COVID hits Pima schools hard before shots for kids 5-11 roll out; one elementary ordered closed

A "significant increase" in COVID-19 cases is worrying Pima County health officials, who said students ages 5-11 are increasingly becoming infected as the rate of local community transmission remains high. 

New coronavirus infections in area schools rose significantly over the past week, officials said Friday, as a Tanque Verde elementary school was ordered closed for two weeks because of the extent of an outbreak there. COVID vaccines for 5-11-year-olds, recently approved by federal health officials, began making their way into the county this week.

A high rate of community transmission of the Delta variant is causing the spike in cases in the county and its schools, officials said.   

Statewide, the number of new COVID cases are at some of their largest totals since late September, when county health officials said they expected the current surge in infections to wane. Instead, the number of new infections has held steady, and even begun to increase again. Arizona reported 3,813 new cases and 58 additional deaths on Friday, and Pima County reported 432 news cases and nine deaths, some of the highest numbers since school years began in late July.

More than 21,300 Arizona residents have died from COVID-19, with 2,766 Pima County residents among the dead. There have been 146,000 reported coronavirus infections in the county, among the 1,182,000 cases across the state since the start of the pandemic.

COVID outbreak closes elementary school

On Wednesday, Agua Caliente Elementary School in the Tanque Verde Unified School District closed their classrooms for two weeks after reporting 40 active cases in the school. Brian Eller, the county Health Department's COVID liaison with areas schools, said that since last week there have been 738 new school-related cases countywide.

For kids 0-11 years old, there were about 380 new cases, Eller said. For kids 12-19, there have been about 228 new cases. In prior weeks, the county was seeing an average of 222 to 223 new cases a week.

The county has recorded a total of 4,249 school-related cases this academic year, Eller said, already more than the 4,069 cases for the entire previous school year, which was almost completely virtual.

There have also been 126 total outbreaks in schools since the start of the school year, using the Centers for Disease Control definition of having two linked cases of students who are not from the same household. This has resulted in 82 classroom closures, 20 of which occurred since last week.

There is a “significant increase in the number of cases happening in schools right now,” said Eller and Dr. Theresa Cullen, director of the Health Department. Children ages 5-11 are experiencing higher transmission, Cullen said, and bringing COVID home, spurring an already high community transmission and contributing to the week’s returning spike in cases.

Pima County, like every county in Arizona, is still designated as an area of “high” community transmission of the virus, according to the CDC, which means there are more than 100 new cases per 100,000 people over a seven-day period.

The county’s current case rate is 255 new cases per 100,000 people though that number is down from an over-300 new case rate the week before. Cullen said there have also been instances of an increasing R-0 ("R-naught"), which reflects how many people can catch a virus from a single person.

The county is also experiencing a 12 percent positivity rate, according to the CDC, reflecting the number of COVID tests with a positive result for the virus.

Officials emphasize masks for kids needed to slow infections

The mitigation strategy of the schools has been praised by health officials, including by Dr. Francisco Garcia, county chief medical officer, who credited them with keeping caseloads down just last week. However, Cullen said the main hole in school mitigation strategies has been implementing masking, and Eller reaffirmed the importance of masking to protect children.

“We know through the literature that we’ve seen that masking decreases the risk of outbreaks within school settings,” he said. “Districts that do not have masking mandates in place have a 3.5 percent more likely chance of in-school outbreak transmission,” referring to a study penned by both Maricopa and Pima County health officials.

However, Eller also said that the sharp increase in school-reported cases is caused by the large increase in community transmission, not in-school transmission. Cullen and Eller floated the idea that the week's jump in cases might have to do with fall festivals like Halloween but said they don’t have enough information to make that conclusion.

Cullen said that what the current rise in caseloads “means for the community is an increasing need to ensure that we can get vaccinated.”

“Overall, this is a call to the community that people who have not been vaccinated need to vaccinate,” she said. “That people that have been vaccinated more than six months ago need to get their booster and 5-to-11-year olds need to vaccinate.”

Last Friday, the Food and Drug Administration authorized the Pfizer-BioNTech vaccine for children 5-11, with the smaller doses for children. Pima County officials outlined a plan to begin vaccinating children with an initial allocation of 11,400 pediatric doses sent to 15 health-care providers.

State officials have said that they expect to deliver 224,700 doses, and Pima County officials have said they expect to distribute 22,000 doses in November, with more doses coming over the next four months.

The total population of Pima County is 60 percent vaccinated, according to the CDC, the over 12 population is 69 percent vaccinated, with 5-11 vaccines rolling out in the coming days. About 79 percent of the over 12 population has at least one shot while 68 percent of the total population does.

Cullen said that the entire U.S. Southwest is “lighting up” on data trackers right now because of a regional surge.

“We are not unique in this situation,” she said. “We’re seeing increasing cases in Pinal, Maricopa, Coconino...People need to get their booster if they’re six months after the completion of their series.”

There are just 10 ICU beds available in Pima County as of last Thursday, though county hospitals had 20 beds available in mid-October, a relatively high availability during the current surge.

Pima County continues to test regularly, Cullen said, and is providing more take-home antigen testing. Take-home positive tests aren’t reported to the county, but Cullen said the increased testing at home is also contributing to high COVID case numbers.

Cullen said that she was reluctant to agree to the idea that the county trend in COVID cases would follow a traditional epidemic curve, or epi-curve, a predictive disease outbreak model that suggests case numbers will reach a peak then drop before rising to lower peaks until infections settle at lower totals. What the county is now seeing, she said, is a rectangle-shaped trend in the COVID cases graph that reflects a “consistently elevated number of cases.”

“I don’t think any of us are surprised by that,” she said. “While we are seeing some increased workload, I do feel comfortable that we’re able to manage it… I’m still comfortable with our county response.”