Michigan’s new definition of a COVID-19 school ‘outbreak’ will mean fewer are reported – Detroit Free Press

The Michigan state health department isincreasing the threshold for the number of COVID-19 cases that would constitute an outbreak at a K-12school.

Themove willresult in fewer reported outbreaks and inconsistent state data, coming at a time when school outbreaks are on the rise and local health leaders are pleadingfor a statewide mask mandate.

As of Monday, an outbreak at a school must have three or more associated cases. For the past 18 months, an outbreak consisted of two or more cases. The new definition will not be applied to older outbreaks.

If this change had been implemented at the start of September when manystudents returned to classrooms, the state could have excluded almost25% of new school outbreaksreported in that time frame.

Outbreakson college campuses and child care/youth programs still will be counted if there are two or more associated cases. The two-case threshold also will continue to count as an outbreak in other settings, such as at restaurants, offices, manufacturing/construction sites and others.

More: Michigan's local health leaders want statewide K-12 mask mandate after threats, harassment

More: CDC approves Pfizer COVID-19 booster shots for essential workers, 65 and older, others

Department spokeswoman Lynn Sutfin acknowledged the change may lead to fewer reported outbreaks in K-12 schools.But she saidthe department followed standard procedure and changed its definition because of guidance from theCouncil of State and Territorial Epidemiologists.

She said the change "represents the assessment of a larger body of public health participation and has been highly vetted and approved."

The council issued school-specific guidance onAug. 6 thatnotes there is no national standard forthe number of cases that constitute an outbreak. That has led to confusion, according to the council. Definitions ranged from two cases to 15 cases, depending on the state.

So, the council's guidance suggested defining an outbreak at a school as three or more cases. Previously, it suggested two or more cases, and continues to use that definition for outbreaks at health care venues and other facilities.

Janet Hamilton, executive director of the council, said Tuesday she could not speak to Michigan's individual decision to shiftits definition.

Broadly, she said a national work group arrived at the updated outbreak definition after substantial deliberation. The group felt it was easier to track down the information necessary to show an outbreak that involves at least three people as opposed to two.

"I think the challenge with this is with two casesin an individual school or setting, it was very hard to establish potentially whether or not those individuals had or hadn't always had contact with one another," Hamilton said.

"So we wanted to set a threshold where, essentially, we could say,with some level of confidence, we really do believe that there is more than just sporadic transmission occurring."

It's more challenging to conduct effective contact tracing in schools, Hamilton said, suggesting experts generally need to get information fromparents who have become less forthcoming over the past year.

However, she said that does not mean that a school couldn't have an outbreak involving two students.

"It's hard. It's not a perfect science," said Hamilton, an epidemiologist who previously attended the University of Michigan.

Changing the threshold of what constitutes an outbreak in K-12 schools from two cases to three, but not in other settings, will make it very difficult to compare outbreaks based on exposure site, said Dawn Misra, chair of the department of epidemiology and biostatistics at Michigan State University.

It is kind of silly to have two different standards. It doesn't entirely make sense. … What's special about schools? she said.

With how transmissible the delta variant is, and knowing that many K-12 schools have dropped mask requirements and other mitigation measures this year, the reality of COVID is that if two or three people are sick, there will be 10 cases in a couple of days, Misra said. The best way to protect students and their families and keep schools open is to get shots into the arms of those who are eligible for COVID-19 vaccines, and to require masks.

State data shows the highest case rates among the 10- to 19-year-olds, most of whom have the option of being vaccinated, she said.

Statewide, K-12 schoolshave reported 74 new outbreaks with two associatedcases since Sept. 7, according to the health department.That's about a quarter of the 306 new outbreaks recorded during that time.

More: COVID-19 cases in Michigan schools doubled in a week: Where there are outbreaks

More: Michigan budget bill bans state COVID-19 vaccine mandates, many local school mask rules

Gov. Gretchen Whitmer and health department director Elizabeth Hertel have declined to institute a statewide mask mandate. Instead, they've called on local health and education leaders to institute such a rule.

However, local health leaders have repeatedly asked state officials to mandate masks in all schools, saying the patchwork requirements that vary by county and by school district are driving spread of the virus.

"Compliance is all over the board," said Norm Hess, executive director of the Michigan Association for Local Public Health."And that is very concerning because last year, when there was more uniform guidance and orders and compliance with masking in classrooms, the transmission in classrooms was pretty well contained.

"But this year is a whole new ballgame. There's masks, there's no masks, there's all sorts of variation in policies.We believe that the impending wave is going to be worse, that we're going to see a surge that is much worse and that we will have more classroom transmission."

Some local administrators were confused and frustrated after Whitmer did not immediately disavow portions of the state budget that would withhold funding from county health departments that ordered masks in schools.

Whitmer's office has since indicated the governor believes this language is unconstitutional and unenforceable.

Two new studies published Friday by the U.S. Centers for Disease Control and Prevention found that schools without mask requirements saw much higher rates of coronavirus transmission than those with mask mandates.

Data from about 1,000 schools in Arizonas Maricopa and Pima counties from July 15-Aug. 31 found that the odds of a school-associated coronavirus outbreak were3.5 times higher in those without mask requirements than in those with them.

Another study analyzed outbreaks in K-12 schools in 520 counties across the U.S. from July 1-Sept. 4. Those with mask rules had a transmission rate of 16.32 cases per 100,000 students. Those without mask requirements had a transmission rate of 34.85 per 100,000 students.

It's rare for COVID-19 to result in severe outcomes for children. However, coronavirus hospitalizations among children are rising in Michiganand students have the capacity to spread the disease to the hundreds of thousands of adults who work in schools statewideand their relatives at home.

On Monday, 35 children withsuspected or confirmed casesof coronavirus had been admitted for treatment at hospitals statewide. That compares with just 13 children hospitalized with suspected or confirmed cases two months ago.

Every day last week, more than 315 Michigan children under the age of 12 were newly diagnosed with the virus that's a rise of 80 cases in kidsper day over the week before.

Contact Dave Boucher: dboucher@freepress.com or 313-938-4591. Follow him on Twitter @Dave_Boucher1.

Read the original post:

Michigan's new definition of a COVID-19 school 'outbreak' will mean fewer are reported - Detroit Free Press