Covid Information Session

001hi good evening thank you for joining us to the information session about health and safety uh we really appreciate you being here and um superintendent mike morris and we have three panelists who are joining me tonight and we really want to appreciate this is our third since the pandemic began i believe third session with medical experts in our community so we're deeply appreciative i'm deeply appreciative i think collectively as a community we're deeply appreciative that folks who are connected to our community here in amherst uh and are knowledgeable and in many ways in the front lines of working uh on the pandemic as well as well as other health and safety issues are able to join us and share their expertise experience and wisdom with us so i think with that maybe i'll uh ask

002each of you to introduce yourself a bit and and um so peter would you mind starting us off by sharing a little bit about your role and uh where you work sure i'm uh peter everett i am a pediatrician i am at northampton area pediatrics uh northampton in amherst and i have lived here in the area since uh 2012 after coming up from from dc of new york and then dc um and so i've been a pediatrician there and live over here in amherst with a daughter in the school system at uh fort river and really um happy to be here to to talk about um about covid and flu and vaccinations and our kids and how to keep everybody healthy this winter right thank you so much peter lauren would you uh you mind

003going next sure i'm lauren westbrook i am an er doctor and a researcher down at bay state and i have young kids that are too young to be in the school system but my wife is a teacher in wildlife thank you so much lauren and bill hi everybody i'm bill soros i'm also an emergency physician at bay state medical center i've been practicing there since and also we have three kids now in the crocker farm system so um yeah we are heavily invested and i'm really happy here to be able to talk and hopefully answer some questions and share some information thank you so much and so just a couple things that i'd like to go over beforehand some of the topics that we're going to be talking about tonight are about moving towards winter

004where being outside may be less desirable for many of us and how to stay safe during that time period some vaccine information both about the flu vaccine as well as the potential of a vaccine for younger children coming up and booster shots which is another topic that's come up a lot in our community i'll start by talking about an update on school cases and school safety we'll also touch on masks and any questions folks have along the way so as people were are interested there is a chat box the bottom right hand corner and people can ask questions i do want to note that as it relates to school-based policies i'm happy to answer those questions these folks don't work for the amherst public schools that'd be my job so if there are questions about

005school specific things i'm happy to answer them and i just ask that everyone maintain a respectful tone as you can see from lauren's screen there's there's some young ones with us so we want to make sure that the tone stays consistent uh because you know we know some of our students are watching with their families so again thank you for joining us this will be uh replayed um and shared um in uh in our newsletter um and on friday for people who can't come also the youtube channel you know the link that you're on now can be shared so um i wanna just start by talking about school-based cases and i think the thing to note is what we've experienced this fall is consistent with what you'd expect us to experience at the beginning of

006the school year late august early september we had a significant number of cases locally and we had significant number of cases in school as those numbers have went down in our community the numbers have went down in school so you know this afternoon i put in every week in the state database we have to put in how many new cases there were in the last week and there are no new cases in our district this week and that's the first week in the school year that we've had that so you know that is a little different and then we've had and some great news but i think the thing that i want to note is that what we have found between last year when kids were in and this follows we're over 20 cases and

007we still have no evidence of school-based spread we've had close contacts those close contacts have tested negative and so we feel um good that our current measures at the current time are promoting healthy safe school environment i am conscious that there are some folks who really wish they were didn't have to wear masks to school um you know i think probably collectively all of us have that feeling in whatever our workplace is it'd be great to be on mass from a comfort perspective from seeing people's faces at this point um you know even though at our high school level we probably do meet the threshold of 50 or 80 of students and staff who are vaccinated we're going to stick with the mass you know our folks our public health department in the town is

008has been really clear that at the current time they believe that's the best course of action and as we keep continue to have positive cases and no spread it really does make us recognize that those mitigation strategies are effectively are being effective that students in school when we when the contract tracing's done they're more often than not when it's known they're finding out that it's from a non-school-based exposure we have no evidence again of a school-based exposure so you know the distancing we've maintained uh the ventilation that we worked on the universal masking we know by next test available for anyone who's symptomatic and in school during the school day you know those have been measures that we've seen as being successful in our schools and we're going to continue them during at the current

009time and you know as public health guidance evolves we may you know evolve along with it but there's no indication right now from our local public health department or lead nurse that we want anything to do anything other than maintain the course around our health and safety measures so i just wanted to start with that kind of broad summary of what we're doing and where we are with things and i thought maybe at this point i would turn and talk a little bit about the changing seasons about um right now today was beautiful this next couple days really gorgeous uh you know sadly for me i'm not a winter lover it's not going to stay like this you know we'll be having the traditional november snow ice muck weather coming in and not so long

010and i think there's a lot of concerns i've heard in the community about being indoors more often not just in school but actually in general as well and concerned about so many people have enjoyed outdoor play dates and things like that for their kids that may not be as accessible as we head towards winners so i think i'll just turn to the panel and see if you have thoughts about as the seasons change what are some strategies parents can can use and some thoughts about how to maintain that safety but also maintain that social connection that we know our students have craved and have really enjoyed as things have opened up a bit more over the last couple months so anyone can uh start off and speak into that i mean i guess i can

011start with uh some general statements um so i you know as mike said i'm definitely not part of the arps system um and that being said i i really kind of admire looking from a physician and from the standpoint of a father with three children the effort that the school has made and i think that's really shown in the data that we really don't have school transmission and it's based on this idea i think of really harm reduction of taking multiple strategies and i think that's really important especially with delta there's not one thing that works for everything unfortunately you know vaccines are very important but it doesn't work for everything maths are very important but it doesn't work for everything and having multiple strategies and multiple things that you can do makes it much

012less likely that you're going to get covert or it's going to spread so right now that has been a combination of vaccines and ventilation and masks and spacing and i think the worry from a lot of us um as was said is that we lose a little bit of that in the winter mostly that idea of ventilation and going outside so the first thing i'll say it's just obvious if we're losing one of those reduction strategies we really want to make sure we strengthen those other strategies i don't know about you but i've been kind of lacks with hand washing and other types of things thinking about that thinking about you know play dates and you know talking with families and what are some exposures and and so i think the first thing is to

013make sure that some of your other efforts are just a little bit stronger as we come to those colder months where we know viruses like to to propagate indoors yeah i would absolutely agree with you there bill i think as the things that we can do is to just to do multiple things to kind of this whole idea that if you do a number of different things and you're more likely to to reduce the transmission um as we get into these colder months i you know it is nice outside i think i would still you know being outdoors during the winter and having outdoor play days and all that is still something that's really good and even as it gets colder um you know finding more time to spend outside even not just from a

014you know southwest spread of cobia perspective but as a pediatrician getting more kids outside and playing outside and being active and all that is a is a big benefit here uh and so i would still encourage that as much as you can and get your you know extra layer on and be outside as much as you can um and then the other thing to remember is is the social aspect too is just i think you can take all these measures and wash your hands and you know have your masks but um i think taking that step and and start one of the big important things i think is starting to reintegrate into to connect with people again um and so finding a way to do that in a safe manner is is important for our

015kids and sort of in that vein one one way that i personally found um helpful in doing that social connection in a way that i feel safe because i have very small children as you might be able to see i have a eight week old baby here is through testing but we test our family on a regular basis because it's free through umass if you're asymptomatic you can go you can pick up a kit and then you can drop it off without contact whenever you want um and usually if it's not a weekend you get test results back um later that day or by the next morning and so we do that regularly just to kind of surveil our family because i'm an er doctor my wife's a teacher um and while we mask and

016we do all those things our kids go to daycare one of our kids is is in a toddler classroom where they don't wear masks so we want to make sure that if we catch something that we can let people know as soon as possible even if we're not feeling symptoms yet the other thing that we do um is they're a little on the expensive side at seven dollars a test but the buy max now test you can get on walmart.com so we bought a bunch of those because we do need to have some of their social connections um and sometimes whether it's rainy and we plan to have people over something um it can always happen outside so what we did is we had people swab themselves um before they came into our house and

017so it made us feel comfortable that they weren't contagious at that time it's not a perfect test um but it's pretty good at saying are you contagious right at this moment um and so these are those tests it's a pack of of two tests um and so those are just some additional ways that that we feel better um and that we are in our family preparing for the winter when some things may need to move sort of indoors um but also preparing for there's going to be more colds because cold we're already seeing more colds in the emergency department i'm sure dr everett is as well um and and things like that to help us differentiate is this cobit how how worried do i need to be right now um before i can give to

018the pediatrician those sorts of things great thank you uh we're going to transition to other topics but you know as i said there is that chat button in the lower right hand corner so you don't have to wait till the end if you do have a question comment or an idea something that's working well for you we'd love to see that too and be able to share good ideas like you heard from from our folks on the call i thought the next thing there's kind of three categories of vaccine related questions that i know i'm getting and i'm not an expert and not a doctor or medical doctor and so you know sort of those three things one is the flu vaccine um you know as that's become more available i got mine uh on

019friday or saturday last week something like that you know thoughts about getting the flu vaccine particularly this year uh the second topic is around the you know at least the hearing and the potential of the ages five through 11 vaccine that's uh being talked about in the data is in and it's been at least publicly reported in terms of a press release not the literal data just any thoughts you have what you're hearing about that particular topic and the last one is for adults who are eligible for booster shots we have a number of staff members all of our staff members actually work in schools to be eligible so i think starting with the flu vaccine you know i think they're they're all topics that people have a lot of questions about and um so

020i don't know if anyone wants to start with any thoughts about flu vaccine in particular as we head towards winter i'm i'm more than happy to talk about flu vaccine it's something that we i mean in a way i guess look plan for every year and this year is no different um as far as getting kids and encouraging kids to get a flu vaccination you know it's it's a recommended for anybody over the age of six months to get their their flu vaccine uh and this year you know last year we didn't really see any flu at all um i think i think nationwide there was i think just one uh one death from influenza which you know usually will have a couple of hundred per year and just we really didn't see any flu

021at all um but what that means for this year is we don't know um we don't know if if you know is the unmasking that we've been doing and all this handwashing and separation gonna be true this winter or not like we are starting to see you know other viruses not flu yet but other viruses coming back rsv and other things and so the flu vaccination is another thing that's going to be really important to help reduce the risk of getting the flu but also reduce the severity of it and so it is something that we definitely recommend it's it's widely available now we've been giving flu vaccines out for the the past couple weeks it's available you know all the possible centers and all around so in the pharmacies um one of the things

022i sometimes hear is that should i wait to get my flu vaccine or should i get it now or when is the most effective time to get it in general my advice has always been to get it when you can get it because a lot of times people will come in sometimes people come in and say well we want to wait we'll come back to get it and then you know we never you never get around to it and so all of a sudden it becomes december and then you start hearing about flu cases spiking and then you have to rush around side but generally recommended that if you're in the doctor's office and you're offered the flu vaccine or you're in the pharmacy and they're giving you the flu vaccine to go ahead and

023get it we're really not sure what's going to happen um like like i said with the flu season this year is it going to be you know bigger or or more cases or less and so one of the best ways we know to prevent it uh is to get vaccinated i think the other thing that i've heard um just and again you all can comment on this if you like but just is is right the flu has its own right as its own illness but also the not knowing is was really hard this year because a lot of the flu symptoms are pretty similar to to covet symptoms um and so you know i think that's another thing that i'm hearing a lot in the community is fears that um if if someone gets the

024flu that they it then triggers a whole number of other things and fears um that that feels a little different than you know in prior years prior to covet being what it is now so i don't know if that messes with what you're hearing or concerns about but i know from families where uh people are having a lot of concerns because you know fever you know a lot of the symptoms you know might feel similar especially to kids um so you don't have to comment on that just something that i know i'm hearing a lot about um but as we you know uh we continually talk more about the flu vaccine but i think you know i am getting you know of all the vaccine questions uh probably because of my job the the five

025the potential of childhood vaccines both five to eleven but i also know we have preschoolers in our district and um that that seems like that's on a little bit slower timeline um as well and you know not at all expecting you to know what's in data that's not been publicly released um in all of its detail yet but just things you know questions i'm getting are what's the what's the dosage is the doses the same as as it is for the 12 plus what would it be two shots one shot um you know in terms of cost benefit of it you know since since students um since children in general compared to like an elderly population the risk factors are different for you know what happens if you can track covet you know how should

026we think about those risks so those are the kind of the three things i hear a lot about is what's a dose how many shots and then how should i think about that uh relative to young kids so i don't know anyone can jump in if you'd like to to weigh in on those sure happy to do so um so the fda meets on october 26th to discuss this pfizer has applied for that five to eleven so uh the the twelve plus already has emergency use authorization the next step they're doing is five to eleven and then they their trial is ongoing for two to five still um and so a lot of the data we don't have yet uh it'll be uploaded to the fda website um under the meetings information usually a couple

027things prior to that meeting so we unfortunately don't have a lot of data yet so the data that we do have is largely from advisors press release thus far um and sort of some inferences that we can make so with regards to the first question the dose is lower so they tested three different doses they tested uh the 30 microgram dose which is what uh i got back in december so it is sort of the adult uh or the 12 plus dose and then they tested lower doses as well and what it looks like they're going forward is the lowest of those doses so it's a third of the dose that many of us who got the faster shot got for that and it appears that it is given in a two dose series um

028you know looking even at the adult doses we know that a lot of the protection is confirmed after the first dose um and then you have sort of more protection after the second dose but it does look like they're gonna go ahead um with the two-day series um for this and we don't know how effective it is and to be honest that's not what they were looking for with this because we know it reduced cases and we know that you know cases of bad bad covet we we've seen them unfortunately we've seen them in our community amongst kids thankfully they're uncommon um so they couldn't go and they couldn't look they'd have to recruit tons and tons of trials and we would never get this vaccine after just tens and thousands of kids into into

029this trial maybe a hundred thousand um so what they looked for was they looked at the antibody levels they wanted to see uh did they achieve a good level of antibodies but the main question they wanted to know and they really want to make sure it was safe so their their primary outcomes the main things they were looking at were really what were the adverse events what reactions did people have um and then they also looked how how what was the antibody response making sure that uh kids nothing bad happened to them we don't want that to happen um and then making sure that they are producing this immune response and then they also looked at cases and stuff like that um but due to the fact that a lot of this happened when our

030case counts were really low across the united states like in massachusetts we we had we had a great early summer there were no cases um you know you wouldn't expect to see a lot of those um so we don't have a lot of the data yet but i imagine that we'll say there's a robust immune response um because that's what the press really said um and that that 10 microgram dose produced side effects similar to what we saw in uh adults in the 12 plus group which are a certain proportion will have fever a small proportion a lot may be a little bit tired but overall people handle it very well um lastly sorry i'm talking a lot here with regards like how useful is it i already said you know kids thankfully don't most

031kids don't get really really sick from coved for most illnesses right kids are a little more robust it must be nice um but we do know that even the young adults are looking at like 18 to 29 year old time range age range um with the primary series so even after the first two doses you would have to vaccinate just under 400 to prevent one hospitalization um which is insignificant right like you look at how many 18 to 29 year olds there in the united states uh you're saving a lot of hospitalizations with that so with kids the thought is you'd still be saving a lot of hospitalizations you may be also you know you're protecting them from getting ill so that's days at school uh that they're not missing because they are not getting

032which as a parent like i know i don't want my kids to mistake you because they're sick so i want them to get vaccinated also not just for my convenience so they don't miss school so they're not you know isolated as well and then because you don't want to see your kids sick and you really really really don't want to see your kids in the hospital so uh the trade-off is is less there um you have to vaccinate a lot a lot more little kids um to prevent that hospitalization you have to vaccinate um a lot of kids but not as many kids to prevent kids from also getting a symptomatic infection um which is also as apparent something i care about even if they're not super safe and uh it's a lot of kids

033but we have a lot of kids in that age range in the united states so those are my general thoughts and interpretation of what i think we're going to see yeah i think that's you know it's really important i want to emphasize kind of what lauren said there um when we when we talk to folks we hear people want to get back to their normal lives right and so how do we start to live with covet and part of that although you know it's exactly right that kids thankfully have less hospitalization less serious disease there are those other impacts of kids can still get sick and they can be out of school and i will tell you all of us will tell you on this call that our health care system is still stretched right

034and if you are a parent and your kid gets sick it may be hard like it may mean if you have to go to the emergency department you may have to wait a lot longer or to your regular doctor you might not be able to get that same day visit and that puts added stress on families that puts added stress on everyone in it and it makes it so you're not back to your normal life right that you know if your children do happen to get sick and they're out multiple days and you're not able to bring them in or get them tested so i i do think that you know a lot of this when we when we talk about these things about wearing masks about thinking about getting your your children vaccinated presumably

035once it's approved it does get back to that allows us to get back to some of that normal life that that we all want to have and i think that's a really important point comments are enabled so i saw eric has he wrote a comment our comments enabled so you know definitely jump in with your uh comment or question um i you know the other thing that i hear a lot is um in the community is concerns about um long covid particularly with kids so you know you know some people are concerned about all the things that they were mentioned here but also you know the potential of longer term challenges coming stemming from covet even if it doesn't involve a hospitalization or something you know even worse that it's it's not something that three

036days later the kid feels okay that there are um some longer term implants and i don't know if you've seen that in your work or just have any concerns about you know long covert but i know it's something that you know over the last couple months i feel like it's grown in terms of conversations discussions and concerns around that so i don't know if anyone has something to share uh along that dimension yeah i mean i think it's not something that we've seen a lot of it certainly has been reported and is out there um you know there are other you know rare things that can certainly happen in kids like i said what kids generally are fine there are certainly um some serious things that can happen with kovid you know we were seeing

037this inflammatory syndrome we still do see it to some extent um and kids i can personally i don't know if you guys have seen it down there in the emergency room but um you know that is something another reason to get vaccinated is that even though the risk is low of getting a severe illness from coveted if you have a young child it's certainly not zero and it's something that it this is you know having a chance of one and a ten thousand or one and a hundred thousand it doesn't necessarily matter if it's if it's your kid that is happening to and so this is one way that you can you know take you know you can protect against um you know those illnesses the things that we've been seeing so far we'll get

038more data certainly from the vaccine files once the fda combs through the data and this is what they're doing it's one of the reasons why it takes so long for these kids i know that you know kids are you know i think many of them are eager to get vaccinated so they can be protected but i think one of the reasons it takes so long for the fda and everybody to go through is that with kids you really do want to make sure that it's safe and they're going through it to really make sure that we're not going to you know we're not missing anything here um and so yeah so i think once it comes out and we review it it's another reason to to to get to get vaccinated uh the other thing

039i guess i wanted to point out another reason to think about it is uh just the standpoint of even if you're in a situation where you're exposed even if you're not necessarily you know sick but this is something that would help to keep kids in school as well because if you know if you're you know exposed you're a close content of the case right now you're you know out for 10 days and you may be doing perfectly fine but that's more time you're spending at home and so being vaccinated is one way to both reduce the case load potentially and reduce the amount of time out of school for our kids so there's a couple question um and i think it's uh the questions asking about what percentage of positive cases at the high school

040were among vaccinated or unvaccinated individuals so we have we've had a total of five cases at our high school since the start of the school year that number is you know and because those people are out for two weeks it's a pretty easily identifiable group so i can't get into the details i apologize in terms of privacy rules but what i can say in responding to the general question is that across our districts elementary middle school high school and summit academy from last year to this year we've seen a disproportionate number of our positive cases be unvaccinated individuals have we had vaccinated individuals test positive absolutely have the majority not everyone but the majority of those cases been mild they're completely asymptomatic oftentimes when they knew they were exposed to someone and chose to get

041tested not because they had symptoms that's true so you know i think our data matches the state data and the national data that can quote-unquote breakthrough infections happen yes do they happen absolutely are unvaccinated individuals more likely to test positive our data is consistent with the state data that that's true and are those cases in general more likely to be um more serious we've experienced the same thing as the state and national data so we're no different you know so i apologize i can't get into specific numbers when our end size is five it's just too identifiable uh along that dimension but you know what we see like i said at the beginning we're seeing the same trends that we see in our community in our state and in our country about the differences there

042and um i think that there shouldn't be a surprise there you know there's nothing unique about our our community or our schools you know at the high school both in terms of students and staff we're over 80 percent of um folks vaccinated at the current time and if you look at places i was sharing before this pa before this show um you know propublica put an article about a different community in a different part of the country and the level of outbreaks they had and i feel very fortunate we're living here and our schools have the vaccination rates they do another question can you share the risk of severe illness or death of healthy unvaccinated children compared to other diseases and risks like flu west nile car accidents etc i can leave that up that's

043helpful yeah i think that's a that's a good question i'm not sure i have numbers off the top of my head i mean the risk of severe illness or death of healthy unvaccinated children death is really low um i think if you're looking at um yeah i guess i don't have the numbers right off the top of my head but compared to other disease and risk the risk the issue with uh healthy unvaccinated kids in covid i think it's multiple factors about why you would want to get vaccinated um but i think that actually the flu and rsv and several of these other viral illnesses in kids is something as a pediatrician i'm actually a little more worried about uh from a kid perspective than necessarily kids getting covered but i also but so from

044that standpoint um you know the covet as a risk to the kids themselves is lower than some of those other things um but if we can kind of take a approach to to reduce the risk of all of those uh other viruses we're going to be able to take the pressure off of the emergency rooms and the pressure off the hospitals and keep kids in schools so um yeah but i think i i think [Music] since we so yeah so i guess overall the risk to the kids who are not vaccinated you know is low overall so and i guess i'm not sure what the yeah that answers the question or if it gets to what the question is just sorry if i interrupt there's a little delay here um i don't know if the

045intent of this question is but reading it a couple ways is um the risk is is is really low right for severe illness or death a lot of it in the younger group is about protecting those around them um but also ensuring that they can uh continue to go to school and things like that and then protecting the rare complications because uh we don't want our young kids getting the inflammatory syndrome um or things like that the other thing is i look at the comparisons and it's hard to know here because it depends on whether you're talking about the risk of severe disease the flu in somebody who's vaccinated gets a flu or not vaccinated against the flu um or car accidents the risk of being in a a death in a product if they're

046wearing a seatbelt or not so um you're looking at the comparisons here look at these are great examples of other things where there are significant uh public health measures um that have reduced the severity of all of these things so we can't you know as somebody who's trained uh has a master's in public health i look at this and i'm like flu we have amazing public health stuff washing hands um you know staying home when you're sick uh and flu shots and from west nile it's again being where mosquitoes are from the south so like deet everywhere um and for car accidents it's you know the seat belts the booster seats the five harnesses until my children go to college um or i guess until uh they grow out of the five-point harnesses um but

047yeah the the thing with cobit is it's it's very very low but as a parent or as a doctor i feel really bad every time i take care of one of those patients who they are 21 and their risk is really low but they were unvaccinated and it was preventable and those are the really really sad cases can i add on to that a bit i think a couple of things i think first we have to bring up the public health because we have delta right and part of the reason we have delta is for many reasons we couldn't vaccinate and lower the transmission right mutations happen when you have unchecked transmission right that's how these viruses work when it spreads kind of like wildfire even if it spreads in folks that don't get too

048sick you can start to get mutations that cause delta and all of a sudden delta changed the game right whereas initially vaccines seem to prevent even illness because of that high replication rate it changed so i do think part of it and part of that consideration to folks is we really overall as a community as a nation as a globe want to get the rates down so it is less likely to turn into whatever the next variant is going to be and the other that i would say i totally agree but like i think all of us as clinicians it's not just about the one risk it's weighing the risk and the the benefit or the the risk of the disease versus the risk of the treatment and in all of those things my understanding

049and i don't know the 5 to 11 data but all other data sets the risk of this vaccine is pretty much as close to zero as we can get right the risk of dying from this vaccine is zero the risk of having a severe reaction is you know one in hundreds of thousands to one in millions numbers that we can't even comprehend so i think when something continues to prove to be that safe and we do want it to be proven to be safe that's why we're waiting for the data and waiting for the fda but if it comes out that yup it's the same and there really aren't downsides to that then it doesn't take as much for me to say you know what i know the the risk of severe disease for my

050kid is really low but the risk of this vaccine is really really really low and there's other things that this can help so it's it's i think weighing that aspect thank you uh that's really helpful and a good question and and i think you know choices that families have to have the data to be able to make for their for their children um here's another one our outdoor play dates on mass no distance still considered safe as we did over the summer i can speak to that from the school perspective and then certainly you can jump in it's a question i've gotten quite a bit this fall it's interesting seeing our recess um you know we you know based on and i'll explain in a second the guidance we've gotten both from state cdc but

051also from our local public health authority um you know we're continuing that practice of not masking at recess and that's because what we're seeing in the community is we're not seeing spread from those scenarios i think if that changes we'll change our strategy but i know a number of people emailed me right when school was opening and i talked to the amber's health director said let me know and she's like well you're not going to have 5 000 students you know convening on the same site for hours on end being you know static and i said no that's not you know our schools aren't that big and and kids move around and um and she she expressed that that's not when they did the contact tracing of the cases that's not where they were seeing

052the spread so for us at leaning waves at recess at school we've maintained that it's interesting that you know i'm at the elementary schools every week i i would say about 50 percent of kids are continuing to be masked that they're choosing to be masked at recess and we would support them in the choice that they and their families make um and about 50 of students are taking off mass and it ranges based on kind of factors that are known you know age level right so we see a little different behavior in kindergarten first grade than we see in fifth and sixth grade at the elementary level and then some of it's just you know random factors of who's choosing to wear that so i think um just wanted to share at least our perspective

053of why we've made the choice we've made at the school and again if the public health director sees different trends in our community we'll be making different choices around that topic but um you know in terms of outside the community and play dates i opened it up to the the rest of you if you wanted to jump in yeah i was uh just gonna say i think it's it's generally okay i mean the number of cases that are being transmitted outdoors uh is is really really low and i think i mean so from that standpoint you know you have play dates particularly if you're talking about you know small numbers of people outside i think the risk of transmitting covert in that situation is going to be extraordinarily low and certainly if you have you

054know i guess large groups of you know your people you don't know in indoor outdoor situations you're there for a long time then you may want to rethink that if you're in a different situation as well where you've got you know a lot of unvaccinated people in the household or you're not sure people you don't know then you're masking you know makes some sense but certainly outdoor play days if it's going to get more kids outdoors and active and playing and being able to socialize then um i think in general that's that's fine yeah i think the other thing i'll just add quickly on that topic is there they're also you know we're talking about young kids here and there's a wide variance in risk in mass tolerance for long periods of time so when

055we think about recess and we think about school school starts the elementary kids you know a little after eight and ends at 2 35 whatever it is that's a long day other than you know meals to be masked and for some students you know well what i would say for all students the safest place to take a mass break is outside and so you know we want to balance those needs of students to to have that mass break to socialize it for some students it does matter that their mask is off around socialization for a whole host of reasons so you know i think there there's a different com different comfort levels for kids for families and that's why we see you know the range that i described of of masking outside at recess and

056we want to support kids and families in the choices they make in that environment while we're not at you know at the point of really considering uh anything but a universal mask makes mandate inside of the current time lauren bill anything you want to add to it yeah yeah just a quick a quick sort of looking at this uh look at this question from a research lens uh absolutely could a case happen from an outdoor play date with how infectious delta is yes uh like i i don't i don't want to sugarcoat things and say like this is never going to happen however that is as safe as you can get particularly in a highly vaccinated county uh like we have here or in a community where we know a lot of people are vaccinated

057um and and so i think that you're looking at all the range of activities that you can do um that's the lowest and it also depends so if i i take an eight month old and another eight month old and i put them together for an outdoor play day they're going they're going to lick each other um so the risk is going to be a little bit higher there than if you have you know five seven year olds 14 year olds running around playing soccer or whatever um but it's as safe as you get and especially if you compare to other things we're almost two years into this pandemic and what we have seen especially in our emergency department is a is a rise in mental health crises um among our pediatric population which is

058something that um is really devastating uh many communities um and even you know people that sound up to be uh physicians and mental health experts uh because this is it's really sad to see this and a lot of it comes from the social isolate isolation so you know there there are ways to protect ourselves against cobin but covet isn't the only thing we face and we kind of obsess about that um but you know if it's uh going to instagram or a social media site um or you know something that they could be uh detrimental to the mental health or playing outside um unmasked uh certainly i think that might be safer from a host of reasons not just the coveted standpoint um but from thinking about how how do we support the health of

059the children and the family in the community from sort of a more holistic uh sort of whole person perspective as well yeah i i really like um what you said there lauren and i think it's it's true and we are to the point of trying to balance um you know i think one of the what i feel like one of the falsities i've heard is that right it's the mass themselves that that children that's affecting children's psyche and and maybe for some and i don't want to discount that and there definitely are children where it's very hard but i think for the majority it's not that it is that social isolation and it is that more the disruption of life more than the mask um and so you know having those trying to do that

060kind of harm reduction standpoint of okay you know we're going to play outside but realizing like my children they're going to have to come in and pee every 15 minutes so they're going to be inside so what am i comfortable with maybe they mask inside maybe they're not going to mask inside maybe that's the time where i take out my binax kit and they're okay you know and this is not for those that haven't done it it's not the swab into the brain it is a like a little tickle that all of my kids have tolerated and maybe i say look i just want to make sure now things are okay and i don't have to worry about outside or inside so we're just going to do a quick test and everyone is fine and

061now you know we don't i don't have to care as much if you're cold and coming inside and gonna play inside for a bit maybe without your mass and you're gonna have a snack so i think you know that's i think an important point is developing some of those strategies to figure out what you're going to be comfortable with when that happens because ultimately for many of us the play date outside turns into something a little bit different and and are you comfortable and are your kids comfortable with that as well um because i think some kids especially as they get a bit older start to have anxieties themselves about what do you mean i can go in without a mask and this so so i think that's important to explain as well so i

062really i don't think it's the actual strategies i don't think many kids are worried about the mask itself but but explaining that to them and how they're going to be safe and and what they can do is really important yeah and i guess one other thing that occurs to me or i've been thinking about is that you know if you look back to you know a couple of years ago or two or three years ago you know you wouldn't be you would have your eight month old outside you know crawling around and licking each other back then and there were risks then about getting rsv or getting the flu or getting adenovirus or any of the other number of viruses yet and our kids would get sick and then last winter that changed partly you

063know part mainly because it was spreading so much and we didn't have a vaccine and that virus could spread and then a lot of people um you know all the reasons we wanted to stop the spread of kovid and not have sick adults and kids caused us all to go into isolation last year now we're at a point where particularly in this community and you can make this decision in your families as well if everybody if all the adults are vaccinated in your household those two eight-month-olds you know are going to be the risk of covet is going to be low and if before you are okay saying okay you know it's important for us to have these kids playing together and we also are now thinking more about okay you know i my child

064doesn't have a sniffle you know if they have if they are sick i'm gonna you know probably be more likely to keep them home instead of just sending them off to school or to this play date then having them play together outdoors or getting those eight-month-olds you know toddlers together uh is going to be you know a similar risk to where it was in the before times meaning that you know yes they might they may be at risk for getting something like the flu or rsv and that's the risk we take you know being out there in a social community you take you do all the things you can you vaccinate the best you can you wash your hands the best you can you stay home when you think that you're sick you do the

065you know you get lauren's tests from wherever you pick them up from and um yeah do the best you can yeah and i think i just want to comment a lot of what was said is an interesting it's something i've spent a lot of time thinking about is what's the arc of this right you know in my job in the schools um you know i don't think schools are gonna mask forever right you know and i know it may not end as soon as some people are hoping and and probably sooner than some other people are hoping but at some point you know i don't know if what normal is and whether we want to go back to it but i i don't imagine us indefinitely masking in schools in the united states or in

066amherst or in massachusetts um using places that i think are looking in a week and a half uh because that 80 percent rule the state put out on december excuse me october 15th and we're not in that category and the public health guidance i've received locally is that we're not going to be in that category for a while that we're more conservative on that front but i think it is going to be a challenge of risk tolerance how it changes and how that arc shifts over time it's going to it's going to be an adjustment for everyone and it's i think the only advice i'd give for folks is to take things slow that you know as your kids are getting more comfortable or as more kids get vaccinated this fall they may be really

067excited to try more things and and be inside more with other kids and for some kids it's still going to feel strange you think as a percent of their life they've been living in this pandemic a pretty high percentage of their like if you're talking life if you're talking about four five six seven year olds and you know the excitement they have in theory may not be realized immediately and just to give everyone some time uh to to get acquainted with that you know for us anytime there'll be a change in health and safety protocol in the schools we'll be sure to communicate it well before it's implemented and i don't anticipate anything coming very soon for us you know that's in my conversations with again my lead nurse robin supernod and jennifer brown at

068the town you know we're not looking to do masks any time soon in this particular district but it it's not going to be indefinite um you know and so i think that that's a hard message to share um it's something i struggle with is saying we're not gonna change now but it's uh we will have some on some some folks not wearing masks at some point you know and perhaps even towards the end of this year it's possible that that that will happen we'll have to see how the virus tracks and the guidance i get i make this decision based on folks like you who are much more knowledgeable than me and and my job is to communicate and implement it with fidelity and so we'll see how that goes but there is an arc

069to this and it's not a straight arc it's not a linear thing where it's a straight line if it was you know thankfully we or unfortunately we would be if you if you if if it was a straight line uh where we were in early july and that continued we'd be having a different conversation tonight but that's not where we are but we'll just you know make sure we're communicating with that and um i think just just being generous with with yourself and with your kids and understanding that it's going to be a process even post-vaccination for the young kids i think the last topic we have yet to get to uh that we talked about was about type of masks which is i think the smallest perhaps of the topics we said we would

070do tonight but i don't know if there was some thoughts that anyone has about types of mass you know in the district i know we don't allow things with you know we don't allow the gator style and some of those other ones with valves uh you know but we are open and we've seen students wearing kn 95s kf kf94s we've seen cloth masks we see surgical masks and sort of everything in between and i don't know if you have thoughts to share about your recommendations or what you see particularly as it relates to younger kids i think some some of this might have been fueled there was a recent study that looked at mass use in communities it was all at the adult level um and so there were a lot of headlines like clock

071master or surgical masks and i think that when as a family when we elect what type of mask to put on our small children um to put on ourselves for various activities we kind of think okay what am i trying to achieve right here um and you know there are sometimes when we really want to protect ourselves because we don't know the community that we're in or it's a risky community for example i needed to fly um and so when i needed to fly even as a vaccinated person i've unvaccinated kids i have an elderly mother-in-law so i wanted to wear it in 95. um and thankfully supply chains are running now so there's not this huge shortage there wasn't the beginning of the pandemic so i stocked up on like some can 95s and

072things like that so it at least allowed me a little bit of mental protection and we know that these add a little bit more protection to the user now when you're looking at protecting those around you a cloth mask is better than nothing a surgical mask is going to be better than a cloth mask but again to achieve when you have high levels of vaccination in the community a lot of that really becomes a lot less relevant it depends on the behavior of the community um in general to determine how effective those various things are and what the added value of a surgical mask of our cloth mask is it may be negligible if everyone's vaccinated and doing other things it may become more important if you are immunocompromised if you have you know a

073transgender you're on medications that make you uh more susceptible to infections and things like that there may be different reasons to select different levels of masks and i know in our family we select different kinds of masks for different reasons whether they are off of the face a little bit more for my small child um or if they're more comfortable for me to wear at work all the time um or if it just makes me feel a little more comfortable in the situation or maybe it really will protect me because the people around me um aren't vaccinated um or are sick things like that so that's sort of my take on where i think the evidence stands at this time and just being realistic about what the goal is at various times and in various

074situations yeah i think that's a really important point and i think it can be further subdivided i think into medical personnel and what we wear like what we wear in the emergency department and how we wear it versus in the general community and especially with kids and i think just like lauren said right for me with the kids the most effective mass is the mass that they are wearing right if there's a mask that's uncomfortable if the mask doesn't fit then i don't care if it's a kn95 versus something else they're not going to wear it they're going to wear it out they're going to pull it down their nose and it's not going to kind of provide that that protection to themselves or to others you know that being said i think you know

075there are some things that are just false right so the mass that folks wear surgical mass things like that they're not going to decrease your oxygen there's no evidence they're not going to build up carbon dioxide they're not going to malform your kid's face right those are the most common things that we see for evidence against are there some potential behavioral things and issues totally i will give that credence that that this some kids struggle with this but some kids do struggle with this because of the way that it fits and the way that it feels and the way that it annoys them so some of my kids with the cloth masks which we we still have some of the cloth masks it would stick to their face and they would literally be eating it

076the whole time and it'd be disgusting and soaked and then they pull it down and we found that the disposable kn95s more for the fact that it stays off of the face a little bit it and it's much lighter it's much more comfortable and they're able to keep it on and i tell you it comes back a lot less dirty so i think it's about finding what is right and there's a lot of different mass right now with regards to the last thing i'll say with it with the guards the 95 the kn-95 the n95 i would be a little bit careful the idea of those mass for us in the hospital is that we've been fitted for specific n95s that actually seal to our face because the n95 loses its n95 capacity if air

077is getting in through cracks right and there have been a lot of false things on youtube where they're saying this doesn't work it's because it's not fitting them because they're not wearing it properly we don't expect kids to wear an n95 properly so to think well i have to use an n95 for my child it really depends and it depends on their fit and if it doesn't fit them you know a surgical math or a cloth mats might be even better so so i think keeping that in mind that especially with kids having something that makes them feel comfortable and fits well no matter what it is is going to help great thank you so we are just about at our time so i'll give another minute or two to see if anyone has uh

078any additional thoughts questions comments or tips uh for us here tonight but i didn't know if there was any kind of final thoughts other things that any of our panelists wanted to share before we head off and let lauren be with her little one thank you very much for uh for joining particularly with that uh additional friend with us tonight but anything uh peter you wanted uh anything else you want to share from the pediatrician's point of view for uh for folks for families no i mean i think you know it's been it's been a hard year and a half for everybody for a lot of reasons um and i guess the you know i'm starting to see people get out more and and having the prospect of these vaccines coming out for the younger

079kids and for for my daughter is is great and really important um i guess the thought would be this the biggest thing that we're seeing actually now in the office the pediatric office apart from when we're starting to see some more viruses but it is um i think bill alluded to it before was just the amount of just mental health stress that's going on with with particularly with our teenagers but also with you know with everyone around and i think we sensed that and so i think uh that's something that we're really working on a lot and our office is trying to reach out to our teams making sure that they're feeling heard and supported and um i guess i would just ask everyone to just take some deep breaths and to continue to be

080kind and show some grace to everyone wearing a mask not wearing a mask whatever it is is just to be kind when you can because i think that's going to go a long way toward helping us come out of this uh pandemic is just is that piece we're doing all the other parts the hand washing and the mask but also just you know talking to one another and listening to one another is going to go a long way so so i appreciate actually like you in putting these these talks together and getting information out there so that we can be talking to one another it's good to be here to be talking with lauren with bill about all these these things so i appreciate that thank you for uh your participation and and what you

081bring to it thanks peter lauren bill any kind of final remarks you'd like to make i'll go i'll leave you for last lauren save the best for last um no i agree and i really commend the community because we are where we are um with our relatively low number of cases because of all the work people have done um so i do think you know this winter is different than last winter and we are going to be able to let our kids enjoy and have some of that life and i would say for those of us that that really want to push through that finish line it is it is getting folks that are unvaccinated vaccinated we can talk about things we can talk about boosters we can talk about types of mass but if

082we're looking at we really want to make the impact even though we're at a relatively high percentage kicking that percentage up even more is going to make that extra difference and that's covid that's flu the more that are unvaccinated can become vaccinated the more we will be able to to loosen those restrictions and kind of get back to normal so so now's the time to make that final push and um yeah thank you everyone i uh just agree on that i think that uh the vaccines have really been a game changer and we can obsess and talk about the minutia about breakthrough infections and things like that um but the thing is is that if you look at almost all of the people that are in the icus and in the hospitals they're nearly all

083unvaccinated and they have that chance to protect them and their family um and it's not it's it's not too late for the people that haven't been vaccinated yet or that that opportunity exists there are plenty of vaccines um we're fortunate in this country um and then there are other ways so like my children aren't old enough to get vaccinated yet as many of the children in the public school systems aren't yet um but we live in a community where there are things like free testing at university of massachusetts where you can do it at your house it's a little tickle they email you the results um and and uh they're relatively cheap although seven dollars a test it depends on how often you test um ways that you can kind of keep your family safe

084as well um when the vaccine isn't an option um for for you uh due to uh sort of the age cut off so i think that we live in a community where there's a lot of resources uh for even the young kids um as well as the vaccines um and so taking advantage of them i think is really important great well i put a link in the chat um to what dr westerfer is talking about and the umass testing with the pickup kits that she referenced earlier so if you click on that link in the chat it'll give you all the information of how to pick it up and uh what happens with that and and you know it is easy uh and it's also a great resource that most communities don't enjoy that level

085of free pcr testing that comes back as dr rushford said so quickly so it is nine o'clock which was our end time so we want to thank you all for coming we will be sharing this in our newsletter this recording it's also as i noted in the chat it is a um if you click on the youtube link that you're watching on once we end this it'll be immediately available and indefinitely available so hopefully some of the things i said hold up in time but if not you'll be able to go back and say i was wrong so that's okay that's the way my life is and yeah it has a public official here but i really want to thank our three guests from the medical community appreciate your continued support of of our community

086and of our school district and hope everyone has a good safe night thank you thank you