead researcher on the recent report examining state reopening guidelines.

"There's a perceived powerlessness around education and a deference to locals that we haven't seen in other parts of the pandemic," said Jochim.

At the end of the day, the state's recommendations are just that: recommendations. School districts and private schools don't have to follow them, and some are choosing not to. Other forces, such as teachers union negotiations and pressure from families, play a significant role in reopening decisions.

Most of the state's counties were considered "high risk" at the time of Inslee's announcement. And by the start of the school year, districts tended to follow the state's voluntary guideposts: Only a handful of the state's 300-plus school systems decided to reopen in person, state education department data shows.

Cautious approach

At the same time Lofy and other states were devising plans, a group of researchers at Harvard and other universities watched closely.

"There was a lot of confusion at that time with state reopening plans," said Tsai, who was one of several researchers following states' decisions.

One of the most confusing issues: States weren't using uniform measures when they reported coronavirus incidence, which refers to new cases in a population over time. While Washington was looking at cumulative case counts over two weeks, some states reported cases over shorter or longer periods. Other states chose to calculate daily averages. Some, like New York, are basing their guidelines on the percentage of positive coronavirus tests, an indicator of how widespread infection is in a community. Attempts to compare one state's policy to another's were difficult.



Like Roza, Washington state leaders were surprised by the diversity of state responses.

"There was an incredibly broad range, which I think pretty much told us we didn't really know in terms of what would be the best option," Lofy said. "But we opted for a cautious approach."

To help standardize these metrics, Tsai, colleagues at the Harvard Global Health Institute (HGHI) and other institutions used disease modeling and expert consensus to come up with a set of risk levels that could be used across states. When daily case counts dropped below 25, they said, schools could consider bringing some students back -- primarily those in younger grades, and those with disabilities -- if they were able to take several safety precautions.

When making such a decision, the researchers said, states should also consider the rate of people who test positive for the coronavirus, hospitalizations and whether case counts are going up -- factors Washington officials also urged districts to account for.

"That was really the goal: to provide actionable data to inform policymakers," Tsai said. The research made national news and has been cited in some states' reopening plans -- but not Washington's.

In West Virginia, Gov. Jim Justice said the state's COVID-19 risk model was inspired by HGHI's. But the state's parameters for reopening schools were far more relaxed than HGHI's, and excluded certain cases from its overall counts, such as those in nursing homes and prisons.

Justice called the tweaks "a real innovation from the Harvard model, particularly when it comes to opening schools." Tsai called them "inappropriate" and emphasized the importance of maintaining transparency. After receiving an onslaught of criticism, Justice backtracked last week.

Examples like West Virginia reveal how fraught and complex it is to tie COVID-19 data to policy decisions -- even when relatively objective metrics exist, such as HGHI's and those from the Centers for Disease Control and Prevention.

HGHI's metrics didn't make it into West Coast state guidelines, and 23 states have no public health benchmarks at all tied to school reopenings. Four of those states -- Texas, Arkansas, Florida and New Jersey -- actually order in-person instruction regardless of coronavirus transmission rates, CRPE found.

The lack of coordination and spread of requirements is feeding into the current "crisis of confidence" and political fervor around reopening schools, said Jochim.

Washington has done a good job making its recommendations clear compared to other places, she said. But the lack of consistency with other states will subject its guidelines to scrutiny beyond its control.

"I can't say if it's the right set of benchmarks," said Jochim. "The consequences are stark -- a more conservative standard means schools will remain closed for longer. The looser one could contribute to a loosening of the pandemic [response]. At the very least, we need to see more of a discussion around these standards."

Taking action

In Washington, school closure policies are slowly loosening.

When Pierce County moved from "high risk" to "moderate risk" as case counts fell in early September, public health officials wrote to school leaders that they could consider bringing elementary students back to school buildings. School districts responded swiftly: the same day, a majority of the county's districts, including Tacoma Public Schools, issued a joint statement with their intention to draft reopening plans.

Last week, Tacoma made its plans official. Children in pre-K through second grade will return for part-time in-person learning no sooner than Sept. 28.

Tacoma officials say the shifts in guidance over the summer -- including initial direction from the state's superintendent in June, and the newest statements from local health officials -- have caused stress and confusion.

"For heaven's sake I hope families out there cut their school districts some slack and give them a little grace because we've been pulled in multiple different directions at different times as the authorities have changed their guidance on what we should be doing to serve kids," said Dan Voelpel, the district's spokesperson. "It's been frustrating for us and I can only imagine how frustrating it is for our families."

In King County, where Roza goes to school, the 14-day average had dropped to about 59.5 per 100,000 residents as of Friday. This number is still far above the state's mark for reopening high schools: to do that -- even part-time -- cases would need to drop to fewer than 25 per 100,000 residents over a two-week stretch.

Roza recently emailed a school official with some of her concerns.

"Today my math teacher mentioned you were optimistic about school reopening soon. That surprised me since I've been doing some research of my own," wrote Roza, who is the daughter of Marguerite Roza, a Seattle-based education finance policy professor at Georgetown University. "My sense is that the high school reopening threshold is impossibly low."

Then, in parentheses, she wrote: So we won't be opening.