Coronavirus Today: The school-reopening battle

Good evening. I’m Amina Khan, and it’s Thursday, Feb. 4. Here’s what’s happening with the coronavirus in California and beyond.

As coronavirus case counts continue to decline and the latest surge recedes in the rearview mirror, a battle over reopening California schools looms. The fight intensified this week when Gov. Gavin Newsom and the Biden administration both said campuses can safely reopen before teachers are vaccinated. Unions pushed back, calling for school workers to be immunized as part of any sweeping effort to get students back in classrooms.

The debate over the necessity of vaccinating teachers is hardly theoretical. Positive-trending health metrics could soon allow for the reopening of campuses that have been closed since March in Los Angeles, Orange and San Diego counties, among others. Outside of Southern California, 18 counties have already seen new coronavirus case rates drop low enough to reopen elementary school campuses under recently adopted state guidelines.

Newsom said he has done his part to protect teachers by placing them in an upper tier of eligibility for COVID-19 vaccines. But under state rules, it’s up to local health authorities to decide whether teachers and other school workers get access to the vaccines now or later.

This issue is roiling school systems all over the United States. Chicago teachers have threatened to strike over a back-to-campus order that was put on hold amid negotiations over making campuses safer. In New York City, which has lower case rates than L.A., 1,052 schools opened in December — and they’ve been plagued with frequent shutdowns due to outbreaks.

There’s no question that many students have suffered during pandemic-triggered school closures, particularly those from lower-income families and those learning English. The part that’s up for debate is this: Is mitigating the academic, social and emotional harms worth the risk that the virus will spread in schools? That hinges on how high the transmission risk really is — something scientists will probably be examining for a while to come. Until then, decisions are being made with the limited data at hand.

Dr. Eric Toner, a senior scholar with the Johns Hopkins Center for Health Security, said increasing evidence suggests that elementary school-age children don’t transmit the virus as much as adults, and that the virus doesn’t make them as sick. Neither of those things were known in the pandemic’s early days. “I don’t fault anybody for imposing the school closures,” he said. “The consensus now is that reopening schools does make sense.”

Outbreaks can occur even when schools have extensive mitigation strategies in place, including masking, distancing, air filtration and coronavirus testing, said Michael Lachmann, an evolutionary biologist at the Santa Fe Institute. But his research suggests that outbreaks can be quickly contained. In one study, fewer than 10% of infected people spread the virus to anyone else. “With all mitigation measures, the virus spreads in school, but not uncontrollably,” he said.

Ultimately, the case that schools can reopen safely is not as clear-cut as some want it to be, said Theresa Chapple-McGruder, an epidemiologist in the Washington, D.C., area. “There are a lot of holes in the data,” Chapple-McGruder said. “We don’t have good rates of children being tested. And we know that children are more likely to be asymptomatic” when infected.

She added that it’s important to remember that “children live within families,” and the disease spreads easily within households. “We need to be limiting our exposure to the virus, either through schooling at home, working from home — any ways that we can try and manage to stay safe at home.”

State and federal officials have insisted for some time that campuses for kindergarteners through high school seniors can reopen safely without teachers being vaccinated — and some doctors agree. Take the Southern California chapter of the American Academy of Pediatrics, which called for schools to open immediately, saying the harms of keeping children out of school outweigh the risks of reopening.

Meanwhile, United Teachers Los Angeles accused authorities of playing politics with the lives of its members, their students and their families. The UTLA, which represents L.A. teachers, librarians, nurses and counselors, also said the pediatricians gave short shrift to a key warning from researchers: Preventing viral transmission in schools requires lowering the community’s levels of infection.

“Saying the temporary trauma from distance learning is greater than illness and death of family members conveniently minimizes the reality that COVID-19 disproportionately impacts” families of color in Los Angeles, said UTLA President Cecily Myart-Cruz. “Although, thankfully, serious illness and death among children is rare, 78% of the children who have died in the U.S. are children of color.”

Myart-Cruz also had this to say to officials pushing for a rapid return: “If this disease was disproportionately killing white children, parents and grandparents, the response to COVID-19 from our politicians would have looked very different.”

By the numbers

California cases, deaths and vaccinations as of 5:53 p.m. PST Thursday:

Track California’s coronavirus spread and vaccination efforts — including the latest numbers and how they break down — with our graphics.

Across California

We’ll start off with some good news for Angelenos: The numbers of new coronavirus infections and hospitalizations are plunging in Los Angeles County. It’s a welcome change following a catastrophic winter wave that overwhelmed hospitals and caused an unprecedented number of deaths. But officials warn that the county is not out of the woods yet. Despite their recent fall, new cases and hospitalizations remain well above their pre-surge levels — and they’re still too high for the county to reopen more of its battered economy or to provide the long-term relief hospitals desperately need, my colleagues Luke Money and Rong-Gong Lin II report.

Remember, the most devastating consequence of the pandemic — the number of lives lost to the disease — remains high. About 201 Angelenos, on average, have died from COVID-19 each day over the last week, and the county’s cumulative death toll is now above 17,500. Statewide, more than 42,000 Californians have died of COVID-19.

Dr. Christina Ghaly, L.A. County’s director of health services, said it appeared daily COVID-19 deaths had finally peaked. But she stressed that “for the families across the county that have lost someone they love, for children that have lost their parents, for parents that have lost children, for people that have lost friends, coworkers, loved ones — that heartbreak is incredibly intense. And that loss is still happening on a daily basis.”

While California is still trying to figure out how to dole out its limited vaccine supply, there is growing debate about who should be getting priority. The state has launched a high-level task force to sort out how residents with disabilities and underlying health conditions will be prioritized next, officials announced Wednesday at a vaccine advisory committee meeting. The group spent a lot of time discussing how those residents will be factored into the state’s priority guidance. That recommendation could come as early as Friday.

“We are taking this incredibly seriously,” state epidemiologist Dr. Erica Pan said. The working group responsible for drafting vaccine guidance told the larger committee Wednesday that it would like to see individuals ages 16 to 64 with underlying health conditions or disabilities become the next eligible group in the vaccine rollout. An official recommendation to the state has not been made yet.

It’s not yet clear whether the committee’s recommendations would override previous plans to target people based on their age, or how vaccine eligibility would be determined. It’s also unclear when vaccinations would become available for people with health conditions and disabilities. Other groups of Californians are also fighting to get earlier access to the vaccines, including teachers and other essential workers.

Teachers and those who work in food and emergency services are slated to come after healthcare workers, long-term care facility staff and residents and adults 65 and older — but because of limited vaccine supplies, it’s unclear when those groups will actually get to roll up their sleeves for a shot.

Meanwhile, across California, motivated anti-government activists loosely connected online through an array of causes — ending COVID-19 shutdowns, the recall of Gov. Gavin Newsom, conspiracies fostered by QAnon and even far-right takes on Christianity — are joining forces. Their common cause: their belief that government at every level, including local, is oppressive and must be resisted. Ignoring public health orders and the deaths of 450,000 Americans due to the coronavirus, they are entering stores without masks, eating at restaurants that refuse to shut down, hosting curfew-breaking parties at the beach — and thinking of ways to go bigger.

Take stand-up comedian Jason Lefkowitz, who a year ago was shopping a script, working three nights a week as a Beverly Hills waiter and posting support for Bernie Sanders on social media. Now, he supports Donald Trump, believes there is an elite ring of pedophiles running loose in Hollywood and Washington, and led a protest that shut down the vaccine clinic at Dodger Stadium last week. “I want my life back,” he said. “I want to go to work. I don’t want government checks.”

Lefkowitz contends that his group did not intend to shut down the vaccine site Saturday, and he was surprised when fire authorities blocked cars from entering in what city officials later described as a precaution to allow vaccinations to continue inside. But he also felt pride when he realized what the group had done, believing it had saved lives by stopping the shots. “I’m like, ‘Oh my God, this is totally going to make the news now. This is going to cause a big stink,’” Lefkowitz said. The Dodger Stadium protest, he and others said, won’t be the last.

See the latest on California’s coronavirus closures and reopenings, and the metrics that inform them, with our tracker.

Around the nation and the world

In Wisconsin, Kelsey Townsend finally got to meet her fourth child three months after giving birth to her. Townsend had COVID-19 and was in a medically induced coma when her youngest daughter was delivered via cesarean section on Nov. 4. She ended up spending 75 days on life and lung support. She finally met baby Lucy on Jan. 27 — the day Kelsey was discharged from University Hospital in Madison. “We instantly bonded when we met. She gave me a great big smile and looked at me like she knew exactly who I was, and that made me feel just so happy,” the Poynette, Wis., woman said.

Dr. Jennifer Krupp, a maternal fetal medicine specialist, said Townsend’s situation was rare (though we’ve written about a hauntingly similar case here in California). Townsend’s oxygen saturation was so low when she arrived at the hospital that her fetus’ brain and other organs could have been damaged, and her skin was tinged gray and blue. Her baby had to be delivered as soon as possible.

Doctors thought Townsend might need a double lung transplant at the end of December. But then she started improving — so much so that she was moved out of the intensive care unit, taken off a ventilator in mid-January and removed from the transplant waiting list.

Townsend’s husband, Derek Townsend, called the experience a “big roller coaster.” “There was many, many nights that I would get phone calls late at night and into the early morning, and the doctors kind of informed me that they’ve done all that they can to support Kelsey and they’re having a hard time stabilizing,” he said. “So there was many times that we thought we were going to lose her.”

On the vaccine scene, Johnson & Johnson asked the U.S. Food and Drug Administration to clear its experimental COVID-19 shot for emergency use. If authorized, it could provide Americans with a third vaccine option and an influx of millions more doses amid a stumbling and short-stocked immunization drive. Don’t hold your breath, though: The process will probably take weeks.

The two vaccines currently on the American market, made by Pfizer-BioNTech and Moderna, were each found to be more than 90% effective in clinical studies. Both are supposed to be given in two doses spaced several weeks apart. A single shot of J&J’s vaccine was found in the U.S. to be 72% effective in preventing moderate to severe cases of COVID-19, 66% effective overall in a global trial, and 100% effective in preventing hospitalization and death.

Officials at the FDA will now review J&J’s trial data, and a committee of outside experts will likely evaluate the trial findings. That panel would then make a recommendation to the agency on whether the shot should be allowed onto the U.S. market. The group’s findings aren’t binding, but the agency typically follows its advice.

Across the pond, U.K. scientists are launching a study to determine whether it’s OK to mix and match doses of different COVID-19 vaccines — a strategy that, if effective, could theoretically ease the challenges of immunizing millions of people amid a global vaccine shortage, officials said. Participants in the government-funded study will get a shot of the AstraZeneca-Oxford University vaccine followed by a dose of the Pfizer-BioNTech vaccine, or vice versa. “This study will give us greater insight into how we can use vaccines to stay on top of this nasty disease,” said Jonathan Van-Tam, Britain’s deputy chief medical officer.

Three different vaccines — made by AstraZeneca, Pfizer-BioNTech and Moderna — are currently being rolled out in the U.K. All three require patients to get two doses a few weeks apart. Current guidelines in Britain and the U.S. say the vaccines aren’t interchangeable, but can be mixed in exceptional circumstances — for example, if the same kind isn’t available for the second dose or if it’s not known what was given for the first shot.

All three of these COVID-19 vaccines train the body’s immune system to recognize the coronavirus — particularly the spike protein on its exterior. The one from AstraZeneca uses a common cold virus to carry the spike gene into the body, while Pfizer’s delivers genetic instructions for making that spike protein inside a little ball of fat. If the vaccines can be used interchangeably, “this will greatly increase the flexibility of vaccine delivery,” said Matthew Snape, the new study’s leader at Oxford University.

Now on to Wuhan, China, where World Health Organization investigators are looking for clues about the coronavirus’ origin. The WHO team, which includes experts from 10 nations, has visited hospitals, research institutes and a traditional market tied to the outbreak, among other sites. Members said Chinese officials have offered a high level of cooperation. Still, they warned people not to expect immediate results from the visit.

“I keep saying that we need to be realistic, a short mission like this one will not have all the answers but it helps advance the understanding of the #virusorigin #wuhan,” WHO team member Hung Nguyen-Viet said in a tweet Thursday.

The first clusters of COVID-19 cases were detected in Wuhan in late 2019, prompting the government to put the city of 11 million under a strict 76-day lockdown. China has since reported more than 89,000 cases and 4,600 deaths — the bulk of them in Wuhan. The Wuhan Institute of Virology has collected extensive virus samples, leading to unproven allegations that it may have caused the original outbreak by leaking the coronavirus into the surrounding community. China has strongly denied that possibility. At the same time, it has promoted unproven theories that the virus may have originated elsewhere.

It is likely to take years and multiple investigations in many parts of the globe to confirm the origins of the coronavirus.

Your questions answered

Today’s question comes from readers who want to know: Is it OK to take painkillers before or after a COVID-19 vaccine?

If you’re experiencing some of those aches and pains that are typical side effects of vaccination, you may be tempted to take some over-the-counter painkillers to ride them out. But experts say it’s best to avoid doing so, unless you routinely take those drugs for a medical condition. That’s because some painkillers might actually hamper the vaccine’s purpose — that is, generating a strong immune-system response.

Vaccines basically trick the body into thinking it has a virus and mounting a defense against it. That may cause arm soreness, fever, headache, muscle aches or other temporary symptoms of inflammation. “These symptoms mean your immune system is revving up and the vaccine is working,” said Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

Certain painkillers that target inflammation, including ibuprofen (AKA Advil, Motrin and other brand names), might curb that immune response. Though current evidence is limited, a study on mice in the Journal of Virology found that these drugs might reduce antibody production.

So don’t take a painkiller as a preventive measure before getting a vaccine unless a doctor has told you to, said Jonathan Watanabe, a pharmacist at UC Irvine. The same goes for after a shot. “If you don’t need to take it, you shouldn’t,” Watanabe said. If you do need one, acetaminophen (AKA Tylenol) “is safer because it doesn’t alter your immune response,” he added.

A caveat: If you’re already taking one of those inflammation-fighting medications for a health condition, don’t stop doing so before you get the COVID-19 vaccine — at least not without asking your doctor, Watanabe said.

The CDC has other tips for a little post-vaccine relief, such as holding a cool, wet washcloth over the area of the shot and exercising that arm. For fever, drink lots of fluids and dress lightly. Also, call your doctor if redness or tenderness in the arm increases after a day or if side effects don’t go away after a few days, the CDC says.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them.