001okay i think we are live so um welcome thank you for coming to this session about medical professionals and schools in covid19 i'm superintendent mike morris i'm the superintendent of the amherst pelham and the amherst pelham regional school district and we really appreciate you coming for this this one hour long session today we know we've gotten a lot of questions from community members and from others about the medical implications and about covid and there's can't help but look at any newspaper magazine or the internet and get a lot of information and you know i'm so deeply appreciative that we'll have some medical providers here today to share their opinions um and and answer some questions that we received before the show started as well as answer some if we have time at the end through
002the live chat which is on the lower right hand side of your screen but thanks for being here i'm just going to introduce a couple people and then we'll get to the the medical professionals so with us today actually i'll let the school commanders introduce themselves um hi i'm cary spitzer i'm a school committee member and i would also just like to express my thanks and gratitude to everybody who's joining us today i'm gonna be listening but in the green room as we call it for most of the call thank you and um i'm allison mcdonald and i'm also with the amherst and amherst pelham regional school committee and um thank everybody here for doing this work and sharing your um your knowledge and and advice with our community so thank you very much and
003i'll also be in the green room thanks and also with us today is jill consolino um so i'll let jill introduce herself and then i'll turn it over to dr source good evening everybody my name is jill consolino i'm the nurse manager for the school district i started the middle of december just before the pandemic hit and i will be here for the duration of the call to answer any questions that from the medical side that are related specifically to the school district in our planning yep joe walked into a job at right at the right time for the rest of us so we appreciate all of your work jill appreciate you being here and uh with that i'm going to turn it over to dr soares who's going to do an introduction and some
004general information about the session thank you perfect thanks mike um hi everybody my name is dr bill sores i'm an emergency physician and i want to thank everyone for taking some time to come to this information session joining me i get to introduce some of my colleagues dr lauren westifer who is an emergency physician dr peter everett who is a primary care pediatrician and dr sev garcia who is a pediatric emergency physician each of us as physicians practice in the community we've all treated patients with covid19 and for many of us we've been involved in larger planning for covid19 and our respective healthcare institutions and i think most importantly is we all have kids who are part of the amherst pelham regional school system um we created this volunteer group independently with our goal of
005of really offering advice experience and expertise to families to teachers to staff members who are involved in this upcoming school year it's important to note that our opinions they're our own they don't reflect where we work they don't reflect the school committee we might not even agree with each other some of the times but there are opinions from our knowledge and our experience really the goal of this session is to help you the community understand covet as we understand it so that each of you can make an informed choice when you're deciding with your family what you're going to do in this upcoming school year and and just to begin i kind of want to have three general principles for everyone to kind of understand as we as we go through this session the first
006to understand is is covid is it's a new virus and really there's a lot that we are still learning you know our opinions are are based on what we know today but understand that that may change especially as future research and guidance emerges so please keep that with a grain of salt that we're talking about what we know about today um second um as we're not part of the the school committee we may not be able to answer questions that have to do with specific policies or procedures for those questions obviously we'll defer to our school committee members and other folks who are with us on the call and then finally really the most important you know in this whole pandemic there really are very few absolutes and very few right answers we're here to
007highlight what we know as far as the medical community about covet and while we can provide guidance it's ultimately up to you to weigh your own risks and decide how your family's going to approach this upcoming school year and in that regard really we ask that as a community that we really respect the thoughts and decisions of others especially when it may be different than our own just understanding that everyone's coming from a different point of view and is weighing different risks and really there are no absolute right answers with that so with that being said um i'd like to turn it over to dr westerfer who is going to just give us some basic kind of foundational information about coronavirus to help lead the discussion going forward now all y'all know what copic 19
008is it's it's not something that i really need to explain we know it's a disease caused by sars kb2 but there is a lot of misinformation out there and things do change rapidly so we thought it would be useful to just kind of go over some of the basics and make sure we all sort of have the same understanding as to where things lie as of today august 12th um the virus it can cause uh the disease kevin 19 but also some people they are asymptomatic and then a lot of the asymptomatic people are actually just pre-symptomatic they will eventually develop some symptoms but sometimes they're so mildly people may chalk it up to just being tired or overworked um the severe cases that we see locally and sort of internationally what is played out
009they're generally in patients who are older and have more medical problems hypertension obesity those sorts of things so those tend to be the higher risk patients although pediatric patients they do get copin 19 and a very small proportion of patients uh may get this post-inflammatory syndrome the virus how's it transmitted it's primarily through droplets and droplets can be small or they can be large um the thought is that it's predominantly through the larger droplet spread so uh somebody coughs it kind of they expect rate these larger droplets and somebody breathes it in or they then touch their eye and rub it through it has to come through a mucosal membrane so the nose the mouth um the eye those are some of the portals of injury that we think are sort of important and then
010there's been this debate is it airborne um what is there this airborne spread and the media really got onto this a couple months ago um but the consensus in the medical community is that we don't think that this is the major role for transmission we think that it's predominantly the larger droplet spread and how this is played out and how transmission in uh other communities and hospitals and places uh that haven't been taking airborne precautions has actually uh not been uh looking like it's airborne and then obviously this is a virus where currently there is no cure there is no single drug not hydroxychloroquine not something else at this time that is a cure uh and there's no vaccine currently obviously there's lots of work being done on that but right now uh there's currently
011uh the unanswered question when will it be over and none of us have the answer to that uh we and we won't dare make any predictions on that and then obviously things y'all know the major mitigation strategies they actually work hand washing uh wearing face covering masks uh in in distancing from each other uh those have been shown in study after study to really make a difference and can actually change the reproduction number so how many people one other person can infect uh quite significantly just by taking some of those steps so that's just a general overview of kevin 19 sarge kv2 of what we know right now and um and so the next point uh we'll stay with dr westerfer for is about transmission rates in schools uh particularly those from different areas uh
012many of which have already opened up schools um already in the school year because in many parts of the country you know we think of labor day ish as our start date in the northeast and that's not true uh actually in most of the countries so um if you if you wouldn't mind commenting a bit on what we've seen and what's been reported sure absolutely it's still foreign to me i'm from the south and we always started at the very beginning of august so it's still new to me up here um you know i i think that we've seen these reports of schools in georgia some in mississippi in places that are really being hard hit right now by cove unfortunately kind of finding out what we found out in march and april which is
013uh when when you have a lot of covid in the community and and then you put people together whether it's in rooms and schools or in workplaces um or in churches that people get more covered when that happens um and and unfortunately over the course of the past month and a half or so georgia's caseload has really sort of exploded as it has throughout much of the south and so i think right now a lot of the thought is that that the transmission in in the schools just like it has in the workplace we did a study at bay state where the transmission mirrored what we saw in the community it wasn't sending people to work in a hospital really exposed them to cobit it was they were getting coveted in the community um rather
014than at the hospital and and you know this has uh i think that a lot of this is the case here is that you know you have to look at the prevalence in the community to figure out does it mean what we have here um and and you know are are there plans to adjust based on on the prevalence and the community prevalence in georgia is not what we are seeing in massachusetts thankfully and i know you know all of us are monitoring the daily massachusetts coven dashboard sort of regularly but fortunately our prevalence is very low right now um and it's it's a sort of a different scenario the other thing that i think it's important to think about is looking at at what people are doing out even outside of the school or
015in the school that make a difference when it comes to transmission things that we know um you know in in the south and and maybe in georgia and some of these places um or other locales not to just single out the south but cultural attitudes towards face coverings towards mass towards distancing towards other mitigation strategies even belief in the virus may be different than it is locally and even person to person and so thinking about how does the community um perceive coronavirus and risk mitigation strategies and what are we doing individually and as a community uh to to prevent the transmission i think that those are really important determinants in spread um and and in what keeps people safe or what may perpetuate transmission uh in a school or in pretty much anywhere where people
016gather it's not just what you're doing at school or a workplace it's what are you doing in your off time is it a church where people are singing without masks is it some other mascara gathering or a party um or is are people really sort of being careful and i think that that's what's driven a lot of this and i know a lot of people are concerned because the aap put out a report that shows this explosion in pediatric cases but which also mirrors the explosion in cases uh in all ages the cases have since june 6 june 18th have risen from 1.9 million to 4 million um and then kids 117 000 to 380 000. so it looks really big if you're just pulling out the kids but it sort of mirrors what overall
017the caseload has been so those are just some of my thoughts on the literature um and perspectives on this thank you so much dr westerfer and i'll just plug that we're going to have a conversation at the school committee meeting tomorrow night i won't get into details in this show because we have people much more knowledgeable than me but we're going to talk a bit about community transmission rate and school opening and and um so we'll have that conversation so if if if you're interested in that conversation you know school can be meeting tomorrow night may be interesting to you but thank you i think at the this point we'll transition to having a conversation um about testing and testing of symptomatic and asymptomatic patients and um and at this point we'll go to dr
018garcia who's going to comment and bring some information on that thank you thank you for being here sure thank you um it's great to be able to be here with everybody and i i appreciate you all taking the time to listen to us speak a little bit about what we know about covid so um certainly i think it's important and testing comes up all the time um where i work uh and um it's you know concerns uh family members calling you know should i get tested should i not what does it mean um and i think the the the interesting thing or the important thing is to understand that symptomatic testing um can happen should happen and um and it helps us to know that if somebody is positive and symptomatic then we understand what
019we need to do for the family um some quarantining those kinds of things even though they don't have to necessarily be hospitalized so that's important and that is we do have that capability in our community um we live in a great community and that capability is here um the asymptomatic testing you know how do we know if we're not testing everybody um well uh so there are a couple and i think you're gonna hear about this more tomorrow but there's certainly uh something called the positivity rate that we look at and that's to decide whether the community is testing enough asymptomatic folks asymptomatic kids and adults to know that that um you know we are actually testing those patients and so the world health organization has uh recommended that you want a uh a positivity
020rate of about five percent there are a lot of different recommendations so anything under five percent um really means that you're testing um and we're currently at two and a half percent i looked at um the john hopkins website um for a state um and so that is really important and i think that that helps me understand that we really are testing enough community members to know that they're we're testing asymptomatic as well as symptomatic a positivity rate of a hundred percent like you might find i don't know in georgia or someplace that's really um off they're off the charts is um uh probably just testing the the ill not necessarily the asymptomatic as well so i think we're we're in a good spot here and um the testing is actually working and i think
021it's guiding a lot of our decisions um individually and then as a community in the society um so that's that's what i can tell you about testing and obviously the testing we're talking about is pcr testing um and um there are a bunch of different ways to do that it could be a nasopharyngeal swab it could be um some places are now doing just sputum uh sorry just saliva um so there are a bunch of different ways to do that but in general our our testing here is um uh a nasal suave or nasopharyngeal swab and you can get results back um um now much better than at the beginning of this um usually within 24 to 48 hours if not even sooner the rapid tests are even faster so um again symptomatic important um
022go to your provider go to your healthcare provider uh and and then asymptomatic um as we as that becomes more and more readily available for us to continue doing i think we're doing enough now thank you and i want to note i probably should have been more explicit about this at the beginning that these are all responses these structures there's about eight questions that our different providers are going to respond to these were responses to questions that came in via email so if people are watching thank you for those of you who clicked the little button in the google form and shared those because i think uh i what i really appreciate about the questions is they're all questions that i'm getting all the time i'm sure you as medical providers are getting all the
023time these are really really critical questions uh from our community and for our community um so we're gonna stay with dr garcia for the next question which is some tips on how to stay safe uh what are active measures uh that contribute to staying safe in the current environment without a vaccine and all the other things that were already mentioned sure so thank you so i think um it's really important as our our kids get ready to go back to school uh um if and when you know when that happens i think it's really important to know that the basics are where where what we're going to focus on it's what you focus on at home it's what i focus on here at work um at the hospital it's what we focus on um you
024know in our offices um and so it's really kind of the basics hand hygiene is incredibly important um you know having that that bottle of hand sanitizer by the door when you walk in um i think is really important the social distancing that you'll hear from this and read from the school plan um of how to keep some um you know some space between um the uh children and you know that six feet is really important um you know some place to say could you go up to ten feet i think you know six feet is probably is probably a good number um face coverings really important i have to admit that early in this uh pandemic i was um on tv saying that you know save the mass for the doctors and the nurses
025don't wear masks um you know we all learn okay so um now we're recommending everyone have those um face masks and it's really important to have face coverings um as for our children especially as they're trying to interact as well and and then the other thing to just drive home is flu vaccine this fall is important uh probably like no other year it is so important and so um it's it's important for us to understand that if you you know if if you have a flu vaccine and we and and you know if you develop fever without the vaccine it's hard to know is that the flu or is that coming from covid um so we're really stressing flu vaccines i mean 100 of us should get our flu vaccine this year um unless there
026is really a medical uh contraindication so that that is also going to help you stay safe and then i know the school is looking at other things and you know including things like screening right so here at work i get screened it's online i get screened every day all of my employees get screened every day um for fever um you know we still have travel questions some places don't um and so that's really important and um temperature check sometimes people are doing that we're not doing that here but that is also something that people have found to be um helpful so all of those screenings will be helpful and then i think um just to kind of um uh finish up a bit i know there's some concerns about like within a school system about
027kind of the hvac system and what is the air flow and so you know what we've recommended all along in hospitals um is that uh you know the the and we've been able to keep people safe in hospitals and in doctor's offices by uh really paying attention to the top three or four that i talked about the face masks and the hand hygiene and all of those things um and this goes to the the question about whether or not it's airborne or droplet and realistically um yes if you can um open windows and have better ventilation that's great but most most of us have been able to keep people safe at work and patient safe by really just a meticulous hand hygiene and face covering so thank you uh i want to note that there's
028a couple questions have come in i i think um we're about uh more than halfway through the questions that we received in advance so please keep those questions coming and we'll loop back to them after as we go around the horn so thank you for commenting and asking some really good questions along the way i'm going to go back to dr stores who's going to talk a bit about quarantine and isolation of individuals great thanks mike so this actually came from a great question and i give a gold star to whoever pointed this out as they cited in the plan from the school that there was a difference between what the school was planning when you have someone who is a close contact so say someone was in school and someone else in their classroom
029got diagnosed with coronavirus with covid19 um the document says that one of the options is to wait four or five days and then get a test and if that test is negative then that person if they are asymptomatic presumably that child if they're asymptomatic can go back to school and that's a little bit different than what has been said um in the state of massachusetts and in the cdc which has basically said if you are a close contact exposure and that's something we can talk about later but basically if you're in the same classroom it's kind of counted as a closed contact exposure that basically you're quarantined for 14 days that even if it's a negative test there's still a risk and there's still a risk that maybe you got the test too early and
030it was falsely negative and so the quarantine was supposed to be for 14 days now looking at and looking at this from an outside perspective i went back to the original document and this actually comes what was developed at amherst in other school districts came from massachusetts guidelines and is actually verbatim from massachusetts guidelines and i want to bring jill back in because um it turns out that this is something that others have brought up as well and is an active point of conversation so i don't know jill if you want to comment on it sure sure thank you so when this original guidance from the department of education came out um many many nurse leaders and managers and local boards of health all picked up right away immediately on the discrepancy between the two
031um with the classification of not the classification of somebody who is independent identified as a close contact but the time frame on which the recommendation for this person to stay home currently at the local boards of health if they identify close contact they will recommend the person stay home for 14 days and also get tested and regardless of the test results you still need to stay home for 14 days department of ed is saying you can get tested after a few days but then depending on your results and if you're well and your test is negative you're able to come back to school originally department of ed said once school starts they're the ones that are dictating what's going to go on with the recommendations for isolation quarantine but they have realized that because there's
032such a discrepancy between the two they are going back to the table with um dph and as as a joint effort they're going to come out with new recommendations and that was brought up on a dph conference call just yesterday and they did say new guidance and new recommendations would be coming out hopefully within the next week um but if they will be changed hopefully changing it or reconfiguring it a little bit but it's definitely been brought up and it's definitely a topic of conversation on every call that i go on twice a week yeah i think you know to take a step back from that um you know realizing again this may change as evidence changes and develops and kind of keeping an open mind to that um but again to stress the big
033thing you know we all worry about the asymptomatic person and the close context but really the symptomatic people um are really the concern and you know as a parent i know right i know oh you know my kid has a bit of a sniffle they're gonna be fine they should go to school this is not the year for that and i think we really need to be careful because whether people are truly asymptomatic or as dr wester mentioned if they are merely have mild symptoms and we know that kids especially smaller kids have mild symptoms and so really keeping that in mind when we're talking about quarantine and isolation and trying as a community to take a really conservative approach to ourselves and to our to our children and thinking about you know do they
034really have symptoms and should i be more conservative and kind of keep them out and make sure this is not something else great thank you so i think that's an ongoing one that i think with miss consolino you know that there's continuing dialogue and and appreciate the question and the research on that one as well um we're going to go to dr everett um who it was responding to a couple questions that really centered around weighing the risks of remote versus in-person school for families in our district as well as across the commonwealth whether to return the school for families for students is a family choice and the first just the local context is for our students in phase one that survey went out actually a couple hours ago so this is a very timely
035that we're doing this call this evening because i think there are a lot of questions and i know dr everton talking to me beforehand given his role and his work is receiving them a lot from from patients of his as well so i'll turn it over to you dr everett sure thanks um it is one of the more more common questions that we've been getting at the office these days is what do i do about returning to school what are the risks to my child to my family should i go back to school should we stay at home and we've we've talked about this a lot in our group and what i've been telling a lot of families as far as a decision to go back to school is to is to look at a
036number of things when you're asking yourself these questions first of which is what the spread in the community is like uh dr westerford said earlier you know the the decision about going back to school in some places like georgia or florida is different than where it is here where we've continued to manage to keep the numbers down um and so keeping an eye on what the spread in the community is is an important thing to factor in when deciding about school and that's something that the school administration will be looking at as well the second thing to look at is what the school is doing and what the uh you know what the school's doing about ventilation and about sanitizing and all those measures and you've heard a lot already you've seen in the what's
037been published about what the plans are and i think so you want to think about that and also like how your your child would be able to kind of participate in that as far as what their risks would be and then the third thing is is to consider what the risk would be if you know if kovid were to come into the home i mean each family is a little bit different that's one of the biggest things about this whole and down thing is that each family is experiencing differently some families will um you know maybe have somebody at home who's immunocompromised or who has you know multiple risk factors or under multiple generation family and even if the risks were really low it may be that that's a that's a concern they wouldn't want
038to take that risk to have kobe come in the home so you had the capability of staying home and were able to do that and you want to take that risk and that would be a reasonable thing to potentially stay home and do remote learning versus in person um on on the other hand we know that there are definitely risks to not being in school as well we've seen that a lot in our patients who for whatever reason um you know can't interact as well with the remote learning and perhaps there's uh you know they're involved in special education or they just don't interact with their with the screens and it's really or they're not able to access their therapists or therapy through school and for those kids it may be that being in in
039person school is a really valuable um resource and is more important um we're also seeing you know an increase in risk uh one of the important things about this is is mental health and we're seeing a definite increase in anxiety and depression in our practice as far as you know not having access to people at school or not having those social connections and so um thinking about the you know what are the risks of kovid were to come into your home versus what are the risks if the children aren't in school is it really going to cause you know increased stress at home you know what are your resources and so those are the kind of the ways that i kind of weigh that out another thing to consider is you know thinking about younger
040versus older kids and it does seem as far as we know that that younger kids seem to be less affected all the research is a little confusing as far as you know um you know whether children carry the virus and or whether they spread it but it does seem that the younger children at least uh don't seem to spread it as much as say the older kids do additionally all of our kids may be able to interact a little bit better with remote learning um and so this is something to consider like how old are your kids what is your capability uh to care for them at home these are the things that we um are are thinking about and advising when we um we talk about it another question that came up that i
041would think about would be if i have a high risk children if a child who has asthma for instance should that be a no-go should i totally stay away because my child has asthma and i wouldn't necessarily say that that would totally uh keep you out of school certainly going into school if you have asthma the covid is a slightly higher risk if you have asthma but overall it seems that covid is is not affecting children as much and even children with asthma you know you have to kind of it wouldn't be a no-go to not go back into schools what i would say um and in fact i'm wondering if this fall if for instance if we get a lot more people vaccinated against the flu or take all these distancing measuring measures that
042we're doing to eliminate to reduce the risk of getting coveted is also going to reduce the risk of things like the flu and other communicable diseases that have well and so the hope would be that you know children going back would not be getting uh hopefully a sec so that's all these are things to to consider thanks peter and on that uh the last question we got that we'll address here is uh relatedly how can i improve the health of others right and that was it was a great question that to think about i think the question that came in was you know if i had the capability of of keeping my child home is that something that i should be doing and that's an excellent question i'm not um sure how to answer certainly
043if you if your children staying home and doing distance learning is something that you you think that he he or she can do and that you didn't want to take the risk of being exposed to covet in the school then i think it will be a reasonable measure to take um one of the things that i really wanted to to focus on as far as like how we can protect our community would be to mirror what dr garcia had said earlier which is about the vaccination right um and and flu vaccination and also getting all of our other vaccinations up to date as well so there's two things one is that we're making a big push this fall to get kids vaccinated against the flu um one of the reasons being is that the more
044people that are that are protected against the flu there's a lower chance of going to get a fever that we have to figure out later in the fall well you have a fever now is this the flu or is this coveted or something like that so that would be one reason um the other thing is not just flu vaccine but other vaccinations as well and one of the things our office is going to be doing is not only putting a push out to try to get kids more flu vaccines and get people to be able to you know come through in a really expeditious way through the office but also to get kids caught up on their routine childhood vaccines as well because of the pandemic we've been seeing overall you know the kids that
045we've been doing more virtual visits and so we're seeing some kids are getting a little behind on their vaccinations and we want to make sure the kids do get caught up on their vaccines to be protected against all the other illnesses that are out there before they get back to school so that's going to be another thing that we can do to to help keep the community more safe is to make sure that we you know get our all children just caught up on their vaccines and get their flu vaccines as well thank you all um that was fantastic before we go to the question and answer i didn't know if you know sort of we slotted different uh medical professionals to be answering different questions but i didn't know if there was anything that
046any of you wanted to share before we get into the the q a part and i think to um to add to what peter was saying go ahead to um to add to kind of the the community is really to think about other community members and folks under stress um you know we are a very diverse community socioeconomically um and while some of us may have capabilities and we'll be able to do remote learning um and may not feel as much pressure i think this year probably will be bumpy i don't think it's going to be straight through i think that there's a good chance that cases may rise as we all come in from the summer and it gets colder out and we're spending more time with people and it may mean that school
047needs to shut down for a time in order to decrease that community level which we've talked about the community spread is the word and so thinking that you know if you yourself are in a good and your family are lucky enough to be in a good situation um knowing and identifying families and other things that you can do for folks that may not be in that good situation as a community is is something to strive for esteban or dr garcia were you going to jump in as well yeah um thank you yes i just wanted to comment a little bit of hopeful news i think we are understanding that all of the social distancing and other things that are that are um helping including flu vaccines down in the um southern hemisphere at least what
048i heard today was that the amount of flu and disease the burden of disease is less than in previous years um and so i think that the social distancing and face coverings and flu vaccines are going to help us not only prevent the flu but obviously covets so this is this is a hopeful sign i i think great any other comments before we go to the q a yeah i mean i'll just say that uh you know the one thing that i continue to push in terms of community spread and i want to thank publicly our state representative um representative dome um on this is is you know what we've been doing to get our percent positive in hampshire and franklin county because in the three districts i work for it covers those two counties
049is doing by town by town it's a 47 town city and town excel spreadsheet that we update every wednesday that hasn't come out yet today but you know i i do think trying to get a good sense of community spread is going to be critical and and it is something that we're actively working on because we are even seeing significant difference between hampden versus new hampshire versus franklin counties um and so you know it is actively something we're doing something i've mentioned or is that you know our borders are porous right emerson belchertown and pelham and shoots very right you drive across the lines and so uh in western mass in particular where towns are relatively small we are actively uh focusing on that and we plan to publish them on a routine basis so
050there's a number of good questions so i want to [Music] start there's a question about should we have kids tested before they go back to school so anyone can jump in with thoughts on that one um i would say that asymptomatic testing at this point before going back to school i don't think is needed um i don't think the research has really shown that it would be helpful and the reason that is is because um you can test today and be positive you know three days from now when you get your exposure so i don't think asymptomatic testing at this point is needed for kids going back to school that's my my opinion okay any other comments or um the next question hey oh i'm sorry i was gonna i'm sorry mike i agree i
051think um you know thinking about the the only thing that comes up that i wonder is travel and those folks that have traveled from a state that does have a high infectious rate um not necessarily testing but but that may mean quarantine for some time um so taking that into account and travel plans and where you're going and realizing that that is changing right rhode island more than just recently um their rates went up and now they are a higher risk state so um if you are planning to travel just just knowing beforehand if you are going to a high risk or more high-risk states and what that requires as far as quarantine when you get back i do just want to jump in that i think it's important to read every that a negative
052test has limited value it's not predictive for the future it looks at a single moment of time and even then it's not a hundred percent so when we're talking about testing the the downside of doing a lot of asymptomatic testing is the false sense of security and the relaxation of the other important measures that are known to contain tournaments the next question talks a little bit about college kids return um but also about research about micro droplets um spread covid so i think dr westerfer was interested in jumping in talking a bit about the micro droplets piece sure um you know this is an area of controversy micro droplets um are sort of the five micrometer or less uh particles so the super teeny tiny droplets um that is what we call airborne spread so
053it gets suspended up in the air um and it could be you know theoretically in the room for hours now the research on this um really does not support that this is a primary role of spread when you look at the things even where you know 60 people are in a room in a chorus what's happening is they're singing they're projecting droplets and droplets and droplets and and not wearing masks and so rather than just suspended in the air um for hours for a later uh sort of somebody comes in the room a little bit later that's not the primary sort of way in which it's thought to be spread so it is a potential way um that we we can't rule out and there there are probably some certain events but when you look
054at the research that looks at at the procedures um that we do in medicine that generate tons of aerosols and if you would see it you would see it then um a lot of these studies show that it doesn't really seem that even in those instances in the highest risk population that many people um are are testing positive so it really just doesn't seem like it is uh very common and the thoughts from anyone else okay um a couple questions uh but this one had a nice friendly hello for dr everett so i'll explain this one um just about when flu vaccines uh this year will start becoming available sure and that's uh i don't have specific numbers on that yet our nurse manager updates us all the time we're having regular conversations about planning
055flu clinics and how to get the most kids through as as efficiently as we can and the last i heard was the beginning of october although it may be i suppose it could be a little earlier than that but i think we're shooting for october we're getting a lot of our our clinic set up which should be before like i said you know before the flu starts to show up which traditionally over the last couple of years i can't the flu can show up as early as you know certainly in november although past years the biggest seasons have been december january but we want to get kids uh vaccinated you know earlier in the season if we can so i think we're looking at october for that and we'll certainly be sending a lot of
056information out about getting kids in when that when that happens all right thank you i'm going to skip around a little bit i'm just to keep the order making some good sense um you know so the question i'll just read it uh dr garcia's reference day asymptomatic testing is helpful are there any plans to specifically monitor the asymptomatic testing rates in amherst or new hampshire gowdy to guide school plans um i can talk about the school piece earlier but um i don't know if any of the medical professionals want to comment on the kind of modern asymptomatic testing area um sure i'll just jump in and say that um you know we are um i think uh right currently um uh some limits on testing and asymptomatic testing i think that will increase as the
057um fall rolls around we'll be able to do more of that and i think the the other as well your your personal providers i'm sure um it's been a challenge to get enough testing supplies enough manpower to do that but we certainly want to be able to have that um you know available so that's that's our goal uh and i think that um it'll be up to um kind of the individual schools and and other um folks to make determinations currently a provider can you know often determine whether somebody needs to be asymptomatically tested um for travel or another one of those reasons but we may we may broaden that i think and then flu testing is going to be interesting and important as well um and our plan is to have that um um
058be able to do kind of drive through flu and um um kovid and strep you know so i think we're trying to to think of all of those things we can do at the same time that might present the same way so um [Music] yeah i was just going to add that you know it is one of the things that we're looking at so last week last wednesday which is the latest data we have was on the fifth when you look at the towns in hampshire and franklin county our percent positive rate was 1.3 percent which actually mirrored amherst uh one of the things that's going to be a little tricky and one of the things that you know i sort of i'll speak about this tomorrow night a little more detail is that amherst
059is going to be hard to calculate because the population of amherst is variable and particularly with the umass decision last week it's going to be lower so you know i think thinking about hampshire and count franklin county rates are going to be the way we were planning to approach it even before this umass decision so right now it is a little cumbersome to calculate those but we have our spreadsheet and we just plug in the numbers every wednesday evening when they come out and it is something that is actively going to be be our focus both in terms of having kids come back in school whether they stay in school as well as whether we increase the number of students in school because our plan has phases to it and we want to make sure
060both the numbers stay low and also that there's not significant increases because it could be the case the number's still low but we're starting to see a significant influence that we may want to pause some of our you know having more students in the building so we are looking at again both the testing rate as described earlier but also the number of positive cases per hundred thousand and um so far this area looks um hampshire and franklin county um is well below the metrics of any recommendation from any kind of uh respected agency or you know cdc world health harvard global health what new york state new york city uh lots of other places are doing and i'm intentionally not comparing us no disrespect to miss dr westerford some places that have metrics that uh
061would not pass muster in the northeast um for instance miss cancelino found i think it was i don't know if i want to mention the state but a state far away from here had metrics of whether you had to wear a mask or not based on um numbers and and for us like all the medical professionals have said wearing a mask is is the way we're going to do school it's not based on what our numbers are it's what we're doing the numbers are really about you know the safety being in school basically you know are we getting is there an increase in number of cases and also are we having enough testing in the area to satisfy and make us feel comfortable and again i won't get ahead of myself because school members will
062have lots to say i imagine on that tomorrow night it's definitely a topic of high interest this week and particularly in the commonwealth but i just wanted to um to mention that as well um you know one of the things that's also come up is you know with some of the colleges coming back mandating asymptomatic testing not just an amherst in the local area how that was going to affect actually the numbers and that's you know in my conversation not with folks in this call but other people in public health it's more reason to have a hampshire and franklin county number because it sort of it may it may look thing make things almost look better than they are if you're testing you know that many asymptomatic people as opposed to people who are symptomatic
063and uh you know because we do have a couple colleges in the community it seemed like it was an important thing to have um so there was a couple comments um you know i don't know there's a couple uh thoughts on this which is um desi had some guidance that came out this week the school district's having more in person in hybrid school than some districts are currently planning or proposing and and i think that some of that there's another comment about that below um based on you know some of the positive uh numbers in most areas of massachusetts um and so um i don't know if you all want to weigh in on that i you know or not that's that's more about um kind of state policy but if you're interested in weighing
064in i'm happy to give you the opportunity [Music] i mean i think the the only thing that i think about um from a parent perspective is still having the choice and the ability to decide what i think is best for my family and for my kids um and so whatever mix that is and whatever offer that is um you know i think knowing what the options are and being able to choose between a more conservative option for which i think for always you know 100 remote distance learning versus whatever the type of other model is you know i think is an important aspect i don't know that trying to increase a little bit here or there necessarily kind of makes a difference in in the grand scheme of things i i think one thing to
065that i think about with all this is that the data is changes quite a bit and one of the things that this whole endemic is required is a lot of flexibility here and so the numbers are low now and i think the district has chosen to kind of take the stepwise approach back and then and then follow the numbers and then follow the science and see where we're at uh which which i think is is important i mean following the science and seeing what it tells us and then being able to respond to that um as as college students come back and you know when more people come back to the valley we don't know what the numbers will do if we can all as a community continue to take the measures and wear masks
066like we've been doing my feeling is that the numbers are going to continue to stay alone we're going to be able to move um and move along but um but that's something that i think we need to just i guess respond to and keep an eye on what the numbers do and then and then keep um you know an eye on that as we decide whether to go back um yeah whether to send our kids back to school uh and i think having the testing available is another important thing to make sure that we continue to have that testing and i think i'm seeing that that that you know we're planning to get more testing available in our offices as well and i you know dr garcia said that it certainly has clueless plan um
067so i think that's going to be important for us so that we can keep track of what's going on in the community thank you so there's a question and i think this one i'll comment on i'm going to try to put a link to a presentation from our night that's already on our website so this is not nothing that isn't already posted publicly but the question was about phasing model uses five percent as the threshold um so uh what what anyone who's interested can take a look at that presentation uh the short story is five percent uh is used right now by new york state the centers for disease control the world health organization um have used that metric uh other places like the harvard global health institute new york city particularly because of the
068density in new york city have used three percent as their metric um cambridge massachusetts another district um that we often compare ourselves to and connect with uh have used five percent and so um it is uh you know something that the school can be discussing you know this isn't a posted public meeting of the school committee so i get to speak and unfortunately for them well fortunately unfortunately they they have to wait till tomorrow night but you know along the way we've tried to take the uh approach that we're going to use the most conservative metrics that are being recommended in the field there is some disagreement about five percent of three percent in the field uh we've opted for the more conservative metric and and that's the way we've approached this whole thing is
069you know let's collect what the recommendations are from a reputable organizations and let's pick the most conservative one i mean this came back from three feet versus six feet of social distancing and school committee myself and others uh very quickly uh recognized that we thought there was value in being conservative with that you know we have another metric that we're using which is a number of new cases per 100 000 people again looking at hampshire and franklin county as i mentioned earlier and i think for for reasons that were discussed it's one of the things that both metrics when combined uh capture different data points that we feel like will be a good reflection of community spread and community testing availability the school committee will talk about it tomorrow night i'll certainly talk about in
070more detail tomorrow night but you know what you see if you are looking at the presentation you know on slide six we really tried to do a uh try to find data of what was being recommended what were people uh in the field doing what was the recommendations um and again we didn't focus on you know i will mention it's oklahoma i believe that has different metrics for for mask where we were looking for the outliers in our opinion we were looking for you know again national international organizations uh what recommendations there were i don't claim to be an epidemiologist or a medical doctor but you know we've all dug in and i did connect with somebody over in the eastern part of the state on this uh to get some some thoughts on the
071metrics and and where we landed was again a little more conservative than some of the recommendations but it's a place that at least for me i'll only speak for myself and just constantly know if you want to jump in you can but we feel comfortable that we're we're being as conservative um as we can be based on the recommendations that are being made by experts in the field jill is there anything you want to add to that or sure and i think having metrics in the reopening plan gives some clear-cut data points to look at so we're not questioning you know do we need to move forward do we need to go backwards and it gives us that based on the trending over the last couple of weeks like we're gonna we're gonna look at
072what's happened in our community in the last couple of weeks leading up to school and then you know can we phase in more kids going into you know the middle of october and that kind of stuff and um superintendent morris and i also looked at um adding something in to look at the change over time to see if we've increased drastically you know by a certain percentage that's going to indicate is it safe to continue on the way that we're going or do we need to take a couple steps back too so that was an important piece to put in there too right um [Music] so see another question came in what do you think about students eating and drinking in shared spaces um and questions about toilets so again anyone can jump in on
073that um i think i'll just describe that um the recommendations we have from cdc are students should be six feet away when they're um not wearing a mask and so in classrooms that's how we do it we wouldn't have our students eating in the cafeteria where first of all the cohort model sort of falls apart uh but also around the distancing uh piece not to answer for anyone else but just at least set the context we're also trying to figure out ways where students can each eat outside as much as possible weather permitting we don't live in you know san diego where that might be possible a little more often than it is here or georgia um i don't want to leave out georgia dr westerfer but um but you know we are trying to
074think about that and take the advice we had but i'd be you know very curious for anyone's thoughts on that particular question can i just ask what's a toilet bloom i i think that this is referring to the potential aerosolization of virus because uh viral rna has been found in urine it's been found in stool and the thought is that when you flush a toilet it generates sort of potentially can increase droplets spread um and sort of spread up and it can become aerosolized the problem is is we don't know we can prove in a lot of ways that that we can detect the virus but it's sort of hard to understand that detecting the virus doesn't mean that that virus can then go infect somebody in fact we know that in a lot of
075circumstances it can't um and what we've not been able to ascertain yet from a research standpoint and just my sort of my background is as a as a researcher an avid consumer of medical literature um is is we we haven't found that that we can determine that that leads to infectivity so a lot of places are recommending obviously uh reducing the number of people that are in the bathroom when it is when a toilet is flushed um and you know lids if they're possible um also to help when it's flush putting the lid on the problem is we don't we don't know that any of this is effective or necessary um those are just sort of some of the thoughts circulating in the medical community um is is ensuring that you know that bathrooms have
076have adequate ventilation which um typically in buildings they might and then you know lids on the toilets if possible when they're being flushed and then just ensuring that there aren't 15 people in a bathroom all at once well we are and also just enhanced cleaning of those spaces um i think is really important i think early on in the pandemic we thought um uh many of us uh that you know surface surfaces and touching was a major way of of uh exposure um and it's clear that that's still a risk but um uh not as much of a risk as somebody coughing on you or sneezing on you and so that uh to me is um you know core we wanna the bang for our buck is gonna be the face coverings but then i'm
077sure the skull is gonna take care of the the cleaning of those height what we call high touch high touch surfaces that's still important but probably not as much a risk as some of the others so we are about out of time i want to just mention uh one thing and then thank uh thank all of you so uh at the very beginning sasha figueroa uh who works for the district mentioned that all of uh our live streams we have a bunch of town halls on monday one for elementary one for secondary uh the way we do it is if people need translation in spanish or in portuguese there's a there's a separate line where there's simultaneous translation we had people accessing those lines today so i just want to note if anyone is watching
078this and felt like oh someone would love to watch it but you know linguistically there would be a challenge we're doing that for all of our sessions so please know that while you won't actually hear dr rushford and dr garcia and everyone you'll hear what they're saying today is probably a high end for the translator's work so thank you all for the translators who are doing this this is a pretty technical one um but we really do want to make sure that people access those ones and much like we did today we put it online at the beginning and sasha's put it online at the end and actually has some of the ones from monday as well uh but i also oh and korean as well i apologize but i really want to thank all
079of you this has been really helpful um for i know many people in the community i got some nice texts from people who are watching who are finding it uh refreshing to have people who are medical professionals and not me i'm talking about this stuff and i found it refreshing as well i appreciate that that also that you offer different perspectives that there's not unanimity in the field uh on many of these issues and and you know deeply appreciate you taking time out of your incredibly busy days uh especially these days um to do that with us so thank you i don't know if there's any you don't have to have parting words but if there's anything any would like to share before we uh close up you should feel welcome too well i guess
080i would just say thanks for i i appreciate being a part of this and i mean as all of us are physicians here but i we're all also parents in the the school district in amherst so i think it's it's important to me to to be a part of this just as part of being part of the community as well because this is something that we need to address this pandemic you know together and i think one of the things that dr soares had brought up maybe before the session was just one of the things that we can do during this pandemic is to make sure they are thinking of the others in our community and thinking of the other different perspectives that are there and just you know just being thoughtful one another is
081is an important part the mental health toll that this pandemic is taking on all of us is huge and so taking that moment to think of each other and having these sessions where the community can come together and to to work on it i think is really really important so i appreciate dr sores and dr morris putting this all together and being a part of it thank you yeah i just want to say i think you know to families out there um just to remember whatever decision you decide to make is the right decision if you decide that you're going to do totally remote learning it's the right decision if you decide you're going to go all in on school it's the right decision try not again i think as we mentioned before as you
082see there are no right and wrong answers per se to this there are no absolutes in this and so whatever you decide is the decision for your family then that is the right decision and hopefully um others see it that way as well so yeah thank you for allowing us to to be able to talk with folks and um it's really been a pleasure yeah thanks for thanks for um having us i i appreciate this a lot and i also i just want to take just a minute um you know we talked about how uh you know dr sores and dr everett talked about how we can look at the others in the community try to understand where they're coming from and be respectful that people have different situations um but i would ask everyone
083in this time you know the same plea that we had back in march is is to try to keep the community safe in other ways so a lot of it isn't like i mentioned what we're doing necessarily at school it's what we're doing where we're traveling um how we're gathering and the other choices that we're making and those have implications for our community and so as a community um you know this is one of those times where i think that there does need to be some transparency in terms of what we do um and the decision to you know my child are they maybe a little symptomatic maybe i could just send them through um you know that's this is not the time to do this um to particularly keep everyone safe because we all
084have family members um and and you know some of us have different situations so it's just a plea to try to keep the community safe yeah and i just want to say thank you i uh really enjoyed it and i learn a lot every time i get to participate in these and um uh get your flu shot yeah yeah and uh you know please if there's questions about anything here you know we we these folks don't uh they're not employed by the district but you know about our plans please email me morris arts.org i can definitely forward it along to ms consolino school committee at arts.org we want to be continuing to engage the community on on these issues it is changing it will continue to change as mr dr sword said earlier um and
085so thanks all of you thanks to our school committee members thanks to judy torres who i should have mentioned by name before as the one who's organizing and doing incredible amounts of work to make sure this that everyone has access to this um regardless of the their first language or primary language and uh thanks to everyone and everyone have a enjoy the lovely evening we have it's starting to cool down and uh hope everyone is doing well we'll see you soon thank you