School administrators squeezed by Tennessee’s flip-flops on COVID

Health officials last year: quarantines ‘not optional’ for exposed kids; This year: ‘it’s your choice’

By: - August 27, 2021 5:00 am
Twins Marshall and Charlie Groves prepare for school at Nashville's Lakeland Design Center. (Photo: John Partipilo)

Twins Marshall and Charlie Groves prepare for school at Nashville’s Lakeland Design Center. (Photo: John Partipilo)

Jeff Luttrell’s voice cracked at times as he laid bare the dire situation he is facing as director of Wilson County Schools just three weeks into the academic year:

209 teachers absent. 38 bus routes down for the day. 562 active COVID cases among students and staff. Secretaries supervising classes. And 60- to 80- hour work weeks for teachers and staff who have added temperature checks, disinfecting, learning plans for sick kids and contact tracing to their primary jobs of educating children.

Then he ticked off the tools the district relied on last year to navigate the pandemic that are no longer available to him now:

Remote learning, hybrid models that allowed kids to alternate school days to ensure social distancing, mask requirements and strict protocols that allowed schools to require kids exposed to COVID to learn remotely until they cleared a quarantine period.

“Folks, I’m pleading with this community,” Luttrell said, addressing a restless group of parents, many motivated to attend the emergency school board meeting on Tuesday by their adamantly pro- or anti-mask stances.

“Your education system is stretched thin, folks. I don’t care what side you are on. Our people are stretched. They’re stressed. And they’re trying to educate our students. I’m telling you there’s going to come a day regardless of what we’re doing that I’m going to have to shut schools down.”

Luttrell is not the only school administrator feeling the squeeze between parent demands and state-imposed restrictions as COVID cases multiply across Tennessee — infecting a record number of children — in a surge that coincided with the opening of the 2021 school year.

Compounding school officials’ frustration is conflicting communications from state health officials that have changed, in some instances, from one day to the next.

“The health department tells us in multiple meetings they are strongly recommending quarantine, but at this time they are not using their legal authority to enforce that quarantine on an asymptomatic students,” Luttrell said Tuesday. Those officials told Luttrell he has no authority to enforce quarantines among students and school employees exposed to COVID.

A new law sponsored by Sen. Janice Bowling, R-Tullahoma, and Rep. John Ragan, R-Oak Ridge, was signed into law by Gov. Bill Lee on May 26. It removes previous language that empowered county health directors to “enforce such rules and regulations as may be prescribed by the commissioner essential to the control of preventable diseases…” and eliminates the authority by county health officials to “adopt rules and regulations as may be necessary or appropriate to protect the general health and safety of the citizens of the community.”

“We can only ‘strongly recommend’ asymptotic (individuals) stay home,” Luttrell said.

A day later, a Department of Health official told school directors across the state that quarantine enforcement was up to them.

“We as the state can’t enforce quarantine,” Dr. Morgan McDonald, deputy commissioner, told school leaders on the call.

“It’s your choice as school policy-makers, and if the choice is not to enforce quarantine – so, to allow those back in school who aren’t quarantined, it will increase the spread of COVID-19.”

Quarantining exposed kids and adults, however, is “necessary and expected,” she said, striking a note seemingly at odds with the statement she had just made that schools had a choice.

Previous guidance from the Department of Health, which schools followed last year, said quarantines among individuals exposed to COVID were mandatory.  The guidance, dated September 20, 2020, said:

Any student or staff who has been a close contact (within 6 feet for > 15 minutes) of a person with confirmed COVID-19 must quarantine at home for a period of at least 14 days from their last exposure to that individual.

This is not optional.

The health department threw its weight behind those guidelines, threatening sanctions against schools that failed to comply. A letter to Sumner County Schools in September 2020 said the Department of Health had learned that individuals had returned to school before the end of their quarantine period.

“The Tennessee Department of Health requires that any close contact of a COVID-19 case, who does not hold a critical infrastructure designation, quarantine at home for 14 days,” the letter from Deidra Parrish, a department regional health officer, to Sumner County Schools said.

“Failure to abide by these guidelines may result in the formal issuance of a Health Directive to individuals that do not comply,” the letter said.

Department of Health COVID guidance sent to schools last month eliminated mandatory quarantine language. It said instead: “the health department makes official decisions regarding which students or staff require isolation and quarantine.”

Tennessee Department of Health's approach is to partner with those impacted by the COVID-19 health pandemic and other highly infectious diseases, encouraging voluntary compliance with isolation and quarantine recommendations rather than enforcement.

– Sarah Tanksley, spokewoman for the Tennessee Department of Health in an email

The guidance, dated July 26, also spelled out scenarios that did and did not warrant a recommended quarantine of up to ten days, including whether masked children would be recommended to quarantine (not if the child wearing the mask is exposed to a COVID-positive student or adult also wearing a mask) and whether vaccinated individuals exposed to COVID would be recommended to quarantine (they are not).

Isolation for at least 10 days for students and staff who have tested positive for COVID-19 has remained a constant requirement since the pandemic began.

On Thursday, a spokeswoman for the Department of Health responded to questions about who had the authority to enforce school-related quarantines by saying state officials were taking a “voluntary compliance” approach.

“Tennessee Department of Health’s approach is to partner with those impacted by the COVID-19 pandemic and other highly infectious diseases, encouraging voluntary compliance with isolation and quarantine recommendations rather than enforcement,” an email from spokeswoman Sarah Tanksley said.

Tanksley did not address questions about why the state had shifted its guidance from requiring schools to enforce quarantines to a position that schools should simply encourage them.

She said the authority and responsibility to enforce quarantine rules in response to epidemics ultimately lies with public health officials.

In all but six of Tennessee’s 95 counties public health officials operate under the direct supervision of the Tennessee Department of Health. Those health officials work closely with school officials to identify COVID cases and flag exposed individuals who should be quarantined or isolated.

But a recent law change has stripped those county health departments of enforcement powers they possessed during the pandemic last year.

Signed into law by Gov. Bill Lee on May 26, the measure is best known for barring the state from imposing vaccine passports requirements on businesses or public institutions.  The law, however, also removes previous language that empowered county health directors to “enforce such rules and regulations as may be prescribed by the commissioner essential to the control of preventable diseases…”

The law also eliminates the authority by county health officials to “adopt rules and regulations as may be necessary or appropriate to protect the general health and safety of the citizens of the community.”

The law leaves intact the authority of county health officers to order the “quarantines of any place or person,” but eliminates their authority to enforce their own rules and regulations, instead requiring them to follow rules and regulations established by the Commissioner of the state Department of Health. It’s unclear how independently county health officials may act on enforcing quarantines given the state’s position that it will instead rely on “voluntary compliance.”

Dr. Leigh Howard (Photo: VUMC.org)
Dr. Leigh Howard (Photo: VUMC.org)

Quarantining is just one of many uncertain rules that schools are navigating – and only one mitigation effort — but infectious disease experts say it plays a crucial role in containing disease.

“Kids potentially exposed to COVID who go back to school without masks – you’re just asking for it,” Dr. Leigh Howard, an assistant professor of pediatric infectious disease at Vanderbilt University Medical Center. “Quarantine is really important as contagious as this virus is.”

In Wilson County, school data shows that 134 children out of 3,306 kids identified as “close contacts” of individuals with COVID have subsequently tested positive for the disease thus far.

That’s a higher proportion than it used to be, said Luttrell, who did not provide specific data from last year.

The mixed messages from the state about quarantine rules and authority have sent other school districts to flip flop on their COVID rules.

Rutherford County initially recommended that close contacts quarantine for ten days. On Monday, after 500 children and 50 staff members tested positive for COVID-19, the district announced quarantine would not longer be a recommendation. It is now required.

How is the school able to enforce quarantines?

“We are no longer ‘strongly recommending asymptomatic contacts to complete a quarantine period,” said James Evans, the district’s communications director. “While the health department is the only agency that can enforce a quarantine, we can prevent students and employees returning to school when there is a potential health issue.”

In Smith County, school officials took a more unusual approach: they surveyed parents on what quarantine policy they would like to see, including giving parents the option of returning kids potentially exposed to COVID to return to school with a mask, without a mask, or requiring them to stay home.

On Wednesday the Smith County Board of Education adopted new COVID protocols that say families will be contacted if their child was a direct contacts of a positive COVID individual and given the choice of quarantining the child at home or allowing the child to return to school with a mask for 14 days after exposure. Parents may opt out of the mask by filling out a form.

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Anita Wadhwani
Anita Wadhwani

Anita Wadhwani is a senior reporter for the Tennessee Lookout. The Tennessee AP Broadcasters and Media (TAPME) named her Journalist of the Year in 2019 as well as giving her the Malcolm Law Award for Investigative Journalism. Wadhwani is formerly an investigative reporter with The Tennessean who focused on the impact of public policies on the people and places across Tennessee. She is a graduate of Columbia University in New York and the University of California at Berkeley School of Journalism. Wadhwani lives in Nashville with her partner and two children.

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