School starts in Washington in less than two months — but according to health officials, transmission of coronavirus is so high in King County that it won’t be safe to resume class in person unless patterns turn around soon.

“We’re heading in the wrong direction,” King County health officer Dr. Jeffrey Duchin said Wednesday. “The bottom line answer is, yes, we will need to consider taking more rigorous restrictions again, unfortunately, if things don’t turn around with voluntary behavior change.”

Duchin’s comments came as health officials unveiled a new report based on earlier King County data that suggests efforts to curb the spread of coronavirus in school buildings — such as screening students and staff, and requiring masks — won’t control the overall pace of transmission unless community activity, such as going to work or socializing, is kept far below pre-coronavirus levels.

The report, released Wednesday and ordered by state and local health agencies, is based on data through mid-June. Since it was drafted, the researchers said, they’ve collected additional data suggesting transmission levels are currently too high to reopen schools. Community-wide efforts to contain coronavirus spread “must improve significantly” to support opening school doors in September “without triggering exponential growth in COVID-19 burden,” they wrote.

The findings come amid a divisive debate here and nationwide over whether schools should reopen in the fall; Seattle Public Schools and several other local districts have decided to offer a hybrid model of in-person and distance learning while other large districts, such as Los Angeles Unified, have decided against reopening buildings.

In a briefing with reporters on Wednesday, Duchin called the report “sobering” and said it may be necessary to return to stricter restrictions on social gatherings to get to a point where it’s safe to open schools. As of Wednesday, 5.6% of King County residents tested for coronavirus were positive, and cases are now rising to levels not seen since late March and early April.

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The study details a long list of stipulations for schools to reopen safely. Among the conditions: community activity — which includes everything from shopping to going to church — must stay below 70% of where it was before the coronavirus took hold in the Puget Sound region, the report says. As of June 15, before cases spiked again here, activity was an estimated 65% of pre-coronavirus levels.

The report estimates that the proportion of coronavirus cases here could double within the first three months of school if buildings reopen without taking safety precautions — an unlikely scenario since Washington officials are requiring schools that open to ramp up cleaning schedules, enforce social distancing and ensure students and staff wear masks.

Returning to school safely won’t be easy.

For school to resume, based on the earlier data, King County must test at least 2,000 to 3,000 people for the virus each day, the report says. Contact tracing must expand. And schools need to institute safety measures with fidelity, a tough prospect for younger students who might struggle to stay distant from friends, or for schools with small classrooms.

“If the rest of society doesn’t do the right thing, nothing we do in schools will matter,” said Chris Reykdal, the state’s schools chief. “On the other hand, if society really wears face coverings and physically distances and does all the right stuff, then all the protocols we put in place in schools can really help to reduce the spread of COVID.”

The report was commissioned by the Washington State Department of Health in partnership with Public Health – Seattle & King County and the Bellevue-based Institute for Disease Modeling. It relies on an unpublished COVID-19 mathematical model developed by the Institute for Disease Modeling that uses demographic information, transmission data and age-specific disease outcomes, among other things, to predict how reopening schools would affect coronavirus spread.

The model incorporates information on daily numbers of tests, diagnoses and deaths, as well as foot-traffic patterns derived from cell phone data. The team simulated various scenarios for how these dynamics, and contact patterns in schools, would affect coronavirus spread. 

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The modeling has several limitations. The researchers based their conclusions on the interactions they assumed students would have with teachers, but they didn’t account for other school staff, such as para-educators or counselors. The researchers wrote that a model that included those staffers would likely “increase the transmission associated with all school reopening scenarios.”

They also did not consider the possibility of hybrid scheduling models that combine remote and in-person learning, such as the A/B schedule Seattle Public Schools officials are considering for fall. The report also doesn’t account for how well children transmit the coronavirus relative to adults, a big unknown that scientists are still researching.

The Washington Education Association union said the report highlights the need for schools to be held to the same health and safety standards as businesses.

“We would very much prefer going back to school buildings this fall. However, with cases on the rise, and hitting new peaks in our state, we have serious concerns about the health and safety risks posed to students, educators, families and our communities,” WEA president Larry Delaney said in a statement. The Seattle Education Association is also pushing back against in-person instruction this fall, and this week called for 100% remote learning.

The report follows recommendations from two prominent scientific and medical groups that are calling for schools to reopen. On Wednesday, a national panel of scientists recommended that schools should make every effort to open buildings full-time for elementary school children and those who receive special education services.

The American Academy of Pediatrics also recently issued a statement supporting reopening schools, citing education’s critical role in supporting children’s academic, social and emotional well-being — especially for children of color and those who rely on school for meals and other services.