My thoughts on the study from Wisconsin schools- a 🧵 "COVID-19 Cases and Transmission in 17 K–12 Schools — Wood County, Wisconsin, August 31–November 29, 2020 | MMWR" cdc.gov/mmwr/volumes/7…
About a week ago I mentioned that the studies we have on Covid in schools were not well done. The recent CDC study based on Wisconsin schools is the best I've seen so far. It describes mitigation strategies & tracks community positivity rates & school positivity rates.
Mitigation- mask wearing in & outdoors, not just cohorting children, but basically assigning close contacts and keeping those as the only close contacts throughout the entire day (I'm imagining this means you sit in class and lunch next to the same person).
I really liked that the school provided masks to everyone, instead of people using their own of varying quality. I do wish they reported on mask wearing of teachers and staff. And need to point out that only about half the schools shared data on consistent mask use.
This point is important because they also relied on schools for some contract tracing. Could we be seeing a reporting bias here? Reporting just the good data? but I'll get back to that.
I'm wondering why the contract tracing was not solely conducted by an independent group, like the health department, or maybe even the researchers that implemented the study. As well done as this study was, here's some other concerns.
Yesterday news report said a) 7 people got it in schools, b) too much community spread to know where 184 others got it.
So can we rule out schools? You may say contact tracing.
By not treating the entire cohort as contacts, are we ignoring the studies that found substantial spread within short periods of unmasked time, further distance than 6 feet? So maybe this 184 were not seen as close contacts, but we're exposed www-mlive-com.cdn.ampproject.org/v/s/www.mlive.… I would be most concerned about that happening during meal times and would broaden who is considered a contact to match what we've learned from restaurant studies.
2. What's the testing rate of people in schools compared to the community? We saw the postivity rates, but did we have undertesting in the school group?
3. why not incentivize testing of those quarantined so we can answer the question of asymptomatic kids deflating the rates?
4. While I feel this was a better conducted study than all others to date, I haven't come to the conclusion that schools can reopen safely.
That conclusion doesn't seem to take into account the ridiculously high rates of covid reported in the study's schools. Yes, it was lower than the community, but that can't be our threshold.
How does that fly? Are we really willing to say the community rates are horrendous, but in school rates are just horrible, so let's open up?
This is not an approach to reduce or prevent Covid-19, related illnesses, or death. This is an approach driven by numbness. We're numb to high rates of Covid, overcrowded hospitals, and rising death tolls.
As I stated a few days ago, we shouldn't be asking should schools open, we should be asking why aren't we shutting things down while providing massive financial and mental health support to all.
You can follow @Theresa_Chapple.
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