Wednesday, November 25, 2020 - 8:44 am
The Board of Education held a 2-hour, 30-minute special session that included a presentation by Dr. Ellen Wald, the chair of UW-Madison's Department of Pediatrics, and a discussion and vote on a blended model concept for elementary grades on Monday, Nov. 23.
Board president Annette Ashley presided over the meeting at the District Services Center, while other Board members participated remotely. The School Board has been meeting virtually since mid-March.
Dr. Sabrina Butteris, a District parent and Middleton native and a pediatric hospitalist with UW Health and the American's Family Children's Hospital in Madison, also attended the virtual meeting. Earlier this fall, the School Board approved collaborating with members of UW-Madison's Department of Pediatrics for guidance and support.
Wald's presentation lasted 45 minutes. She noted there has been a huge surge of cases in the United States and Wisconsin of late. Last Wednesday there were more than 159,000 new cases in the United States and that jumped to 195,000 by Saturday. At that rate, the United States would see more than 1.4 million cases per week and 1,000 deaths per day, she noted.
Wald reviewed the percentage of positive tests per person in Wisconsin and noted it had reached 34.7 percent recently. "That's really astonishing,'' Wald noted.
She reviewed Dane County COVID-19 inpatients at the three main hospitals -- UW Hospital, Meriter and St. Mary's -- in Madison and noted it has jumped from 40-50 per day in the summer to 179 recently. ICU patients in Dane County have more than doubled from about 22 per day in the summer to about 50.
Wald noted SARS-CoV-2 is the virus and Covid-19 is the name of the infection. It is a respiratory virus and coronavirus is the name of four viruses that are a frequent cause of the common cold. She briefly reviewed where virus came from, noting most experts believe coronaviruses are spread by bats and then moved on to an intermediate host animal.
She noted this is the world's third epidemic caused by coronaviruses in past 18 years. The SARS1 mortality rate was 10 percent, although no cases of SARS have been reported since 2004. The MERS mortality rate is about 30 percent and the virus still exists in a few places. The current mortality rate for CoV2 is about 0.5 percent.
Respiratory viruses are spread by large respiratory droplets, airborne spread by tiny droplets or hand transmission and the most common way for CoV2 to be spread is by large droplets, Wald said.
Current data indicates that 40 percent of adults are completely asymptomatic and another 40 percent have mild illness if they have COVID-19, while another 15 percent have moderate symptoms. Of the 5 percent who become severely ill, 1 percent end up in the ICU. Risk factors include age, ethnicity, obesity, diabetes and high blood pressure. Hispanic and Black communities are over represented in numbers of those who become severely ill or die.
Earlier this year it was believed only 1-2 percent of children get infected, but health experts now believe it is closer to 12-13 percent. Wald noted children make up 20 percent of population so they are still less likely to get the virus. In general, children are asymptomatic or have mild illness and severe illness is seen in about 1 percent of children. Teenagers start seeing a similar form of the illness as adults. Hispanic and Black children are also are over-represented, as Wald noted whites make up 60 percent of the child population but 19 percent of deaths through mid-September.
Wald reviewed ways to limit spread of virus through protection measures, including masks, physical distancing, and handwashing. She noted people can't be protected if they don't wear a mask correctly and offered if someone is wearing one properly, they shouldn't be able to blow out a candle 12 inches from their face.
Wald also presented on reopening schools. She noted some questions educators grapple with include:
- Will children spread virus to other children and teachers?
- Will they bring the virus home and spread to others in household?
Wald believes must keep children at the forefront of all decisions. She noted schools are an essential part of every community. Schools also provide meal programs and social and emotional support for children, Wald said. And she said studies have shown increased depression and suicide attempts by school-aged children during the pandemic.
Wald also noted virtual educational disparities from COVID-19 disproportionately affected disadvantaged and minority children.
She doesn't believe there is a right answer. She encouraged School Board members to focus on the data and children's health and well-being. She also said understanding the community dynamic is crucial. Efforts to reduce community spread can only occur if enforce physical distancing, wear masks, and restrict large gatherings, Wald said.
Wald noted Dane County is at about 68 cases per 100,000 of the population, while the current Public Health Madison Dane County school reopening metrics equal about 10 cases per day for 100,000 of the population for PK-2 students and less than 10 cases for 100,000 of the population for other grades. CDC suggests using one or both community factors and mitigation strategies in making decisions.
She suggested the following considerations need to be considered in determining what blended model to select: transportation, cleaning issues, exposure of teacher, food needs, access to internet and specific learning issues. She noted the first three favor a 2-1-2 model more than a half-day model.
No strategy will completely eliminate the risk, Wald said.
Board members asked questions for about 30 minutes.
Wald also noted the viral load in younger infected children now appears to be similar to that from older children and adults so they can spread the disease.
Wald believes 54 cases per day, which PHMDC used as the criteria for opening schools for PK-2 students, makes a lot of sense. She noted younger children have lower risk, are the most needy and likely struggle the most with virtual learning. She did wonder wonder why PHMDC made the criteria much more stringent for grades 3-12. However, she noted even if left at 54 the current daily numbers are well above where they need to be.
She believes the next couple of months will be rough , as it is very difficult to control because so much disease is in the community. She called this a public health emergency and encouraged state government officials to come up with a plan for all of Wisconsin.
Wald is very encouraged by the early vaccine information. She expected it to be 50-60 percent effective, but noted the three studies released so far showed each was 90-95 percent effective. "It's the best news I've heard in a long time,'' she said.
Wald also believes by continuing to wear masks and physical distance, communities should see a much lower rate of infections, influenza and strep throat than in past years.
"You're asking such great questions and you are agonizing over the right things,'' Butteris said. "Please know that you could talk forever about all of them and know that none of them is going to be perfect.''