Dr. Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, spoke with the Des Moines School Board about public health issues around the re-opening of schools.
Way back in March, when it became clear COVID-19 would have a significant impact on education in Iowa, Superintendent Ahart began consulting with healthcare and public health experts to monitor the virus and its consequences, including the significance of community spread in school buildings and its potential to endanger teachers and staff, students and their families. The consequences of not taking this virus seriously enough goes beyond a teacher workforce shortage, though that is a significant worry, and becomes personal as the district considers the still largely unknown long-term health impact on employees, the children in our care and their caregivers at home who become infected because we failed to lead at a critical time.
During the July 31, 2020 DMPS School Board workshop, Dr. Michael Osterholm, PhD, MPH, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, spoke with the Board and answered questions regarding concerns over the impact of COVID-19 if students return to school. Dr. Osterholm, an Iowa native, is Regents Professor, McKnight Presidential Endowed Chair in Public Health, Distinguished Teaching Professor in the Division of Environmental Health Sciences, School of Public Health, a professor in the Technological Leadership Institute, College of Science and Engineering, and an adjunct professor in the Medical School, all at the University of Minnesota. From June 2018 through May 2019, he served as a Science Envoy for Health Security on behalf of the U.S. Department of State. He is also on the Board of Regents at Luther College in Decorah, Iowa. He is also a regular expert source for the national news media on a range of public health issues, including the response to COVID-19.
Below is a summary of comments and key points Dr. Osterholm conveyed to the School Board during its recent meeting (you can also click here to watch/listen to the entire virtual meeting).
SCHOOL SAFETY
The key message for me has been flexibility. We very strongly oppose the federal top-down must-do kind of approach realizing that each school district was different that the expertise of the school district level was by far the best expertise we have, that school districts are committed to trying to educate their kids in the best way they possibly can and we need to listen to them to understand how to do it.
IOWA COVID-19 DATA
One of the challenges that I saw with the Iowa data is, first of all, I looked at those numbers, they seemed very, very high in terms of how you could operate in your community being wide open. I think the point is the likelihood of having a problem in your schools is going to be tied directly to how much transmission is going on in the community. I don’t think in Iowa you necessarily can count on your health departments to give you the backup or the leadership that you’re going to need right now. I know them well. I think highly of a number of them but I just know resource wise they don’t have to give what you really need right now.
STATE GUIDANCE TO RECALL INFECTED TEACHERS SHOWING NO SYMPTOMS BACK TO THE CLASSROOM
If someone’s in quarantine I would not call them back if in fact we thought they’re potentially exposed and may be infectious, You know the transmission for a number of people is highest in the two days before they get sick so that even among those who do get sick we’re worried about asymptomatic or pre-symptomatic transmission. I surely don’t want to leave you short staffed, but I think you’re actually inviting a stick of dynamite to the campfire.
STATE ASSERTION OF LOW RISK VS. HIGH RISK COVID-19 SYMPTOMS
I don’t know how you divide them into high risk or low risk symptoms. I’ve seen no one including the CDC distinguish them into high risk and low risk symptoms. I’ve never seen that before.
IMMUNITY FOLLOWING RECOVERY FROM COVID-19
There have been very, very rare reports of possible reinfections and for everything we have right now if you’ve been positive recovered, I would treat these people as basically being immune. I think that is reasonable. (Dr. Osterholm noted that antibody tests are unreliable and shouldn’t be used to determine immunity.)
TEENS AND YOUNG ADULTS
- Sports: In pre-college sporting activities and some high school events (nationwide) by last night that number (of infected) was over nine thousand. This is a hot group.
- Bars: I was involved with investigating the bar in Mankato, MN, where 200 people got infected over a course of two nights with one mildly, mildly ill bartender and he didn’t walk through the place he just stayed behind the bar.
- Spreading at home: I just in the last two days have learned of five different situations here in the Midwest where young adults came home for Father’s Day, brought the virus with them and in all those instances either the father the mother are now dead and they were healthy.
TEACHER CONCERNS
I think that’s the kind of transmission spillover we’re beginning to see more and more of these younger individuals spilling the virus over into older individuals that’s why teachers have a concern.
FALL/WINTER WITH COVID-19
I think the challenge we have is that when we bring all these people together we’re going to see enhanced transmission and then by October when the temperatures start to drop we’re getting a much more indoor air exposure. Indoor air is our worst enemy in terms of dissipating the virus. I think it could be a tough time between now and the end of the year.
HOW WILL TRANSMISSION OCCUR AT SCHOOL
You’re breathing virus out in these little tiny aerosols. If you want to understand what an aerosol is like next time you’re sitting in your house and you see dust coming through in the window where you see the sunlight coming through that’s an aerosol or you’re at a department store and you’re four aisles away from the perfume department you still smell it or even more so you’re walking down the street and you smell a cigarette even though the person’s 45 feet in front of you those are aerosols. I have to also be completely honest with you and say there’s no way that we could adequately distance ourselves completely in schools.
WHAT WE CAN DO TO MITIGATE RISK
- PPE: Masking slows transmission of virus but shouldn’t be the only action taken.
- Cleaning/sanitizing hands/surfaces helps for all diseases but shouldn’t be the only action taken.
- Physically distancing helps.
- Maximizing ventilation/Improving HVAC systems is the most effective.
EXPOSURE TO INFECTED PERSON
Assume everyone nearby exposed if they were near an infected person for 15 minutes over the course of one day. In a classroom environment, all present should be notified of exposure.
