Written and edited by Norm Scott:
EDUCATE! ORGANIZE!! MOBILIZE!!!
Three pillars of The Resistance – providing information on current ed issues, organizing activities around fighting for public education in NYC and beyond and exposing the motives behind the education deformers. We link up with bands of resisters. Nothing will change unless WE ALL GET INVOLVED IN THE STRUGGLE!
Ed Notes Extended
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Sunday, March 21, 2021
New CDC Guidelines to Reopen Schools, Based on Outdated, Cherry-Picked, and Misinterpreted Data, Put Students, Teachers, and Communities at Risk
I haven't been a hard liner on keeping schools closed and am trying to listen to science. If we were still at the original COVID I'd say let's go with the low rates for kids and teacher vax but variants are still a wild card and children seem to be susceptible. But consider the article and comments below including long-term lung scarring from even people with mild cases. Every single person I know who had it even a year ago complains of some shortness of breath or being more tired. I may never leave my house again.
As usual the UFT and AFT are waffling. Do we think the CDC is suddenly not politicized under Biden who has promised to get schools open and viola, distances shrink from 6 to 3 feet.
Yves here. Biden repeatedly promised to
“follow the science” in developing Covid policies. But as has become the
norm in American medicine, the science has instead been distorted in
the interest of profits and political expedience. This post provides a
devastating takedown of the Biden plan to reopen schools with little in
the way of additional protections for teachers and students,
particularly more ventilation (how about the simple expedient of opening
windows?). It explains why Covid cases among children have been
severely undercounted and where population-wide surveys were made,
children were vastly more likely to introduce Covid into a household
than adults. It also shreds the CDC’s astonishing assertion that
distancing as little as three feet would be OK.
On the one hand, parents and children are suffering due to the lack
of in-person instruction. Keeping schools closed is politically risky
for Team Dem, particularly since it is seen as a staunch ally of the
(formerly) powerful teachers unions. But simply pretending that schools
can implement hand-wave level measures and everything will be hunky-dory
is the sort of wishful thinking that is guaranteed to produce problems
down the road, just like our insufficient test capacity and
unwillingness to enforce quarantines and mask mandates. As a result, how
much luck do you think schools and teachers will have in getting
children to wear masks properly (particularly not take them off if they
start to cough and keep them over their noses), and how much support
will they have from parents if they try to discipline the non-compliant?
Lambert almost immediately challenged the CDC’s recommendations on schools for ignoring evidence on aerosol-based transmission. He also found evidence that they relied on a National Academies of Sciences, Engineering, and Medicine report
that punted on the question of “indoor air quality of schools” because
addressing it might mean spending money! In other words, they refused to
consider the issue at all, even low cost mitigations. This article
confirms his concerns and adds quite a few others.
Your humble blogger also expressed doubts about Dr. Rochelle Walensky
as the new head of the CDC, that she had signed up for Biden
Administration priorities (as in she appeared not to have attempted to
negotiate the agenda), some of which looked like an impossibly big leap
for a weak agency, and others looked unconstitutional. Two particular
weaknesses look relevant to this fiasco:
Fighting yesterday’s war
Treating better PR as the solution to way too many problems
There’s much more information in this carefully argued and well
documented piece, which I hope you’ll circulate widely. As we’ve been
saying from early on, it’s the disease dynamics that are in control.
Wanting that not to be true won’t begin to make it so.
By Deepti Gurdasani, Senior Lecturer in Machine Learning,
The William Harvey Research Institute, Queen Mary, University of
London; Phillip Alvelda, CEO & Chairman, Brainworks Foundry, Inc.;
and Thomas Ferguson, Director of Research, Institute for New Economic
Thinking and Professor Emeritus, University of Massachusetts, Boston.
Originally published at the Institute for New Economic Thinking website
The
scale of disaster visited on the world by the COVID-19 pandemic defies
any easy summary. But it is safe to say that the question of keeping
schools open is among the most fateful decisions facing public
authorities. As the pandemic stretches into its second year, it is now
becoming among the most contentious.
In the U.S., after some hesitation, the Biden administration seems to
be encouraging rapid opening of schools, despite high levels of
community transmission in many places, before robust mitigations are
completely in place. Many Republican governors and officials also demand
the step, including former President Trump in his recent CPAC address.
Languishing under lockdowns and zoom or hybrid classes, many exhausted
parents, anxious employers, and bored students seem receptive, though
polls show widespread reservations about whether premature reopening
might trigger new waves of infections. In recent days, more and more
states have moved to mandate full in-person classroom instruction within
a few weeks.
Accompanying these decisions are organized efforts to recycle earlier studies of school safety[i]
designed to reassure skeptics that reopening schools to full-time
instruction is really safe, even as new variants of COVID-19 spread that
are more contagious and possibly more dangerous than earlier forms.
Even the Center for Disease Control is joining this rush to judgment,
suggesting that seating students as little as three feet apart might be
an acceptable rule for social distancing.
Bitter experience has taught us a great deal since the beginning of
the pandemic. Among the most important lessons we have learned is that
it is not, in fact, safe to open schools as the pandemic persists without close adherence to significant and stringent abatement measures.
We begin with the most important point as to how we now better
understand the risks that eluded us in prior surges of the virus. In
those earlier episodes, many people who in fact had the virus showed few
indications that they did, even as they went on to spread it to others.
This “asymptomatic” transmission was a genuine novelty that researchers
only slowly came to grips with.
Unfortunately, the display of coronavirus symptoms is highly
correlated with age, thus the younger the student, the less likely they
are to show symptoms, or exhibit what are considered “typical” COVID-19
symptoms. The younger students, therefore, were much less likely to be
tested. So they continued participating in the school community even as
they spread the disease and even having suffered symptoms and long-term
side effects that absent a COVID-19 diagnostic determination, were
falsely attributed to other illnesses. As a result, the studies commonly
cited as supporting school reopening are deeply flawed; they are based
on having only tested students who showed symptoms, rather than applying
broad screening tests either universally or with true random samples
capable of catching the otherwise undetectable asymptomatic spreaders
and infected.
The extent of this bias has now been quantified in several studies in
the UK, such as the Office for National Statistics Infection and
Household Surveys[ii] and REACT-1 Studies.[iii]
These studies randomly sampled large numbers of households within the
UK at regular intervals regardless of symptoms. The results are
dramatically different from the earlier studies, and even from
symptom-based testing from the UK during the same time period; they show
that contrary to the conclusions from earlier studies based on biased
symptom-only testing protocols, in-person schooling is associated with
much higher risk than previously thought. A recent study published by
the Center for Disease Control (CDC) from Mississippi confirmed these
findings; it showed that case-based reporting of infection in children
underestimated infection by between 14-68-fold over May to September
2020 compared with serological surveys.[iv]
With the more recent large-scale random sample testing performed in the UK, Sweden, and the US, we now know the following facts:
1. The secondary COVID-19 attack rate – that is, the rate at which the coronavirus spreads – was actually higher
for both elementary and high school students than adults when the
schools were open for in-person instruction between April to November in
England (ONS Household Infection Survey).[v]
2. Both elementary and high school children were far more likely than
adults (2x and 7x, respectively) to be the first case in their
households rather than the adults between April-December in England.[vi]
3. The spread of infections among school-age children and in the
community closely tracked school openings and closures as well as
attendance, with the prevalence of infection being highest in these
groups compared to all other age groups while schools were open and
tiered restrictions for broader society remained in place. Importantly,
particularly with the new variants, growth of the pandemic continued in
regions where these variants were prevalent even as other institutions
were shut down in the national lockdown in November.[vii]These statistics were mirrored in a recent study on the risk of coronavirus spreading in U.S. schools.[viii]
4. Increases in the prevalence of infection among school-age groups
preceded rises of infection in other age groups. This has a vital
implication; the new studies suggest that infections among children at
school do not just reflect infection rates in the community. Rather,
they drive increases in infection within the community through spreading
from schools into homes, and from there to the broader community.
5. Claims that teachers do not face serious risks are simply false.
The risks of infection turned out to be two times greater for teachers
of in-person classes relative to those conducting virtual online classes
in Sweden.[ix]
The study also found an approximately 40% higher infection risk in
England in those in teaching occupations compared to those in
non-teaching occupations, even when schools were only partly open
(REACT-1 study).[x]
6. Several studies also show an increased risk of infection among
parents of primary and secondary school children being taught in-person
within schools.[xi]
7. The spread of new, more easily transmitted and more deadly
variants underscores the true dimensions of the threat from in-person
school instruction. With the new B.1.1.7 variant now surging in many
parts of the world, variant cases continued to rise with an R=1.45
(compared to an R of only 0.9 for non-B.1.1.7 variants) even during
national lockdown while schools were open. R only dropped below 1 – a
critical level for controlling the rate of infection – following
complete school closures. The numerous outbreaks linked with B.1.1.7 in
school settings across the globe over the past few weeks are of grave
concern.
8. Between 12-15% of primary and secondary school children had one or
more persisting symptoms 5 weeks after infection, according to an ONS
survey that took care to examine all infections, including asymptomatic
infections.[xii]
Before that study appeared, it had been widely thought that because
mortality is low among children exposed to SARS-CoV-2, that children are
not impacted. Given we know so little about the long-term implications
of “long COVID” syndromes, which at least in adults have been often
associated with organ dysfunction, it is important to adopt the
precautionary principle, and reckon with long COVID related outcomes in
addition to deaths.
9. Recent evidence supports the role of mitigations in reducing the
impact of transmission within schools. However, it is clear that
multi-layered protections are needed, rather than single or a few
measures, as the risk reduction is associated with the number of
mitigations in place.[xiii]
Figure 1 On the left is a graph from
an earlier study based only on testing symptomatic U.K. patients that
seemed to indicate that children aged 0-19 were the least likely to be
infected or carriers of the coronavirus. Such symptom-based data from
children are still being used to promote the notion of sage school
reopening. The graph on the right shows the data from the large scale
ONS study based on random sampling of households across England.[xiv]
The latter study catches the large number of asymptomatic carriers,
showing clearly that when asymptomatic carriers were counted, those
school-age cohorts were, in-fact, the most likely to be infected
carriers of the coronavirus. The ONS study also shows the correlation of
new case growth in the elementary and high school-aged cohorts with
times when the schools were opened for in person instruction and
declines over vacation, half-term and shut-down periods.
The coincidence of the rush to reopen with the spread of the new
variants of concern to the CDC and the World Health Organization is
particularly unfortunate. The new B.1.1.7 variant is both 50% more
communicable, and about 30% more lethal than the earlier strains. It is
now the dominant and resurgent strain across Europe and is now endemic
across the United States. All through the pandemic, the United States
has lagged in testing for the virus. It has trailed not only in sheer
volume but also in the form of testing: most tests cannot sort out the
new more dangerous variants from older forms of COVID-19. Only so-called
“genetic survey” tests can do that reliably and they are used only in a
few places.
Data from the relatively few U.S. states that use these viral genome
survey tests strongly indicate that the now widely reported declining
case numbers mask a dangerous, exponential rise in cases of the newer
more contagious variants. These appear even now to be turning around the
recent falls in total cases in some areas of the country. We expect
that in the next few weeks that phenomenon will show more widely.
Figure 2 After months of steady
decline, we can now see the return of significant growth in new COVID-19
cases across six states where the B.1.1.7 strain is known to be growing
in prevalence. Cases are now flat or starting to rise in 21 additional
states, and we expect resurgences soon there as well. Relaxation of
abatement measures is clearly premature.
Another lingering concern testifying to the persistent impact of
outdated science is that so much of schools’ reopening guidance remains
aimed at hygienic measures, surface wipe-downs, and plexiglass barriers,
all of which are completely ineffective in limiting what we now know is
the primary mode of indoor transmission, airborne aerosols.[xv]
The latest CDC guidance suggesting that the risks to students are
similar at 6 foot or 3-foot distances and thus that schools can safely
reopen with more-or-less normal student seating density and populations
in the classrooms completely misses the point. A close analysis of the
“3-foot paper[xvi]”
the CDC cited shows it to be riddled with errors in protocol, most
importantly, that it again relies on data from primarily symptomatic
carriers; that it improperly conflates infectious susceptibility with
contact rates; and is based on a flawed sampling methodology.
Neither did it measure the actual distancing practices within
classrooms, but rather considers guidance at district levels, and only
for all schools with attendance greater than 5%. This could mean that
schools were wrongly categorized to different distances that were not
accurate. Differences in other mitigation measures, class size, or class
attendance were also not accounted for. Ultimately, the study is also
too small to come to any scientifically supported conclusion, as the
results show that the risk of infection among districts with guidance to
distance greater than 6 feet could vary from half of those with
guidance to distance greater than 3 feet by up to 1.3 times as much.
Most critically, while the authors were correct in saying that there
is little difference in risk relative to seating distance, they drew
exactly the wrong conclusion from the distance data. Newer science has
demonstrated quite definitively that the coronavirus spreads heavily
through the air, more so, in fact, than through droplets on surfaces or
direct contact. As a direct result, the earlier 6-foot indoor social
distancing rule guidance was proven to offer misleadingly false comfort
wherever ventilation is poor. A beautifully illustrated and simulated
interactive New York Times article highlights “Why Opening Windows Is A Key to Reopening Schools”
safely. It’s worth a read, because it also demonstrates clearly why
relaxing distancing measures, say to seating students 3 feet apart
instead of at a 6-foot distance is not necessarily a good idea.
Contrary to the notion that even 3 feet of distancing is sufficient
protection, and 6 feet is overkill, the critical safety issue is that
students are all uniformly at risk in poorly ventilated rooms no matter
where they are or how they distance. With one infected person in an
enclosed and poorly ventilated room, the coronavirus permeates the
entire space, putting everyone inside at similar risk regardless of
where they sit. The key corrective abatement measure necessary is
wholesale improvement in ventilation, filtering, and HVAC systems.
Nothing whatsoever in any of the cited studies supports safely moving
students closer together.
The Biden administration’s new emergency aid bill contains
substantial funding, at last, for states and localities. They could use
some of that money to refit ventilation systems in schools and implement
rigorous testing programs, and even quickly roll out portable HEPA
filter systems. But as of 2020, a GAO
study indicated that ventilation and heating systems in slightly under
half of the school systems examined required substantial new
expenditures to meet code, much less enhanced protection necessary
for coronavirus abatement. With substantial federal support only now
coming available, properly replacing older ventilation systems with HEPA
filters will take time.
And though rapid COVID-19 tests are now available, few public schools
can afford the current generation of tests. The simple mathematics of
exponential growth and airborne transmission in confined areas means
that tests on everybody – students, teachers, and staff, including
cafeteria workers and janitors – need to be performed at least twice a
week. Testing less often means that the virus cannot be identified fast
enough to stop outbreaks from sweeping through schools and that contract
tracing and quarantine efforts come too late to be effective. And
similar to the VHAC upgrade concern cited above, it will also take time
for forthcoming federal aid to flow down to schools and labs to enable
frequent and affordable school testing on a national scale. In any case,
these tests should not replace robust mitigatory measures within
schools, but rather complement a robust, multi-measure mitigation
approach.
A reconsideration of the current rush to reopen in-person instruction
with less than sufficient mitigations is, therefore, clearly necessary.
The understandable hopes for a return to normalcy raised by the
stepped-up campaign to vaccinate everyone are premature. The vaccine
effort, while gathering momentum, will not reach enough people quickly
enough to make opening this Spring safe, without more robust mitigation
measures within schools. And the costs of making a rushed mistake based
on outdated science will take too long to become obvious.
We understand and sympathize deeply with the pain that the continued
delay of reopening causes our colleagues and fellow citizens. But it
cannot make sense in the actually existing state of most public schools
(or, for that matter, all but the most affluent private schools) to push
to reopen without all the critical mitigations, as this will once again
potentially lead to educational disruption in the form of school
closures and further lockdowns. Better to ensure schools can remain open
once they do restart through robust mitigation, ramping up testing,
ventilation, and, above all, vaccinations than send new waves of sick
students, teachers, and parents to already overstretched hospital and
emergency medical facilities in a third resurgence of the coronavirus,
and unnecessarily put a generation of students, teachers, and parents at
risk of Long COVID side effects.
Reopening most schools now, before most schools lack robust
protective measures, and don’t yet have broad ability or finances to
conduct frequent surveillance testing to prevent asymptomatic spreaders
of the latest, more dangerous coronavirus variants from infecting their
community, is thus very unwise.[xvii]
I note a couple items missing. First, any discussion of the
counterpoint, meaning the cost to young people without in-person
education. Shouldn’t there be a cost benefit discussion in an unbiased
report? Second, I do not see a reference to a study on the prevalence of
asymptomatic spread. I saw something recently, possibly related to
in-person schooling in the US, that listed asymptomatic spread as being
less than 1% of positives. I continue to look at medrxiv.org and I see
no studies showing that asymptomatic spread is a real thing.
What I do find in this are a lot of reference to studies saying “… in
England”. What are the data points in the US? This is anecdotal, but
the state I live in has had in-person learning for K-12, colleges and
universities since the fall session began. Peak cases and
hospitalizations occurred months after, not 2-weeks after the
re-introduction of in-person education. In my community we had one
professor die from C-19. He taught at a university with tens of
thousands of students. He contracted C-19 *before* school began in the
fall.
In my state, C-19 hospitalizations are currently about 3% of bed
capacity, while just under two-thirds are occupied for other reasons. I
mention this because lockdowns were about saving the healthcare system.
If you look at hospitalization rates in the US as of March 7, 2021 at
covidtracking.com, the highest hospitalization rate in the US is for New
York. Washington DC and New Jersey are close company. These are hard
lockdown locations – obviously. If you look at the 6 states that never
locked down, their numbers on case fatality, positivity,
hospitalizations and yes unemployment are all better than Florida and
the national average.
> Peak cases and hospitalizations occurred months after, not 2-weeks after the re-introduction of in-person education.
Given that a peak results from a rise followed by a subsequent
decline, not sure how this is relevant. More relevant would be the
timing of the rise after the prior trough, in relation to the timing of
changes in public policy that could affect transmission.
This comes off as if you did not read the post in full, as is
required by our site Policies. It makes clear that only the UK (Imperial
College) has been testing large numbers of the population (100,000 each
time, distributed by age, gender, geography, etc) every six weeks or
so. It’s called Real Time Assessment of Community Transmission.
We don’t have anything even remotely like that. The UK data is vastly
better than anything in the US. Our testing is just about the worst in
the world.
And we have pointed out repeatedly that Covid deaths are not a good
metric of health costs. Covid does serious ant potentially permanent
damage to nearly everyone who gets it. A large scale study in Texas
found that 100% of symptomatic cases and 70-80% of asymptomatic cases
showed lung damage worse than if they’d been pretty serious smokers. Not
clear if that damage will ever abate. Covid also leads to Long Covid
(often in asymptomatic cases), heart and liver damage.
A Texas trauma surgeon says it’s rare that X-rays from
any of her COVID-19 patients come back without dense scarring. Dr.
Brittany Bankhead-Kendall tweeted, “Post-COVID lungs look worse than any
type of terrible smoker’s lung we’ve ever seen. And they collapse. And
they clot off. And the shortness of breath lingers on… & on… &
on.”
“Everyone’s just so worried about the mortality thing and that’s
terrible and it’s awful,” she told CBS Dallas-Fort Worth. “But man, for
all the survivors and the people who have tested positive this is — it’s
going to be a problem.”
Bankhead-Kendall, an assistant professor of surgery with Texas Tech
University, in Lubbock, has treated thousands of patients since the
pandemic began in March.
She says patients who’ve had COVID-19 symptoms show a severe chest
X-ray every time, and those who were asymptomatic show a severe chest
X-ray 70% to 80% of the time.
“There are still people who say ‘I’m fine. I don’t have any issues,’
and you pull up their chest X-ray and they absolutely have a bad chest
X-ray,” she said.
In X-ray photos of a normal lung, a smoker’s lung and a COVID-19 lung
that Bankhead-Kendall shared with CBS Dallas, the healthy lungs are
clean with a lot of black, which is mainly air. In the smoker’s lung,
white lines are indicative of scarring and congestion, while the COVID
lung is filled with white.
“You’ll either see a lot of that white, dense scarring or you’ll see
it throughout the entire lung. Even if you’re not feeling problems now,
the fact that that’s on your chest X-ray — it sure is indicative of you
possibly having problems later on,” she said.
Comments are welcome. Irrelevant and abusive comments will be deleted, as will all commercial links. Comment moderation is on, so if your comment does not appear it is because I have not been at my computer (I do not do cell phone moderating). Or because your comment is irrelevant or idiotic.
I note a couple items missing. First, any discussion of the counterpoint, meaning the cost to young people without in-person education. Shouldn’t there be a cost benefit discussion in an unbiased report? Second, I do not see a reference to a study on the prevalence of asymptomatic spread. I saw something recently, possibly related to in-person schooling in the US, that listed asymptomatic spread as being less than 1% of positives. I continue to look at medrxiv.org and I see no studies showing that asymptomatic spread is a real thing.
What I do find in this are a lot of reference to studies saying “… in England”. What are the data points in the US? This is anecdotal, but the state I live in has had in-person learning for K-12, colleges and universities since the fall session began. Peak cases and hospitalizations occurred months after, not 2-weeks after the re-introduction of in-person education. In my community we had one professor die from C-19. He taught at a university with tens of thousands of students. He contracted C-19 *before* school began in the fall.
In my state, C-19 hospitalizations are currently about 3% of bed capacity, while just under two-thirds are occupied for other reasons. I mention this because lockdowns were about saving the healthcare system. If you look at hospitalization rates in the US as of March 7, 2021 at covidtracking.com, the highest hospitalization rate in the US is for New York. Washington DC and New Jersey are close company. These are hard lockdown locations – obviously. If you look at the 6 states that never locked down, their numbers on case fatality, positivity, hospitalizations and yes unemployment are all better than Florida and the national average.