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On Jan. 28, District 65 administrators made a 75-minute presentation summarizing how they planned to open the schools for in-person learning starting on Feb. 16. Several doctors on the District’s recently formed Medical Advisory Group also spoke about the latest research they say shows it is safe to open schools for in-person learning, assuming masks are required and other mitigations are in place. Administrators discussed the mitigations being used. The presentation was available by zoom and streamed live on the District’s you tube channel.

Some Background

On Jan. 20, District 65 Superintendent Devon Horton announced that schools would open for in-person learning on Feb. 16, using a hybrid model.

Under the model, all students will engage in remote learning for the entire school day on Mondays. For Tuesdays through Fridays, the model provides:

·      K-5 students whose parents indicated a preference for in-person learning will attend half-day sessions in-person on Tuesdays through Fridays, either a morning or afternoon session. They will attend the remainder of the instructional day in remote synchronous and asynchronous learning (including math and literacy practice, PE, Fine Arts, Science/Social Studies).

·      If K-5 students have three priority flags, they will have full day in-person learning with an in-person session in the morning and supervision for asynchronous learning in the afternoon on Tuesdays through Fridays.

·      Students in grades 6-8 with one or more priority flags will have full-day in-person learning on Tuesdays through Fridays. Students whose family indicated a preference for remote learning or who do not have any priority flags will have remote learning.

There are some variations for the middle schools.

 Dr. Horton said 3,618 students will return to in-person learning; and 3,697 students will continue with remote learning. He said the learning pathways were based on parental choice to the greatest extent possible.

He said there are limitations on the number of students who can be brought back to in-person learning due to building capacities and the need to adhere to social distancing. He said the District is prioritizing the return of students in accordance with the guidelines of the Illinois State Board of Education. The guidelines prioritize students who qualify for free- and reduced-fee lunch, emergent bilingual students, students who are regarded as homeless under McKinney Vento, and students with an IEP or Section 504 plan.

The Decision to Return to School

Dr. Horton said, “I want to reiterate the science of this pandemic, as it shifts, we make better decisions and stronger decisions in our work to reopen our schools safely. There are a lot of questions regarding, ‘Why didn’t we do this back in the fall?’ There was not a lot of science available that we were comfortable with.”

He said the District has been able to get more comfortable with the science relating to opening schools for in-person learning “because now we have a Medical Advisory Group; and I would just like to say we convened in January.” He added, “There was an original communication led by Dr. Wild in December, which was important, extending an olive branch.”

The Medical Advisory Group is composed of “a diverse team of medical professionals who represent various disciplines, work both within and outside of our community, and all with firsthand COVID-19 experience,” Dr. Horton said, adding that the advisory team also includes union leaders, District administrators and parents.

Dr. Horton said the advisory team did not make the decision that the District will return to in-person learning. “This is a decision made by administration, myself and my team and our School Board.

“I want to make sure that that is clear as we move forward. They [the Medical Advisory Group] were our partners, and they gave us the research and the knowledge that we need in order to open our doors, ongoing collaboration to monitor local and regional health conditions, mitigation plans, vaccine awareness, which is huge, and more than anything, just additional support.”

Input from the Medical Team

David Soglin, MD, Chief Medical Officer La Rabida Children’s Hospital and a member of the District’s Medical Advisory Group, said, “First of all, we will be following, you will be following, all the State directed mitigation. If the test positivity rate, which is usually measured on a rolling seven-day average – so that one single spike doesn’t determine actions – reaches 12% or higher in our Region, Region 10 [Suburban Cook County], then we will be moving by State order into phase three mitigation. And that would require an adaptive pause and a pivot back to remote learning.

“We’ll also be looking at more local metrics including our attendance area, specifically, advice from Evanston, Health and Human Services Department. And then if there is enough community spread that there’s difficulty staffing in-person learning, then that obviously would also have an impact, as well as decreased access to key PPE and other issues that may arise.

“As Dr. Horton said, this has been an incredible year of learning, for us medically as well as in the school systems.”

Dr. Soglin displayed several charts showing the trends of new COVID-19 cases in Cook County and Illinois, and said “The new cases in Illinois are on a nice decline, as are new cases in Cook County – both are moving in the right direction. They’re both still high. They’re higher than they were in the spring when we first of all learned about COVID-19. So, the fact that they’re coming down is important, but does not mean we can stop wearing masks or stop distancing or any of the other mitigation techniques we’ve been using up till now.”

Dr. Soglin also said the test positivity rates in Suburban Cook County were “coming down very nicely. We are significantly below the 12% that would move us into mitigation.”

He noted that the test positivity rate in Suburban Cook County is now below 8%, “so we’re moving in the right direction, although there’s still a significant COVID burden.”

Dr. Soglin discussed two recent studies. “I think at the beginning of the pandemic, we were very worried that just getting people together in schools would add to community spread,” he said. “We’ve learned quite a bit over the last year, both in the United States as well as internationally.”

Dr. Soglin displayed a graph that is contained in a study, “Factors Associated with Positive SARS-CoV-2 Test Results in Outpatient Health Facilities and Emergency Departments Among Children and Adolescents Aged <18 Years — Mississippi.” The graph is below.

“This first graph is a reflection of cases of COVID in children and adolescents less than 18 years of age in Mississippi,” said Dr. Soglin.

The graph illustrates the risk of contracting COVID-19 if a person under age 18 participates in 12 different types of activities. He said the center vertical line is the “even mark.” If a described activity has a blue horizontal line on the right side of the vertical line, it indicates that engaging in the activity presents a greater risk of contracting COVID-19. If an activity has a horizontal blue line on the left side of the vertical line, it indicates a lesser risk of contracting COVID-19.  Anything that crosses the vertical line means the risk is about the same.

Looking at where the horizontal blue lines were entirely on the right side of the line, Dr. Soglin said, “If you have close contact with someone with COVID-19, that puts you at dramatically greater risk of developing COVID-19. Similarly, being involved in social gatherings, like weddings, or funerals or holiday parties, or even children’s social gatherings like playdates, those also put you at significantly higher risk, as does having a visitor in the home.

“Really, interestingly, is what protects you from developing COVID,” said Dr. Soglin. Referring to the third horizontal line, he said, if a child under the age of 18 is in a school where people wear masks, it does not increase the spread of COVID-19 but decreases the spread. “It protects children to be in a school where people are wearing masks. Even being in any school at all is neutral, which is the line right above that. But being in a school where people are wearing masks, which is what’s called for in the District 65 plan actually protects children from getting COVID,” he said.

Dr. Soglin referred to another graph contained in a study which took a look at 17 schools in a rural school district in Wisconsin. The graph is reproduced below.

 Dr. Soglin said the graph shows that even in communities that have very high test positivity rates (reaching as high of about 40%), and a very high number of new cases per 100,000 population (reaching as high as 1,200 per 100,000 population), the number of COVID-19 cases spread in the schools “is very small, … almost none.” He said there was “almost none despite huge community spread.”

The bottom dotted line running along the very bottom of the chart shows the number of COVID-19 cases attributed to in-school spread.

Dr. Soglin said 92% of the students in the 17 schools wore face masks; the schools had pods of students; staff maintained six feet of distance whenever possible; and the schools had good contact tracing, and quarantine after exposures.

He said during the 13 weeks of in-person learning, “there were seven cases of COVID among students, among almost 5,000 students, and no cases of COVID amongst staff who got it at school.”

A second chart illustrating that the number of new COVID cases attributed to attending school is very low is below. The line, which is barely visible running along to bottom horizontal line of the chart shows Covid cases attributed to attending school.

Sharon M. Robinson, MD, Physician Director, Primary Care NorthShore University HealthSystem and a District 65 parent, said, “What we know is that schools can successfully conduct in-person learning, regardless of the community metrics, as long as the mitigation strategies are in place and are layered.

“And I want to reiterate that there has been so much data that has come out recently to support this, that is incredibly compelling.”

Dr. Robinson said District 65 is “taking a layered approach to mitigation” and there are three levels.

Level One: “These are the most important things that we must do, in order to keep everyone safe and to keep schools running,” said Dr. Robinson. They include face masks, hand hygiene, and distancing. Dr. Robinson said, “In Evanston, in particular, we have proven that we know how to keep ourselves safe. We know how to wear masks over the age of two; we practice good hand hygiene; and we practice social distancing. So, if you do those things, and those things alone, you have a very, very good chance of keeping everyone safe.”

Level Two:  “On top of that, you layer level two initiatives,” said Dr. Robinson. This includes things “such as symptom screening, and cohorting, or putting students in pods, which again, is what District 65 is doing.”

Level Three: Dr. Robinson said level three is “an additional level of protection,” and “again, District 65 has kind of gone above and beyond, as you’ll hear in their enhanced cleaning, ventilation systems and their contact tracing.”

 Dr. Robinson added, “In addition to our facemask, hand hygiene, social distancing, you’ll hear me say it over and over is our behavior outside of the school environment. What we do outside of school as parents, and children and staff is what is going to dictate how safely we can re-enter with in-person learning.”

Dr. Robinson also touched on vaccines. “I know there’s new variants out of the COVID-19 virus and people are concerned about the vaccine efficacy. We do know that these vaccines are still effective against these variants, we just don’t know if they are as effective as they are against the original strain of the virus where they had an efficacy of about 94 to 95%.

“But that’s why it’s so important to still anchor off of our masking, hand hygiene, and social distancing.”

Bridget Wild, MD, Pediatric Hospitalist, NorthShore University HealthSystem / Child Protection Committee Chair, NorthShore University HealthSystem, and a District 65 parent, said, “I was going piggyback and say we are so grateful that the vaccine is over 90% effective. But that the mitigation strategies that District 65 is implementing within schools is also greater than 90% effective in mitigating risk.

“And so regardless of what is going on with people’s vaccination status, we just cannot reiterate enough how important it is going to be to adhere to the masking and hand washing, and with that layered approach to safety.”

Some of the Mitigations at District 65

District 65 administrators summarized how the hybrid instructional program will work. For example, at the middle schools, students who are participating in the remote learning model at home will see live instruction being delivered to their classmates who are participating in in-person learning at the schools, said Terrence Little, Assistant Superintendent of Secondary Schools.

Administrators also summarized what the District plans to do to mitigate the risk of COVID-19 infections at the schools. Some of the actions are summarized below.

Self-Screening. Parents will be required to fill out and email a daily heath certification for their students. As part of the self-certification, parents must take their student’s temperature, which must be lower than 100.4 degrees. Teachers and other essential workers must also complete a self-certification form on a daily basis. Students must enter their school through a designated entry.

Bus Transportation: Before a student may board a bus, the student’s parent must have submitted the daily health certification form. Students will have their temperature checked by an aide prior to boarding the bus. Buses will operate at about one-half capacity, which will facilitate social distancing on the bus. Students will have an assigned seat. A bus aide will be on each bus for supervision.

Face Masks. Students will be required to wear a face mask at all times except when eating.  Students are encouraged to bring extra masks with them each day. The District will have a supply of masks available in case a student needs one.  

Maintaining Six Foot Distances:  There will be a lower number of students in each classroom to enable social distancing. Desks are placed so there is six feet of distance between students; and the floor is marked for the desks. Plexiglass partitions are installed on tables. To maximize space in the classrooms, furniture that is not needed for instructional purposes has been removed.  

The hallways are marked to assist in maintaining social distancing. Lockers will not be used. In the washrooms, alternating sinks and stalls are closed off. Strict social distancing will be enforced when masks cannot be worn, such as when eating.

Limiting Movement: Students will be kept in the same classroom for their courses, and teachers will move from one class to the next, as needed. Students who have lunch at their schools will eat in their classroom.

Cleaning: There will be increased cleaning of restrooms and commonly touched spaces such as doorknobs, light switches, railings, sinks, countertops, etc. The District will use electrostatic cleaning of restrooms, carpets, and other surfaces. Disinfectant will be available in all classrooms to use as needed. Hand sanitizing stations will be spaced throughout the schools.

Ventilation: Raphael Obafemi, Chief Financial and Operations Officer, said the District has spent a lot of time on ventilation and upgrading air filter. It is adhering to guidelines of CDC, he said.

 

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