Hannah Watters, sophomore and whistleblower, posted a photo – which went viral – of a crowded hallway at her high school outside Atlanta, where students were largely missing masks.

As though COVID-19 were merely an urban myth.

So, with municipal school districts and private schools set to reopen here, that photo was enough to cue a few symptoms of its own – from chills along the spine to migraine headaches.

Shelby County data is the same, local school districts are not

“That’s the kind of situation we don’t want to have happen,” said Shelby County Health Department Director Alisa Haushalter.

The image Hannah captured between classes at North Paulding High School provided in-the-moment evidence of total disregard for accepted safety protocols amid the pandemic: wear a mask, maintain six feet of separation.

In an interview on CNN, Hannah said: “I was concerned for the safety of everyone in that building and everyone in the county because precautions that the CDC and guidelines that the CDC has been telling us for months now, weren’t being followed.”

Fair question: Is it reasonable to assume some version of that crowded hallway and limited mask-wearing could happen in a Memphis-area school?

And what are the chances that the return to in-class instruction is short-lived because of a combination of the local transmission rate and the difficulty in obtaining a high level of compliance on the protocols?

Whatever the answers to those questions were several days ago, Haushalter said the viral photo taken from North Paulding High has the potential to do some good: “It would be my hope that it being made public shows the need to stay vigilant and that everything you do can still go awry to a degree. You can have policies in place, but you need to have adherence.”

Back in June, the average COVID-infected person in Shelby County was spreading it to 1.2 others. A month later, however, after the health department closed bars and the county had a mask ordinance, the rate had dropped to 0.82 – the lowest mark to date.

While Shelby County Schools are opening with virtual instruction only, the six municipal suburban districts are offering both in-class education and virtual learning. Private schools are largely following the same path.

Virtual learning only for Shelby County schools until further notice

Haushalter says she believes it is good those schools are opening and she is not alone.

“My sense is schools can do this if everybody follows the polices,” said Dr. Jon McCullers, pediatrician in chief at Le Bonheur Children’s Hospital. “My sense also is not everybody will follow the policies because kids are kids.”

Even with almost total compliance, McCullers believes it is impossible for schools to reopen without registering some positive coronavirus tests.

“I see a couple of things,” he said. “Both scattered positives and clusters of cases. We might need to close some classrooms, send some people home, and learn how to deal with all that. And I’m sure we’ll get a lot of media attention at first.”

But McCullers also believes in-class learning will be ongoing.

Not easy, not guaranteed, not without possible interruptions, but sustainable.

“It’s going to be complicated,” said McCullers, who is an infectious disease expert at the University of Tennessee Health Science Center. “We’ll evolve and learn as we go, figure out what does and doesn’t work.”

Different choices

Lakeland School System Superintendent Ted Horrell has stressed that compliance cannot land only on students and parents.

“The main thing I’m emphasizing with teachers is we have to be as careful with each other as we’re asking everybody else to be,” he said. “So, six feet is six feet. We can’t break those best practices.”

Jason Manuel, superintendent of Germantown Municipal School District, knows the importance of wearing masks but also understands that absolutes are much more of an abstract idea than a practical reality.

“If I’m walking down the hallways, I should see students wearing masks,” he said. “But there will be moments when they pull them down, or they’re eating, or they’re outside to take a break.”

In the wake of Hannah Watters’ snapshot of a prolonged moment with enhanced risk of transmission, it is clear that the concept of safely returning to school will be tested.

Shelby County School Superintendent Joris Roy, in announcing in a July 27 video that the district would employ virtual learning only until further notice, said: “We have to stop the negotiation of the safety of people’s lives because we are desperate to resume normal routines in one of the most abnormal times in our history.”

Prior to that announcement, Dr. Chris Hanson, a Memphis pediatrician, was fielding a lot of calls from parents with kids in Shelby County schools and seeking advice.

The more Hanson heard, the more obvious it became that there was not a one-size-fits-all answer.

“One woman was worried about the grandmother picking the kids up after school and taking care of them for three hours. Virtual was probably the right choice,” Hanson said. “But a family where both parents work, being in school is probably the right choice.”

Evangelical Christian School is offering parents the option of their children learning virtually or in-class. As of Aug. 5, Head of School Braxton Brady said only 35 of their 750 students (or 4.7%) were enrolled in the online-only option.

But he’s glad they can give parents a choice, and after the first nine weeks, parents can change that choice in either direction.

“These are hard decisions for everybody,” Brady said.

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Virus only one factor

For Kendra Diamond, whose son Jackson will be a senior at Collierville High School, the decision for him to continue with virtual-only instruction was not that hard. And not even because from age 9 to 13, Jackson was undergoing treatment for a rare form of Leukemia (he is in remission now).

Rather, the immediate danger is that Kendra has Lupus – a chronic autoimmune disease that leaves her compromised even when not in the midst of a flare-up.

“At any point in time, I’m at risk. He is absolutely supportive,” she said of her son. “He understands because of what he went through when he was sick.”

Tiffany Maclin’s oldest son, Tanner, is going into fifth grade at Lakeland Preparatory Middle. She has two younger sons and they all will be at home for the first nine weeks as she has chosen the remote learning option.

“My decision is not based on the virus – maybe 20% -- but more on he’s going to middle school for the first time and it’s a big jump,” she said. “After the first nine weeks, I’ll reassess how Tanner is doing.”

And reassessment is the working concept for all parents.

Mandy Magness, who has an 8th-grader, Molly, and a second-grader, Brenner, is sending her kids back to school in Lakeland. Mandy, who is a paralegal, and her husband Parker, who sells medical devices, work full-time.

Having the kids back in school makes sense on a practical level, but it is more than that.

“My daughter wanted to be back in school in April,” Magness said, adding that being away from friends was difficult for Molly. “Emotionally and mentally, she needs to be in her routine.”

That said, once the doors open, no one knows what comes next.

“Three positive tests, 10, 100 … we’re all speculating,” said Paul Childers, whose daughter Olivia will be a freshman at Collierville High, while his 11-year-old son, Beau, who is non-verbal autistic, will be participating in a four-day-a-week cohort.

“We’re hoping for the best, right?”

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Signs of encouragement

The United States’ experience with COVID-19 is not the same as other countries. The Wall Street Journal noted in a recent report that every European country that reopened schools in the spring, plans to start the fall school year on time.

From Denmark to Germany, from Finland to France, the spring reopening of schools reportedly went well. Germany reopened schools in May with one-way hallways, class sizes reduced by half, masks for teachers, and COVID-19 tests were given to teachers and students twice a week. Some schools mandated masks for students in hallways and bathrooms, but not when seated at desks.

A study of about 2,000 students in the German state of Saxony, by researchers at the Technical University of Dresden, found just 12 positive cases and concluded: “The dynamics of spreading have been overestimated … (and) schools did not become hot spots after reopening.”

As encouraging as that might be, Dr. Hanson notes that the term “best practices” is always subject to change because “it is best practices with very little data.”

For example, the preliminary release several weeks ago from a study out of South Korea seemed to support the theory that the virus was less easily transmitted among children 10 and younger.

“But on the other hand, the study was looking at a population not in school,” Hanson said.

So what’s the transmission forecast as schools open across the Memphis area?

“From a public health perspective, I don’t think we’ll have to close schools,” Dr. McCullers said. “If there’s a school closure, it will come from pressure from parents. If everybody’s wearing masks and following the protocols, there shouldn’t be any big outbreaks.”

Schools are not doing random testing, but there are screenings for symptoms and touchless temperature checks. And a student who reports symptoms – or is observed to have symptoms – would be sent home and would need to see a medical provider and be cleared before returning to school.

When a school learns of even one positive test, authorities are directed to notify the Shelby County Health Department.

“At that point, it’s taken out of our hands,” said Brady, the ECS head of school.

“For us (in public health), it’s typical business,” Haushalter said. “But with schools, it has to be close monitoring and quick action. If we have cases in a school, then you address those immediately” and start the contact tracing.

And what does that look like?

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In other words, what’s the bar for temporarily closing a class, shutting down a grade, or a wing of a school?

“It’s not as black and white as people think,” Haushalter said.

Although COVID-19 is its own infection, the methodology is not that different from other diseases in terms of the public health response to it.

“If we found Legionella in a hotel room, we only close that one room,” Haushalter said. “Not the entire hotel.”

So, the contact tracing of positive COVID tests in the schools will start with individual cases, Haushalter says.

For instance, say a 3rd-grader and a 5th- grader each have a positive test. Contact tracing leads one way if the two children had no interaction, don’t even know one another.

It leads another if they are brother and sister living in the same home.

“We’re still learning quite a bit about COVID,” Haushalter said. “We talk a lot about masking in public and in schools, but now the conversation nationally is that children in multi-generation households, or households (where people have underlying health conditions), need to wear masks all the time.”

Both Haushalter and Shelby County Mayor Lee Harris have expressed encouragement that as of Thursday, Aug. 6, the seven-day positivity rate was at 15.3% because it represented a downward trend from 16.4% in mid-July.

Harris has spoken of the need for a “marathon” mentality, taking special care to protect those most vulnerable, while also striving to maintain some level of normalcy, within safe parameters, for the community and its children.

“You can’t have society or community unless kids have someplace to go that is safe other than their home,” Harris said. “You can’t have society or community without the education and welfare of kids being taken care of.”

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No two school districts are the same. No two schools within a district are the same. No two private schools are the same.

In Lakeland, Superintendent Ted Horrell says to achieve the social distancing they are moving furniture around in classrooms and also making use of the library and gym.

At ECS, they’re implementing one-way hallways, Brady says, and taking advantage of having multiple buildings to at least keep lower grades separated from one another.

“We’re doing regular cleaning and have built-in hand-washing breaks,” added Manuel, the Germantown superintendent.

Hanson believes elementary schools have a better chance to avoid outbreaks.

“They can be fairly successful because they have cohorts with 20 kids (or perhaps fewer), one teacher, one classroom,” he said. “Middle school’s a little more complicated with kids in the same classroom (for the most part), and the teachers rotating to them.

“High school is going to have a hard time; I expect contact tracing to be very difficult.”

The photo from North Paulding High School near Atlanta, with many students not wearing masks in that jammed hallway, also raised another challenge: Older students might tend toward less compliance.

Said Manuel: “We’re going to ask all students to wear masks. We’re saying it’s strongly encouraged. We’re not saying required.”

On reason, he says, is because there are logical exceptions: eating lunch, exercising in PE class, or individual cases where, for medical reasons, students need to take breaks from mask-wearing.

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If any students are willfully disobedient about wearing a mask, Manuel said, “It will be addressed on a case-by-case basis with students and families.”

Other potential complicating factors to keeping positive tests down at schools: Playing contact sports, such as football, and, believe it or not, the playing of some musical instruments.

“We’ve seen it spreads easily among teams,” McCullers said, noting outbreaks that have suspended summer workouts among college football programs, and the spread among MLB teams playing outside a bubble.

“And those students,” McCullers added, “would be taken out of class as well as off the field.

“We also shouldn’t be using horns and woodwinds. They’re super-spreaders. You’re putting out a lung-full of air, and spreading it. It’s like that camp in Georgia that had to close because they were sitting around and singing campfire songs.”

According to a CDC Morbidity and Mortality Weekly Report, the camp only required staff to wear cloth masks – not the youth attending the camp. Test results were available for 344 of the 597 attendees from Georgia. Among those, 260 (76%) were positive for COVID-19.

The report also noted that windows often were not opened for improved ventilation.

It’s all fairly remarkable given what Hanson has observed in his own pediatrics practice: Children as young as 6 have a pretty good grasp on what the coronavirus is and precautions that need to be taken. Even a 4-year-old, he says, can understand – “at least at a 4-year-old level.”

Hanson says one child, age 4, walked into an examining room, surveyed the surroundings, and then announced: “There’s no books cuz of the virus.”

Said Hanson: “They’re recognizing the change in their world.”

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We are all recognizing changes in our world. But we don’t all necessarily see things the same way.

While Rhodes College is going to be virtual-only, the University of Memphis is going with a “phased return” with classes for the first month primarily online.

Rhodes, which is private, is not having a football season. Memphis, which is public, is still pushing toward a football season. Memphis also is asking for season-ticket holders and boosters, who may be able to attend only one game because of the 12-foot social distancing guidelines in place for fans, to please consider leaving their money with the athletic department to mitigate drastic measures, including employee layoffs.

Memphis Athletic Director Laird Veatch recently described the impending financial situation as “dire.”

McCullers, citing the multiple benefits to kids being in school – physical safety, mental and emotional health, continued educational and social development – said he hopes that transmission rates will allow Shelby County School officials to feel comfortable about opening sooner, rather than later.

The numbers, however, will have to cooperate.

“Ideally, I’d like us to be at 5%,” McCullers said. “Ten percent heading in the right direction is doable. We are at 15% right now, but heading in the right direction.”

As other districts and schools reopen, Haushalter increasingly will be providing more micro-community-specific data on transmission rates: “At least every other week.”

Health and school officials understand there will be positive COVID tests. They understand there may be multiple positives within a specific class or grade. But if clusters remain somewhat contained, there is reason for optimism overall.

Which doesn’t mean that what we think know now – and the protocols that flowed from that data and knowledge – will be at the same place in October or December. Or that transmission rates will be in the same spot.

Paul Childers, who is sending his son and daughter back to Collierville classrooms, says it’s really no different than how it works with Goodman Manufacturing, where he is a regional manager.

“Our protocols are dynamic,” he said. “Change daily.”

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And as protocols change throughout the community, and for the schools, parents might reassess – and reassess again.

“This is a personal decision for a family,” Manuel said. “There is a scale of risk.”

But, too, a scale of opportunity. It’s all part of the “marathon” that Mayor Harris referenced.

We’re all still running it. Now we add the return of tens of thousands of kids to schools, and we see where it leads.

“We have to be flexible based on what the data tells us,” said Haushalter. “We can’t anticipate a perfect school year without any disruptions whatsoever.

“If we can make it through the school year (albeit with some short-term closures), I think we will have done quite well.”

Call it grading on the COVID Curve.