In line with recommendations form the Centers for Disease Control and Prevention, students and staff who have been in contact with a positive case are required to quarantine for 14 days. In schools with hundreds of students and little flexibility for social distancing, this can mean many students can come in contact with one positive case, causing a high number of students in quarantine.
During the Oct. 12 county commission meeting, Williamson County officials said this policy, which has already caused four school closures so far this year, is sparking outcry from parents who feel the number of confirmed positive cases are not high enough to warrant high levels of quarantined students.
“All of us are getting a lot of concerned calls from parents because right now we have three high schools that have been shut down in the county, and we had one before that, so really a total of four high schools since the start of the school year have been shut down, and the primary reasons for that is because of the quarantine rules," District 4 Commissioner Gregg Lawrence said. "You end up getting a large number of quarantine cases off of those few cases."
The latest available data as of Oct. 6 shows there are students quarantining at all 49 of the district's schools; however, positive cases had only been identified at 34 campuses. This may be due in part to the shorter time required for isolation—10 days—versus the two weeks required for quarantine, school officials said.
Since the school year began, there have been approximately 300 school-related cases, according to Cathy Montgomery, Williamson County Health Department director.
Dr. Deidra Parrish, regional medical director for the Mid-Cumberland Region Department of Health—which oversees 12 counties, including Williamson—said the state has been working closely with counties to develop contact tracing practices to help limit the number of students and staff who have to quarantine; however, she said the practice is necessary to limit the spread of the virus.
"A lot of the outbreaks associated with different schools might not have necessarily started within the schools, but maybe at a party out of school and then the students come back and they’re spread within the school," Parrish said. "So it can be difficult, but remember, the goal of isolation or quarantine is to stop or at least interrupt that chain of transmission, because we don’t want those eight cases to go to 18 cases and 28 and 40 cases within a matter of days in a school."
There have also been concerns raised in recent weeks about the number of probable cases reported in the county, which are cases that have not been confirmed by a laboratory test.
While these probable cases are treated as positive cases, health officials have said probable cases only represent about 5% of cases, and the other 95% are laboratory-confirmed cases. Williamson County had a recent increase in the number of probable cases, with 17 new probable cases reported in the last 24 hours as of Oct. 12, according data from to the Tennessee Department of Health.
Parrish said the number of overall probable cases has gone down as testing practices improved since the start of the pandemic. However, as less-accurate, but faster, antigen test options gain popularity, there could be an increase in probable cases, she said.
"Because we now have a lot more access to testing especially in Williamson County, the vast majority of our cases are laboratory-confirmed cases, and with all of our positive cases we have the same approach ... investigating every case, identifying all the contacts, making sure isolation and quarantine are appropriately instituted, and providing education and support for folks during the process," she said.
Parrish said probable cases are not just guesses from health official, but rather they fit a standard definition used when identifying similar respiratory disease. This includes meeting a clinical criteria and being a recent close contact of someone who has a confirmed case.
During the meeting, District 4 Commissioner Chad Story called for the policy to change from quarantining for two weeks to quarantining until the individual gets a negative test. However, Parrish said the 14-day period is needed to allow time for an incubation period of the virus.
Quarantine requirements are mandated by the state and county health departments, not WCS, school officials have previously said. The Williamson County Health Department carries out guidelines issued by the state health department, Montgomery said.
Parrish said the state will continue to work with local districts to be as precise as possible to limit the amount of students who have to quarantine.
"The issue with this pandemic particularly is you can have no symptoms and have the infection and spread and spread it," she said. "And again, this is one of the reasons that isolation and quarantine are two of our most important tools in trying to mitigate the spread of this virus because if you wait for people to develop symptoms and get a [test], you're behind the eight ball already."