Should Miami’s public schools change quarantine procedures? Medical experts weigh in

The medical expert task force advising Miami-Dade County Public Schools on its COVID-19 protocols and procedures reconvened Monday for the first time since schools reopened their classrooms in October.

No new actions or guidelines came out of the meeting. Though the school district had six questions for the experts, the two-and-a-half-hour meeting held virtually seemed to be more of an open-ended discussion forum.

The main topic up for debate was whether the school district should adjust its quarantine protocols to looser guidelines floated last week by the Centers for Disease Control and Prevention. The CDC still recommends a quarantine period of 14 days, but recently said that quarantine could end after 10 days with no symptoms or seven days with a negative test.

Dr. Yesenia Villalta of the Florida Department of Health in Miami-Dade County said the health department is in the final review of new CDC guidelines, and some changes are forthcoming.

Villalta said the “gold standard” is 14 days of quarantine, and that individuals must be mindful and not let their guard down. The CDC says individuals must continue monitoring for symptoms and masking through day 14.

Dr. Aileen Marty, a public health expert and Florida International University professor who has been advising the county, agreed with Villalta. She said 95% of people who have COVID-19 show symptoms by day 14.

“You always have to think in terms of how much risk you are willing to tolerate versus the benefit of that risk,” Marty said, adding that there’s still debate over the CDC changing its guidelines. “Many things have changed since the last time we were together.”

Since schools reopened Oct. 5, 972 employees and 561 students have tested positive, according to the district’s COVID-19 dashboard. That’s as of Thursday — the district has said that the dashboard has a lag.

Parents’ frustration over quarantines

School Board members also shared some concerns from their constituents frustrated by lengthy and constant quarantine procedures. They said parents have complained of constantly switching from in-person learning to online because of automatic quarantine, despite never getting sick.

Board member Christi Fraga said she went through that with her son, who is in Pre-K. She said her son had to quarantine for two weeks twice, back-to-back.

“It’s definitely challenging and affects these children,” Fraga said. “Again, from personal experience these past few months we’ve been back in school...each time no one else in the class has contracted COVID except for the student who came in with a positive result,” she said.

Not all COVID tests are equal

Fraga floated the idea of allowing individuals to return to school based on proof of a negative test. Marty shot down that idea because not all tests are equally reliable.

“They don’t all have the same sensitivity,” Marty said. “I would urge that it be a sensitive or specific test. Forget about the stupid antigen test, no rapid test. It has to be a RT-PCR test.”

Marty said she would support decreasing the quarantine time if the district had the capability of a quick turnaround PCR test.

“It’s also emotionally better for the whole family to not be on pins and needles,” she said.

Other health experts emphasized how the PCR test, done by a mouth or nasal swab and with about a two-day turnaround for results, is considered the gold standard.

The school district distributes rapid antibody tests for employees and their dependents at three sites. Dr. Lisa Gwynn, a pediatrician with the University of Miami, said the false positive and false negative rate for those tests is as high as 20%.

The district’s chief of staff, Jaime Torrens, says of the 5,711 rapid tests conducted at those three sites, about 5% were positive. About half of those positives detected a current infection of COVID.

Torrens said the transmission in schools has not grown “exponentially” as some predicted. He said individuals are infected when they arrive at school.

Board member Mari Tere Rojas said she also received those same complaints about quarantines.

“There are families that believe the School Board is the one who makes the determination of 14 days as opposed to 10 days as opposed to 7 days,” said Rojas. “That is what we are being confronted with. We have to weigh everything very, very carefully.”

Some board members were frustrated that medical experts, pressed for time, had to leave early.

Board member Lubby Navarro wanted to ask Villalta about quarantine procedure inconsistencies around the state. She said one parent told her that he called around the state and found that other schools in other counties only quarantined those who were in immediate contact with the infected individual, not a whole class.

But Villalta was off the call an hour after the 1 p.m. meeting began.

“It’s a real shame,” Navarro said. “I’m now left without a possible response to my constituents.”

Superintendent Alberto Carvalho said the school district has a decision tree that allows for some cases where an individual may come back to school after 10 days instead of 14.

Carvalho harped on the benefits of students learning in school. He opened with 1,000 students “missing” from the school district whose families have moved, with some who have left the country.

“There is a strong case for opening schools,” he said, adding that the district’s decision to reopen schools is “a decision that I think has brought a degree of normalcy and regularity and support at all levels.”

There was no talk about uniform procedures that would trigger the shutdown of a school. Carvalho dismissed that idea at last Wednesday’s School Board committee meetings when pressed by board members.

“If we were to provide a specific metric, as a guarantee that would be a trigger to close a school, I believe I know what that would bring about,” he said, alluding to backlash from the Florida Department of Education.

The recent executive order out of Tallahassee dismissed the possibility of closing schools again. It did ensure that students whose parents prefer for them to learn online from home could continue to do so, fully funded, for the rest of the school year.

Educators should get vaccine priority, experts say

Looking to the future, health experts agreed that educators should get priority to get the vaccine if they choose.

Asked about COVID vaccines for students, Gwynn, the pediatrician with UM, warned about vaccine hesitancy.

“The anti-vaxxers are going to be coming out in full force,” she said, adding that those vaccinations will not be ready for children by the end of the school year, but maybe for the start of the 2021-22 school year. “There’s a long way to go with that.”

This story was originally published December 7, 2020 at 7:22 PM.