When students went back to school in Maryland, major COVID-19 outbreaks didn’t follow. Here’s where things stand.

Six weeks after students returned to school, Maryland’s pediatric COVID infection rates cases have gone up — but not to the same level seen in Southern states that saw rampant infections and quarantines that shut down schools.

In Maryland, the kinds of serious outbreaks that legislators pointed to in other states before school started appear to have been largely avoided. Officials credit a statewide mandatory masking mandate that took effect in early September, as well as being diligent about testing, social distancing and other safety measures.

Statewide, pediatric cases have increased, and experts say the return of students may have been one of just several factors that drove that rise. But the difficult start in some districts — like the closing of a school in Carroll County and the thousands of students who have been quarantined — has given way in many cases to a more stable school year.

Statistics from the Maryland Department of Health show that the increase in cases among children mirrors the statewide spike seen in the general population as the delta variant took hold at the end of July. Since Aug. 15, COVID-19 metrics for ages 0-9 and 10-19 “do not show any significant spikes,” said Andrew Owen, a health department spokesman. The state has reported 98,000 cases of COVID-19 and 11 confirmed deaths in children from birth to age 19 during the pandemic.

Pediatric cases have risen by 10% in Baltimore since August and now represent a larger percentage of the overall cases, Baltimore Health Commissioner Letitia Dzirasa notes. She believes a variety of factors have contributed to that rise, including a significant increase in testing of children in the city.

Baltimore City is the only school system in the region using weekly testing of unvaccinated students and staff through an expensive, but effective, program that has turned up dozens of asymptomatic cases. Dzirasa called the school’s testing program “cutting edge.”

In addition, Dzirasa said some of the increase could be related to parents getting vaccinated and letting their guard down in terms of other precautions. And, she said, there’s been an increase in normal childhood diseases and infections that worry parents and send them rushing for a COVID-19 test.

“Perhaps being back in schools is one of the many factors” for the increase in pediatric cases, she said, but narrowing the cause to just one factor is difficult. Pediatric cases have risen from 20% of total COVID cases in the city to 30%, a figure she said is representative of most of the state.

While the overall rates may not have soared, localized outbreaks have occurred in some rural counties in Southern Maryland, on the Eastern Shore and in Western Maryland, areas that have higher case rates in their communities as a whole.

In St. Mary’s County, for instance, Margaret Brent Middle School reported 83 cases of spread within the school last week to the state. And three other schools in that county had 39 cases or more. The state does not ask school systems to report single cases of COVID, but rather cases where it is likely the virus spread from one person in the school building to another.

Several schools in Allegany County also saw more than 20 cases of spread.

Gigi Gronvall, a senior scholar at the Johns Hopkins Center for Health Security, said some school systems, like Baltimore City’s, are doing better than others in terms of taking measured precautions necessary to keep kids from getting sick.

“These protections work. Yes, kids tend to do much better than adults if they get COVID, but it is considerably more serious than the flu, even for kids. And we do not know what effect COVID will have on kids in 20, 30, 40 or more years,” Gronvall said.

In the Baltimore region, only Anne Arundel reported significant cases of spread in the public schools last week. For instance, Chesapeake middle and high schools together had 55 cases of spread within the school, and Northeast middle and high schools had nearly 50 cases of spread within those schools.

“What we are seeing in schools is what we are seeing in communities,” said county school spokesman Bob Mosier.

The Anne Arundel County school system will start weekly COVID testing for unvaccinated staff and students, similar to a program being run in Baltimore City. Mosier said the program will begin after the county finalizes a contract with a company to do the testing, which is expected soon.

So far the Anne Arundel outbreaks, Mosier said, have not been severe enough to warrant shutting down a whole school, but there are more than a thousand students in the county now being quarantined at home.

“I think that surveillance testing is critical to removing an infectious source,” said Dzirasa, the city health commissioner. “But with all things there has to be a layered strategy,” she said, adding that schools must enforce mask-wearing and encourage social distancing and hand-washing.

Baltimore City had only two schools with active cases of spread last week, and they both affected fewer than 15 students, according to state data.

Private schools in the city, however, have reported significant outbreaks. Friends School in Roland Park has 40 cases of spread. The majority of those cases were tied to an outbreak in unvaccinated elementary school students, a Friends spokesman, Theo George, said in a statement. Friends now tests students and staff weekly to uncover asymptomatic cases.

“As a result of this outbreak, the school has further reduced the pod sizes of lower school classrooms and in recent weeks, has seen an enormous reduction in case numbers,” George said.

Baltimore County reported no spread in a public school, although Talmudical Academy in Pikesville and St. Ursula School in Parkville had significant outbreaks.

In a number of school districts, including Anne Arundel and the city, school systems are coordinating with their local health departments to ramp up vaccination clinics — sometimes in schools — to get elementary students vaccinated as quickly as possible once the vaccine is approved for their age group.

Dzirasa is also encouraging parents and teenagers to be vaccinated, saying it is the best way to protect young children.

School officials said they are beginning to see a decrease in the number of cases overall in their schools as the year goes on. City school CEO Sonja Santelises, in her remarks at a recent school board meeting, said the numbers of cases in schools are beginning to come down, after peaking two weeks after school began. City school officials believe their weekly testing is now working to reduce the numbers.

The numbers reported by other school systems in the state on their dashboards reflect the same trend. In Carroll County, for example, school officials reported Wednesday that the number of students and staff testing positive for COVID-19 dropped from 248 to 197 over the week, and hundreds fell off the quarantine list.

But while numbers are inching down, school officials know things can change. They say they are concerned about how family get-togethers and travel over Thanksgiving and Christmas might affect spread.