If Knox County Had Followed the Above Metric for COVID Mitigation
A recent letter posted on Facebook caught my attention. Addressed to the Knox County School Board, it offers a path forward with objective markers for when students should mask and when they have less need to do so. She offered it in hopes it might break the current impasse between the court system and the schools, which resulted from the School Board’s reversal of their earlier commitment to follow CDC guidelines and the resulting lawsuit brought by a group of parents.
Written by Christy Smith of Knoxville, and shared here with her permission, she included the above chart developed by an epidemiologist. She took it on herself to build the chart below (with help, she says, from her husband), which shows how following this approach would have played out across the last two years for Knox County. In an encouraging note, she understands that lawyers for each side have viewed her letter, so perhaps that is a start.
She introduces herself in the letter, so I’ll leave it at that and give it to you in her words:
I am a parent of two Knox County Schools students in Virginia Babb’s District. I was the school nurse at Pond Gap Elementary School for four years, the last of those being the 2020-21 Pandemic School Year. Currently I am working as a COVID Response Temp for the Knox County Health Department. My views do not represent those of the Knox County Health Department.
We are all tired of the pandemic, (and) for some of us, that anger and frustration and sadness gets misdirected because we don’t know where else to put it. We’ve never done this before. I don’t think anyone wants to wear masks indefinitely. But I am not here to debate the effectiveness of masks.
There are undoubtedly widespread mental health problems in our students. But let’s not mistake correlation with causation. My students at Pond Gap came to school cheerful and engaged during the 2020-21 school year. They hardly ever complained about wearing masks and were happy to oblige to a gentle reminder to put their masks up. I didn’t have one single incidence of a student having an asthma exacerbation secondary to mask wearing, in fact, with fewer viruses circulating, there were fewer incidences of asthma exacerbations. During that year I had less than five cases of COVID in my student population. The mitigation measures worked.
Fast forward to Spring Semester of 2022…
Cases are higher than at any point during the pandemic
Knox County Schools is under a federal judge’s mandate
Everyone is tired of masks
Everyone is tired of the pandemic
Nobody wants to wear masks until 2024
Places around the country are easing mitigation measures
You need a plan to present to the Judge so we don’t have masks until 2024
Parents need reassurance
1. That their children aren’t going to be wearing masks until 2024
2. That their children are going to be safe at school should circumstances change
3. That there is a Pandemic Plan, just like there is a Fire Plan, an Active Shooter/Lockdown Plan, a Tornado Plan, an Evacuation Plan, etc…
I have attached a chart done by an epidemiologist that outlines risk levels based on county-level cases per 100,000 and Positivity Rate. She separates risk levels into four different zones: Blue, Yellow, Orange and Red. She describes activities which are low risk during each zone of risk. It doesn’t really matter what your beliefs are about how you arrive at the numbers. You have to agree to a basic set of facts to move on any further from this. Otherwise you might as well be speaking different languages without an interpreter. So pick a metric and go with it. And don’t look back.
According to the descriptions of safe activities in this model, students would be masking during orange and red zones and unmasked during yellow and blue zones. Your all or nothing approach has landed you on nothing. (For those that want to discontinue mask wearing altogether.) With this approach we would have had approximately 30 unmasked days so far this school year. Which is better than none.
For those that want to remove masks, I have attached my own graphic depicting how the zones would have played out over the last two school years. My chart uses three different types of data, which look very different. But again, take your pick. I think it is very important to have a plan going forward, not knowing what the next wave will be like. Parents need reassurance that there is a plan. We are two years into this, too long to be flying by the seat of our pants anymore.
If you will notice at the top of my chart it says, “All Mitigation Measures Can Be Lifted With A School-Wide Vaccination Rate>85%.” (A previous version included this.) This is a metric from Dr. Jetelina’s chart. If you want to get rid of all mitigation measures here is your goal post. I know how excited Ms.Horn and Ms. Henderson got about states lifting their mask mandates. Let me just point out a couple of things there. California, Massachusetts and Rhode Island have far lower hospitalizations and case rates than Tennessee. And far higher vaccination rates. And California and Massachusetts still have school mask mandates. And they had mask mandates to begin with so they have control over them.
Hospitalizations per 100,000: California 4.5 Massachusetts 3.6 Rhode Island 2.8 Tennessee 5
Cases per 100,000: California 98 Massachusetts 47 Rhode Island 66 Tennessee 136 Knox County 161.5
Vaccination Rates: California 62% Massachusetts 64% Rhode Island 74% Tennessee 54% Knox County 58.8%
Don’t Let Perfection Be The Enemy of Progress
You can nitpick the facts, the data, the scientists, the evidence all day long, but you are going to have to present something to Judge Greer that has some traction. This is a very moderate approach. It is probably not going to please either side a whole lot. But, it is a compromise. Or a starting point at the very least.
You cannot negate the rest of the community when you look at the data. Using school level or pediatric only data is not a true representation of the risk level for the community. I have talked to countless families through both the Delta wave and now the Omicron wave. Over and over I hear about families who work from home, don’t go anywhere and the only place their child goes is to school. And now four people in the home have COVID.
What happens in schools affects the rest of the community. When school closed for a week, cases dropped. And it’s not true that kids are just going to get it outside of school anyway. I talk to plenty of families who can’t afford to or are being cautious and do not participate in any extracurricular activities. School is their entire family’s only exposure to COVID.
I wish you the best of luck in your negotiations with Judge Greer. Please let me know if I can be of any assistance. And if you have read this far, I would REALLY appreciate even a one word response. I am attaching both photo and PDF versions of the charts for your choosing.