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The Health 202: British schools reopened with little covid-19 spread, new data show

with Alexandra Ellerbeck

Now we know what happened when the United Kingdom sent kids back to school.

There were very few coronavirus cases — and they were mostly among teachers, not students.

The United Kingdom’s new report, released yesterday, is the most comprehensive look yet at what might happen when hundreds of thousands of kids return to classrooms amid the coronavirus pandemic. The information could prove valuable and timely for schools in the United States, caught in the midst of a heated and politicized debate over the best approach for fall learning.

“I was surprised by how low the numbers were, to be honest,” said Emily Oster, a professor of economics at Brown University, who analyzed the report. “I thought they would be higher.”

U.K. schools saw infection rates of 0.02 percent among staff members and 0.008 percent among students.

The data, collected by the country’s public health agency, comes from reports from nurseries, preschools, elementary schools and secondary schools that reopened for a “mini” summer term in June after the country’s spring shutdowns.

An average of 843,430 students and 519,590 staff members were at school facilities each day, according to the report. During the entire month, schools reported 70 cases among students — but 30 of those students didn’t seem to have acquired the virus at school, and none of the children were hospitalized for treatment of covid-19, the disease caused by the novel coronavirus.

Out of 128 staff cases, one of the staffers was hospitalized and required intensive care. Thirty-seven of those cases weren’t linked to a school, including a single case resulting in the death of a secondary school teacher who had acquired the virus from a household member.

Overall, secondary schools appeared to experience wider transmission of the virus and larger outbreaks than primary schools or preschools — a finding consistent with studies indicating older children are more likely to spread the virus than younger ones.

The researchers concluded this: Schools aren’t driving big coronavirus outbreaks.

“The re-opening of schools was associated with very few covid-19 outbreaks after easing of national lockdown in England,” wrote experts from Public Health England, the London School of Hygiene and Tropical Medicine, and St. George’s University of London.

“SARS-CoV-2 infection and outbreaks were more likely to involve staff members, emphasizing a need to improve education and infection control measures for this group both within and outside the educational setting,” they wrote.

The debate in Britain is over whether children should wear masks in school — not whether they should return to school at all, like in the United States.

Children in England are preparing to return to school next week.

While the governments in Scotland and Northern Ireland are requiring mask-wearing in schools, England’s deputy chief medical officer said yesterday the evidence is “not strong” in favor of secondary school students wearing masks.

But Prime Minister Boris Johnson left open the possibility of changing the guidance dependent on medical advice, saying he was “really pleased” by the work being done to prepare schools for reopening.”

Meanwhile, a large slice of U.S. schools are starting the fall with virtual-only school.

That’s particularly true in urban areas, and in politically blue states. The whole issue has been caught up in a heated and emotional public debate, further inflamed by President Trump’s repeated insistence that schools must reopen.

Teachers unions are threatening to strike in some school districts that are planning a return to the classroom. Yet districts insisting on a virtual approach have prompted concerns about the disastrous consequences for kids — especially those who are disadvantaged — if they’re kept away from school for months on end.

There’s also a frustration that many colleges and universities are opening up as elementary schools keep their doors closed. 

Studies have suggested teenagers spread the virus more easily than younger kids. And the consequences of virtual learning are clearly harsher for preschoolers and elementary-age children.

MSNBC's Chris Hayes:

If Britain is any example, communities need to get virus transmission under control to reopen schools safely. 

The country had largely gotten its outbreak under control by June and was enforcing social distancing and mask-wearing. There was a “strong correlation” between coronavirus outbreaks and regional incidence of the virus, the report says.

“I think we’re increasingly getting a sense of when schools are opening, where prevalence is relatively under control, we’re not seeing a lot of cases,” Oster said.

Under this philosophy, you might expect more virtual school in high-transmission areas and more in-person school in low-transmission areas.

But in the United States, it’s the opposite.

School districts in northeastern states — including New York, New Jersey and Massachusetts — are going all-virtual, even though cases and deaths are well below the levels seen in April and May.

“I feel like in some ways the choice about reopening appears to be driven entirely by politics and very little by science,” Oster told me.

Many districts in Southern states have opened their doors but are already walking back in-person learning amid positive tests and outbreaks. These include K-12 schools in Georgia, Mississippi and Tennessee — all states where daily new cases are still elevated well above levels in the spring.

“While a growing number of schools have backed off reopening, opting instead for online classes, others are hoping a host of new rules and adaptations can keep the coronavirus at bay,” Hannah Knowles writes of colleges and universities.

“They are requiring masks, mandating testing and threatening students and campus groups with penalties for partying,” she writes. “Ohio State University alone said this week that it has suspended 228 students over virus-related violations.”

On Night 2 of the RNC, Melania Trump praised the administration’s efforts to combat the opioid crisis. 

“Our administration has also devoted historical resources and produced lifesaving results by raising awareness around opioid addiction and drug abuse, especially for children,” the first lady said. 

The opioid epidemic, which did not receive much attention during last week’s Democratic National Convention, got significant play on the second day of the Republican convention. 

Ryan Holets, a police officer from New Mexico who was invited to speak at the convention, described his decision to adopt a baby from a homeless woman who was using opioids and his subsequent friendship with the mother. 

Holets praised the president’s leadership in fighting the opioid crisis, pointing out that drug overdose deaths decreased in 2018 for the first time in 30 years. Recent data, however, does not look as optimistic. Drug overdoses may be increasing during the pandemic, possibly fueled by unemployment and less access to mental health and addiction resources. 

Republicans also sought to rally anti-abortion voters.

Activist Abby Johnson told the story of how she went from directing a Planned Parenthood clinic to becoming a leading voice against abortion. She praised Trump, saying that he “has done more for the unborn than any other president.”

Johnson cited Trump’s appointment of abortion-opposing judges and new rules that protect health care workers who decline to provide services for religious reasons. 

Susan B. Anthony List, a leading anti-abortion group:

She also praised the president's 2017 ban on federal funding for global health groups that promote or provide referrals for abortions. While a version of this rule has been in place under every Republican president since Ronald Reagan, the Trump administration expanded it to include global HIV funding, a decision that researchers have found led to disruptions in care in some places.

In her speech, Johnson also accused Margaret Sanger, the founder of Planned Parenthood, of being a “racist" and eugenicist. While Sanger was a feminist icon for many, she made appeals to eugenics in her push for birth control.

Planned Parenthood of Greater New York announced last month it was removing Sanger's name from its Manhattan health clinic.

Johnson changed her views on abortion upon witnessing what an ultrasound-guided abortion. Details of the story – the inspiration for the 2019 film Unplanned – have been called into question by investigative reporters at the Texas Observer and Texas Monthly. Johnson has also courted controversy in the last few days for a video in which she claims that police are justified in racial profiling.

Ahh, oof and ouch

AHH: The Centers for Disease Control and Prevention modified its testing guidelines to exclude people who don't show symptoms of covid-19.

While previous versions of the testing guidelines called for testing anyone who had close contact with an infected individual, the newest iteration released on Monday said that those individuals “do not necessarily need a test.” The guidelines make exceptions if testing is recommended by a health provider or by local officials, or if the person is high risk.

“The change is alarming experts who point out that a large share of transmissions occur before individuals develop symptoms,” The Post's Antonia Farzan writes. “Some individuals infected with the coronavirus never exhibit symptoms, but can still transmit the virus to others, too.”

The CDC's revision comes as health experts push for more frequent and widespread testing.

Global infectious-disease expert Krutika Kuppali:

Leana Wen, an emergency physician and visiting professor at George Washington University’s Milken Institute School of Public Health:

A spokesperson from the Health and Human Services Department told the New York Times that the change reflected the best available evidence and was not due to any shortage in testing supplies. 

OOF: The particulate pollution being spewed by hundreds of wildfires in California can reach deep inside the lungs. 

The air quality in California is lower than that of New Delhi, an Indian megacity known to have high levels of pollution, and it's affecting people “already at a high risk of pulmonary disease because of the COVID-19 pandemic,” USA Today's Jorge L. Ortiz reports.

Experts say that fine particulate pollution (PM2.5) spread by the fires can exacerbate chronic heart and lung disease. Declines in air quality have been seen across the Western United States and as far as the Midwest.

Some scientists have an additional worry: Poor air quality could potentially make people more sensitive to the coronavirus.

Air pollution is “going to weaken the whole system,” said John Watson, an expert on air quality at the Desert Research Institute in Reno, Nev. “You’re going to be more susceptible to any other disease just because your system is already overtaxed.”

The National Weather Service has been sending out regular warnings showing the spread of the pollution:

OUCH: Local governments are worried the Trump administration may cut off coronavirus disaster relief funds.

“City and state leaders expressed fears Tuesday that the Trump administration may cease reimbursing some of their purchases of masks, gloves and other personal protective equipment, a move they said could tear new holes in their budgets while threatening public health,” Tony Romm and Erica Werner report.

The Federal Emergency Management Agency, which is charged with disaster relief, has indicated that it may change its criteria for providing funds to cover coronavirus costs, even as local officials say they need more testing supplies and masks as schools and workplaces reopen. While the agency has not finalized its plans, the uncertainty has prompted a backlash from state and city officials.

A letter from organizations representing state, city and county governments, sent to FEMA head Peter Gaynor on Tuesday, cited “a troubling pattern of shifting costs and responsibilities onto states and localities when they can least afford it.” 

The letter also questions whether the agency is facing a budget strain because of a Trump program that directs money from the disaster relief funds to boost unemployment checks. The debate also comes as hurricane season kicks off in the United States and threatens to further stretch the agency’s resources.

Coronavirus latest

  • After increasing steadily through June and July, cases have fallen to their lowest levels in two months, the Wall Street Journal's Allison Prang and Melissa Korn report. They could rise again, however, as the country confronts natural disasters in California and the Gulf Coast.
  • The Centers for Medicare and Medicaid Services issued new rules on Tuesday mandating that nursing homes test staff members and offer testing to all residents. The United States has purchased 750,000 tests to be distributed in nursing homes, Reuters's Mrinalika Roy and Carl O'Donnell report.
  • Public health officials are bracing for the flu season, which could make delays in testing for the coronavirus even worse. The flu and the coronavirus share many symptoms, which means doctors may order more tests to diagnose which virus is affecting their patient. Testing for two separate viruses could strain already short supplies, the Times's Katherine J. Wu reports.
  • After a heated debate about the efficacy of neck gaiters in preventing spread of the coronavirus, some researchers are coming to the defense of the mask alternative popular among runners, Allyson Chiu reports.

Elsewhere in healthcare

Health-care policy has become a dividing line in the Democratic primary race for Massachusetts’s 1st Congressional District. 

Early voting opened this week in the election, which pits liberal Holyoke Mayor Alex Morse against incumbent U.S. Rep. Richard E. Neal, the influential head of the House Ways and Means Committee.

Morse, who supports Medicare-for-all, has attacked Neal for receiving money from health-care industry lobbyists and has accused his opponent of scuttling a bipartisan bill aimed at ending surprise medical billing, the practice in which patients are hit with exorbitant medical bills when unknowingly referred to an out-of-network doctor. 

The latter allegation is supported by a 2019 BuzzFeed News investigation that found Neal tanked the momentum for the surprise-billing legislation by introducing a counterproposal at the last minute.

Neal for his part claims that he has a plan to end surprise billing that will protect doctors and hospitals. He has also touted his work in passing the Cares Act.

If Morse wins, Neal will be replaced at the head of the Ways and Means Committee by the more left-leaning Rep. Lloyd Doggett (D-Tex.). The chair of the committee, which oversees the government budget, plays a key role in legislative health policy.

Politico health reporter Susannah Luthi on the race:

Prosecutors have indicted Teva Pharmaceuticals in a price-fixing investigation.

“Teva, the world’s largest generic-drug maker by market value, is the most high-profile company to be charged in the Justice Department’s probe into allegations that companies conspired with one another to prop up the prices of certain widely used medications,” Bloomberg News's David McLaughlin reports. “Nine of every 10 prescription drugs dispensed in the U.S. are generics.”

The Justice Department charged that the U.S. unit of the Israeli-based company colluded with competitors to increase the prices of drugs used to treat cholesterol, seizures, hypertension, blood clots, brain cancer, arthritis and other conditions. 

Five other companies have settled charges with the Justice Department and agreed to pay $426 million in criminal penalties, while a sixth was charged in June, David reports. Teva was charged after the company refused to agree to a settlement that would require it to admit wrongdoing, a course that could potentially open it to civil litigation.

“Today’s charge reaffirms that no company is too big to be prosecuted for its role in conspiracies that led to substantially higher prices for generic drugs relied on by millions of Americans,” Makam Delrahim, the assistant attorney general for the department’s antitrust division, said in a statement.

Sugar rush