Hawaii Department of Health links COVID outbreaks to high school graduations

The state Department of Health on Friday issued a COVID-19 cluster special report on recent outbreaks linked to school events — specifically, a high school prom that resulted in both coronavirus and influenza infections.

While the DOH stopped publishing bi-weekly cluster reports in early January, it now publishes reports when special circumstances warrant it.

“As case numbers rise, the state has seen an increase in clusters related to large school events,” health officials said in the report.

Since April 1, the DOH said the state has been investigating 27 clusters related to schools and school-sanctioned events across the state. A third of these are related to high school degrees.

In April, an Oahu high school contacted the health department for assistance after 37 students attending their senior prom reported suffering from common respiratory symptoms. Upon investigation, health officials found that the students were infected with both COVID-19 and influenza. The DOH did not identify the school.

More than 300 people, including students and escorts, had attended the prom, where mask use and social distancing were reportedly not practiced. More than half, or about 57%, of the prom attendees had received a first batch of COVID-19 vaccines.

Most students with symptoms had either taken home a COVID-19 test kit or gone to a lab to get tested.

The DOH was able to confirm that six tested positive for COVID-19 and four positive for influenza A, while one tested positive for both. Due to limited testing, state health officials said the number of infections was likely higher than reported.

Noting that influenza activity has increased statewide and that co-infections can occur, the DOH recommended that those attending large school gatherings such as proms stay up to date on their COVID-19 and flu vaccinations and do not participate if you feel ill or show symptoms.

Some ways to prevent an outbreak are to test for COVID-19 beforehand, maintain indoor masking and social distancing, and ensure the gathering space is well ventilated. Masking when returning to school after the event will also help prevent later spread, DOH said.

In a separate cluster case, health officials were investigating an April outbreak related to another high school prom on Oahu.

They were 16 COVID-19 cases related to a prom with 600 attendees, including students and escorts. Indoor use of masks was required except during meals.

Ten people tested positive for the coronavirus, while another three showed symptoms and have been epidemiologically linked to the outbreak. In addition, three secondary cases were identified among household contacts.

The DOH said both schools required that prom attendees be vaccinated with the basic line of COVID-19 vaccines or submit a negative test, which was taken within 48 hours of the event. But both proms were held indoors, which may contribute to a higher risk of COVID-19 transmission.

Many of Hawaii‘s public schools are implementing their own COVID-19 health and safety rules for events as the school year comes to a close. Kaiser High School, for example, required its prom attendees not only to wear masks, but also to follow the no physical contact dancing rule. But the rules can vary greatly from school to school.

The Prom clusters emerged as infection rates on the islands began to increase and accelerate again, driven by the presence of more contagious omicron variants such as BA.2, BA.2.12, and BA.2.12.1.

On Wednesday, the DOH reported 4,249 new COVID-19 infections in the previous week, bringing the total since the pandemic began to 252,654 cases.

The state’s seven-day average of new cases was reported as 485 — its sixth straight weekly increase. The state’s average positivity rate, meanwhile, rose to 11.5% — the seventh weekly increase.

The state Department of Education said in a statement that public schools remain the top priority for student health and safety.

“There are a variety of factors that go into safely planning large events such as graduations and proms,” DOE said in an emailed statement. “The Department’s guidance on safety protocols for such events has been developed to offer schools flexibility while we continue to monitor COVID-19 conditions. While we want to ensure our students continue to celebrate these special occasions they deserve, it is a collaborative effort to make sure it happens safely.”

The department has received 750,000 home testing kits and distributed more than 400,000 to schools during this season of special events.

Despite some protests, DOE intends to maintain indoor mask requirements for all students and staff through the end of the school year.

While proms made up a third of April’s cluster, certain classrooms also made up a third of the total. Early childhood education and athletics accounted for 11% each, and much of the rest related to other large gatherings.

There were some common factors in eight classrooms, including the optional mask requirement, the proximity of students to one another and the presence of sick people at school.

“Classrooms are at low risk of COVID-19 transmission when the school implements multiple mitigation measures — vaccination, staying home when sick, proper and consistent use of masks indoors, social distancing, and increased ventilation,” DOH said . “In the classroom, students are encouraged to maintain a physical distance of at least three feet between students and when closer together, masks are an effective tool to reduce the spread of COVID-19 in the classroom.”