More than half of school employees are at increased risk of COVID-19, study finds
One of the biggest challenges during the coronavirus pandemic was and still is figuring out how to safely open schools this fall without putting lives at risk. A new study reveals how complex the feat really is.
Using pre-pandemic data, researchers found that between 42% and 51% of all school employees are either directly or potentially at increased risk of severe COVID-19 based on their underlying health conditions such as obesity, diabetes, age and cancer. Other factors that can lead to higher risk include smoking, high blood pressure and asthma.
The study also found that between 33.9 million and 44.2 million adults with severe coronavirus risk factors had direct connections to schools or indirect ones by living with staffers or students, according to the researchers from the Agency for Healthcare Research and Quality, one of the 12 agencies within the Department of Health and Human Services.
And like most other papers on COVID-19, the team learned of racial and socioeconomic disparities, with Black school employees more likely to be at risk of a severe illness than white ones.
A peer-reviewed manuscript of the study was published Sept. 17 in the journal Health Affairs, but the paper is awaiting a final round of editing. Estimates were weighted to be nationally representative.
“Given the magnitude of these results, it is not surprising to read about teachers, other school employees, and even students who say they are reluctant to return in the fall if schools reopen and protections are viewed as inadequate,” the team wrote in their study. “Our results highlight the public health challenge that arises when the risk of school-related exposure is coupled with the potential for within-household transmission.”
The team used data from the Medical Expenditure Panel Survey collected between 2014 and 2017 of about 122,000 Americans connected to elementary, middle and high schools who are teachers, administrators, school-aged children or low-skill support staff.
Obesity was the main factor contributing to increased risks for severe COVID-19 among school employees, as well as high blood pressure. Meanwhile, men had higher risks than women.
Among school employees, low-skill support staff (58%) were the most likely to be at increased risk of severe COVID-19 compared to teachers and teacher assistants (38%) or administrators and high-skill support staff (39%), according to the study.
Having multiple risk factors, such as kidney disease and diabetes, puts individuals at an even greater risk of a dangerous coronavirus illness. The study found that 9.7 million adults who had two risk factors and 5.2 million who had three or more worked at schools or lived in homes with school employees or school-aged children — that’s a total of about 15 million adults.
At the same time, about 63% of school employees lived with at least one adult who meet the criteria for increased risk, the researchers found.
School-age children
Kids in high school were the most likely to live with adults at increased risk of severe COVID-19, with Black and Hispanic children more likely than white kids to live in homes with these individuals.
“While it is not surprising that the health issues of parents and other household members would increase as they and their children get older, this finding takes on special importance in the context of COVID-19, insofar as transmission risks also increase with child age,” the team wrote.
The researchers said that between 59% and 71% of school-aged kids lived in homes with at least one increased-risk adult.
“These findings regarding potential within-household transmission take on greater import in light of random testing evidence that living with a household member diagnosed with COVID-19 was associated with a 15-fold increase” in positive test results for the virus.
Limitations
The team notes that their estimates are likely undercounted for several reasons.
First, their data includes information only on the “civilian noninstitutionalized population,” meaning hard-hit populations in nursing homes, long-term care centers and correctional facilities were excluded.
The study also does not consider any changes in employment, school attendance or household contacts that may have occurred since 2017 when the data were collected. The researchers did not include individuals with liver disease, organ transplants, immune deficiencies, HIV, sickle cell disease and cystic fibrosis — among other illnesses.
The survey was also based on self-reported conditions and treatments, a type of survey style known for undercounting condition prevalence, the team said.
This story was originally published September 21, 2020 at 11:07 AM with the headline "More than half of school employees are at increased risk of COVID-19, study finds."
