COVID rules divide San Diego Unified parents and doctors as summer school starts

Tens of thousands of students returned to campuses across San Diego Unified School District last week for summer school and enrichment programs, and more could join activities in coming weeks. 

Yet despite COVID-19 cases being on the rise across San Diego County, and having steadily increased in schools through the end of the school year, students in the district’s summer program will not be required to wear masks – that is, unless there’s been at least three outbreaks within 14 days and more than 5% of the school population is infected, SDUSD guidelines show.

The district recently announced plans to offer free testing at summer school sites.  

During the first week of summer school, June 21-25, there were 85 confirmed cases reported among students and staff, said Maureen Magee, communications director for San Diego Unified. Initial reporting through the district’s dashboard was delayed as a result of the COVID-19 team awaiting final enrollment and staffing numbers to set calculating formulas, she said. 

There may be more cases, she added. Results from on-site testing at the summer school sites are still being compiled. The district’s dashboard, which hasn’t been updated since June 11, will be updated next week, she said. 

The district’s summer program, offering both a morning academic program and afternoon enrichment activities for free to K-12 students in the district, is in its second year. There are nearly 25,000 students enrolled in the morning program and more than 13,000 enrolled in the afternoon enrichment programs, said Magee.

San Diego Unified lifted its mask mandate on April 4, after which COVID-19 cases began rising in schools across the district. Later, the district also adjusted its requirements for students, allowing them to return to class without a mask six days after testing positive for COVID-19 with proof of a negative antigen test or after 10 days regardless of testing. 

“Testing after day 10 is not recommended and the results aren’t actionable even if you continue to test positive,” said Bob Mueller, assistant incident commander for COVID-19 operations for the San Diego County Office of Education, echoing what county health experts have told him.

He added that testing positive for the coronavirus after the 10th day doesn’t mean that isolation should be extended. The amount of virus a person can spread significantly drops by days 6-10 following symptom onset, he said.

Some parents have criticized not requiring masks for students who’ve recently tested positive and return to school, especially if San Diego experiences more case surges when students return to class in the fall. 

“I find all of this just really concerning that children (and teachers) spend large periods of time indoors together,” said Dr. Linda Liu, a board certified emergency doctor whose child attends a school in Del Mar School District. “If we allow people to come back without a mask, I think invariably we will spread COVID to more people which will lead to more days of missed school,” she added.  

San Diego Unified and Del Mar Unified are two of the 42 districts in San Diego County. Each district gets to decide its own COVID-19 policies, and the San Diego County Office of Education provides those districts with technical assistance, training and supportive services, Mueller said.

Health experts debate risks

For Liu, a parent and medical professional, districts should be erring on the side of caution in setting policies for allowing students who’ve tested positive to return to school.

A person who tests negative on an antigen test five days after testing positive could still be contagious enough to spread COVID-19, especially while indoors and maskless for a long time, she said. 

Furthermore, getting an accurate test result depends on proper administration of the test and getting a good sample, which depends on the parents’ accuracy, she said, adding students should be required to take a PCR test initially to confirm whether they’re positive for the virus. 

But other health experts say, even if antigen tests sometimes produce false negatives, the risks of someone spreading COVID-19 after six days of illness are relatively low. And doctors say it’s difficult to nail down a specific day someone stops being contagious. 

“It’s really hard to pick a precise cut off. Most people are not contagious after day five … but certainly a few people may be contagious beyond that,” including people with compromised immune systems, said Dr. Mark Sawyer, a pediatric infectious diseases specialist at Rady Children’s Hospital.

Antigen tests are better for detecting if someone could still spread the virus than the far more sensitive PCR tests, which can detect the virus long after someone is no longer contagious, Sawyer explained. Even though a well-collected sample can result in a false negative antigen test, which is why self-testing shouldn’t be relied on when critical, he said if the test result is negative it’s very unlikely that that individual will spread COVID-19.

 “Parents who do still have significant concerns about their kids getting exposed, the best they can do is have their kids wear a mask (and get them immunized),” he said.

Some parents concerned about masks being optional 

San Diego Unified’s summer program runs through July 22 for elementary school students and July 29 for high schoolers, a little more than twice the time it will take for a mask mandate to kick in should a summer school site experience COVID-19 outbreaks. 

A two-week mask mandate would go into effect if there are three or more outbreaks within a two-week period and more than 5% of the school population is infected.

Masks would be required in all school districts in San Diego County if COVID-19 levels reach a “high” level again, as tracked by the Centers for Disease Control and Prevention, Magee said in an email. She said students are strongly encouraged to mask indoors but required to wear a mask at the school nurse’s office even if they aren’t ill. 

Currently, San Diego County’s community COVID-19 level is low, according to the CDC, while levels are “medium” in neighboring counties.

Holly Wright, president of the San Diego Unified Council of PTAs and whose stepson goes to Madison High School, said she appreciates San Diego Unified “sticking to the science,” but she’s been concerned about transmission since state and local mask mandates were lifted. 

“In May, that mask mandate should have been slapped back on across the board, both in public areas and in schools,” she said.

She believes masks only work if mandated because kids may give into the peer pressure of not wearing a mask like their classmates, adding that it may be due to culture that it’s not widely accepted. 

“You can’t expect a kid to choose to mask,” Wright said. “They have to be uniquely strong to put a mask on when their friends are not, or uniquely terrified.” 

Unlike students, San Diego Unified teachers who test positive are required to wear a mask indoors for the sixth through 10th days back in school.  

Mueller, with the county’s education office, said some guidelines like masking differ for teachers because they’re subject to state rules governing employees which are more strict than the guidance for students. 

Dr. Howard Taras, a UC San Diego pediatrics professor specializing in school health, is among the doctors giving guidance to the county on its COVID-19 safety guidelines for schools. 

“I will tell you that in-classroom contagion or transfer of disease is really pretty rare,” he said.

Omicron, which has led to recent spikes in cases, seems to be leaving the body sooner than other variants, he said. 

Taras also said the fact that many students have been maskless and there haven’t been that many outbreaks means that the risk of contracting COVID-19 in schools isn’t high. He believes that the investment some districts made into their filtration and ventilation systems have played a role in mitigating spread. 

He added that districts had to set some target for reimposing a mask rule should cases rise rapidly again, even if some may think those targets are arbitrary.

“If you are paralyzed by the fact that anything would be arbitrary so you do nothing, to me that would be much worse,” Taras said.

COVID-19 cases have been steadily increasing throughout the county since March. According to county data, there were 7,895 new cases reported in San Diego County for the week of June 12, up from 1,638 new cases reported for the week immediately following Gov. Gavin Newsom’s March 11 decision to lift the mask mandate in schools and businesses. 

Data for San Diego Unified show a similar trend, with positive cases up since the school guidance change that made masks optional. A total of 1,868 students were confirmed to have COVID-19 in the last full week of school, compared to 410 student cases reported less than a week after the district’s guidance update in April, district data shows. 

Despite an uptick in cases, health experts agree that parents shouldn’t be discouraged from sending their children to summer school and programs. Summer classes tend to have fewer students, and if a child did fine during their regular school year they’re bound to have no increased risk during summer school, Taras said.

“I would say at this stage, education first. And (parents) should think mostly about making sure their kids do not fall any further behind than they had to because of the last two years,” said Taras.