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Norfolk Academy’s data from the 2020-21 school year is the basis for a new study showing that students can be transported on near-capacity buses without spreading Covid-19. 

The study, published in the July issue of the Journal of School Health, “demonstrates a model for the safe operation of school buses” this fall, through employing low-cost mitigation efforts, such as universal masking and keeping windows partly open to improve ventilation, according to its conclusion. Norfolk Academy had 39 Covid cases on the buses — 37 students, a driver, and an adult aide — and the school’s testing regimen demonstrated that there was no person-to-person spread, even though the students sat in every row, two students to a seat. 

“In this study of 15 buses involving 462 student passengers, no cases of COVID-19 were linked to transmission during transit,” the study concludes. 

In the past week, the study has been the subject of numerous articles and it has been shared on Twitter by scientists and doctors. “I am actually surprised at the amount of interest,” said Dr. Dana Ramirez, a pediatrician at Children’s Hospital of The King’s Daughters and the lead author on the study. “It has been quoted in national publications, scientific websites, and translated into other languages.”   

Ramirez said that she, and her co-authors noticed a paucity of information about transmission on buses, even as more data emerged about transmission in schools, so she asked if the school would share its data. The school had not envisioned being the subject of research, but administrators shared data as the year progressed and answered numerous questions, she said. 

Bus transportation is a critical component to getting students back into school this fall. Many school districts simply don’t have enough buses or drivers to transport students if buses cannot operate at full capacity, she said. “Pediatricians have seen the detrimental effects on children of being out of school, from poor nutrition to depression. Anything that can be done to keep children in school needs to be the priority.” The work done at Norfolk Academy may be able to help guide other schools as students return to face-to-face learning. 

Norfolk Academy’s busing approach required careful planning. Students sat in assigned seats with siblings sitting together; the rows just 2.5 feet apart, and on some buses, every seat was occupied. On several routes, an adult aide, seated at the back, provided additional supervision. 

Everyone on the buses wore masks, including the bus drivers, who were not separated from passengers by a plexiglass shield. In addition, buses were required to provide a one inch opening in the middle two windows and the two windows in the last row regardless of inclement weather. Additional windows could be opened at the driver’s discretion, but this was not tracked. The study provides a diagram of the bus layout. 

Students were on the buses from 36 minutes to longer periods of time.  

The school conducted surveillance testing throughout the year; all students and staff were tested every two weeks using saliva-based testing. Those who tested positive had a PCR nasal swab test to confirm the positive result. Students had assigned seating in classrooms as well, so school nurses were able to conduct contact tracing and rapidly quarantine those in close contact with positive cases. The school’s results were regularly reported to families and employees. 

The frequent testing allowed the school to know conclusively that even though students and adults were on the buses during their infectious periods, no transmission occurred.  

The study was conducted prior to the spread of the delta variant, which is believed to be much more contagious than the original alpha strain of Covid-19, Ramirez noted. Still, she said, “while we have many questions about the delta variant, we know that masking and ventilation work for prevention of spread of respiratory diseases, and we are hopeful these same mitigation strategies will help prevent the transmission of the delta variant.” 

Ramirez serves on the Virginia Chapter of the American Academy of Pediatrics School Re-Opening Task Force. Her co-authors on the study include Dr. Leah Rowland, a CHKD pediatrician who chairs that statewide task force, and Dr. Martin D. Klinkhammer, an assistant professor of emergency medicine at Eastern Virginia Medical School. 

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