COVID-19 Trends in Florida K-12 Schools, August 10

COVID-19 Trends in Florida K-12 Schools, August 10 – November 14, 2020

Rebekah D. Jones

, MS, GISP (corresponding author)

Affiliations:

The Covid Monitor, Florida

Address correspondence to: Rebekah Jones, The Covid Monitor, PO BOX 13747, Tallahassee,

FL 32317, plans@thecovidmonitor.com

Short title: COVID-19 Trends in Florida K-12 Schools, August 10 – November 14, 2020

Conflict of Interest Disclosures (includes financial disclosures): The author has no conflicts of

interest to disclose.

Funding/Support: No funding was secured for this study.

Abbreviations: none

Table of Contents Summary:

Using the most comprehensive database of K-12 COVID-19 case data in the country, Florida

provides clues for understanding student and staff cases in schools.

What’s known on this subject:

Florida schools began reopening to in-person instruction in August have reported more than

18,000 student and staff cases of COVID-19 as of November 14, 2020. Incidence of COVID-19

cases in K-12 students and staff is of urgent public health concern.

What this study adds

COVID-19 cases reported in Florida schools were most influenced by community case rates,

district mask policies, and percent of students attending face-to-face. Student case rates were

highest in high schools (12.5 per 1,000).

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NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.

Abstract

Data collected from 38 states from August 3 – November 15, 2020 showed more than

250,000 confirmed student and staff cases of SARS-CoV-2 in K-12 schools

. Yet, analysis of

COVID-19 case data in USA schools has been extremely limited

2,3

. To date, no large-scale or

state-wide analyses by school level and grade has been published, opening a wide gap in

understanding COVID-19 in American schools. A large-scale assessment of available data and

trends could provide a baseline for understanding the virus in the K-12 learning environment and

dispel misconceptions about the prevalence of COVID-19 in schools.

Background

Florida school case data provides an opportunity to examine the extent to which COVID-

19 has been detected and reported in schools through reporting of cases by day, by school level,

by location, for both students and staff. Student enrollment across Florida’s 67 districts totals

more than 2.67 million, with five of the ten most populated districts in the country within

Florida’s public-school system. Schools in Florida’s mix of urban, suburban and rural districts, in

addition to the variety of policies ranging from availability of virtual instruction to mandatory-

mask mandates, make it an ideal case study for examining larger trends in COVID-19’s

prevalence in American schools. This data could help inform decisions makers evaluating

mitigation strategies and access to virtual learning, as well as build upon current knowledge of

COVID-19 in American society.

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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

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Methods

During August 10 – November 14, 2020, laboratory-confirmed cases of COVID-19 in

10,088 students and 4,507 staff in K-12 schools were confirmed by either the Florida Department

of Health, or directly from the 43 independently-reporting school districts in the state (Table 1).

School case data, collected daily, and school enrollment data for both in-person (including

hybrid) and virtual learning were obtained by public records request to each of Florida’s 67

districts for each week of the study period. Data regarding mask policies were obtained either

from each district’s reopening plan, or from public records request. No assessment of school

case data or rates with consideration of age groups and mask policies at this scale or with this

level of granularity were discovered after an exhaustive search.

The Centers for Disease Control (CDC) provides guidance for safely reopening schools,

based primarily on the rate of community spread within a given district or county

. County

COVID-19 case rates were calculated based on new cases over a 14-day period at a rate per

1,000 people based on data reported by the Florida Department of Health

Table 1: Florida COVID-19 case totals by school level for students and staff, August

10—November 14, 2020.

Case totals

Grade Levels Student Staff Total

Elementary 2728

1811

4539

Middle 1373

600

1973

High 4124

897

5021

K-8 716

300

1016

Jr./Sr. High (6-12) 476

143

619

K-12 166

123

289

Private/spec. ed 1305

633

1938

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Results

During August 10 – November 14, 2020, the state-wide incidence rate (cases per 1,000

students enrolled in face-to-face or hybrid instruction) in Florida high school students (12.5) was

70% higher than younger cohorts (7.4). School data by grade level (e.g. elementary, middle,

high) shows trends consistent with earlier findings by the CDC regarding case rates between

younger and older adolescents

. Staff rates are higher than student rates in all school

environments except high schools. The proportion of student to staff cases in Florida schools was

closest in the elementary setting (60% students – 40% staff) compared to the high school setting

(82% students – 18% staff).

Approximately 61% of all students in Florida returned to in-person instruction during the

report period, with 39% enrolled in virtual-learning programs or withdrawing from the district by

November 1, 2020. Most students (87%) in the state who attended in-person classes were

enrolled in districts with mandatory mask mandates, though the percent of students enrolled in

face-to-face instruction was highest among districts without mask mandates. The state-wide case

incidence rate in districts without mask mandates (12.7 per 1,000 students enrolled face-to-face

or hybrid) was 38% higher than those who attended in-person within districts that did have mask

mandates (9.2). However, the staff case rate in districts without mask mandates (29.2 per 1,000

on-campus employees) was nearly twice that of staff case rates in districts with mandatory mask

policies (14.8) (Table 2).

Case rates nearly tripled in the period October 3 – November 14 for students in Florida

compared to the period August 10 – October 3

(4.5 per 1,000 in high school and 2.3 per 1,000 in

elementary students to 12.5 and 7.4 per 1,000, respectively). Only two of Florida’s 67 counties

had school case rates lower than the community case rate (Monroe and Walton), while 19

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counties had higher pediatric case rates overall compared to school case rates (Table 2). Seven

counties had more school cases reported than pediatric cases reported, which could be due to a

number of high school students being over the age of 18 and thus not counted in the pediatric

community rate, or do to the school reporting previous cases after-the-fact.

Discussion

Case incidence varies significantly between school grade levels and between students and

staff. Staff rates are higher than student rates in all school environments except high schools, and

staff benefit most by mandatory-mask mandates. The rate of cases within schools is highly

correlated with cases within a community, more than the size of the district by total enrollment.

Percent enrollment in face-to-face instruction is a secondary influencer of case incidence rates in

schools. In areas with higher pediatric community case rates compared to school case rates,

districts may be under-reporting school case totals for students, or “disqualifying” student cases

based on when a student tested and whether the case could be directly linked to the school

environment. More research is needed to further understand the wealth of data available

regarding COVID-19 incidence in Florida, and to develop proper mitigation strategies to

confront this unprecedented challenge.

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Table 2:

Florida COVID-19 school-based case rates (August 10 – November 14, 2020), community and school-age case rates

(November 1 – 14, 2020), and mask policies by county

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is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted December 3, 2020. ; https://doi.org/10.1101/2020.11.30.20241224doi: medRxiv preprint

. CC-BY-ND 4.0 International licenseIt is made available under a

is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted December 3, 2020. ; https://doi.org/10.1101/2020.11.30.20241224doi: medRxiv preprint

Acknowledgements

The Covid Monitor provided data related to cases in K-12 school districts in Florida.

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print MedRxiv:

. CC-BY-ND 4.0 International licenseIt is made available under a

is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)

The copyright holder for this preprint this version posted December 3, 2020. ; https://doi.org/10.1101/2020.11.30.20241224doi: medRxiv preprint