Mere weeks ago — though it may feel like a lifetime — K-12 operations seemed to be moving toward something of a pandemic equilibrium. Studies had confirmed that COVID than the surrounding community, children as young as 5 had gained access to vaccinations and, according to the White House, of schools were open for in-person learning.

Then came the Omicron variant, sweeping over the country like a tsunami and plunging nearly all aspects of everyday life back into deep uncertainty.

In the weeks since, daily reported COVID cases in the U.S. have exploded, . More children are being with the virus than ever before. And positivity rates among school communities have reached levels that were previously unheard of: in Chicago, in Yonkers, in Detroit.

While most districts reopened as planned after the holidays, nearly closed their buildings for all or part of the first week of January, according to the data service Burbio. 

Even where classrooms did reopen, many parents chose not to return their children. In New York City, for example, nearly a third of students did not show up on the first day back from break and on Friday when parents were also dealing with a morning snowfall, attendance plummeted to

The unprecedented case numbers usher in a “new math,” in the words of Harvard University infectious disease specialist Jacob Lemieux, for understanding and navigating life as the variant circulates.

“It’s likely that Omicron COVID is going to be so ubiquitous that every child will be exposed repeatedly at school and elsewhere,” Rebecca Wurtz, professor of health policy at the University of Minnesota, told The 74.

For many parents, that may be an unnerving reality.

The questions swirl: Do vaccines work against Omicron? How much protection does my child get from a cloth mask? What about an N95? What should I do if my kid tests positive?

The risk calculus can quickly become overwhelming.

Amid the widespread anxiety, and as pandemic fatigue continues to creep, The 74 spoke directly to health experts for clarity on how to understand the virus during this latest stage — with many of their takeaways offering reassurance.

Experts also weighed in on hot topics like what masks to wear in school, how to handle positive cases and the recent, controversial move from the Centers for Disease Control and Prevention to cut its recommended quarantine time for infected individuals from 10 to five days.

Here’s what they had to say:

1 Are schools safe for children right now?

Yes, under the right circumstances, doctors agreed.

“I think for school districts that have a high vaccination rate, I think for school districts that have mandated indoor masking and I think for school districts that have appropriate ventilation and distancing … they’re going to be OK,” Philip Chan, medical director for the Rhode Island Department of Health, told The 74.

Numerous academic studies underscore that when schools employ multiple mitigation strategies together — like masks, distancing and ventilation — transmission of the virus happens less frequently in classrooms than in the surrounding community.

“Teachers and students are far more likely to be infected at social gatherings, restaurants, etc. than at school,” George Washington University Professor of Public Health Leana Wen wrote on .

Even as thousands of schools across the country announced closures in the early days of the new year, President Biden implored K-12 leaders to continue in-person learning.

“The president couldn’t be clearer: Schools in this country should remain open,” said White House advisor Jeff Zients during a Jan. 5 press briefing.

But school leaders are running into a roadblock: not enough staff due to high shares of K-12 workers testing positive for the virus. Where COVID spread is especially rampant, it may be the right call to take a brief pause on in-person learning, said Kristina Deeter, a physician at Renown Children’s Hospital in Reno, Nevada. Teachers, she added, should not be coming into school if they’re sick.

In Chan’s Rhode Island, the majority of schools are open, though a handful had to close due to positive cases. The father of a 10-year old and a 14-year old, Chan said he felt confident sending his children back to their public school classrooms after the winter break. Both are fully vaccinated and wear surgical masks inside the building.

“I’m reassured that they’re protected, even against the Omicron variant,” he said.

2 Do vaccines work against Omicron?

The unanimous response from health professionals came in the form of a three-letter word: Y-E-S!

(Doctors, often technical and somewhat restrained in their email responses, answered this question using more exclamation than any other.)

Omicron has caused more breakthrough infections than other strains, they acknowledged, but emphasized that the immunizations have overwhelmingly succeeded at their key functions.

“The vaccines are still doing what they are intended to do: preventing severe infection and death,” said Peyton Thompson, assistant professor of pediatrics at the University of North Carolina-Chapel Hill. 

“Deaths are declining despite the rapid rise in cases, thanks to vaccination,” she added.

And while it remains possible to catch the virus if you have received two, or even three shots, each dose of the vaccine provides an added layer of protection. Such cases tend to be mild, explained Wurtz.

“Breakthrough infections are almost always asymptomatic or trivial. Occasionally flu-like. So, yes, we can count on our vaccinations to keep us from getting really sick,” the Minnesota professor wrote in an email to The 74.

Children under the age of 5 are not yet eligible for shots, and are not expected to gain access until this spring at the earliest, Pfizer on Wednesday.

In the meantime, “the best way to protect kids under 5 is to vaccinate all of the people around them – their older siblings, other family members, day care providers [and] teachers,” said Wurtz.

3 Boosters for kids — yay or nay?

The Food and Drug Administration on Monday and, on Tuesday, the CDC recommended an extra shot for as young as 5, five months after the initial two-dose series.

Deeter recommends that those who are now eligible receive their third doses.

“Many of our vaccines are actually three-shot series,” she told The 74, citing the Hepatitis B immunizations, for example. 

“My message to teenagers is this: you got your first shot, you got your second shot, you’ve got to finish the series.”

4 Why are so many children being hospitalized with COVID?

The answer, doctors say, boils down to two factors: vaccination rates and community spread.

Nationwide, pediatric COVID and are at a pandemic high, the latter surging 66 percent in the last full week of December to an average of 378 daily admissions.

But at the same time, vaccination rates among young people remain much lower than adults. Less than a quarter of children ages 5 to 11 have received a single dose of the COVID vaccine, and just over half of adolescents ages 12 to 17 have been fully immunized, according to data published by the . By comparison, of U.S. adults have received both shots.

The overwhelming majority of hospitalized pediatric COVID patients are unvaccinated, . “This is tragic, as the vaccine could have kept these children out of the hospital,” said UNC-Chapel Hill’s Thompson. 

And regardless of vaccination status, the ballooning pediatric hospitalization levels do not mean that the Omicron strain is more severe to kids than previous variants.

“​​In large part, this is a numbers game,” said Kanecia Zimmerman, a study lead on Duke University’s , which guides school leaders on how to navigate COVID policy. 

Even though surging caseloads nationwide have meant that more children have tested positive for the virus in recent weeks, “the proportion of hospitalized children remains small among the number of infected children,” the pediatrician explained.

5 What kind of masks are “good enough?”

The extreme transmissibility of the Omicron variant has spurred , some in red states, to reinstate mandatory masking rules — and has also reignited debates over which face coverings are most effective at protecting against infection.

There’s no doubt that the N95 and KN95 models do a better job of filtering out viral particles from the air, doctors agreed. They have a layer of polypropylene, a type of plastic, that can . Compared to a cloth mask, they can extend the time it takes to transmit an infectious dose of COVID by over seven times. If both the infected and exposed individuals are wearing N95s or KN95s, compared to both wearing cloth masks, transmission can take up to 50 times longer.

That said, Chan admits that the N95 and KN95 masks can be uncomfortable, and some may find it harder to breathe while wearing them.

“With my kids, I send them to school with surgical masks,” he said, noting that he himself will slip on an N95 before walking into crammed indoor spaces like the grocery store. 

But whether you opt for a simple surgical mask, or something beefier, here’s his bottom line: “The cloth masks just aren’t quite as good as other types of masks,” said the Rhode Island doctor.

6 How should my child’s school be testing students and staff for the virus?

In December, the CDC endorsed “test-to-stay” guidance that allows students and teachers who may have been exposed to the virus to take rapid tests and return to the classroom if their results are negative.

It’s a helpful approach, Duke’s Zimmerman believes. Through the Delta variant wave, 98 percent of people who were exposed to the virus were never ultimately infected, she said — meaning that without test-to-stay, the vast majority of quarantines are forced to miss class without ever having gotten sick.

But testing can be costly and a heavy logistical lift. Furthermore, COVID tests are in nationwide. To cut down on the total number of noses to swab, schools in her state of North Carolina target resources to lunchtime exposures, where children drop their masks, she explained, eliminating the possibility of quarantine among less-likely cases where both students are masked.

Also important, according to Zimmerman: testing location. If students need to travel to an off-site area to receive their tests, it can exclude youth without access to transportation from participating in the program, forcing them to miss class for quarantine and creating further setbacks for the students already most affected by the pandemic. 

“Offering testing at individual schools (not centralized locations) is critical for [the] success of this program because it is more likely to provide equal opportunity to all eligible staff and students within the district,” said the Duke pediatrician.

7 How should I navigate quarantine if my child or I test positive?

In late December the CDC reduced its quarantine guidelines for those who test positive for the virus from 10 days to five, a move that divided many in the medical community.

The takeaway, according to the doctors we spoke to? “Yes, returning to school or work five days after a known infection when someone is no longer symptomatic is fine,” said Wurtz.

Emphasis, they noted, is on no longer being symptomatic. Many individuals will continue having symptoms well beyond the five-day quarantine recommendation. If that’s the case for you or your child, you should continue to isolate until symptoms subside, or test results come back negative, as you may continue to be infectious, doctors said.

“Come back symptom-free,” said Deeter.

8 How long will the Omicron surge last?

A bit of good news here. 

Though epidemiologists don’t know for sure how long the Omicron surge will last in the U.S., cases have in South Africa, where the variant was first identified in late November. Some believe the peak in many American communities will arrive of January.

“In most countries that saw Omicron, it went up sharply, which is happening now in the U.S., and it came down sharply,” said Chan. “There should be a steep decrease in the near future for us.”

”I don’t think we should be considering remote options,” Cardona said Tuesday in an interview with The 74. “Our students deserve more, not less, and our parents have done enough to help balance school closures the first year of the pandemic.”

The secretary’s comments, however, come amid a sharp increase in schools already shifting to remote learning, either because of or . According to , which tracks schools’ response to the pandemic, there are 646 school closures this week, up from 356 last week. Following the holiday break, 421 closures are expected, but that’s still less than a fifth of the number of closures in August, when the Delta variant postponed the return of many students to in-person learning. 

Cardona’s comments amplified those made by the president in an afternoon news conference Tuesday.

“Today, we don’t have to shut down schools because of a case of COVID-19,” Biden said. He urged parents to vaccinate their children and said the best way to protect those under 5, not yet eligible for vaccines, is to ensure their family members and caregivers are fully vaccinated and have had a booster. “The science is clear and overwhelming,” he said. “We know how to keep our kids safe.”

The president announced several steps to increase COVID testing availability and expand capacity at hospitals. The administration will deliver 500,000 at-home tests to those who want them, starting in January, open more pop-up vaccination clinics, and make emergency response teams available to hospitals.

On Friday — the last day before the holiday break for many schools — the Centers for Disease Control and Prevention released two studies showing that test-to-stay procedures can prevent lost instructional days due to quarantine. Cardona said he didn’t have a hand in pushing for the announcement before the break, but that, “our teams talk regularly.”

“I was glad they were able to communicate it early enough,” he said. “As we’re thinking about 2022, we can use test-to-stay, as we’re thinking about how to utilize the [American Rescue Plan] funds, we can use test-to-stay to limit quarantine and keep our children in school.”

The secretary added that there’s room for improvement in providing up-to-date numbers on school closures. The National Center for Education Statistics produces data on the percentages of students attending school in-person or remotely, but are released monthly, compared to Burbio’s weekly update, and in the past, have frequently been months behind. The latest data, released last week, reflects in-person and remote learning as of Dec. 3.

“We’re going to continue to refine those systems, especially if there’s an increase in spread,” he said.

According to the Center on Reinventing Public Education, which has tracked school closings and openings since the beginning of the pandemic, only eight states have provided schools with detailed guidance this school year on when they should consider closing. 

Cardona said it’s important to not only know what percentage of students are in school, but “what’s causing potential, short-term remote learning options or what they need in order to keep their schools open.”

Under the protocol — which many states and districts have had in place for months — unvaccinated students who are exposed to COVID-19 can remain in school if all students wear masks, don’t display any symptoms and test twice a week. 

Data suggests “that a school-based [test-to-stay] strategy in a large and diverse county did not increase school transmission risk and might greatly reduce loss of in-person school days,” according to an evaluation of a program in Los Angeles County, one of two studies released with the CDC’s statement. “Thus, schools might consider [test-to-stay] as an option for keeping quarantined students in school to continue in-person learning.”

With schools breaking for the holidays and rising concerns about the spread of the Omicron variant, observers said the announcement — now part of the CDC’s for schools — comes just in time. John Bailey, a senior fellow at the American Enterprise Institute who publishes a daily newsletter on COVID-related research, called it “welcomed news” that helps schools prepare for the potential Omicron wave in January. But the agency also urged all eligible students to be vaccinated and get a booster shot, and said schools shouldn’t abandon other safety procedures, including social distancing, improving ventilation and handwashing. 

“It’s encouraging that test-to-stay strategies are proving effective both in limiting transmission of the virus and in ensuring that students can remain learning in school, so that entire classrooms or schools do not have to shut down when a case of COVID-19 is discovered in the school community,” Education Secretary Miguel Cardona said in a statement.

It’s unclear, however, how many students those shutdowns have affected. Bailey faulted the Department of Education for not issuing weekly reports on how many students are in quarantine and whether they’re receiving instruction.

“We should not be relying on third parties for that data,” he said. “An agency that is using civil rights authorities to enforce mask mandates should be curious about the civil rights of kids who are not being served in the midst of quarantines.”

The CDC’s two studies show that test-to-stay is significantly minimizing disruptions in learning.

Thirty-nine of Los Angeles County’s 78 school districts implemented test-to-stay. In those that didn’t follow the model, 4,322 students tested positive between Sept. 20 and the end of October, compared to 812 students in the districts that implemented the program.

In Lake County, Illinois, 90 schools implemented test-to-stay between early August and Oct. 29. Just 16 students out of a total 65,384 tested positive. The authors wrote that assuming students would have missed eight school days during a 10-day quarantine, the program “preserved up to 8,152 in-person learning days” for students that were exposed.

Leah Perkinson, a manager at the Rockefeller Foundation, which has worked with districts to implement testing, called this “one of the happiest days for me throughout this whole entire pandemic” and said the announcement will likely prompt more districts to adopt the strategy. “Some people are only willing to move forward when the CDC releases guidance.”

The data, she added, could also inspire other settings, such as child care centers and camps, to see if they can implement test-to-stay.

One challenge, however, is that some rapid COVID tests are not picking up Omicron, according to , director of the National Institute of Allergies and Infectious Disease. 

The two studies also noted complications that limit districts’ ability to implement the model, such as staffing shortages, the need for “robust contact identification and tracing” and a lack of support from parents. 

“Some schools reported a shortage of testing supplies, requiring [test-to-stay] participants to access off-site testing, which might have presented a barrier in low-resource school settings,” according to the second evaluation on Lake County, Illinois. “State and local public health and education agencies should strive to ensure that schools in low-resource areas have equitable access to staffing and testing supplies to implement [test-to-stay].”

In December and January, his 8,900-student district just north of Atlanta partnered with the Centers for Disease Control and Prevention to study classroom virus transmission, ultimately adjusting their distancing protocols to reduce spread. In September, after reading an written by a Harvard University professor that proposed using rapid antigen tests to give healthy kids an alternative to quarantine, he reached out directly to the author asking about the model — and ultimately implemented the “” scheme in his schools. Now, the district is planning to hold for students this month as COVID shots roll out for younger kids.

But despite a keen eye for the latest coronavirus safety research, Rivera made another move in mid-October that many parents had clamored for, but health experts cautioned against: He lifted Marietta’s mask requirement.

“​​We tried to get to a solution that we think is good for our community,” the superintendent told The 74. “Could I give kids a bit more sense of normalcy back that they haven’t had for two years? I think that’s a question we’re grappling with.” 

The move typifies a trend emerging nationwide, as school leaders respond to .

At least a dozen districts that previously required face coverings are now mask-optional, including ; and . Of the 200 largest U.S. school systems, 135 now have mask mandates — down from 150 on Oct. 1 and lower than at any point this school year since mid-August, according to , a data service that has tracked school policy through the pandemic.

That pattern worries Benjamin Linas, professor of medicine at Boston University.

Over the summer, the health expert used simulation modeling technology to predict how many positive COVID cases would be transmitted in schools, depending on their vaccination rates and mitigation measures. The that he and his team published in August recommended that schools drop universal face-covering rules only once 80 percent of students and staff are fully immunized and community transmission is below 10 cases per 100,000 people. 

Currently, the U.S. averages . And while as many as , of eligible youth have received both shots.

Vaccines for children ages 5 to 11 are expected to roll out in days and as many as with children in the age group plan to have their kids immunized, according to surveys, but a significant share before doing so, they say. About a quarter said they definitely would not vaccinate their children.

With vaccination rates as they currently stand, school buildings are largely full of people unprotected against the virus, Linas pointed out.

“That is a setup for trouble in the future, having ongoing smoldering transmission because people are under vaccinated and we’re not wearing masks,” he told The 74. “The virus continues, new variants emerge — those threats are real.”

Other experts, including Joseph Allen, the Harvard public health professor that Rivera corresponded with about Marietta’s test-and-stay approach, argue that schools should take a more dynamic approach to masking requirements, dropping them when transmission falls. Given the current situation, he advocates for the end of all school face-covering requirements by January, if not sooner.

“If things change for the worse — and they might — then we just pull the masks back out of the drawer. But we must be just as willing to put them away when things look better,” Allen wrote in an October .

At the state level, Massachusetts has set a benchmark that aligns with the Linas’s recommendation, for any school that reaches 80 percent student and staff vaccination. But new guidance in allows schools to scrap face coverings where community transmission is low and gives districts the option to do the same if they maintain stringent quarantine rules. Neither policy accounts for immunization levels in the school community.

Georgia, similarly, is a state that gives local school leaders the power to set their own coronavirus safety policies. In Marietta, the district’s program for testing students and staff who may have been exposed to the virus played into the calculus for Rivera’s decision to go mask-optional.

“There’s an interplay between these approaches,” the superintendent said. “Your approach to masks will impact the distance at which you are identifying close contacts — three feet vs. six feet, indoors. The number of students who are identified as close contacts, that drives your test-and-stay demand.” 

Because 98 percent of would-be quarantines in his district never ultimately tested positive, Rivera hoped the testing policy, which the district has funded partially through relief dollars, would keep students learning in the classroom, regardless of whether they were wearing masks. 

Out of 281 tests so far administered by the program, 271 have come back negative, the superintendent said — meaning those students have been able to stay in the school building.

The “test-to-stay” strategy has been this fall and is lauded by public health experts. The CDC said in mid-October that they are considering into their school coronavirus guidance.

Regarding masking, the CDC recommends universal use, but in practice, the policies have been much more controversial, with eruptions over the mandates in dozens of districts. 

“I felt like I’ve had to navigate this path by myself,” said Rivera. “I feel like most people sit on either side of it. Either it’s, ‘Nope, we have to follow blindly what the CDC says,’ or we pretend that COVID doesn’t exist. And I don’t think either one of those is right, there’s a balance in the middle.”

The softened masking rules have had some real benefits, according to teachers in the district. Foreign language classes, for instance, were strained when everyone had to cover up.

“It is really tough when kids are learning a new language for the first time to pronounce new sounds, not seeing how to form their mouth, or [seeing] my mouth because I’m covered up in a mask,” Wendy Locke, a French teacher at Marietta High School, told The 74.

Barbie Esquijarosa, who teaches English to non-native speakers at the high school, agrees that face coverings make school more difficult for young people learning English. But she also worries that the mask-optional policy presents an added stressor for the students she teaches, many of whom may live with older relatives and lack health insurance.

“They come in concerned,” said Esquijarosa. “They’re wearing [the mask] the whole time. They’ll stay away from the kids who don’t wear the masks.”

What’s more, many of her students lack transportation, meaning they aren’t able to participate in Marietta’s test-and-stay program if they have possible COVID exposures.

Rivera recognizes that the program is accessible only to students with transportation and is working to designate a bus to pick up kids for COVID testing. But as of yet, no such route is in operation. Like many other districts across the country, Marietta’s bus driver reserves are amid wider facing schools and the U.S. economy.

Elsewhere, some school districts have taken an opposite stance on masking. When the department of health in Douglas County, Colorado moved to remove face-covering mandates, the school district sued on behalf of nine medically vulnerable students — winning a on the new rule.

“No parent should be forced to choose between sending their child to school and risking their child’s health, and no family should have to fear that their child may face life-threatening illness just to access their right to a great education,” Superintendent Corey Wise said in a statement.

Back in Marietta, there has been no increase in coronavirus infections since Rivera dropped universal masking rules. Total infections have fallen from 233 in the first five weeks of schools to 143 in the seven weeks that followed, according to the district.

Still, Linas, the Boston University medical expert, cautions against the mask-optional policy. 

Breathing room now for students and staff may mean breathing room for the virus — to mutate and evolve — in the long run, he said.

“It just doesn’t make sense to start rolling those dice when we’re so close to the actual finish line.”