In the United States, school reopenings have been linked to a higher risk for COVID-19 exposure among teachers, other school employees, students and their families. Now, new findings published in the journal Health Affairs suggest that between 42% to 51% of all school employees could be at greater risk of developing severe COVID-19. 

Researchers followed Centers for Disease Control and Prevention guidance to classify individuals as being at increased risk for severe COVID-19 illness if they had obesity, age greater than or equal to 65 or any of the following treated conditions: diabetes, cancer (other than non-melanoma skin cancers), emphysema or other chronic obstructive pulmonary disease, kidney disease or coronary heart disease.

Researchers used data gathered prior to the pandemic to determine how individuals most susceptible to COVID-19 were linked to elementary and secondary schools, either as employees or through living with staffers or school-age children. Among school employees, low-skill support staff were more likely (58.2%) to be at increased risk for COVID-19 than teachers and teacher’s assistants (37.8%) or administrators and other higher-skilled support staff (39.1%).

Scientists also noted that obesity and high blood pressure put school employees at greater risk for infection. In addition, among school employees, men were more likely than women to contract the coronavirus, and Black employees were at greater risk for infection than white employees.

Children, especially those who were younger, were less likely than adults to become severely ill or to transmit the virus. However, vulnerable adults exposed to children with COVID-19 faced an elevated risk of acquiring the illness. Almost 59% of school-age children lived in households with at least one adult at increased risk.

High schoolers were more likely than kids in elementary school to live with adults who were at greater risk (62.1% versus 55.7%). Additionally, Black and Hispanic children were more likely than white children to live with adults at increased risk, while Asian kids were less likely than their white peers to live in households with higher-risk adults.

When looking at how many adults, especially those at increased risk, lived in households with at least one school employee or school-age child, investigators found that between 27.5% to 29.2% of increased-risk adults (33.9 million and 44.2 million, respectively) had a direct or household connection to schools. Overall, 35.2% of all adults were so linked.

“For many school districts, decisions over whether and how to reopen will likely be revisited throughout the school year, depending on local infection rates, evolving research on the effectiveness of preventative measures used by schools and the effectiveness of local public health measures that are in place, such as the use of masks, testing, social distancing, self-quarantining and eventually vaccinations,” wrote the study authors. “Against this backdrop, evidence regarding the health risks of adults with connections to schools is one piece of the puzzle.”

For related coverage, read “As Schools Reopen Amid COVID-19, Teachers Worry About Their Mental Health.”