NC hospitals brace for a back-to-school Covid surge

School administrators and medical professionals are bracing for a continued surge in Covid-19 cases, compounded in part by North Carolina public school students’ return for the start of the state’s traditional school year.

Covid cases have been rising in the state. And school districts in other states, including Kentucky, Oklahoma and Texas, have already canceled classes due to Covid-19 outbreaks.

“Families should expect to see an increase in illness as students return to school and congregate in indoor settings,” Franklin County Schools spokesman Dawayne McIntosh told WRAL in an email.

It’s common for respiratory viruses to spread early in the school year, when students are suddenly clustered indoors. But a constellation of other factors could lead to a continued climb in Covid cases in schools and beyond. That could contribute to capacity problems for hospitals, which are also expecting more patients with respiratory syncytial virus and the flu.
New variants of the Covid-19 virus have been spreading in the U.S. — including some mutations that might not be covered by recent boosters. A new booster designed to combat a prominent variant isn’t due out until late September or early October — after students and employees have been in school for a few weeks, possibly bringing the virus home. Some people are delaying their next booster shot appointment to get the new shot, meaning immunity could be lower for some who are holding out. Complicating things: Yet another variant could evade that new booster.

Meanwhile, the prevention landscape has changed: Fewer people are testing, meaning more sick students might turn up to school rather than stay home.

“We have more people who are kind of fed up and fatigued with public health precautions, wearing masks, being careful indoors, staying home when you’re sick, that sort of thing,” said UNC Health spokesman Alan Wolf. “… And then back-to-school season, typically, is a time when respiratory illness gets shared indoors.”

‘Mini surge’

Covid-19 hospitalizations in North Carolina totaled 485 during the week ending Aug. 26. That’s up 12% over the previous week, a number that is still far below pre-vaccine levels but the most since March, according to data released Wednesday by the state Department of Health and Human Services. Wastewater virus particles, another Covid indicator tracked by testing sewage samples, were at their highest levels since January.
In early July, about 20 patients were hospitalized across the UNC Health hospital system. By the end of last week, that number had more than quadruped to 95. Those numbers are paltry when compared to the hundreds of Covid patients hospitalized at UNC Health hospitals in 2021.

Wolf says the recent increase is worrisome nonetheless. “Unfortunately, it probably will get worse before it gets better,” he told WRAL, referring to the increase as a “mini surge.”

The rise coincides with a national increase. In late August, more than 12,600 Americans were hospitalized with Covid-19, jumping 22% in recent weeks.

The latest Covid surge, however, isn’t expected to be as bad as previous upticks. Doctors are better prepared to treat the virus. And much of the population has built up immunity through vaccines or by simply surviving a Covid infection, Wolf said.

“We have the tools to manage Covid so Covid doesn’t manage us,” Kody Kinsley, the state’s secretary of health and human services, told WRAL in a recent interview. Kinsley said his department is promoting vaccinations, at-home testing, treatments for those who contract Covid-19 and masking for those who aren’t vaccinated.

Even if state officials wanted to close schools, their ability to do so is more limited than in the worst phase of the Covid-19 pandemic. A state of emergency giving the state government special authority to address the virus ended a year ago. And Republican-backed legislation reduced Democratic Gov. Roy Cooper’s power to enact certain emergency Covid restrictions at the start of this calendar year.

“What we need to be careful of is not allowing the overreaction like we had when Governor Cooper shut this state down … where neighboring states around us were operating with much more freedom and North Carolina was stifled,” Republican House Speaker Tim Moore told reporters last month. “And so, we’ve put protections in place to prevent that from happening.”

He added: “We need to trust people with their own health care decisions and not go into all these government mandates. … They need to see their doctor. They need to follow their doctor’s advice.”

In the absence of state mandates, it’s up to individual school districts to manage their own protocols. That’s led to a mishmash of rules and guidelines.

Mishmash of policies

School systems in and around the Triangle are generally relying on guidance from federal, state or local health departments and urging people to follow the advice of physicians and other health professionals. But their interpretation of those guidelines has yielded slightly differing policies.

School officials are generally trusting students and staff to stay home when they are sick and return to school when they are not. But the guidelines for returning vary across the region and can be open to interpretation.

Chapel Hill-Carrboro City Schools, for instance, “expect” those who test positive to stay home for five days. In Warren County Schools, they’re “required” to be in isolation for five days, administrators from the districts told WRAL. Some counties offer free tests, others don’t. Many ask that students and employees isolate until they’re feeling well again but don’t require a negative test to return.

In Hoke County, a person who has been exposed to an infected person — but who hasn’t tested positive — must wear a mask in school for 10 days. It’s the same Warren County, but they also are required to take a Covid test five days after exposure.

Bladen County Schools, meanwhile, doesn’t have Covid-specific protocols. “Students and teachers alike should follow the advice of their health care provider,” Elly Johnson, the district’s spokeswoman, told WRAL in an email. “Should an outbreak occur, we would work with our local health department and align our procedures with any active state guidelines.”

Wake County simply recommends parents keep their students home when they get sick and offers a link to a Centers for Disease Control resource website about Covid-19.

If an outbreak occurred among faculty, many districts say they’d rely on substitute teachers or consult with health officials about whether to briefly cancel school. Canceling school for a few days during disease outbreaks is rare but has been done from time to time during flu season.

Schools these days are more prepared for such interruptions. Ever since the pandemic — and even before — forced remote learning, school systems have increasingly made class materials available online so that students who are home sick can stay on top of lessons. School systems told WRAL News all students should have some access to their coursework while home.

While school officials monitor the rising number of cases, medical professionals are urging people to follow public health guidelines and precautions that were commonplace at the height of the pandemic — testing, isolating if you’re sick and, for some, wearing masks in tight quarters.

“No one wants to hear about mask mandates or being forced to wear masks again,” Wolf said. “But if you don’t want to catch Covid, it’s not a bad idea to wear a mask in public indoors.”

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