"We're all holding our breath": Health experts on school reopenings in Texas

As schools and universities across Texas begin reopening, families, students and educators are adjusting to remote instruction, schools are preparing to file weekly reports on COVID-19 cases and universities are providing free on-campus coronavirus testing.

The Texas Tribune spoke to epidemiologists and health experts about what the state can expect with schools and universities resuming online or in-person instruction. The Tribune also talked to the same experts about the state's coronavirus data backlog.

Question: As hospitalizations decline, schools and universities are reopening — and already seeing outbreaks — and Labor Day is coming up. What do you think the state can expect in the weeks ahead?

Dr. Ron Cook, professor at Texas Tech University Health Sciences Center and the city of Lubbock’s public health authority: I think we’re all holding our breath on … what opening schools and opening colleges and universities is going to do. ... So I think we're going to see a surge, I think we'll see a surge of positive cases in the next 10 days to two weeks. That [student] population more than likely will do pretty well. But another 10 days after that we may see those that they come in contact with ... may not do so well.

Catherine Troisi, infectious disease epidemiologist at UTHealth School of Public Health in Houston: It is great news of course the hospitalizations have been declining, probably due to better treatment … we've learned a lot about the infection, and the fact that it's younger people being infected and they are less likely to have more severe outcomes and need to be hospitalized. It may also be that people are getting tested earlier so the disease is caught earlier and supportive measures can be given.

However, there is concern that the fact that hospitalizations are going down will be taken as a sign that, ‘Oh we can go back to normal,’ because we're all tired of this. We were tired of it four months ago and now we're really tired of it ...

We've got a holiday weekend coming up [Labor Day weekend], and we saw what happened Fourth of July and Memorial Day. The fact that schools are opening is a big experiment, particularly the elementary schools and the role of children in the spread of this virus, and there's a lot we don't know. … Colleges — it’s less of an experiment because I think we know what's going to happen. Eighteen-year-olds, first of all, think they're invincible. They're not going to die of anything. They're social animals. They haven't seen their friends since March. It is understandable that they are not going to keep up masking and, particularly, physical distancing. And anytime you get a lot of people together, especially when 40 to 50% of them are infected and don't know that they are, there's a possibility of spread.

The short answer to your question is, yes, we are concerned. … We've got these three things happening and I would predict that we're going to see an increase in cases.

Dr. James McDeavitt, dean of clinical affairs at Baylor College of Medicine: I've got a forecast and I've got a fear. My forecast is hopeful, but my fear is that history could repeat itself. We had what we thought was a surge in April that turned out not to really be a surge, but sort of an appetizer. And then we hit all the events of the summer.

Many factors were in play: the early May and mid-May reopening of the economy, the Fourth of July holiday, the George Floyd protests, a general lack of patience with social distancing on the part of the public and the politicization of masking. I don't think it was any one of those things that caused the second surge that we saw – they likely all contributed to a degree. But clearly in July, we saw a surge that was at least five times what we experienced in April. We skated right up to the point that we were risking overrunning our hospital system capacity, though thankfully we never did.

Well, now we've come to the backside of that surge, and my fear is that we'll lose our focus. We still have a relatively immunologically naive population out there that is susceptible to the virus. ... With upcoming holidays, school reopenings, a looming flu season, there are a lot of dynamics at play that could reignite the spread of the virus.

I don't think we can adopt an attitude that the calvary is going to ride in to rescue us — I don't think a vaccine will emerge and suddenly the virus vanishes. … My guess is by December we will probably see one of the vaccines in current phase three clinical trials demonstrate adequate safety and effectiveness and will start to be distributed. But to get to the point that adequate numbers of people – or high risk subpopulations of people – are actually vaccinated to the point we develop a degree of herd immunity, I think we're looking at springtime. And that's if everything goes like clockwork, which it won't...

So the reality is if we are going to be able to resume some semblance of life as we knew it before COVID-19, we need to adopt good masking, distancing and hygiene practices for a good long while — for months to come. We will have a vaccine, we'll get there, and this will end. But it's not going to be tomorrow — so I think that's important for people to get their heads around that. We’re in this — all of us together — for the long haul.

Disclosure: Texas Tech University and UTHealth have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.