Lindsay Haskell is seeing a little bit of everything.
A student, unmasked, exposed to the coronavirus at an athletic event — and unknowingly passing along the virus to classmates the next day.
A parent passing the virus to their child, triggering a cluster of cases in a classroom.
A child who catches the virus from a classmate, and goes home and exposes family members.
The easily spread — and pervasive — COVID-19 delta variant can move within a community pretty much as it wishes. Intersecting and interconnected, the lines of infection move from schools or to schools.
But health officials have only so much time to track the transmission from an ever-growing number of cases. They need help from schools and parents, and they don’t always get it.
“Our information is only as good as what we’re receiving,” said Haskell, communicable disease control program manager for Boise-based Central District Health. “It’s challenging to have an accurate picture.”
The contract tracing challenge
Since the coronavirus first arrived in Idaho in March 2020, the job of “contact tracing” has fallen to the state’s seven health districts, such as CDH.
It’s a labor-intensive task — trying to pinpoint anyone who could have caught the virus from a COVID-positive contact — made more difficult by the virus’ two-week incubation period.
The sheer volume of cases further complicates the job. The state added another 8,400 cases for the week that ended Sunday, numbers approaching the record caseloads from late last fall. Nearly 1,400 of those cases involved school-aged children, a number well in excess of last fall’s peaks.
It’s tougher to contact trace now, Haskell said, simply because there are more ways the virus can spread. In the spring of 2020 — when schools went virtual, many employees worked from home, and public events and gatherings were shut down — there weren’t as many opportunities to transmit the virus. Not so in the fall of 2021, as the delta variant rages through an Idaho where most kids are back in school and many people are trying to shop and socialize as they did pre-pandemic.
“With transmission where it is right now in our community, a lot of people are being exposed every time they leave their house,” Haskell said.
Which brings us to the central contract tracing question for the 2021-22 school year: Are the schools acting as the incubator for community outbreaks, or are community events the point of origin for the rising child COVID case numbers?
The Boise School District reported 168 positive cases last week, but district officials believe most of these cases originated outside the schools.
The West Ada School District cites its numbers. “Positive cases have been trending down since school began indicating that schools – with a structured environment — are safer for kids as opposed to being in the general community,” spokeswoman Char Jackson said Wednesday.
The state’s largest district reported 105 active cases Wednesday — up from 66 cases on Monday, but still down from 168 cases on Sept. 13.
Statewide, the Department of Health and Welfare says it has pinpointed very few verified transmission events within schools. “What’s happening in the communities is impacting the schools,” deputy state epidemiologist Kathryn Turner said last week.
Under the best of circumstances, though, contact tracing is extremely complicated. Making matters worse, some schools aren’t even trying.
School plans are spotty
North Idaho had a delta variant crisis on its hands before schools could even open. The Panhandle’s hospitals got the state’s go-ahead to ration health care on Sept. 7, the first of class in Coeur d’Alene and other school districts.
Panhandle District Health is already seeing signs of spread within the schools, spokeswoman Katherine Hoyer said. But the health district can’t tell exactly what’s going on without some help.
“One of the major difficulties we are facing in pinpointing outbreaks … is the lack of contact tracing and collaboration in investigation from the school districts,” Hoyer said.
The Coeur d’Alene School District pulled the plug on contract tracing this year, on a 3-2 trustee vote. The amount of staff time needed to investigate cases across 18 schools was one factor. But contact tracing required school leaders to quarantine hundreds of students during the last school year, and trustees didn’t want to see a repeat.
“The loss of class time was immense,” district spokesman Scott Maben said.
Last week, the district counted 126 coronavirus cases — as self-reported by parents.
Coeur d’Alene isn’t the only large district that decided not to contact trace.
Nampa trustees ordered the district to put an end to the practice, which means any student quarantining is voluntary.
Nampa reported 113 student and staff cases last week, as school case rates continued to outpace the community at large.
Kuna doesn’t have the staff to contract trace. “We are striving to notify families and staff when COVID positive individuals are in a classroom,” spokeswoman Allison Westfall said this week.
Kuna reported 47 positive cases Tuesday.
Boise will use federal coronavirus relief money to hire contact tracers. But even so, teachers, principals and school nurses have to spend a chunk of their time filling in the pieces. “Contact tracing does require considerable time and effort by our staff,” spokesman Dan Hollar said.
West Ada’s contact tracing program is also a team effort, Jackson said — involving principals, school nurses, teachers, bus drivers, and even the use of video to track COVID-positive students’ movements within buildings. Ultimately, close contacts will be ordered to quarantine, and on Wednesday, more than 650 of the district’s 40,000 students had been ordered to stay home.
Spotty responses from parents
Overburdened with cases, CDH has had to make some contact tracing tradeoffs. Investigating school cases is a priority, Haskell said, since children under age 12 cannot get a COVID-19 vaccine, and are especially vulnerable to an outbreak.
But when CDH calls a child’s parents, the investigators never know exactly what to expect.
Some parents are cooperative — sometimes going to extra lengths, even while trying to stay in quarantine themselves. “They’re having that conversation through a door,” Haskell said.
Other parents want to help, but they only know so much about their kids, and the names of their close friends or teammates.
Other parents won’t pick up the phone, for any number of reasons. They might be bedridden themselves. They might not want to get the news of a positive test result from CDH, because they don’t want to have to think about quarantining. Or they might just be skeptical of the government.
“As the pandemic’s gone on, we’ve seen people become less responsive to working with us,” Haskell said.
So here’s where we stand, 18 months into the pandemic.
We know more Idaho children are contracting the delta variant — as COVID-19 fundamentally shifts and affects a younger and generally unvaccinated population subset.
We can never be exactly sure why.
But some trustees and some parents are making it tougher to get answers.