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CDC Details Color-Coded Risk Levels for In-Person Learning During Pandemic

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New guidance from the Centers for Disease Control and Prevention shows the risk of COVID-19 transmission within a school, using a color-coded scale to show levels of vulnerability.

Some data suggest large portions of the country fall into the highest risk categories.

To determine risk level, the scale relies on a few health-related indicators, like cases of the virus. It also includes a school's ability to carry out key mitigation strategies like use of masks, social distancing, cleaning, hand hygeine, and "respiratory etiquette," as well as working with local health officials on contact tracing to monitor transmission of the virus.

The scale's release comes well after most states and districts have started school—either remotely or in-person—and well after state and local decision makers have set priorities that have affected case levels in communities. Public health experts have said the national conversation about school reopenings has focused too narrowly on the decisions of school administrators. And they've said some states sealed their fate early in the summer when governors chose to open bars or ease stay-home orders too early, making it more risky to open schools.

The five-level CDC scale transitions from green, the lowest risk of transmission, to red, the highest risk. The tool is designed to help school administrators and local health officials make decisions about "beginning, continuing, or pausing in-person learning," the CDC said in a press release. But the scale does not mandate or recommend a specific response from schools for any of the outlined risk levels.

"The indicators reflect the mutually dependent relationship between schools and their surrounding communities," the CDC said. "The measures do not set strict cutoffs for individual schools and school systems; they should be used as guideposts for monitoring local conditions and adjusting teaching models as needed."

School administrators have long pushed for more specific and consistent federal guidance about when and how to open school buildings to students. Even as President Donald Trump pressured schools to reopen, they cited seemingly inconsistent or insufficient guidance about issues like social distancing in classrooms. 

And clarity may also be hard to come by at the state level, according to an analysis released last week by the Center on Reinventing Public Education, a research center at the University of Washington, Bothell. Assessing state reopening guidance, the organization found that 23 states plus the District of Columbia "provide no clear public health criteria to guide reopening decisions." And the states that do provide guidance on health use widely varying criteria to deem when its safe to provide in-person instruction, the report's authors found.

CDC Details COVID-19 Risk for Schools

Click on the CDC scale below for a larger version and a detailed explanation of the health criteria.

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The scale uses two primary health indicators:

  • The number of new cases of COVID-19 per 100,000 residents in a given area within the last 14 days. Some states have adopted similar metrics with slight variations. For example, Washington state says schools can open for in-person learning when daily cases fall below at 5 per 100,000 people in a county, and Connecticut sets the bar at 25 cases per 100,000 people in a county. 
  • The percentage tests for active coronavirus cases that have come back positive in the past 14 days. CDC Director Robert Redfield has previously said schools are in a "hot spot" and should adjust in-person learning plans if the case positivity rates in their area top 5 percent. The new CDC scale says areas with test positivity rates of 5 to 8 percent have "moderate risk of transmission in schools." Areas at the highest risk have positivity rates above 10 percent.

Some states have already committed to health thresholds that are far more lenient than the CDC's. In Iowa, for example, state guidance requires schools to open for in-person learning unless case positivity rates in their county exceed 15 percent. That's well above the highest risk level on the new CDC scale. The most recent state data show 26 Iowa counties have case positivity rates above 10 percent, which would put them in the most extreme risk category under the CDC criteria.

There's no publicly accessible county-by-county data source to show how many school districts nationwide fall into the highest risk levels outlined by the CDC. But early analyses suggest many do.

Ashish K. Jha, dean of the Brown University School of Public Health, tweeted his reaction to the CDC metrics Wednesday. Using the two health metrics, 56 percent of U.S. counties are at the highest risk level, he found in a preliminary analysis. Thirty-one percent of counties are in the second highest risk category, he found.

How are states handling school reopenings? View our interactive map.

Photo: Getty


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