Friday, July 17, 2020

CDC Sets a False Choice for Opening Schools

The CDC released "considerations for schools for ways in which schools can help protect students, teachers, administrators, and staff and slow the spread of COVID-19." The CDC frames these "Guiding Principles" in a false premise that may likely lead to a paradigm shift far more detrimental to children's physiological, social, and educational health then COVID is to their physical health.

The preface to these "guiding principles" begins with this statement, "The more people a student or staff member interacts with, and the longer that interaction, the higher the risk of COVID-19 spread." It's a fact but followed by some very extreme measures to prevent that spread would indicate that the CDC believes the risk for significant spread is the reality. Clearly the CDC believes that the close interaction of children in natural ways will lead to COVID spread on a scale that would warrant a serious consideration of highly irregular and intrusive measures to prevent children from being infected and transmitting COVID to others. These "guiding principles" are therefore presented under a false premise. The data on COVID and how children contract and pass the virus does not support this premise.

The general data as well as a multitude of studies have shown that the vast majority children who test positive have mild to no symptoms. Children have shown to be less likely to contract COVID and less likely to pass it to adults. An Australian study recently released impressive data confirming what we have suspected from the start of the pandemic. Australia tracked eighteen infected children from fifteen schools for six weeks, only two of their 863 close contacts became infected. A transmission rate of less than 1%. This isn't the only finding with similar results. Schools in England have not completely closed during the COVID pandemic, they remained open for children of "key workers" and those with special needs. The children were not made to practice strict social distancing or mask wearing, but their daily interactions with both their teachers and peers, as well as their working parents who were regularly exposed to the general public, did not result in any marked outbreaks attributed to children passing COVID. Some schools in England will begin opening schools this week with no masks required and with regular interactions with their teachers and other students.

This trend is not a stand alone trend, many countries did not respond to COVID by completely closing schools. Tiawan, Sweeden, and Denmark kept schools completely open throughout the pandemic without seeing any evidence that children were a driver of COVID spread. A nine-year-old boy who contracted Covid-19 in Eastern France did not pass the virus on despite coming into contact with more than 170 people. So why would the CDC begin the conversation of opening schools in the U.S. under the premise that there is a significant risk of COVID spread from children or among children in schools while the rest of the world is reporting that the risk of coronavirus spreading in schools is "extremely low?" Are they concerned about children dying? Is that a reasonable concern?

The truth is that COVID children have been mercifully speared. Not only have we seen that children aren't putting their close contacts at risk of contracting COVID, but we also have solid data that children are not at high risk of being harmed from COVID either. A study in the Journal of American Medical Association; Pediatrics reported that only 48 children -- TOTAL -- were admitted to the ICU in the U.S. in a three week period from March 14 to April 3. Compare that to the number of adults admitted to the ICU in that same period and you will see how astonishing low that really is. 83% had an underlying condition and the fatality rate for children admitted to the ICU with COVID was 5% compared to the variable death rates of 50-60% for adults admitted to the ICU with COVID. Not only has death from COVID among children been extremely low, children are at significantly greater risk of dying each year from the seasonal flu then from COVID, and yet we have never considered it acceptable to cancel lunch and recess, make children wear masks all day, or separate children from their friends in order to create a sterile learning environment to prevent yearly deaths from the seasonal flu.

As if there is a complete disregard for the overwhelming data on COVID in child populations the CDC publishes a long list of "things to keep in mind" as schools consider whether to reopen. Among the things that schools should consider are measures to socially isolate children in verily extreme ways, especially in light of the COVID facts. This photo graphic has circulated Facebook, highlighting some of the extremes in the CDC "guiding principles."

Do these sound like reasonable considerations in light of the data?

Besides the misspelling of the word "guidelines" by the creator of this poster, which has been highly criticized as a way to undermine the message of the poster, the poster doesn't contain one guideline that isn't in the CDC's published document. That didn't stop Facebook from placing a warning over the photo. 

Is it misleading? Is the CDC recommending these measure be taken by schools? 

Yes. Read the document for yourself. Look at how the CDC lays out these "guiding principles" and CONSIDER THE PARADIGM THE CDC IS SETTING UP. After making a statement that infers that COVID presents a risk significant enough to warrant schools to consider their guiding principles, it then builds a false frame from which we will now discuss these measures. This is how the CDC categorizes the risk assessment for the school setting:
  • Lowest Risk: Students and teachers engage in virtual-only classes, activities, and events.
  • More Risk: Small, in-person classes, activities, and events. Groups of students stay together and with the same teacher throughout/across school days and groups do not mixStudents remain at least 6 feet apart and do not share objects (e.g., hybrid virtual and in-person class structures, or staggered/rotated scheduling to accommodate smaller class sizes).
  • Highest Risk: Full sized, in-person classes, activities, and events. Students are not spaced apart, share classroom materials or supplies, and mix between classes and activities.

Let me Interpret
  • Lowest risk: SCHOOLS REMAIN CLOSED! 
  • More Risk: Schools open but only if schools implement highly restrictive measures.
  • High Risk: Schools open and children interact in natural ways.

The supposition here: IF SCHOOLS OPEN and choose to take on "more risk," they MUST do so in ways that will prevent "high risk" behavior. 

The “More risk” category is the category that contains the suggestions that appear in the graphic shared on Facebook. The graphic that has been dismissed as misleading under the charge that the creator cherry picked the most restrictive suggestions merely focus on those considerations that most directly impact the experience children will have on a day to day basis. The "high risk" category is framed as unacceptable, therefore it is the purpose of the entire document to present restrictions, "principles" as the CDC likes to call it for a softer affect, for this "more risk" category we are entering as we consider opening schools in the fall.

It is apparent from the false premise in the first place, and the frame for which they identify risk in the second, that the CDC does not support children returning to school in the fall under natural and normal interaction. I do not believe it is misguiding to represent this document as the CDC promoting the implementation of socially isolating measures under the false premise of preventing greater spread of COVID. The document discourages natural social interactions by categorizing them as leading to a high risk of COVID spread, and they do this knowing full well that the data doesn't support the tone they are setting for this national discussion.

The silver lining...

Schools can determine, in collaboration with state and local health officials to the extent possible, whether and how to implement these considerations while adjusting to meet the unique needs and circumstances of the local community... Implementation should be guided by what is feasible, practical, acceptable, and tailored to the needs of each community." (CDC "Considerations for Schools)

Possible, feasible, practical, acceptable?

Most of the suggestions made in the document related to the personal interactions of students with their educational environment aren't practical, feasible, acceptable, and highly unlikely to be possible in practice. Does that mean the CDC is recommending schools choose to open in the "high risk" category? It's more likely that they are setting up a false choice.

It's a great thing that state and local leaders are free to choose the feasible, practical, and acceptable “high risk” opening and give children a more normal and mentally healthy learning environment, but the set up is in. The CDC has drawn up a document that puts governments and schools who choose not to implement socially isolating policies in a compromised position and guaranteeing they will be charged in the court of public opinion with the great crime of being highly irresponsible, the facts be damned!

SO WHY? Why would the CDC in the US go far beyond what experts in other countries have recommended, what even the WHO has recommended, and far beyond what the data indicates is necessary, and set up a social paradigm where a school that opens in a natural normal way is acting in a “high risk” fashion? Why would the CDC frame the guiding principles that will feel uncomfortable, frightening, and extreme to children as the principles of moderation? Ponder those questions.

SO YES, it’s voluntary. YES, it’s not the law. YES, some schools may choose not to follow these guidelines — THANK HEAVEN — but how does that excuse the way this discussion is laid out by the leading institution for public health in the U.S.. How does that excuse the way these guidelines will be used to put social and legal pressure on states and local leaders to make a false choice between the "safer" paths and the “high risk” option?

MARK MY WORDS — This stuff has a HUGE impact in decision making on a local level and it will be covered by the media nationally to judge which states and communities care the most about the safety of their children. 

I believe we need graphics like the one getting traction on Facebook, and now censored by Facebook, because it is necessary to push back against this kind of paradigm and follow the facts about COVID, and what is natural and logical about life, so that our children are not needlessly traumatized. I hope that our state and local leaders won’t rely heavily on these guidelines because socially isolating children is not a healthy way for children to interact in a learning environment, or any environment.

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