As schools reopen, we answer 5 key questions about delta risks, vaccine requirements and healthy precautions

As Wisconsin schools prepare triumphant returns to in-person classes this fall — many shirking COVID precautions in a quest for normalcy — health officials are wearily bracing for the worst. 

With thousands of classrooms of mostly unvaccinated students sharing long periods of time indoors, schools could become a significant frontier for the highly contagious delta variant.

“Schools are the wild card,” said Jim Conway, a pediatric disease expert for UW Health. “If schools are going to ignore the threat on the doorstep and act like it’s not happening, it could be much worse than we are now.”

Conway said the course of the pandemic in schools will largely depend on how well schools can adhere to what has proven to work, including encouraging vaccinations, requiring masking and improving airflow. 

“Somebody’s got to start telling people that if this doesn’t go well, we’ll be back to where we were a year ago with schools closed,” he said. “Delta is that serious.”

Milwaukee Public Schools will open 40 of its schools Monday with comparatively strong COVID precautions, including a mask requirement for all students and staff. The district will fight an uphill battle with low vaccination rates and high case numbers in the city.

How is the delta variant affecting children? 

After some reprieve over the summer, the delta variant has caused a rise in cases and hospitalizations for all age groups, including children. 

From May 27 to July 15, Wisconsin hospitals saw no more than 10 people under age 20 admitted per week with COVID. In the first week of August, 18 people under age 20 were hospitalized with COVID, according to state data. 

The numbers aren’t as high as peaks in November, when as many as 83 people under age 20 were hospitalized in a week’s time. But as the burden of the pandemic shifts and grows for those who are not vaccinated, health officials are worried about what’s to come especially for children under 12 who are not yet allowed to vaccinate. 

Beyond the risk of short-term illness, researchers are still learning how the delta variant, or any coronavirus strain, can cause long-term health problems for children. Weeks after an initial period of illness from COVID, some children have developed a rare inflammatory condition called multisystem inflammatory syndrome in children, or MIS-C, from which most are able to recover. 

Conway said some children have had lingering neurocognitive problems, respiratory issues and fatigue. As has been true for all age groups, children of color and children from low-income families may be at greatest risk for more severe cases due to underlying health inequities, including higher rates of asthma and diabetes.  

“We don’t know what the long-term effects are going to look like in kids,” Conway said. “We’re learning in real time.”

Can schools require students or staff to be vaccinated? 

For Wisconsin students, other vaccine requirements like polio and Hepatitis B were instituted with state administrative rules from the Department of Health Services. 

DHS Deputy Secretary Julie Willems Van Dijk said Aug. 12 that officials do not intend to implement such a rule for COVID vaccines this school year, as the rule process is time-intensive. 

Willems Van Dijk said local school boards could consult with legal resources about whether they could implement requirements for their own students. It doesn’t appear any school boards in Wisconsin or nationwide have signaled an intent to do so. 

Any requirement would come with broad exceptions. Wisconsin allows families to opt out of vaccine requirements by signing waivers attesting to personal conviction, religious or medical/health reasons.

Similarly, school districts in Wisconsin have not made COVID vaccine requirements for staff. The Federal Equal Employment Opportunity Commission has said employers are legally able to require COVID vaccination.  

Chicago Public Schools announced Aug. 13 that its employees must be vaccinated, with some exceptions for medical and religious reasons. The move followed California Gov. Gavin Newsom’s announcement that all schools in California would require vaccinations for staff.

Milwaukee School Board President Bob Peterson has drafted a resolution, to be considered by school board members Tuesday, that asks administrators to research the feasibility of a vaccine requirement for staff. 

How many eligible students and staff are vaccinated? 

While health officials haven’t shared data about each school, they have provided data by age group in different areas. Most eligible students have not yet been vaccinated. 

Statewide as of Aug. 12, about 31% of those ages 12-15, and 40% of those ages 16-17 have completed vaccination, state data show. 

Local health departments share data in different ways. In the city of Milwaukee, about 20% of those ages 10-14 and 42% of those ages 15-19 have received their first dose, according to local data.

Milwaukee health officials said they do not know how many students or school staff have been vaccinated. They said schools would have to survey their populations to find out, as Atlanta Public Schools has already done with its staff. 

When will younger students be able to get vaccinated? 

Pfizer could apply for federal approval of its vaccine for children ages 5-11 by the end of September, while Moderna will likely come later, the companies’ spokespeople have told reporters. Applications for younger children could come after that. 

The vaccines then require approval by the Food and Drug Administration, which previously took about a month to approve Pfizer’s vaccine for ages 12-15. 

Both companies are currently conducting clinical trials with children. Moderna recently announced a clinical trial based at UW Health for children under 12, greeted with high interest. 

“There’s a ton of interest, almost overwhelming interest, of people really eager and desperate to move the needle and potentially get their kids vaccinated early,” Conway said.

What else can schools do to reduce COVID risks?

One of the most significant steps, health officials say, is requiring masks regardless of vaccination status. COVID spreads in small aerosols when people exhale (and especially when they talk, yell, cough or sneeze). Masks are able to block some of these aerosols from getting into the air, where they can otherwise circulate for hours. 

While some districts have announced masks will be optional, others like Milwaukee Public Schools are requiring masks indoors for all students and staff. MPS also has HEPA air filters in every classroom to improve ventilation. 

The Centers for Disease Control and Prevention recommends regular screening testing of both symptomatic and non-symptomatic students and staff to identify cases before further spread. Schools across Wisconsin are taking different approaches to testing. MPS plans to offer rapid testing for those who are symptomatic. 

Other important measures include contact tracing and quarantining. At MPS, when a student or staff member tests positive, MPS nurses will contact-trace to identify students and staff who spent at least 15 minutes within six feet of the person. Those contacts who are unvaccinated will be asked to quarantine until they test negative. 

Contact Rory Linnane at rory.linnane@jrn.com. Follow her on Twitter at @RoryLinnane.