Is omicron leading to in-school transmission? Bay Area districts say there’s no way to know

Austin quickly understood it would be nearly impossible to determine where students or staff got the virus or who they might have exposed — and then send letters home to those who were close contacts. The number of parents getting letters could be in the hundreds at any given school every day.

He decided the district would no longer track cases or send anxiety-inducing exposure notifications home.

Instead, given the highly contagious omicron variant raging across California, he told students and staff to assume they were exposed, to test weekly if desired and definitely if symptomatic, and to keep coming to school unless sick or positive.

"We said we're going to stop the insanity on this one," Austin said Friday, after more than a week under the new policy. "I'm watching my colleagues working their tails off trying to manage this. Why?"

Austin was among the first to take the leap into what has quickly become a new stage of the pandemic for some districts, at least under omicron. Cases in classrooms are now a given, quarantine for anyone who is a close contact but asymptomatic is not necessary — even if unvaccinated — and masked students and staff are advised to keep going to school unless they are sick or test positive.

The shift is occurring after a tumultuous two weeks back with teacher and student sickouts, district-shuttered schools, and frantic parents and staff searching for tests and upgraded masks.

On Friday, Marin County health officials, noting that 1 in 20 to 25 county residents is currently infected with COVID-19, announced a similar recommendation. They advised schools to no longer send any notification of exposure, but rather advise parents to simply keep an eye out for symptoms.

The North Bay county also went a step further than Palo Alto, saying students and staff exposed in a classroom setting do not need to test, leaving testing as a recommendation only after exposure in high-risk activities like close-contact sports or child care settings.

The assumption of the recommendations is "we're all exposed to COVID," said county schools Superintendent Mary Jane Burke, and that schools are still a safe place to be. "It begins to take us into the endemic vs. the pandemic. I think it's the right thing."

At the same time, the inability to track individual cases has left districts and counties unable to count in-school transmissions. Under previous strains, few cases of in-school transmission occurred, reinforcing that in-person instruction presented a relatively low risk of catching the virus.

Currently, Bay Area counties can't say whether there are more cases coming from exposure inside classrooms than before or whether students and staff are getting the coronavirus in the community.

"Identifying affected individuals, tracking down all their contacts, quarantining all those individuals for some time or testing them is simply not possible," said Dr. Arthur Reinhold, UC Berkeley epidemiologist. "We're just at a different stage of the pandemic."

In Alameda County, health officials said it's too soon to say whether in-school transmission is occurring, given that many students and staff got the virus during the break.

Santa Clara County health officer Dr. Sara Cody said Friday the focus should be on vaccination, masking and testing rather than trying to figure out who gave it to whom and who was exposed.

"There is so much COVID circulating in the community that everyone has a risk of exposure in the classroom, on the campus, in the community, at home, after school, etc.," she said. "It is getting increasingly difficult to pick out which is which."

Over the past two weeks, the reality of the omicron surge has started to sink in among many Bay Area school districts. They have started to adjust their pandemic protocols, even as state and county health officials are updating recommendations to discontinue contact tracing and individualized close-contact notification.

The California Department of Public Health has recommended schools use a group contact tracing method to notify classmates, teammates or other groups exposed to someone with the coronavirus in a shared indoor airspace for at least 15 minutes.

Exposed students should be tested within three to five days from exposure, but continue attending school.

The guidance seeks to alleviate the significant labor involved in tracking each individual case.

Oakland Unified has been using group exposure notification since before the winter break, officials said.

Yet the problem with the recommendation under omicron is that parents, especially those with children in middle school and high school, could get notifications of exposure virtually every day, meaning nearly constant testing.

Palo Alto's Austin rejected the idea out of hand.

"I've tried to be nice about it, but I'm done: The California Department of Public Health has no understanding of how schools work," he said. "On any given day if you follow this procedure, 90% of the kids in any high school will receive a letter."

Those same kids are walking across the street to a store for lunch, with friends they don't have classes with, and there is no exposure notification for that, which is probably far more risky, he said.

"This is not a time to be lukewarm and wishy-washy," Austin said. "People are craving definitive information and a sense of direction even when they disagree."

San Francisco Unified, however, is among district outliers, doubling down on individualized contact tracing to prevent spread in schools by hiring an outside contractor to do the work to alleviate the burden on principals and other staff.

"We are committed to alerting you if there is a close contact at a school," Superintendent Vince Matthews said in a letter to families Friday, noting the challenges the district is facing under omicron. "Some days students won't learn as much because of too few staff or because they have to miss school due to COVID or being a close contact."

Families were expected to inform the contractor of positive cases, district officials said.

Also Friday, San Francisco public health officials said they would be working with local schools to incorporate the new group-tracing approach for students exposed to the coronavirus.

It was unclear whether San Francisco Unified would adopt the new guidelines despite hiring the contractor.

With omicron starting to wane, according to some Bay Area health officials, it's possible schools will revert to contact tracing as cases decline, health experts said.

Yet amid the current surge, contract tracing has taken a back seat to testing, which has been hailed as a critical piece of keeping students and staff safe in schools.

In recent days, San Francisco agreed to teacher and student demands to offer weekly testing at all school sites. Many other districts offer similar access to testing, in addition to symptomatic testing at schools.

Some experts question whether the cost and logistics of weekly testing are worth it, considering the likelihood that many if not most cases will remain undetected given timing of exposure or sensitivity of the test.

"You need to test twice a week if you're going to do it," said Dr. George Rutherford, UCSF infectious disease expert.

Is it worth it to test all students and staff weekly, especially under such a contagious strain?

"The logistics and costs are so enormous that I know lots of people who think they know the answer to that question, but I'm not smart enough to know what the answer is," Reinhold said. "Even the best of these approaches is going to be imperfect."

Jill Tucker is a San Francisco Chronicle staff writer. Email: [email protected] Twitter: @jilltucker