key: cord-0892895-fe2t612f authors: Jones, R. D. title: COVID-19 Trends in Florida K-12 Schools, August 10 - November 14, 2020 date: 2020-12-03 journal: nan DOI: 10.1101/2020.11.30.20241224 sha: 951e38786e1709b31264e6f90707144b78773293 doc_id: 892895 cord_uid: fe2t612f Data collected from 38 states from August 3 - November 15, 2020 showed more than 250,000 confirmed student and staff cases of SARS-CoV-2 in K-12 schools1. Yet, analysis of COVID-19 case data in USA schools has been extremely limited 2,3 . To date, no large-scale or state-wide analyses by school level and grade has been published, opening a wide gap in understanding COVID-19 in American schools. A large-scale assessment of available data and trends could provide a baseline for understanding the virus in the K-12 learning environment and dispel misconceptions about the prevalence of COVID-19 in schools. During August 10 -November 14, 2020, laboratory-confirmed cases of COVID-19 in 10,088 students and 4,507 staff in K-12 schools were confirmed by either the Florida Department of Health, or directly from the 43 independently-reporting school districts in the state (Table 1) . School case data, collected daily, and school enrollment data for both in-person (including hybrid) and virtual learning were obtained by public records request to each of Florida's 67 districts for each week of the study period. Data regarding mask policies were obtained either from each district's reopening plan, or from public records request. No assessment of school case data or rates with consideration of age groups and mask policies at this scale or with this level of granularity were discovered after an exhaustive search. The Centers for Disease Control (CDC) provides guidance for safely reopening schools, based primarily on the rate of community spread within a given district or county 5 COVID-19 case rates were calculated based on new cases over a 14-day period at a rate per 1,000 people based on data reported by the Florida Department of Health 6 . . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted December 3, 2020. During August 10 -November 14, 2020, the state-wide incidence rate (cases per 1,000 students enrolled in face-to-face or hybrid instruction) in Florida high school students (12.5) was 70% higher than younger cohorts (7.4). School data by grade level (e.g. elementary, middle, high) shows trends consistent with earlier findings by the CDC regarding case rates between younger and older adolescents 4 . Staff rates are higher than student rates in all school environments except high schools. The proportion of student to staff cases in Florida schools was closest in the elementary setting (60% students -40% staff) compared to the high school setting (82% students -18% staff). Approximately 61% of all students in Florida returned to in-person instruction during the report period, with 39% enrolled in virtual-learning programs or withdrawing from the district by November 1, 2020. Most students (87%) in the state who attended in-person classes were enrolled in districts with mandatory mask mandates, though the percent of students enrolled in face-to-face instruction was highest among districts without mask mandates. The state-wide case incidence rate in districts without mask mandates (12.7 per 1,000 students enrolled face-to-face or hybrid) was 38% higher than those who attended in-person within districts that did have mask mandates (9.2). However, the staff case rate in districts without mask mandates (29.2 per 1,000 on-campus employees) was nearly twice that of staff case rates in districts with mandatory mask policies (14.8) ( Table 2) . Case rates nearly tripled in the period October 3 -November 14 for students in Florida compared to the period August 10 -October 3 7 (4.5 per 1,000 in high school and 2.3 per 1,000 in elementary students to 12.5 and 7.4 per 1,000, respectively). Only two of Florida's 67 counties had school case rates lower than the community case rate (Monroe and Walton), while 19 . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted December 3, 2020. ; P a g e 5 o f 8 counties had higher pediatric case rates overall compared to school case rates (Table 2) . Seven counties had more school cases reported than pediatric cases reported, which could be due to a number of high school students being over the age of 18 and thus not counted in the pediatric community rate, or do to the school reporting previous cases after-the-fact. Case incidence varies significantly between school grade levels and between students and staff. Staff rates are higher than student rates in all school environments except high schools, and staff benefit most by mandatory-mask mandates. The rate of cases within schools is highly correlated with cases within a community, more than the size of the district by total enrollment. Percent enrollment in face-to-face instruction is a secondary influencer of case incidence rates in schools. In areas with higher pediatric community case rates compared to school case rates, districts may be under-reporting school case totals for students, or "disqualifying" student cases based on when a student tested and whether the case could be directly linked to the school environment. More research is needed to further understand the wealth of data available regarding COVID-19 incidence in Florida, and to develop proper mitigation strategies to confront this unprecedented challenge. . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted December 3, 2020. ; P a g e 6 o f 8 is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted December 3, 2020. is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted December 3, 2020. The Covid Monitor Most schools should close and stay closed through winter. The Washington Post Shut them down: The surprising data behind COVID-19 and schools COVID-19 Trends Among School-Aged Children -United States United States Centers for Disease Control. 2020. Indicators for Dynamic School Decision-Making School Report for Florida -Summary of COVID-19 Cases Associated with Primary and Secondary Schools The Covid Monitor provided data related to cases in K-12 school districts in Florida.