Dr Ashish K. Jha’s brilliant comment on the new, helpful metric published by the CDC on when to reopen schools in the United States, based on the level of COVID-19 circulating within communities.


First published in September 2020.


The U.S. Centers for Disease Control and Prevention (CDC) is out with metrics to guide school reopenings. I like it. It sets out risk levels based on key metrics using a color scheme.

But if you apply their metrics, the news isn’t good. Most of the United States is in red or orange.

CDC indicators and thresholds for risk of introduction and transmission of COVID-19 in schools. | CDC

There are three key criteria:

  1. Number of cases in community;
  2. Percentage of test positives;
  3. Number of mitigation strategies you can do.

Cases in the community range from <5 per 100k/14 days as dark green to >200 as red.

Percentage of test positives from <3% as dark green to >10% as red.

CDC indicators and thresholds for risk of introduction and transmission of COVID-19 in schools. | CDC

So, how do communities across America fare?

We applied these two criteria to the 50 states plus DC. What did we find?

  • 20 states in red “highest risk”
  • 28 states in orange “higher risk”
  • 2 in yellow “moderate risk”
  • 1 light green “low risk”
  • 0 dark green “lowest risk”

Ah, you say, states are too big! How about counties?


So, what about counties?

  • 56% counties are highest (red)
  • 31% are higher (orange)

But counties vary in population.


What about where people live?

  • 40% of people live in counties that are red (highest risk)
  • 48% of people live in counties that are orange (higher risk)
  • Only 11% live in the yellow counties (moderate risk)
  • 1% live in the light green counties (lower risk)

Theses are super sobering numbers.

It will be very hard to re-open schools in many places across the United States.

What does this mean?

First, it is awesome to see the CDC putting out this risk criteria.

It is a bit agressive in its threshold (I might have made orange a bit higher) but it is still quite good. It is not meant to be prescriptive – saying red counties cannot open. But it does mean it will be very hard to re-open schools in many places across the nation.

My take is that counties that are orange – but close to yellow – can open if they have the mitigation strategies. But red counties will struggle no matter what they do.

Finally, it is a reminder that we had all spring and summer to get our schools ready. And we largely didn’t.

And the new CDC criteria is laying out how much of America hasn’t done the job to open schools safely. And by that failure, we are letting our kids down.🔷



Dr Ashish K. Jha, Physician, health policy researcher. Dean of the School of Public Health, Professor of Health Services, Policy and Practice, Brown University, Rhode Island.





[This piece was first published as a Twitter thread and turned into the above article on 16 September 2020 with the purpose of reaching a larger audience. It has been minorly edited and corrected, and published with the author’s consent. | The author of the tweets writes in a personal capacity.]

(Cover: Pixabay.)

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