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COVID And The Classroom: Dartmouth Doctor On Returning To School

picture of school bus

With the start of school just around the corner, questions about COVID-19 safety measures are still in the air. All Things Considered host Peter Biello spoke with Dartmouth epidemiologist Dr. Lisa Adams about COVID safety as a new school year approaches.


  • For those who can get them, vaccines play a vital role in slowing the spread and severity of COVID-19.
  • Optional events, like birthday parties or indoor sports, should be planned with precautions in mind. Masking, holding events outdoors or limiting the number of guests are good ideas.
  • Regular testing for COVID-19 at schools will still be important come the new school year.

Below is a transcript of their conversation.
Peter Biello: This is All Things Considered on NHPR. I'm Peter Biello. As families and teachers prepare to head back to school, questions are still in the air about safety, particularly as the highly contagious delta variant continues to spread and so many young people are still not vaccinated. Dr. Lisa Adams is an epidemiologist at Dartmouth and she's here to talk about COVID transmissibility in schools and what that means for the coming school year. Dr. Adams, thank you very much for speaking with me.

Dr. Lisa Adams: Pleasure to be with you.

Peter Biello: So, as we start this new school year, we're seeing high COVID-19 numbers across the state again. How is this moment different from, say, the end of last school year? What's different about what's happening with the delta variant?

Dr. Lisa Adams: Many things are different right now, of course. You pointed out that we have this new delta variant, which seems to be highly transmissible, and the other flip side that of that, though, is that we have a greater number of individuals who are vaccinated. And in many college and university settings [there are] high rates of vaccination coverage. So, one thing we've learned through this pandemic is having to be able to adjust policies, make decisions on less information than we wish we had, sometimes incomplete information, balancing out these issues of keeping our communities safe and healthy, protecting the most vulnerable in those communities, while also recognizing the mental health consequences and trying to balance that out with being as open on our campuses as we can to allow that social interaction, the personal connections that we've all been craving for so long and have gone without for so long.

Peter Biello: What challenges do you see on the horizon when it comes to testing students and maybe faculty for COVID-19?

Dr. Lisa Adams: So, I think most colleges and universities have really had to rely heavily on intense testing regimes. Before people were vaccinated, right, we had a cadence for testing people frequently. It was often once a week, twice a week, even at some New England schools I know it was three times a week. So, it was setting up the testing operations to accomplish that, figuring out how to ensure compliance with testing, figuring out who is going to get the testing data, who is going to react to it. But I think most of us really, pre-vaccination, were relying heavily on testing. And even now in the setting where we are now, the situation where we are now, where we have high vaccination rates amongst our employees and students, we still are finding a critical role for testing.

Peter Biello: There's been a lot of attention paid to ventilation and spacing within classrooms. Even with those changes, how could the virus spread in a school environment?

Dr. Lisa Adams: We know that COVID can spread from close contact when people are unmasked in poorly ventilated spaces, and particularly if those individuals are unvaccinated. So, many colleges and universities used the time last year to do a, when everybody went remote, to do very careful assessments of their classroom spaces to determine if they meet some acceptable standards. And again, when the weather is good, encouraging classrooms, classes to meet outside under tents. And I think those are some of the actionable steps that we've taken to promote optimal ventilation dynamics.

Peter Biello: Ventilation, of course, much easier when you know, you can open windows perhaps, or maybe even, as you mentioned, have classes outside. This is New Hampshire, though, and there's a clock ticking, and as winter approaches, it's just going to be too cold to be outside. So is the hope here on the part of colleges and universities that the curve starts to bend downward again with respect to cases before folks definitely have to move back into the classroom?

Dr. Lisa Adams: We certainly hope so. And there are other interventions that can be taken. I think many of us have seen this graphic of what we call sort of the Swiss cheese model of trying to control this pandemic. So the idea being each slice of Swiss cheese has some holes in it. But if you line up several slices in a row, one of those interventions will prevent further transmission. So, good ventilation is just one of the slices of Swiss cheese. Another one, of course, is indoor masking.

Peter Biello: When it comes to preventing the spread of COVID-19, in your view, would it be best to nix optional events? I'm thinking of parties and indoor sports. Are these things best left by the wayside as we try to get delta under control?

Dr. Lisa Adams: Again, thinking about our slices of Swiss cheese, we know that the more people congregate in crowded events, the greater the chance for there to be someone who's infected, who would spread to others. So, in accordance with CDC guidance, and certainly actually all of New Hampshire meets the substantial level of transmission criteria now, indoor masking in public spaces and at large crowded events is, I think, going to be a critical step that can be taken. And again, I know everybody's so fatigued and my view of this was, the slice of Swiss cheese that I would prefer to use would be to have everybody masked at an indoor event, but allow the indoor event to proceed maybe again, maybe keeping a little bit more limited size when possible when that's realistic, rather than canceling the event altogether.

Peter Biello: Dr. Lisa Adams is an epidemiologist at Dartmouth. Lisa, thank you very much for speaking with me.

Dr. Lisa Adams: My pleasure.

Peter Biello: And for more in-depth dialogue about COVID-19 and the upcoming school year, tune in Tuesday, August 24th for a live call-in show Community Conversation: COVID and the Classroom. That's from 7 to 8 p.m., here on an NHPR.

(This transcript has been lightly edited for clarity.)

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