Veronica McClane was looking forward to sending her child back to school this fall.
Now she is not so sure she wants her 8-year-old son, Mac, a student in the Little Rock School District who's been studying remotely since the pandemic began last year, to return to in-classroom learning for the fall semester, which starts Aug. 16.
"We were fully prepared to send him back in the fall because the [covid-19 case] numbers were so low," McClane said. "Now, I don't know. We are still trying to figure it out. We are still undecided at this point."
McClane is not alone in her uncertainty.
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As Arkansas continues to experience rises in new cases of covid-19, driven by the highly contagious delta variant and low vaccination rates, parents and administrators say they're growing more concerned. They're worried that schools, once deemed relatively safe environments during the pandemic, may no longer be so safe.
This is because much has changed since the spring semester when masks were still mandated in public schools, people were clamoring for vaccines, new covid-19 cases were steadily falling and there appeared to finally be an end in sight.
"We thought this might have been behind us," said Mike Mertens, the assistant executive director of the Arkansas Association of Educational Administrators, a professional organization. "It looks like with the recent developments, it will be another year with a lot of tough decisions."
"It is almost like, 'Here we go again,'" Mertens said.
What has changed is that public schools can no longer mandate that faculty members and students wear masks. Arkansas is one of several states -- including Arizona and Oklahoma -- that passed legislation blocking mask requirements in schools.
Earlier this month, the Centers for Disease Control and Prevention issued new guidance to mitigate the spread of covid-19 in schools, recommending that students and faculty members who aren't fully vaccinated continue to wear masks.
Vaccination rates have slowed in the state, particularly among younger demographics, including children 12 and older who are eligible for the shots, according to public health experts.
Children under 12 are not yet eligible for vaccination.
Arkansas public schools are also barred from mandating vaccinations for employees. Many school administrators estimate that only 50% to 60% of faculty members have been vaccinated.
These factors -- combined with growing anecdotal evidence that the delta variant may cause more severe illness in young people, including kids -- could turn classrooms into spaces for the unfettered spread of the disease, particularly if students and teachers are not vaccinated and no longer choose to wear masks.
"With the delta variant's increased contagiousness, places where we have groups of unprotected individuals, like schools and colleges, unfortunately will be a setting that has the potential for a pretty significant health event," said Dr. Joe Thompson, head of the Arkansas Center for Health Improvement, a nonpartisan health policy center.
"The superintendents are worried about the level of threat," Thompson, who held a meeting with school administrators last week, said. "Everyone is concerned about the exponential uptick in cases just over the last couple of weeks."
"That is obviously front and center."
WARNING SIGNALS
There already are signs of what could be coming.
At Camp Siloam, a Christian camp in Siloam Springs, more than a dozen children were sent home last week after a camper tested positive. It was the second time in three weeks that a group of campers had been sent home after a covid-19 case.
"Please beware, if you or your camper is at high risk of complications from covid-19, we recommend you not send them to Camp Siloam," the camp said on Facebook. "The responsibility for protecting against the virus will be on the camper."
Meanwhile, in the Mountain Pine School District, a tiny, rural district near Hot Springs, administrators canceled the last session of summer school because of rising cases.
"With the uptick in the delta variant, we made the decision because many of our students are not vaccinated," Denise Smith, the district's curriculum director, said.
"Because we can't require students to wear masks now, we decided to err on the side of caution," Smith said. "We don't want to face possible quarantines or a delay for the start of school because someone got sick with covid."
Already, Smith said, parents are calling, asking if children will be required to wear masks at school.
"A lot of students were not thrilled last year when they had to put a mask on," Smith said. "That is a big concern for parents."
Without mask and vaccine mandates, superintendents say they are left with few options other than to encourage students and faculty members, particularly those who are not vaccinated or who are not eligible for a vaccine, to do the right thing to protect themselves and others.
They say they will enact social distancing when possible, provide personal protective equipment such as masks and hand sanitizer on campuses for those who want to use it, and educate those who are eligible on the importance of getting vaccinated.
But beyond that, there may not be much they can do.
During a town hall-style meeting in Blytheville last week, Gov. Asa Hutchinson told participants that he would have to call a special legislative session to change laws banning mask and vaccine mandates.
"I don't know if I would have that support or not," Hutchinson said during the event. "It is all about individual decisions, making good judgments."
Administrators say they are exploring ways to incentivize teachers and students to get vaccinated, which health experts say is the most effective defense against becoming seriously ill with covid-19, including the delta variant.
They're explaining to parents that students who are unvaccinated and who become ill will still have to quarantine, which could mean missing football games or other events. Unvaccinated teachers who become ill may be forced to use sick days this year instead of paid covid leave available last school year.
But questions remain as to how to handle situations in which an unvaccinated faculty member may be teaching a classroom of kids who are not old enough to get vaccinated and who may not be wearing masks.
Or if a teacher has to use sick days because of a covid infection, whether reporting of infections might go down.
"The situation is now very muddy," Jared Cleveland, superintendent of the Springdale School District, said. "There are less certainties today than there were last year at this time going into the school year."
"I am very concerned just because of the increase in [case] numbers," Bobby Hart, Searcy School District superintendent, said. "We are planning to work just like we started the school year last year in regard to physical distancing, trying to make sure things are properly sanitized and having adequate ventilation."
"It is not ideal, but it is where we are right now in order to try to keep kids safe," Hart said.
As of Friday, the North Little Rock School District had seven covid-19 cases and 13 students and staff members quarantined.
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North Little Rock Superintendent Gregory Pilewski said he is worried that another year of schools frequently pivoting to remote learning because of covid cases could have even more devastating effects on learning.
"Data indicates our kids need to be back with us face-to-face," Pilewski said. "For the vast majority of kids, remote learning just was not working for them."
"It has been hard, but we are willing to do whatever it takes and move forward," Pilewski said.
The Arkansas Department of Health and the Arkansas Department of Education are in the process of finalizing guidelines to distribute to schools.
"We are working on guidance for schools that we will release in the near future," spokeswoman Kimberly Mundell said via email. "Our guidance will align with guidance from the C.D.C. and Arkansas Department of Health, as well as state laws and policies."
Dr. Joel Tumlison, the Health Department's physician specialist in outbreak response who is working on guidance for schools, said many of the safety interventions implemented last year should still be effective this fall.
"If we continue them, they will continue to be effective," Tumlison said. "Will they be as effective? Well, that is an open question, but they should largely be effective as long as we keep having all of those layers in there as much as possible."
He added: "If we throw a bunch of them out, it won't be as successful from keeping the spread from happening in schools."
EFFECT ON KIDS
Fueling fears about the fall semester are stories emerging about children who are becoming critically ill with covid-19.
One such story reported by THV-Channel 11, which has gone viral among parents, is that of a 13-year-old who had been placed on a ventilator for nearly two weeks at Arkansas Children's Hospital.
As of Friday afternoon, of the seven patients at Arkansas Children's in Little Rock who were covid-positive, two were on ventilators, said Dr. Rick Barr, the hospital's chief clinical officer.
To be sure, adolescents have contracted the disease throughout the pandemic. Yet public health experts said they believed the expression of the illness was milder in children.
In a past interview with CNN, for example, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that "children tend to have milder symptoms or even no symptoms when they are infected with covid-19."
Throughout the pandemic, there have been rare cases of a sometimes-deadly condition called multisystem inflammatory syndrome, or MIS-C, in children, which the CDC defines as "a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs."
The CDC says the cause of this condition remains unknown, but "we know that many children with MIS-C, had the virus that causes covid-19."
Barr said it is too early to know whether the more severe cases of covid-19 showing up among adolescents not only in Little Rock but also at other hospitals across the country are directly related to the delta variant.
"It is a complicated answer because we are still gathering a lot of data," Barr said. "Since the emergence of the delta variant, we are seeing kids with respiratory failure who have developed pneumonia, but it is too early to tell whether it is a true effect of the delta variant."
While underlying conditions, such as obesity or asthma, could make a child more susceptible to a serious case of the virus, Barr said there is no clear trend emerging yet to indicate that certain age groups are more vulnerable than others.
Those who are ending up in hospitals are not vaccinated, he said, adding that pneumonia caused by covid-19 has been more prevalent in teenagers, so far.
"It is all age ranges," Barr said. "Certainly we are seeing it in younger kids who are not eligible for the vaccine, and we have seen covid infections in adolescents who are eligible for the vaccine."
Hospitals across the state have reported a shift in the ages of patients showing up in emergency departments with covid-19. Now patients who are sicker are younger, likely because many older people have been vaccinated.
So the increasing severity of cases among children could simply be a matter of numbers; because the delta variant is more contagious, more people are getting infected, which means, statistically speaking, that more will become seriously ill.
"We are seeing younger and younger people hospitalized," Thompson, of the Arkansas Center for Health Improvement, said. "We are seeing particularly adolescents negatively impacted and hospitalized, so the delta variant appears to have a little bit of a different infectiousness profile but also clinical profile."
ADVICE FOR PARENTS
Thompson advises parents who have children ages 12 and older to get vaccinated immediately since it takes a few weeks for the immune system to develop "optimal protection."
Time is of the essence, Thompson said.
"Parents are in a tough situation in making decisions about how and under what circumstances they will send their kids back to school," he said. "Clearly kids need to go back to school. We lost too much educational progress with too many kids through the year last year."
Experts recommend that parents ask school administrators what safety precautions will be in place and to voice their concerns.
They also recommend that kids who do not yet qualify for a vaccine to continue to wear masks at school, practice social distancing and regularly wash their hands.
"Families can help their children make those decisions," Barr said. "We know this has been an incredibly hard year for children, and the social and educational aspects from not being in school are really profound."
McClane, the mother of 8-year-old Mac, said the isolation her son has experienced now for months is her biggest concern. She said she worries about keeping him home again to learn, as well as the repercussions that may have for his social and emotional development.
"I am terrified," McClane said.
"I don't want my children to be on a ventilator or to have a heart condition for the rest of his life," she said. "They could be fine, and it not be a big deal, but I don't want to ever say I did not try my best to keep them safe."