Utah’s high schools are seeing more and bigger COVID-19 outbreaks. What can be done to stop it?

(Rick Egan | The Salt Lake Tribune) Murray High students leave school, on Tuesday, Nov. 24, 2020. Murray is one of 53 high schools in the state that has had a COVID-19 outbreak.

When the bell rings at 2:25 p.m., math teacher Melissa Brown watches from a window as kids file out of Riverton High.

“The first thing they do,” she said, “is rip off their masks. The second thing is they hop in a car with a bunch of their friends like COVID doesn’t exist once class is over.”

Her school is one of the 53 high schools, or roughly a third of those in the state, that have crossed the 15-case coronavirus threshold that state officials say should trigger two weeks of online instruction. That list includes every traditional high school in Salt Lake County in the four districts that reopened in person. And Brown has seen firsthand what’s driving the outbreaks.

“When the public sees that we have a certain number of cases at a high school, I don’t think that demonstrates what is actually going on in the building and just outside of it,” she added. “Our students are getting the virus, and they’re spreading it because they’re so social.”

[RELATED STORY: Here’s our list of at least 84 Utah schools that have had a COVID-19 outbreak or closed as a precaution]

Counting the 23 times that high schools have hit the mark for a second time, or even a third time, such as Riverton, there have been 76 total outbreaks among them, according to calculations by The Salt Lake Tribune.

Meanwhile, only 17 middle or junior highs have topped 15 cases this year, along with two elementary schools in Herriman, Butterfield Canyon Elementary and Blackridge Elementary. Another 10 combined have closed as a precaution as their numbers neared an outbreak.

The problem of spread in schools here, then, seems very much to be a problem of spread among high school students.

(Christopher Cherrington | The Salt Lake Tribune)

“You can see that in the numbers,” said Mary Hill, epidemiology supervisor with the Salt Lake County Health Department. “It’s just skyrocketing.”

In fact, “it’s possible that there is even more spread now among high school students than college students,” added Dr. Adam Hersh, who specializes in pediatric infectious diseases at University of Utah Health.

But beyond a brief pause in some extracurricular activities, the state has done little to intervene with high schools — and high school students are being treated the same as kids in first grade.

Unlike their younger classmates, though, they have jobs and driver licenses and more freedom to hang out when and where they want, which teachers like Brown are witnessing. And experts say that makes them more similar to college students, who are getting targeted testing in Utah.

Should the same or more be done for high schoolers?

Social spread

Currently, the 15-to-24 age range in Utah that includes high school and college students has the highest case rate of any age demographic. It accounts for 36% of all cases, although they are only about 10% of the population.

Copper Hills High teacher Jacob Rollins said at least part of the challenge with young people are the “mixed messages” from Utah officials. They’ve stressed how serious the pandemic is, he noted, and then allowed people to continue dining and shopping.

It leaves teens in a weird place, he said, especially at “a time when kids crave social interaction.”

He drove by a huge group of teenagers last week hanging out, he said, about a block away from the school; there was little distance between them.

That isn’t to say teens aren’t spreading it inside schools, too. The data shows they are.

In the cafeteria at lunch time, students can be packed in so tightly that many are left standing against the wall, Rollins added. Inside classrooms, masks stay on for the most part. But there is not enough space to social distance there, either, with nearly 40 high schoolers in each period. And every time one student tests positive for the virus, up to eight more are quarantined because of how close the desks are.

Jordan District school board member Janice Voorhies cited “an in-school explosion” for the most recent decision to shut down Riverton High.

With elementary schools, Hersh said, that kind of spread in the school is “infrequent.” He said his research confirms that high schoolers are at least four times more likely to get COVID-19 than their younger classmates, both in class and outside it.

Some might suspect that kids in elementary school just aren’t getting tested as much because they often don’t show symptoms, he said. But experts have not found that to be the case, especially when they consider that teens are also often asymptomatic and many don’t want to get tested so their school isn’t shut down.

So far, those decisions have been left to school districts.

With Riverton’s first two outbreaks, for example, Jordan School District’s board of education chose to ignore the recommendation to close for two weeks of online instruction. Now — with the third and biggest outbreak involving 29 sick students and staff — it has shut down the high school, as well as all five others in the district.

(Christopher Cherrington | The Salt Lake Tribune)

As Brown talked after school last week, a cleaning crew knocked on her door to start its daily sanitation routine. “Even with all of these precautions,” the teacher said, waving off the custodians to come back later, “our high schoolers are still getting the virus here. We’ve got to do something about it.”

There are at least three options to address it.

Option 1: Stop extracurriculars

The state’s biggest attempt to combat the rising transmission among high schoolers, so far, has been a two-week pause on some extracurricular activities that ended Monday. It’s unclear yet that it will work.

The data will show whether cases among schools declined with sports and clubs on hiatus. After the first week, they actually went up. There are now more than 13,000 cases from schools since most reopened. The highest single day — with 598 cases — came Nov. 18. The second week hasn’t been reported yet.

K-12 students and teachers are now directly contributing about 16% of the daily case counts in Utah, which are exploding at a rate of about 3,000 a day.

Gov. Gary Herbert insisted during a news conference with Dr. Angela Dunn, the state’s epidemiologist, earlier this month that inside a classroom is typically a safe environment. But outside, he said, “our high school students are a little more independent and casual.”

So now, under the new order he announced last week, participants in extracurricular activities, including coaches, trainers and staff need to be tested every other week.

Drawbacks • School sports have taken a big part of the blame. And Utah was the first state to have a high school football game canceled because of the coronavirus. But organized teams may not actually be the leading cause of the spread. It’s likely more informal gatherings, which the state has less power to control.

Dunn shared data this month that after all 1,500 high school athletes participating in the playoff football games were tested, the positivity rate was 3.5%. That’s lower than the general population.

“These kids are incentivized not to get sick,” said Ben Horsley, spokesman for Granite School District. “They want to be able to play.”

(Trent Nelson | The Salt Lake Tribune) Timpview's Raider Damuni runs for a touchdown against Salem Hills High School in a football playoff game at Cedar Valley High School in Eagle Mountain on Friday, Nov. 13, 2020.

The pause on sports has upset a lot of parents and students, some of whom are vying for athletic scholarships. Hill said her office has received hundreds of complaints.

Brown, the math teacher at Riverton High, said she knows of students and parents who have hosted proms and tailgates despite the limits on gatherings.

“Students are still getting together,” she said. “There’s only so much you can do to limit that.”

Option 2: Move high schools online

Salt Lake City School District has provided researchers with a nearly perfect case study.

The district is the only one in the state to have remained with all virtual learning this fall. And with that, doctors, including Hersh and Hill, have been able to examine the differences in infection rates for kids who returned for face-to-face instruction and those who stayed home. What they found is surprising.

The positive cases of COVID-19 among the elementary students at the four other districts in Salt Lake County — which have all reopened in person — were around 1%. The 10,000 elementary kids staying home in Salt Lake City School District caught the virus at about the same rate.

The rate for middle schools in the Canyons, Granite, Jordan and Murray districts was slightly higher, around 2%. Again, the students in Salt Lake City School District matched.

But the data diverged significantly for high schools.

Of the high schools in the county that reopened, the average infection rate was 4.6%, including teachers. But it went as high as 7%. For Salt Lake City high schoolers staying home, the rate was 2.85%.

That leads to the second option: Close all high school to in-person instruction.

It’s a solution that the Utah Education Association, the state’s largest teachers union, has strongly supported. In a letter to Herbert last month, the UEA urged him to close all secondary schools in hot spots.

Union President Heidi Matthews said the measure might be “more drastic,” but she believes it will lower spread for the community, stop the back and forth of schools opening and closing for each outbreak, and ultimately protect vulnerable teachers.

“What we are seeing with our high school students and our families,” she added, “is that we’re not doing enough to curb the virus.”

(Christopher Cherrington | The Salt Lake Tribune)

Drawbacks • The proposal has a long list of opponents. That includes Herbert, the state superintendent over Utah schools, as well as some teachers and most students. Hersh and Hill also don’t believe it’s in the best interest of students to learn entirely online. And most school board members feel the same.

“This is the first time in the history of the world that kids actually want to be in school,” Horsley joked.

Doctors say that because most of the spread seems to be coming from gatherings outside of school, and since masks are worn inside, that high school classrooms are actually a fairly safe place to be. Hill also notes that virtual instruction isn’t effective for many students. And a lot of students suffer when they can’t interact with peers, even on a limited basis.

Madilyn Ratliff, a junior at Riverton High, said she’s experienced that this year. She hasn’t gotten COVID-19, but she’s been quarantined four times after coming in close contact with classmates who have tested positive.

The first time was three days into the new school year. The second time came on her first day back from two weeks at home, when the health department called to say she’d have to start over again after another exposure.

Now, less than three months into the year, Ratliff has been out of school watching “The Office” in her bedroom for more days than she’s been there in person.

“It’s been really hard,” the 17-year-old said. “I don’t want them to shut down the schools.”

She said she learns better in person and likes participating on the drill team. Taking those away, she said, has made it hard for her to cope with everything else going on. “These are supposed to be the best years of our lives,” she added.

Superintendent Sydnee Dickson agreed that it’s “not optimal” to go entirely online. She believes, too, that teens would continue to hang out with their friends, even if the state took such action.

Option 3: Do rapid tests

The state could try with high schoolers what it is currently doing with college students: regular testing. This is probably the most likely solution when top leaders are adamantly against a move to all-online learning.

So far, the state is set to require compulsory weekly tests for university students beginning in January. Some schools have already started. The mandate applies to those who live on campus or who are taking at least one in-person class.

The hope is to detect asymptomatic cases early and have those individuals isolate before the virus spreads.

Dickson said plans are in the works to provide rapid testing to K-12 students and educators, noting that schools wouldn’t have to switch from in-person to online as much.

Drawbacks • There are roughly 665,000 students in Utah’s public schools. While some of them are taking classes remotely, it would still be a gargantuan effort to provide weekly testing for those who aren’t.

The state will need plenty of rapid-testing supplies and people to administer them. It will be a logistical challenge to make sure all students complied. And there almost certainly would be parents opposed to having their kids tested. Would there be exemptions for them? Would that undermine the effort?

Additionally, the effort is not ready yet as the months of cold weather and flu season arrive.

Will anything change?

At the end of September, Dr. Eddie Stenehjem, an infectious disease expert for Intermountain Healthcare, warned that if the state didn’t take action, high school cases would explode. At the time, only seven high schools had closed.

“Clearly, if we don’t do anything,” he said, “we’re not going to see a change in the trajectory of our kids.”

He was right. Of the total 76 outbreaks in high schools, 44 have come this month.

Hersh also added that the limited two-week shutdowns aren’t working and have “not been enough to turn things around.”

But it doesn’t seem like anything will come from state leaders anytime soon. Herbert has insisted that the decisions be left to districts: “They know best what’s taking place in their jurisdictions.”

He added again last week that schools should try to remain open so students can be there in person.