By Madeline Heim, Annysa Johnson and Samatha West, USA TODAY NETWORK-Wisconsin
As hundreds of thousands of students return to classrooms across Wisconsin, the state has no plans to publicize details about COVID-19 outbreaks when they occur at schools.
Freedom of information advocates say that information should be available to the broader public, and some researchers say data could help schools learn from one another. But others worry about protecting students, parents and communities from stigma if information about outbreaks is shared widely.
Without a state-level source of information, what you know about outbreaks in your schools may depend on the openness of local school districts and health departments.
The Wisconsin Department of Health Services confirmed last week it will publish only the number of schools in the state with COVID-19 investigations, which launch when as few as two cases are identified in a given space. The department doesn’t plan to name the schools or describe the severity of the outbreaks.
This is similar to how the state treats other facility-wide investigations, which it tracks by category, like outbreaks in group housing, health care settings and other workplaces. One exception is nursing homes, which are regulated by the state and federal governments and are named on the DHS site when an investigation occurs.
Bill Lueders, president of the Wisconsin Freedom of Information Council, said the location and size of school outbreaks should be made public, just as he believes the state health agency should post the names of businesses and other establishments connected to at least two cases of COVID-19, as it had initially planned.
“I think it’s tragic that the Department of Health Services is being so secretive of COVID cases, and I think it’s contrary to public interest and public health,” he said. “They consistently have shown they don’t particularly trust the people of Wisconsin to make reasonable and rational use of public information. Instead they just assume people are going to flip out if a school or business has some experience with COVID.”
School teachers and staff across the state also are wondering what information will be available to them, since most school decisions are made at the district level, said Ron “Duff” Martin, president of the Wisconsin Education Association Council, which represents about 50,000 members across the state.
While schools are bound by privacy laws, he said, teachers and staff have concerns about keeping themselves, their families and their students safe.
“Isn’t this just a prime example of how this is the Wild West in Wisconsin, that we don’t have one consistent policy for all of our schools?” Martin said.
“There’s a difference between local control and being able to give the direction and guidance from state level,” he said. “There are certain things that should be consistent from school district to school district and county to county.”
Jenni Hofschulte of the Wisconsin Public Education Network said the education advocacy organization supports local control in school districts but would prefer districts follow a common set of rules and practices so families can better understand how they’ll be applied in their communities.
“We’re disappointed as a network in some of the guidance that’s come out and that so many of these decisions — big decisions with big consequences — have been put onto local schools in a way that’s not something like choosing a textbook for a class,” she said. “It’s about how to handle a global pandemic.”
Schools are often the heart of their communities, Hofschulte said, meaning everyone should have access to information about outbreaks.
“How many people have contact with a school building in a day? It’s far more than students, parents, teachers or school staff. It’s volunteers, grandparents and so much more,” she said. “People deserve the right to know.”
At national and state levels, school outbreak sources are few
Across the country, schools have cited medical and educational privacy laws in keeping outbreak numbers confidential. But legal experts recently told USA TODAY that these laws don’t bar schools from sharing this information, as long as it can’t be used to identify specific people.
Standing guidance from the U.S. Department of Health and Human Services says that the Health Insurance Portability and Accountability Act, or HIPAA — which prohibits medical providers from releasing identifying information about a patient — doesn’t apply to elementary or secondary schools.
Educational records are kept private by the Family Educational Rights and Privacy Act, or FERPA, but the U.S. Department of Education said in March that the law doesn’t prevent schools from sharing non-identifying details about COVID-19 cases.
Wisconsin statute requires schools to notify local health officials if they know or suspect a communicable disease is present in a building, either among students, teachers or other staff.
New DHS guidance issued to schools last week says administrators should track cases, other illnesses and student absences. In the event of a confirmed or probable case of COVID-19, DHS said administrators should notify families and all teachers and staff.
But no recommendations are given as to how or when Wisconsin schools should inform the public about the size and location of outbreaks.
Other states have similarly shielded details about specific school outbreaks from the public, including Michigan and Tennessee. In Oklahoma, school districts aren’t even required to report COVID-19 cases to local public health officials, according to a New York Times report.
In the absence of a federal system to track school outbreaks, Emily Oster, an economist at Brown University, has teamed up with national school superintendents and principals’ associations to collect data on school COVID-19 cases from as many schools across the country as possible.
Their dashboard, which is expected to go live about a week after data collection starts in early September, will provide the public with basic information like enrollment numbers, the school’s reopening plans and precautions taken, as well as suspected and confirmed COVID-19 cases, and absences.
Schools can choose to participate, Oster said, but she’s hopeful that support from the superintendents and principals will persuade many districts to opt in.
“The best thing we can do is just be honest about what we see as the value here,” Oster said. “There’s a lot of enthusiasm about having these data, and I think we’re going to have to rely on making clear to people: ‘If you want this data to exist, then we do need participation.'”
The value of the data, she said, would be as a tool for more informed decision-making. With this data in hand, schools can look to one another to determine what mix of precautions and COVID-19 prevalence creates the safest situation to open schools, and they also can track differences in outbreaks across age groups.
It also rids parents, teachers and families of uncertainty, she said.
“When we report on outbreaks without doing a comprehensive data collection, it can be hard for people to understand: Was that just one outbreak, or is every school like that?” Oster said. “This effort can answer those questions and allay some fears — or, maybe, tell us it’s not safe.”
Is it enough for a school to send letters to parents?
For many school officials and families, the benefits of having information about an outbreak are clear. But some disagree on whether the general public needs to see it, too.
Dr. Maggie Nolan, a preventative medicine physician in Madison whose oldest child is starting first grade this year at Madison Country Day School in Waunakee, said she’s asked the school to provide parents with the number of students absent from school on a given day.
Because COVID-19 has a wide range of symptoms and may not present the same way in all children, she said, she might opt for virtual learning if several of her daughter’s classmates are out sick — whether or not they’ve been confirmed COVID-positive.
She served on a medical advisory board to help guide the school’s reopening, and said she feels like she’s gotten “a strong commitment” from school leaders that they’ll tell parents what they want to know about outbreaks.
Still, Nolan said she doesn’t believe that information necessarily needs to be shared with the broader public. Especially within smaller schools, she said, even de-identified information about cases could be enough to make someone’s identity known.
“There will be talk of it in the community enough to make people aware,” Nolan said. “But adding stigma to certain schools or communities (with outbreaks) is really a slippery slope.”
What no one wants, she said, is a situation where parents are discouraged from getting their kids tested if they feel a positive COVID test will stigmatize them in some way.
But Patrick Remington, an epidemiologist at the University of Wisconsin-Madison, said people like day care providers and coaches also need to be informed about an outbreak involving students.
He recommends schools to go beyond sending a letter home to families and operate some sort of dashboard to track outbreaks.
“In my mind, I can’t imagine any information that parents need to know that a community wouldn’t also be interested in knowing,” he said.
It’s critical, Remington said, that schools take control of the message and share information on outbreaks transparently rather than letting rumors proliferate on social media.
“You’ve seen schools where (they’ll say), ‘Ms. Johnson isn’t going to be here tomorrow. She’ll be gone for two weeks,'” he said. “You think a parent doesn’t know what’s going on?”
Without outbreak details from DHS, the responsibility falls to local health departments and the school districts themselves to decide what information to share, and how.
Martin said the state teacher’s union has been holding town halls with its members and state and local officials trying to address their concerns.
“What really has our educators anxious.” he said, “is if there’s an outbreak, what can we know? What can’t we know? … They’re very anxious about what’s happening in their districts and beyond.
“And the onus of tracking down information, on top of getting ready for an uncertain school year, just places another layer of stress on them.”
Disclosure decisions fall to local officials
It’s not clear how much more transparency there will be at the local level.
Two health departments in Milwaukee County — in Milwaukee and Greenfield — said they have no plans to publicly list numbers of COVID-19 cases by school or school district.
The Milwaukee Health Department said in an email to USA TODAY NETWORK-Wisconsin that schools will be required to notify all parents in a school about positive cases, but the health department will not report numbers publicly by school or district. It said it does not provide information about positive cases for companies or organizations in any other sector and that it would not treat schools differently.
“Sharing specific, small-scale, demographic information with the public does not aid in the public health mitigation strategies,” the department said in an email.
But Milwaukee Health Commissioner Jeanette Kowalik, in her regularly scheduled Tuesday briefing, appeared to suggest that listing cases by school might happen eventually. She called it “a sensitive topic” and said any decision would have to be made in collaboration with districts, teachers unions and the Department of Public Instruction.
“Most schools are virtual in the city of Milwaukee, so it gives us a little time to figure this out,” she said.
In the city of Greenfield, in southwestern Milwaukee County, Health Officer Darren Rausch said his office has not yet thought through whether and how it will release information about schools to the general public. But he said his office doesn’t typically release public health data in small numbers because that can identify individuals. And schools would likely be treated the same way, he said.
“Disease is all around us,” Rausch said. “I’m not any more concerned because there’s a case in my school, because I know there are other settings that my child is in or could be in where I could get COVID.”
In Waukesha County, west of Milwaukee, health officials added a map to their COVID-19 dashboard showing the number of active cases involving children under 18 by school district geographic area. But it does not cite numbers by school or district, and it includes all children, regardless of where they go to school, including those in private and charter schools and those who are home-schooled.
Nicole Armendariz, spokeswoman for Waukesha County Executive Paul Farrow, said it will be up to schools and districts to determine whether to notify anyone, including parents and staff, “who are not close contacts of a positive COVID-19 case.”
Contact Madeline Heim at 920-996-7266 or [email protected]. Follow her on Twitter at @madeline_heim. Contact Annysa Johnson at [email protected] or 414-224-2061. Follow her on Twitter at @JSEdbeat. Contact Samantha West at 920-996-7207 or [email protected]. Follow her on Twitter at @BySamanthaWest.
