CHICAGO GOES BACK TO FULL IN-PERSON SCHOOL TODAY AS COVID SURGES ACROSS SCHOOLS ALREADY OPENED; IS NYC READY? THE LATEST FROM DR. OSTERHOLM AND AN ICU PHYSICIAN

As Delta variant rages out of control in the USA and the government and many people continue to pretend the pandemic is over, our colleagues in Chicago returned to school this morning with only a very limited remote option. Teachers will be returning in New York next week and the kids are coming back on September 13 with a remote option only available for very few. 

I am worried about the kids, including my own who are 12 and 7 as obviously the 7-year-old cannot be vaccinated. I am concerned for the adults too as it seems this country is just in major denial about COVID, particularly when it comes to schools. The national mood seems to be we are tired of the pandemic so we will move on. COVID has other plans, however, and there are some dire consequences. Look at what is occurring in schools already opened.

This is from AL.com by columnist Kyle Whitmire:

Whitmire: The South walked kids into a COVID buzzsaw. Don’t repeat our mistakes, America.

America, it’s time for class. Take a seat and pay attention.

Pay attention to Tennessee, where 36 percent of new COVID cases are among children, about triple the rate of a year ago.

Pay attention to Georgia, where more than 125,000 students have already had in-person school disrupted.

Pay attention to Mississippi, where COVID cases among students, teachers and staff are more than 10-times what they were this time last year.

Pay attention to Alabama, where …

Well, we can’t say how bad things are here because our public health officials can’t yet compile the data we need. We’re driving this school bus with our eyes closed.

In its latest attempt to show the rest of the country that we know better, the South has shown America, alright. We’ve played our customary role. Like the kids in those grisly Drivers Ed videos, we’re the cautionary tale.

Don’t let this happen to you.

If you’re not from the South, you might be wondering how we could have such problems in schools this time of year when school starts after Labor Day. Through some quirk of the calendar I can’t explain, schools here start in early August, a month or more before the first bells ring elsewhere in the country. This little asynchronicity gives the rest of you the opportunity to learn from our mistakes.

Whitmere now has the numbers for Alabama and they are horrible:

UPDATE: After this column published, the Alabama Department of Public Health launched a public dashboard for COVID cases in Alabama schools, although the data it uses is still incomplete. The Alabama Department of Public Health now reports that more than 5,571 students contracted COVID in one week, a 700 percent increase over the same time last year.

Is NYC going to be any better? More people are vaccinated here and the city says they improved ventilation in schools but this story in Chalkbeat shows the DOE probably didn't buy the best product:

Brent Stephens, a professor and chair of the civil, architectural, and environmental engineering department at the Illinois Institute of Technology, recently conducted an independent test of the product after Allen raised concerns about the device on social media. The Intellipure was among the least efficient, he found. It ranked ninth out of the dozen his team tested in terms of its clean air delivery rate, or CADR, which measures how often a purifier turns over the air in the room.

Once again, I listened to Dr. Michael Osterhom's weekly CIDRAP podcast on COVID-19 and I became deeply concerned as I paid very close attention to the part on kids and schools which starts around the 45-minute mark.

He talks about the vaccine for kids under 12. He says that only 20% of kids who could be vaccinated have received at least one dose.

He then says we have to stop with the "happy talk" about the schools. Public health is doing a disservice on schools being opened throughout the US. Public health has bought into the emotional issue of in-person education being needed but we have to be transparent and honest. Public health is saying the risk of kids missing in-person learning is so great that we will emphasize that over other data on what the risks might be. Data used for CDC guidelines on schools was collected before Alpha and Delta variants came to the United States. The idea that there was very little transmission from kids was valid in the first 8-10 months of the pandemic. They don't hold up now. CDC recommendations have some validity but they are built on a house of cards. 3 feet distance if you have a face cloth covering on defies gravity. He wants adequate masking. Aerosol won't stop at 3-feet or with plexiglass.

Look what is happening in the last couple of weeks in the Southern states. Osterholm goes over some of the data. Over 1 in 100 school-age children have tested positive for COVID-19 in Georgia. Florida has the same situation. Over 11,000 infected students and over 2,600 staff positive. His conclusion: He doesn't think it's possible to get kids back to schools safely today. We gotta tell the truth. CDC says the priority is getting kids back to in-person schools. CDC's priority should be the science. What does safely mean? It's not what's going to happen in the next 6 weeks. CDC recommends universal indoor masking but what about the quality of the masking? What are we doing putting kids in harm's way by putting them in rooms closer than 3 feet? The aerobiology is terrible. Do you think if you were closer than 3 feet to someone smoking you would smell it?  You bet you would. CDC misrepresenting what science says. They have dropped the ball on this one.  Science is telling us it is impossible to open up schools with delta spreading. Put beliefs aside. Health equity is real. CDC says health equity is a critical part of this. It is not scientifically sound information to say you can make schools safe. We can make them safer.

There is a hierarchy of environmental controls:

1-Vaccines, they are not being used effectively. The vaccine will trump a mask every day. Why don't we put an emphasis on vaccine mandates? We know it will tear our communities apart.

2-Ventilation, we need rooms with 5-6 air exchanges per hour. Use portable air cleaners. HEPA filters very effective. It may be too expensive or they might not be available. You can build a Corsi Box.

3-Physical distancing, plexiglass shields are part of hygiene theater. 6-feet isn't magical. Someone 20 feet in front of me on the sidewalk was smoking and I smelled it. 3-feet distance is wrong, wrong, wrong. It defies gravity to think it will make a difference.

4-Testing and quarantine. Frequent testing is needed. CDC is wrong saying 15 minutes of exposure for transmission; it is probably only seconds to a minute with Delta. Quarantine is needed if exposed. Pediatric intensive care units in this country are filled in the United States

5-Masks. A good quality mask can reduce transmission. Face cloth coverings provide little protection. You need an N95 or KN95 or barrier face covering. Next level to N-95. Putting a mask under a nose is like closing three of four doors on a submarine. Quality masking.

Delta is going to do what it's going to do. CDC has provided unscientific recommendations.

Next up, Dr. Osterhom introduces Dr. Jenna, who is an intensive care unit physician. She promotes vaccination. and talks about how demoralized front-line healthcare workers are because of patients who don't vaccinate and ask for experimental remedies that don't work and then threaten to sue if they don't get them. It's like a house being on fire and someone coming and yelling at a firefighter saying to use a squirt gun. The vast majority in the ICU are unvaccinated or a few who are vaccinated but were unable to get an immune response. Training can't prepare us for the anger. We have PTSD, panic attacks and insomnia. It's not safe to travel which she usually does to relax. ICU professionals are frustrated as information from trustworthy sources is being blatantly ignored. She adds we are spread so thin. Misinformation and politics are getting in the way. People are moving beyond the pandemic but it isn't over for me. 

The system is not created for this pandemic. She urges people to get vaccinated. She is confident the vaccine is safe and will keep people out of the ICU. Patients in ICU are almost all unvaccinated. People coming in now are younger and don't have comorbidities. Pregnant women coming in. Babies born early. Patients in ICU for weeks and months. 25% have long-haul symptoms.

 She volunteers to vaccinate people. Every patient she vaccinates is one less person she will see in the ICU. ICU doctors will tell you to run, not walk, to get the vaccine.

There is more. Please listen to this woman.

If you want numbers, here are some: 

What about a real remote option?

Update:

A picture from a crowded Chicago high school says so much.