San Francisco has the lowest coronavirus case rate of major U.S. cities. But its schools are among the last to reopen – San Francisco Chronicle

San Franciscos public schools have been virtual-only for nearly a year, despite increasing pressure from parents and politicians to reopen for in-person instruction. Even the city attorney has called on the school district to immediately reopen elementary schools.

The school district is set to vote on a plan Tuesday that would allow schools to reopen in Californias second-most-restrictive red tier once staff is fully vaccinated.

But local politicians say that plan is still too restrictive, given the reality that vaccinations are proceeding slowly because of lack of supply.

Some have noted that other major school districts across the U.S. have opened to some form of in-person schooling despite having higher levels of community transmission than San Francisco.

In New York City, where an average of 51 people per 100,000 are testing positive for the coronavirus every day, elementary schools have been open on a hybrid schedule for months, and middle schools are in the process of reopening. Other large school districts, including Atlanta and Miami, have fully reopened for elementary, middle and high school students (with remote learning options), despite having higher daily case rates than San Franciscos current rate of 9 per 100,000.

Supporters of San Franciscos prolonged closures have argued that keeping children and teachers at home is part of whats driving the citys low case rates, and that opening schools too quickly could lead to transmission among students and teachers.

We need a clear and coordinated state, county and local plan that puts the health and safety of our communities first and does not take shortcuts toward the path of opening schools in person, the California Teachers Association wrote in a letter to Gov. Gavin Newsom in late January as part of an effort to keep schools in counties under the states widespread purple tier closed for 100 days.

The idea that keeping schools closed has kept coronavirus numbers low isnt supported by the evidence, according to numerous Bay Area health experts.

There is not data to support that claim, Dr. Jeanne Noble, head of UCSFs emergency department COVID-19 response, said in an email. Noble cited a December study published by the CDC that found that, among children younger than 18 in Mississippi, attending school or child care did not make students more likely to test positive for the coronavirus. Instead, children who didnt consistently wear masks or had close contact with people outside of their household were more likely to test positive.

In fact, Noble said, the study found that kids who had gone to school or day care where masking was enforced during the previous 14 days were more likely to test negative for the coronavirus.

In other words, not only did attending in person not raise the risk for acquiring COVID, attending a school with universal masking actually lowered the childs risk for acquiring COVID, suggesting that schools may indeed be protective, she said.

In another recent study of 90,000 students and 10,000 teachers in North Carolinas school system, only 32 in-school transmissions occurred all of which were related to breaches in masking protocol, Noble said.

Carrie Byington, executive vice president of University of California Health, said the rate of coronavirus within a community remained an important factor when considering whether and how to reopen schools.

Case rates and other indicators of community transmission are important considerations when planning for school openings or any in-person activity, she said in an email.

But she agreed that opening schools was unlikely to drive San Franciscos infection rates up: There is now evidence from the U.S. and other countries that in-person school is not a primary driver of community transmission of SARS-CoV2, she said.

Some experts said that case rates a factor that the CDC has weighed heavily in its school reopening guide should not even be considered when making the decision to reopen.

We have seen major cities all over the country including New York, Chicago, Dallas, Houston, Washington DC, Miami, Philadelphia, Atlanta, and Boston open to some component of in-person learning (hybrid or full-time) despite much higher case rates than San Francisco without significant issues of school-based transmission, Dr. Mitul Kapadia, associate clinical professor of pediatrics at UCSF, said in an email.

Kapadia pointed out that many public schools in Marin County have been open since October, with more than 17,000 students attending school in-person on a daily basis. With similar case rates Marin Countys daily new case rate is at 12 per 100,000 residents Marin has seen minimal school-based transmission and zero transmissions from student to teacher, he said.

Safe school reopening can happen despite high levels of community transmission, Kapadia said. The biggest predictor of transmission within schools is consistent implementation of layered mitigation strategies particularly mask use and physical distancing.

Susie Neilson is a San Francisco Chronicle staff writer. Email: susan.neilson@sfchronicle.com Twitter: @Susieneilson

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San Francisco has the lowest coronavirus case rate of major U.S. cities. But its schools are among the last to reopen - San Francisco Chronicle