Schools will shape the next phase of the pandemic


(Posted July 22, 2020)

By Chris Cook, Madison County Health Commissioner

On July 16,  Madison County moved from Level 1 to Level 2 in the new statewide Ohio Public Health Advisory Alert System (PHAAS) by triggering three significant health indicators: new cases per capita, sustained increase in new cases, and proportion of cases not in congregate settings. In fact, Madison County added more than 50 new cases over the last two weeks. COVID-19 is spreading at an increased rate with higher chances of exposure to the virus in Madison County. Residents should double-down on efforts to wear masks, avoid large gatherings, and practice social distancing.

Our continued response to COVID-19 is as much about prevention as it is about addressing current conditions. There are milestones in a pandemic that can decide what the coming months will hold. The next phase of this pandemic will be shaped by schools. The health of our entire community relies on making good choices for our school environments.

We know how COVID-19 moves through indoor congregate settings.  School environments pose a significant risk of outbreaks and rapid spread through students and staff. Given where we are with this pandemic in Ohio, starting the school year with remote instruction makes the most sense from a physical health and prevention standpoint. However, many parents and school districts do not consider this to be a viable option. Increasing numbers of schools across Ohio are settling for a blended option; this allows for both remote learning and in-person instruction with the goal of creating options and reducing exposures.

As we approach the school year and this critical juncture in this pandemic, here are things that we know:

Congregate settings are a problem. The virus spreads quickly in environments where people are indoors and in close contact for extended periods of time. Congregate locations such as nursing homes, churches, public transportation, workplaces, bars, parties, and family get-togethers have proven to be places where the virus spreads easily and rapidly.

It’s about more than just students. Our primary focus for health and safety tends to be on students. The health of school staff and their families is just as important. Our school staff are not called upon to intentionally sacrifice their health. Healthy students support healthy teachers, moms, dads, siblings, and grandparents. At the end of the day, every person leaves school and goes home to loved ones. They take with them every microscopic interaction of the day. The health of our entire community is directly affected by our schools.

People spread it before they know they have it. People are most likely to infect others two days before they have symptoms. There are some infected people who never have symptoms but can spread it to others. This means when a seemingly healthy person talks, laughs, sings or coughs, they could be infecting many people who are in close contact (such as in a classroom).

Physical distancing is a challenge. Very few schools are set up to permit six feet of distance between students. Choosing to bring all students back means there will be times that teachers and students are in close contact. Other protective actions must be taken besides distancing.

Masks make a big difference. Cloth facial coverings capture and reduce the number of infectious droplets in the air and are effective at slowing the spread of COVID-19. When cloth masks and physical distancing are used together, the opportunity for COVID-19 to spread to others is much lower. Social media posts falsely warn that wearing a mask can cause a dangerous lack of oxygen called hypoxia. There is no credible evidence that cloth face masks cause hypoxia.

Workplaces and schools are interlinked. Employers are using distancing, facial coverings, and increased cleaning to keep their workers safe and their business moving forward. Keeping COVID-19 at bay in our schools using similar prevention tools is key to a safe learning environment that also keeps parents healthy and headed to work each day.

Using all prevention tools available helps with sustainability. Layering all protective actions that we have reduces the risk of COVID-19 spreading and gives us the best chance to keep our schools open as much as possible. An “all-in” approach to prevention that is initiated and maintained from the first day of class will help avoid the light switch effect; on-and-off in-person education is very taxing for both schools and parents.

Cases in schools will cause a major disruption. When there is a positive case of COVID-19 in a school, the case and close contacts must quarantine at home and be out of school for 14 days. A close contact is anyone who makes physical contact with a case or is within six feet of the person for at least 15 minutes anytime during the two days before the positive case started having symptoms. The ripple effects of multiple positive cases are significant in a close indoor environment.

There is still a lot we don’t know. Although we have only been combating COVID-19 for six months, this pandemic has felt like six years. Students have not been together in school during the height of the pandemic, so there is much we do not know about how it will spread in schools. We continue to learn new ways COVID-19 is impacting young people and the long-term effects that this virus has on the lungs, kidneys, heart and brain of children and adults.

We know that vaccine is the game-changer. A vaccine will not make COVID-19 a distant memory, but it will turn the tide in our favor. It will reduce the number of people who get sick and shorten the duration and severity of the illness for those who do get sick. A vaccine is not here yet, and we have a lot of hard work to do until we get it.

This pandemic is far from over. It is not too late to change our course. It can start with our schools. Educators know that in-person learning is better than virtual, especially for the social and emotional aspects. But things must be different. This is a pandemic. We must use every tool at our disposal to slow the spread of COVID-19 in Madison County. If we act like it’s over, we will realize all too soon that it’s just getting started.

Chris Cook is the Madison County health commissioner. For local COVID-19 data and information, call (740) 852-3065, visit and social media (@madisoncountyPH), or send email to


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