GRIFFIN, Ga. — Natalia D’Angelo got sick right after school started in August.
She was driving a school bus for special education students in Griffin-Spalding County School System about 40 miles south of Atlanta and contracted COVID-19.
One of her three sons, Julian Rodriguez-D’Angelo, said his mother, who was not vaccinated against the COVID virus, had a history of health problems, including Graves’ disease and cancer.
Rodriguez-D’Angelo said his mother “was pretty certain” she got COVID from her work duties. He added that D’Angelo’s assistant on the same bus also had the disease, and that his mother said some kids on the bus did not wear masks, even though it is required.
The virus spread through the whole family, including her husband, Americo Rodriguez, who came with her to the U.S. from Uruguay 20 years ago. But D’Angelo’s illness grew worse, and she was hospitalized at a Griffin hospital in mid-August. On Aug. 28, she died. She was 43.
D’Angelo is among at least 12 school bus workers in Georgia — including three in the Griffin-Spalding district—who have died of COVID since the beginning of the school year. News reports and a Twitter feed called “School Personnel Lost to COVID” show that school bus drivers in at least 10 states have died of the disease since August.
The deaths raise questions about whether school bus drivers are at higher risk of getting COVID. But medical experts are split. It’s difficult, if not impossible when local infection rates are high, to determine how any particular bus worker became infected—whether it occurred at home, in a community setting or on the job.
The buses should be relatively safe. The Centers for Disease Control and Prevention requires that masks be worn on public transportation, including all school buses, public or private and regardless of whether the schools themselves require masks.
“There’s no enforcement of that,’’ said Ronna Weber, executive director of the National Association of State Directors of Pupil Transportation Services. “Police are not going to board a school bus” to make sure the students are wearing masks.
As with school employees in general, statistics on the number of COVID deaths are sparse, without any central government repository, according to the National Education Association union. The Florida Education Association, though, lists seven bus workers among the more than 70 school staffers in the state who have died since July. The School Personnel Lost to COVID account says more than 185 bus drivers have died of the disease during the pandemic.
An estimated 500,000 school buses nationwide operate on a given day. Many drivers are retirees from previous occupations, so age and health conditions could contribute to the deaths. “Every life is an unfortunate loss,” said Weber.
Xiaoyan Song, chief infection control officer at Children’s National Hospital in Washington, D.C., said drivers are not at increased risk of getting COVID from students because they see children up close for only a second or two, when the kids board and exit the bus.
It typically takes several minutes of exposure to an infected person to transmit the virus, she said, adding that drivers face forward with their backs to students while driving, which also diminishes their risk. She said driving with windows open is another factor that can limit transmission of the virus.
But Ye Shen, an associate professor at the University of Georgia College of Public Health, believes drivers face a greater risk.
Shen, lead author of a JAMA Internal Medicine study on COVID transmission on buses in China, noted that the vehicles are enclosed spaces in which ventilation can be poor, creating an environment with a high risk of COVID transmission.
The danger of airborne transmission is significantly reduced if the kids and the driver are all wearing masks, Shen said. In the China study, no one was wearing a mask and there was a high rate of virus transmission. “Kids often don’t fully comply with the mask rule,” Shen added.
Risks may climb within school districts that lack mask mandates, he said.
The Bulloch County school district in southeastern Georgia has no mask mandate in classrooms or buses. In early September, Bulloch district bus driver Norma Jean Carter, 55, died of COVID.
Besides mask-wearing, the CDC recommends that, whenever possible, drivers and monitors open bus windows to increase air circulation. Bus surfaces should be cleaned and disinfected after each use of the vehicle, the agency said.
Even when precautions are taken, the fears surrounding COVID have worsened a nationwide shortage of school bus drivers.
Michael Cordiello, president of the Amalgamated Transit Union local chapter in New York City, representing more than 8,000 school bus workers, said more drivers have retired in 2021 than in previous years.
Officials in several states are working to find solutions to the shortages, and some are requesting that their governors send National Guard troops to help. A Wilmington, Delaware, school is paying its students’ parents to drive buses. Some regular drivers have had to work extra shifts.
“Our drivers are scared to death,” said Jamie Michael, president of Support Personnel Association of Lee County, a union in southwestern Florida that represents bus drivers and other school staffers.
One county school bus driver there died of COVID in mid-August, she said. It is unknown where the woman was infected. She said five drivers then quit Sept. 7 and the county school district is about 100 drivers short of what it needs.
The district requires drivers to wear masks, and they try to ensure that at least some windows are kept open on the bus no matter the weather.
“It’s a scary time for anyone working with students,” Michael said.
Drivers in the district get paid between $16 and $23 an hour depending on seniority, amounting to $31,000 to about $45,000 annually.
Michael said drivers like to keep the seat behind them vacant to allow for physical distancing, but that is not always possible due to demand for rides, especially amid driver shortages.
The Griffin-Spalding district temporarily switched to remote learning for students after D’Angelo, another bus driver and a bus monitor died of COVID. Several more have been infected since school started Aug. 4, said Adam Pugh, spokesperson for the Griffin-Spalding County School System. The school district added a mask requirement early in the school year.
“No one has an exact answer” as to why the district’s bus workers have been hit so hard, he said. Many buses are being driven with windows open, and the vehicles are sanitized between routes, Pugh added.
Julian Rodriguez-D’Angelo said his mother “loved being a bus driver and never missed work. She drove for years.”
He said he doesn’t blame the students but does feel anger about district policies. The delta variant, the dominant strain of COVID, “is spreading like crazy,” he said. He added he doesn’t think students should have been in school amid the surge.
The vaccination rate in Spalding County for all residents, 37%, is far below the state’s 46% rate. Both rates are below the national average.
This article originally appeared in Kaiser Health News.