Yes, COVID-19 is real. But that’s not the only question that matters.

Let’s start with some links, just to share where I’m getting my statistics at the moment.

A site called rt.live tracks the effective rate of transmission for each of the 50 states, by incorporating positive tests and testing rates — in other words, in the spring when there was a shortage of tests, they adjusted the metrics to reflect what the case numbers would have been.  As I write this, Illinois is at 1.18, and its cases have been increasing since September 10th.

The Financial Times has a good graphing tool for comparing states to each other, and countries as well, and this is clearly not paywalled.  As I write, France’s rate is twice the US’s, the UK is 50% higher, and Germany is 60% lower.

The New York Times tracks covid data by state and by county, on a per 100,000 per week basis.  (They had been providing coronavirus coverage without a paywall, but I believe that’s no longer the case.)  Unfortunately, they don’t provide good information for changes over time, just a simple visual.  At any rate, Illinois right now 10th in the country, with a rate of 211 cases per 100,000.  By comparison, some of the states which were supposedly deemed to be putting kids at risk by re-opening schools, are now much lower — Georgia at 94, Florida at 96, Texas at 128 — despite having been much higher in late summer.

A site called Wirepoints tracks, for Illinois only, not just cases but also hospitalizations.  When Illinois’s case counts increased over the late summer months, the hospitalization rates stayed level.  This was astonishing to me.  However, starting in early October, that rate has been increasing.

But the difficulty with these metrics is that it doesn’t tell us anything about to what extent the increase in Illinois is a matter of “each community gets hammered once, and the new cases are in small towns that weren’t previously impacted.”  For that, the Illinois DPH has historical data by county.  It’s not great — it starts only in June,  it only counts cases, not hospitalizations, you have to select a county from a drop down, and the “cluster %” graph is visually incorrect — but it’s decent, anyway.  (One issue that I’ve read and not been able to figure out the impact of, is that they have added in antigen tests recently, and have not shown the impact of this change.)

The Cook County Department of Health tracks cases, hospitalizations, tests, and positivity rates specifically for suburban Cook County (excluding Evanston and a few other cities which have their own DPHs).   Here there’s a peak in late August, then a drop to mid-September, and then a spike since then.  Unfortunately, as with all these sites except the rt.live, there’s no adjustment to reflect testing volume.   This site also provides hospitalization statistics, which show that, despite this increase over the past month, hospitalizations have actually dropped to 0.   The numbers drop from 19 on Oct. 5, 15 on Oct. 8, 13 on Oct. 11, 1 on Oct. 15, and 0 on Oct. 18.  Is this a matter of data collection, and a delay in compiling the data?  Maybe, but it seems unlikely that it takes as long as 2 weeks to collect in full.

And, again, none of this really tells us what we need to know, because what matters with respect to the school’s reopening is this:  what impact does school reopening, either partial or full, have on covid spread, and, more specifically, the degree to which individuals are severely impacted by covid (hospitalizations, long-term consequences, deaths), and does this impact outweigh, all factors considered, the harms done to students by remote schooling?

This is not a matter of covid spread in the community.  This is not even a matter of covid spread in schools — but of identifying whether there are clusters, that is, whether students are spreading covid among each other and to their teachers, as well as identifying whether students and teachers with covid are getting infected at school, or after-hours, especially to the extent that students deprived of the ability to attend school in person may be more likely to socialize at parties or in other riskier ways.

So far, we had warnings that Florida reopening its schools would lead to mass deaths.  That hasn’t happened, per a September 28 USA Today report.  In Georgia, in August, a photo circulated of a crowded school hallway, prompting widespread criticism.  While it is difficult to comprehensively identify the results of their schools’ policies, it is nonetheless the case that a look at rt.live shows a steady decline in overall cases in Georgia to essentially the same level as it’s prior low of early May and an effective rate of transmission that’s been less than 1 since July.  Locally, when the Chicago Public Schools announced its plan to partially reopen for young children and special needs children, the Chicago Tribune reported that

Chicago Department of Public Health Commissioner Dr. Allison Arwady said her team has been investigating COVID-19 cases among children in public settings such as day cares, athletic events and summer programs, and found transmission in such settings is rare.

Furthermore, she said Chicago students who have returned to parochial and private school classrooms have a lower rate of COVID-19 than what has been detected among children who have not been learning in-person. A full data set was not immediately provided by the health department. Arwady said 31 cases were reported in September through early October among the nearly 23,000 students and staff.

The health department encountered “less than a handful of situations where we could not rule out transmission in a school setting,” Arwady said. Most cases at those schools have been isolated or tied to siblings, she said. Local officials have also been closely watching data emerging from other states.

The city needs to think about limiting risk, not eliminating, Arwady said.

All this being said, it is nonetheless possible that the particular circumstances of Illinois mean that it is impossible to reopen schools safely; there is no certainty here, but we nonetheless need to look at the right metrics and use a proper understanding of balance of risks.

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