Steps to take before reopening schools
LENOIR, N.C. — In less than two weeks, students are scheduled to return to school across North Carolina, including in the Caldwell County Public Schools. While totally remote learning is an option to begin the school year according to the system’s website, teachers and support staff will still be reporting to schools, as will many children.
The only problem is, it’s simply not safe by basic disaster response principles to reopen schools. A quick dissection of the statement on the Caldwell Schools website helps us understand why. Here’s the statement: “After much discussion that involved considerable input from focus groups and parent, teacher, and community surveys, the Board of Education approved a blended education model consisting of in-person instruction combined with remote learning and parents may opt for full remote learning in grades K-12 to begin the 2020-2021 school year.”
What’s missing from that statement is glaring. No mention is made of consulting public health officials, nor of following basic guidelines for disaster response and public health, as I wrote about yesterday in discussing the Precautionary Principle. Perhaps they have done so; if so, it would be helpful to say so.
The school system did not have to choose to return to classrooms. It could have chosen remote learning only, but did not. I believe that was a mistake. So, before schools open, we need to back up and ask a few questions. These are the steps that should be taken, based on the Federal Emergency Management Agency’s (FEMA) National Response Framework (NRF) and the National Incident Management System (NIMS). By law, all communities, through their Local Emergency Preparedness Committees (LEPCs) are to drill, plan, prepare and respond according to NIMS. The school system is expected to have a representative on the LEPC who is also trained in NIMS. (More on the LEPCs in future articles).
First, we identify the scenario as best we understand it.
We are in the midst of a pandemic, that to date, has infected 4.8 million Americans and killed 157,000 according to the Johns Hopkins dashboard. In North Carolina, nearly 129,000 people have been infected and Caldwell County has had nearly 1,200 of its citizens infected. In North Carolina, 2,901 people have died from a Coronavirus infection.
In the midst of this, Governor Cooper has ordered the reopening of schools.
Schools have been closed since March because of the pandemic and educators and parents are concerned that children are going to suffer academically because of the long period without structured instruction for the students. Additionally, economic hardship, as well as family challenges and even dysfunction could be causing harm to children that returning to school could help mitigate.
Conclusion: There are many things we don’t know, limiting our Situational Awareness. Hence, while there are compelling reasons to reopen the public schools, the unknowns, especially combined with the fact that there is no vaccine yet available, must be considered as potentially aggravating factors that could inject a disaster within a disaster. This requires that we operate by the Precautionary Principle, accepting responsibility for proving, by facts as best as can be determined, that returning to school is safe. If we are unable to do so, then we will project under what circumstances we believe — based on current information — that we can reopen schools safely.
First, we must acknowledge there is much uncertainty about many aspects of the Coronavirus.
What we do know is that it is highly contagious and is deadly (especially among those with comorbidities).
There is currently no vaccine for it.
We know that the overwhelming majority of infectious disease physicians and other experts agree that face masks are, for now, the most effective means to mitigate transmission (if sheltering-in-place is not an option). Following that, social distancing of at least six feet also helps mitigate the transmission rate.
We are uncertain about the transmission rate, but a consensus is emerging that it is currently at about 3, meaning an infected person will infect three others. According to Paul Klotman, M.D., President, CEO and Executive Dean of the Baylor College of Medicine, that number needs to be below 1 for children to return to school safely. Indeed, in this video, Dr. Klotman offers his plan for how we can return children to school safely. (This is a must-watch video, not only for his return-to-school plan, but also his sensible, realistic, and hopeful outlook — if we start doing things properly. Most importantly, he attempts to turn our focus to the proper parameters; if you want to go straight to Klotman’s school opening plan, it starts at the 11 minute mark, but the preceding portion helps understand his plan).
Testing rates remain inadequate, though relatively better in Caldwell County.
Because testing rates remain inadequate, the positive case rate is also not fully known.
The number of new cases daily in the county can’t be accurately known because of inadequate testing.
Personal hygiene of children is notoriously poor, meaning the number of people they could infect is higher than the average contact.
We know that infection rates have and will increase if a person’s number of contacts are increased.
We know that the length of time that a person is in contact with another person increases the likelihood of infection.
We know that close proximity to the individual will increase the likelihood of infection.
We do not know the number of infections children and those they infect will create, but it is reasonable to expect the number will increase.
We do not know the total population susceptibility. In short, we have not identified vulnerable populations, such as a teacher that might have asthma or a second-grader that has serious health issues.
We know that Dr. Klotman demonstrates that three factors are required before reopening schools: 1) The transmission infection rate is less than 1; 2) We have substantially and consistently reduced the new case rate in our community; and 3) Less than 5 percent of the population is testing positive.
Conclusion: We have inadequate Situational Awareness to safely open schools. Vulnerable populations have not been identified. Every re-opening to this point has led to spikes of cases. Lacking enough information, we are unable to prove that opening the schools is safe for children, teachers, staff and the general public. Hence, we shall develop an Incident Action Plan (IAP) for utilizing only distance learning initially, and identify the circumstances in which in-person classroom activities will be safe.
INCIDENT ACTION PLAN
The school system needs to identify crucial operations and the logistical needs to support them (steps already taken, based on conversations I had with Superintendent Dr. Don Phipps a couple of months ago).
The school system needs to identify costs with operations and a plan for limiting and/or recouping costs associated with reopening schools (also likely addressed as much as reasonable at this point) .
More importantly, the school system needs to insist on robust community collaboration with emergency services and public health. Regular meetings — essentially consisting of LEPC members — should have begun months ago and be ongoing regularly. The system needs help identifying vulnerable populations, with contact tracing, and other needs, such as providing Personal Protective Equipment (PPE).
The School System must also have a Crisis Communications Plan (again, the school system is generally quite competent in this area).
The Precautionary Principle requires that we delay reopening school because we do not have enough scientific evidence to prove it is safe to do so.
The school system — in particular the Board of Education members — must insist on full cooperation from local and state public health officials to implement community restrictions so that our community can achieve those goals outlined by Dr. Klotman.
All leaders must recognize that the “old normal” is exactly that. Old. It is gone. Those people and organizations that will thrive through this pandemic will be those that are nimble in thinking and reaction. That is why the school system should be operating by NIMS. It, followed properly, allows for tremendous discretion in decision making. It does not prescribe solutions; rather, it merely provides a framework for properly identifying the problem(s), response and mitigation strategies, and finally recovery.
The fundamental principle of disaster management is that all disasters begin and end locally. This is even true in a pandemic. Local officials are best equipped to address local needs and issues. This principle is particularly true in this event, as the federal response — which also should have followed the NRP and NIMS — was and remains inadequate. So, it is incumbent upon our local officials to assume full responsibility for every decision they make.
© Michael M. Barrick, 2020. Barrick holds a post-graduate Certificate in Community Preparedness and Disaster Management from the University of North Carolina Gillings School of Global Public Health. He holds numerous certificates in FEMA’s NIMS program. He worked as the Safety Officer and Emergency Management Coordinator at Frye Regional Medical Center in Hickory, N.C. and Stonewall Jackson Memorial Hospital in Weston, W.Va. He has served as Incident Commander, Safety Officer and first responder in numerous disasters, including the H1N1 pandemic, an airline crash, hazmat incidents, mass casualty events, power outages, floods and other such events. He designed and developed the disaster websites for both hospitals, demonstrated as a “Best Practice” at the Triad Regional Advisory Committee, Winston-Salem, N.C.. In his leadership of the FRMC response to the H1N1 outbreak, a news conference to educate the community was highlighted in the Raleigh News & Observer as a model of crisis communications. He has served on numerous LEPCs and written about disaster management for two decades. In the 1970s he worked as an EMT/paramedic in Charlotte, N.C. He is also a retired educator and served on the Caldwell County Board of Education from 1998 – 2001.
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