Quarantining kids doesn’t stop covid. It just keeps them out of school

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During the pandemic, Americans have been re-familiarized with quarantines – an age-old tool for curbing the spread of illness. Notably, schools embraced quarantines as a coronavirus-fighting measure as they reopened this fall. In most districts, any unvaccinated student who has been in close contact with someone who contracted the virus must leave school for 10 to 14 days. (The Centers for Disease Control and Prevention recommends 14.) A single case in a school can lead to dozens of children being sent home – and in large districts, thousands of kids can be home in a given week. Following the logic of quarantine, more than 2,000 schools across the country have shut down for some period since reopening in the fall.

With a pathogen as contagious as the delta variant of the coronavirus, there is a place for quarantines in the public health tool kit. But it’s important that they pass a basic cost-benefit test: The risks of quarantine, in a given situation, must be outweighed by the risk of contracting the virus. We, as parents and concerned individuals, would gladly embrace this public health strategy if it met that standard – if the tactic prevented dangerous spread in the school setting.

But in many cases, quarantines are probably doing more harm than good – given the well-documented costs, intellectual and social, of keeping children out of school and the low rates of transmission of the coronavirus within schools. The United States kept schools closed for in-person learning longer than many of its peer nations, despite evidence that schools could open safely. The popularity of quarantines shows that an inordinate fear that schools will become the epicenter of community spread continues to dominate our discussion of coronavirus mitigation.

We now have clear and reproducible outcomes across the country showing what secondary spread in schools looks like. Large population-based studies in Wisconsin, North Carolina, Utah and New York City have demonstrated secondary transmission rates of less than 1 percent in school classroom and bus settings. These low transmission rates contrast starkly with the significant spread demonstrated in informal indoor gatherings or households. And these school transmission studies were conducted well before widespread vaccination of adults (who originated the majority of in-school transmission). This may be a testament to the layered mitigation strategies that schools have implemented in this country – including masking, physical distancing and testing. (Although studies from around the world, examining school systems with vastly different approaches to masking, testing and distancing – including in Norway, Canada, Germany, France, Ireland and Australia – affirm that in-school transmission remains rare across multiple contexts.)

To be sure, some of those studies were conducted before the delta variant had become dominant. But more-recent school data is also reassuring. The Los Angeles Unified School District has been testing a half-million students and staffers each week. As Reason’s Matt Welch notes, according to a Sept. 16 report, only 0.5 percent of students and 0.7 percent of staffers have become infected. Those figures are even more impressive when you remember that most kids – unlike most teachers – are unvaccinated. And both rates are lower than the “baseline” rates of infection identified by the school district before the semester began.

Even more importantly for our argument, a mere 0.2 percent of L.A. students sent home to quarantine tested positive for the coronavirus.

When students do get infected, it tends to be from outside school. In its most recent covid-19 report card, Los Angeles Unified reported one active case that resulted from in-school transmission (out of 1,085 cases).

Consider the costs of keeping 1,000 kids out of school to prevent two new coronavirus cases in a school district. Drawing on national statistics, nearly 300 of those kids probably come from “food insecure” families; missing school means they go without nutritious meals for two weeks. Nearly 250 come from a single-parent household, meaning that family’s primary breadwinner may have to stay home from work while the kids are barred from school. Sadly, many children will simply be left home alone.

Recognizing that strict quarantine rules come with a steep price, a number of states – including Illinois, Kansas, California and Massachusetts – and some school districts (including in L.A. and New York) have modified their practices. Typically, they will allow an unvaccinated student who had close contact with an infected student to stay in school if both were masked. The exposed students then must test negative for the coronavirus – sometimes twice. (Unfortunately, the CDC remains skeptical of modified quarantine. The agency “does not have enough evidence at this time to support this approach,” it tells parents on its website.)

School districts should keep a close eye on their statistics. If in-school transmission rates go up, a strict quarantine policy might be justifiable. But in the circumstances that prevail in many, but not all, U.S. communities – the majority of adults vaccinated, schools decently ventilated, children masked and screened each day for symptoms – a policy of an automatic 14-day quarantine is overkill.

Keeping thousands of kids out of school to prevent a handful of coronavirus cases is unjustifiable. An excessive use of quarantine causes children to fall behind educationally and cuts at-risk kids off from an important support system. We should encourage those school officials who understand that “zero risk” is unobtainable and that an effort to drive case numbers to zero can have unintended negative effects. Schools should keep sick children out of school, stress the importance of multilayered risk mitigation (masks and so on) – and they should switch from quarantine to a “test and stay” approach. They should always be mindful that keeping kids out of school can hurt their health, too.

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Jeffrey Vergales is an associate professor of pediatrics at the University of Virginia.

Monica Gandhi, an infectious-diseases specialist, is a professor of medicine at the University of California, San Francisco.