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Closing Schools Because of Illness Common In Tennessee, But Rare Elsewhere


To working parents in East Tennessee, the school closures this winter may seem relentless. Before the floods came the flu. Illness has become a common reason to cancel school in recent years. But the phenomenon is relatively new, and almost never happens in some other Southern states.


The unpredictability of these closures for illness puts stress on working families like Christi Wampler’s. As a sales rep, she doesn’t get paid if she doesn’t work. But she’d rather have her two sons home if it means the family won’t actually get sick.


“For a lot of people, taking the time off work is unpaid time. They don’t have babysitters for their kids,” she said. “It is a huge, huge burden to deal with it -- but so is being out with the flu.”


In reality, absent students and spreading germs are only part of the reason for the closures, said Knox school board member Evetty Satterfield.


“The biggest issue is not really whether the kids are coming to school -- the kids are coming whether they’re sick or not,” said Satterfield, who represents East Knoxville. “We’re having to close school because we don’t have the adult capital to supervise the kids.”


When lots of teachers are sick, there aren’t enough substitutes to cover the classes. Sometimes when this happens, classes are split up and students farmed out among other teachers. This can be chaotic, and reduces the amount of actual teaching as well as the attention each student receives.


The sub struggle


“Ultimately the decision to dismiss school revolves around how significant the educational impact will be in the classroom,” said Scott Bolton,human resources director for Knox County Schools.


He said the district has a good pool of substitutes, paying them as well or better than other nearby districts. But many will only accept jobs on certain days, or at a specific school or two.


That’s normally fine. But during outbreaks of illness, it may not be enough.


On average, Knox schools have 377 absences per day that require a substitute, Bolton said. In contrast, there were around 600 teacher absences on one of the days before Knox schools closed in January.


Recognizing the dilemma, Knox County Schools created a task force last year to look at the sub shortage, Bolton said. Its recommendations are expected soon, and will probably focus on substitute pay and ways to encourage teacher attendance.


Starting in 2015, the district began offering incentive pay to substitutes willing to work at certain schools, or on the weekdays when teachers are most often absent. (Satterfield said that’s typically Mondays and Fridays.)  Bolton said the task force is evaluating whether that approach has been effective.


Some schools cultivate a longer list of willing substitutes, partly by including them in training and teacher appreciation events, Bolton said.


“Those schools really, for lack of a better word, love on the subs -- make it a welcoming place for them to come and they feel supported,” he said. “And it really encourages them that, in a pinch, they’re going to come through for that school.”


But concrete enticements are important.


Knox County doesn’t pay benefits to substitute teachers. Greg Deal, assistant director of schools in Anderson County, said the district started hiring subs this year through a contractor that pays them benefits. He said the number of subs has increased slightly as a result. The county also increased its substitute pay two years ago.


Satterfield said she’d like to see Knox County Schools administrators research best practices and bring them to the school board.


“This should lead our HR department to look at how we’re recruiting substitute teachers, and what are some other barriers that might keep people out,” she said. “So that maybe that could be something the district could do a case study on. What is North Carolina doing to get it right, or South Carolina?”


Regional variations


The CDC offers no general guidance for schools or public health officials on when to close for flu.


School closures for illness have become fairly common in Tennessee, Kentucky and Ohio. But they are almost unheard of in the Carolinas and Georgia, and relatively rare in Alabama and Virginia. Even in East Tennessee, they were unusual until about three to five years ago. 

The difference isn’t apparently related to the number of flu cases, either. For example, at the end of January, the Centers for Disease Control identified widespread flu activity all across the South except for Florida.


During the week when many East Tennessee school districts closed, 10 percent of patients tested positive for flu at designated Tennessee clinics. That was one of the highest rates in the Southeast. However, Knoxville’s reported flu rate was less than half that -- and schools still closed for three days.


In contrast, no South Carolina public schools seem to have closed that week, even though its flu rate was almost as high as Tennessee’s. Counties where Greenville and Columbia are located had some of the most flu activity. The South Carolina education department, and officials with those school districts, said schools there rarely close unless the state health department directs it.


But slim staffing doesn’t seem to be a trigger for shutting schools in South Carolina. Libby Roof, chief communication officer for the Richland School District Two in Columbia, says it struggles with a substitute shortage just like East Tennessee. (It’s common in most places when the job market is strong, many said.) Even so, teacher vacancies don’t climb high enough to close Richland Two schools.


What’s different? School officials aren’t sure. South Carolina allows larger classes than Tennessee, which could be a factor. But other policies might also be helping its schools get teachers and substitutes into the classroom.


For example, Greenville schools provide their teachers a third more sick days than Knox County does. And four of those can be used as planned personal days if teachers don’t use them for illness.


Substitutes are paid at a higher rate than surrounding districts, and they are eligible for benefits if they work more than 30 hours a week, said the district’s communication director Beth Brotherton. Subs are offered extra training during the summer and they are eligible for the district’s employee discount program.


Brotherton said Greenville might also have fewer sick staff in the first place, because over half of the district’s 6,000 teachers received flu shots at school vaccination clinics this year.

Carly Harrington, communication director for Knox County Schools, said local school flu clinics for students are also open to teachers. But the district doesn’t track how many teachers get the shot. 


Why now?


Neither school nor health officials have a clear theory about why East Tennessee schools have closed for illness more often during recent years. Martha Buchanan, director of the Knox County Health Department, said flu prevalence hasn’t worsened.


“Levels of flu vary from year to year,” Buchanan said. “Public health recommendations haven’t really changed. I’m not sure why the threshold for closing seems to have changed.”

Deal estimated that in Anderson County, schools have been closed for illness a couple of days each year for the last decade.


Harrington could not find records about the first closures for illness in Knox County. In recent memory, it began in 2017, when students missed two days for illness. The number climbed to four the next year, then five in 2019. Harrington said Knox County usually tried to combine the days off with a weekend to remove kids from the building for as long as possible.


William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center, said there is some evidence that closing school may help a little with the spread of viruses. But he and Buchanan said the benefit is limited if students don’t avoid social interactions. Often, that’s not what happens.


“We must remember, they’re often not at home isolated in their own bedrooms even if school is closed. They get together with other kids and supervisory adults,” Schaffner said.


As a result, sanitizing classrooms while school is closed is mostly a feel-good measure, Schaffner said.


“It does not help that much in preventing the transmission of flu once kids get back into school,” he said.


According to Knox County Schools data, the days off in January didn’t have much effect on student attendance, which hovered between 91 and 92 percent both before and afterward.

On the other hand, teacher attendance climbed back up. District records indicate that before the break, only 69 percent of teacher and staff positions were filled. The second day after schools reopened, 76 percent were.


Anderson County doesn’t usually close school unless student attendance drops below around 85 percent across the district, Deal said. Bolton says Knox County doesn’t set a student attendance number as a trigger. In January, some individual schools in the northern and eastern parts of Knox County saw student attendance fall below 90 percent. Austin East High School dropped lowest, to 85 percent. In the western part of the county, many schools were barely affected.


Bolton said trends in flu cases are also part of the equation. For this, Knox Schools  consults Buchanan at the health department. For example, in late January Buchanan shared that Tennessee was seeing an uptick in very young kids going to the emergency room for flu-like illness, plus a small increase among school-age kids. She said the department can also offer perspective by comparing flu activity with previous years.


In the end, schools might need to look even more broadly at the problem, Satterfield said.


“The last three years, around this time we’ve been closed for a good majority of the month,” Satterfield said. “And if we’re looking to increase education and really make an impact we really don’t have time to close school. I don’t know if it has to do with the region, where we live, the climate, or if it really is another factor. But that really is worth investigating.”

S. Heather Duncan has been reporting on the environment, local government, business, and education for 20 years, mostly for newspapers. Her work had won dozens of state and several national awards, and she was part of the Pulitzer Prize-winning team that covered the aftermath of Hurricane Katrina for the Biloxi Sun Herald.