James Lawler, MD, MPH is the Co-Executive Director of International Programs and Innovation, Global Center of Health Security. He’s the Director of Clinical and Biodefense Research and an Associate Professor in the Department of Internal Medicine at the University of Nebraska Medical Center. He’s a widely published researcher, including articles about the coronavirus in peer-reviewed journals.
3 News Now reporter Alyssa Curtis interviewed Lawler on Wednesday about COVID-19 cases rising in Omaha area schools. They spoke about the implications of schools not implementing mandatory mask policies. Lawler was blunt in his analysis of the situation.
In summary: if COVID-19 continues to spread in schools those children will spread it to vulnerable people, many unvaccinated, in the community. The delta variant is more contagious and results in more serious illness than the strain of COVID-19 we saw last year. As cases rise, hospital beds fill up. As hospital capacity is reduced, anyone needing care for any reason — car accident, heart attack, stroke — will be at risk of not receiving the best care possible. This scenario is already unfolding in other states.
Lawler started by saying he was “concerned about the level of transmission we already have in the community and I’m concerned about the vulnerability of kids and their families when we’re sending kids back to school in full density, in-person classrooms without facemasks and, for most of them, without vaccines.”
Children under the age of 12 cannot be vaccinated and middle and high schoolers do not have high vaccination rates yet. When it comes to sending kids back to school Lawler said it’s entirely predictable that COVID-19 will spread through schools.
“You cannot expect a highly transmissible respiratory virus, like delta variant, to not create explosive epidemics in school settings where that is the highest density of any place in our communities in terms of people per square foot,” said Lawler.
He suggested that people who are surprised by the rapid COVID spread in schools are maybe not paying attention or are “maybe listening to information sources that aren’t accurate or reliable.”
Lawler explained that the delta variant is more infectious and causes more severe disease. The spread, even among children, will be more obvious.
He said that kids get infected as often as adults, but they don’t get counted because they’re not tested at the same rate as adults. Antibodies studies show that kids have more COVID-19 antibodies than do adults, which suggests that they’ve had the virus at a higher rate because they’re in schools where illnesses spread easily, explained Lawler.
“We’re going to see this continue to get worse in school populations and that’s going to translate into more cases in the community,” said Lawler, pointing out that we’ve already seen this play out in the U.K. where kids go to school through July.
One of his concerns is that as COVID-19 spreads through schools and is carried into the community, the capacity to treat patients at the hospital will be diminished. A full hospital puts everyone who needs hospital care — of any kind — at risk.
In order to avoid the desperate scenarios now unfolding in other states like Florida, Mississippi, and Alabama where there are not enough ICU beds, Lawler recommends the following:
- Universal masking in schools
- Social distancing/Reducing classroom density
- Avoiding large gatherings
- “Cohorting” students
- Vaccinations for those who are eligible
Lawler also warns that the capacity of ICU beds could be easily overwhelmed as cases rise and with it, the possibility that triage tents will be set up in hospital parking lots as they have been in other parts of the country where hospitals have been overwhelmed.
Alyssa Curtis asked Lawler how he feels when school districts do not adhere to the guidance set out by health officials.
“I think we’re used to it by now, by a year-and-a-half,” Lawler said as he pursed his lips and paused.
He said there was a recent meeting of most of the infectious disease physicians in Nebraska and “that caucus was unanimous in our assessment that universal facemasks are necessary for schools. There was not one dissenting vote. So, I think that the consensus of the experts is pretty clear.”
Lawler went on to discuss vaccine misinformation and the importance of continuing to educate the public about the efficacy and safety of the COVID-19 vaccines. He also recommends compulsory vaccines for students as we’ve done with other vaccinations over several decades.
We asked Lawler at what point schools should start considering a change in their COVID-19 protocols. His response was blunt.
“Any reasonable benchmark that one would have set to trigger those things we’ve passed a long time ago.”