Top SC epidemiologist says K-12 COVID outbreaks are inevitable without widespread masking

South Carolina’s top epidemiologist said she’s extremely concerned about the potential for the highly contagious delta variant to spark COVID-19 outbreaks in schools this fall if districts don’t enforce infection mitigation measures.

“I’m greatly concerned that this school year could be a perfect storm for disease spread if we have unvaccinated and unmasked students and teachers together,” State Epidemiologist Linda Bell said Wednesday, shortly after health officials announced South Carolina had surpassed 10,000 deaths from the pandemic.

The state Department of Health and Environmental Control Tuesday reported 85 COVID-19 cases in schools statewide — 68 among students and 17 among employees — following the first week of classes for some districts.

Bell said the numbers were an early indication that South Carolina schools could experience more coronavirus cases this year than last.

“The first day of school hasn’t even begun yet for the majority of our school districts,” she said.

Bell said she fears more COVID-19 outbreaks in schools this year because of the delta variant, which is far more transmissible than past variants, and the relaxation of school masking requirements, as required by state law.

“We know that if schools and parents are compliant with CDC and DHEC recommendations, or measures that should be in place in schools, those layered prevention measures, we can avert these outbreaks that we’re currently anticipating,” she said.

Despite concern last year that school settings might accelerate the spread of COVID-19, studies found that minimal disease transmission occurred in schools that employed mitigation measures like facial masking and physical distancing, even in areas where community transmission was high.

State lawmakers and education officials seized on that data earlier this year, including a study conducted by a Medical University of South Carolina pediatrician that found minimal COVID-19 transmission in Charleston County schools, to push for all districts to resume offering face-to-face instruction.

“Supporting studies have found schools to be safe when they’re following key mitigation strategies and they’re implemented consistently,” State Superintendent Molly Spearman said at a February press conference where she announced that schools need not consider the severity of coronavirus infection in their communities when deciding to reopen.

State and federal health officials’ belief that schools can safely return to in-person learning this fall is contingent on schools following their guidance about COVID-19 mitigation measures, such as universal masking for all students and school employees, regardless of vaccination status.

While South Carolina education officials have recommended districts follow the facial masking guidance disseminated by health experts, unlike last year, they can’t mandate compliance.

A one-year law slipped into this year’s state budget by Republican lawmakers prohibits districts from using any state money to impose mask requirements for students or staff.

The Columbia City Council flouted that law last week when it passed a mask mandate for students and faculty at local elementary and middle schools and daycare centers in the city, but the city’s ordinance appears likely to face a legal challenge.

Republican South Carolina Attorney General Alan Wilson said he believes the city’s emergency ordinance violates state law and told the city council he’d give them until the end of the day Friday to bring it into compliance.

Columbia leaders do not seem likely to budge on the matter, meaning it will almost certainly head to court.

COVID-19 outbreaks in schools

Experts fear masking in schools could drop significantly if the prohibition on mask mandates is not overturned or amended.

When the state lifted its school masking requirement in mid-May, as case counts were dropping, roughly half of students continued wearing face coverings, education spokesman Ryan Brown estimated.

Compliance could be higher this fall with the delta variant surging, but that’s not a given.

“I think it’s going to be very difficult,” Brown said last week. “We’ll continue to encourage it, but it’s hard for people to change once they’re used to something.”

Bell said she believes school outbreaks are inevitable under the current circumstances.

“I see no way around outbreaks in schools with the current track that we’re taking,” she said. “Unless the recommended mitigation strategies, including the widespread use of masks in school, are widely adopted, I unfortunately do anticipate that we will see higher transmission and significant outbreaks in schools.”

She said the agency had heard from many parents concerned about the safety of schools in the fall and that she echoed those concerns.

“We have abundant evidence about how we can prevent transmission within schools,” Bell said, citing CDC studies showing that mask use made schools among the safest places in communities. “But if we move into the fall where we remove the practices that were in place that kept those schools as the safest settings, then we will see what we saw in the surrounding communities when those studies were done. And what that was was high transmission.”

This story was originally published August 11, 2021 at 4:50 PM with the headline "Top SC epidemiologist says K-12 COVID outbreaks are inevitable without widespread masking."

Zak Koeske

The State

412-334-2443

Zak Koeske is a projects reporter for The State. He previously covered state government and politics for the paper. Before joining The State, Zak covered education, government and policing issues in the Chicago area. He’s also written for publications in his native Pittsburgh and the New York/New Jersey area.