Massachusetts school reopening plan gets an A from me

There's much to like about the new Massachusetts Initial Fall School Reopening Guidance document. It is:

• Purposeful --aiming to meet the objective of educating children in person while keeping them and staff members safe
• Timely --coming at the end of the school year, with updates promised over the summer
• Evidence based --relying on the latest medical and public health guidance and the experience of schools abroad
• Appropriately detailed --with enough specifics to  guide decisions that need to be made now without being overly prescriptive
• Circumscribed --acknowledging and accounting for issues of racism and disparities without purporting to solve every problem
• Balanced --recognizing that we are living in the real world (such as it is!) and that COVID-19 is part of it. None of the measures (hand washing, masks, staying home when sick, social distancing) on their own will prevent the spread, but taken together they have and will

I'm not an easy grader, so my A for this assignment is real. I have publicly criticized Massachusetts' reopening plan and its testing plan for being vague, non-evidenced based, and irrational. Privately, I've admonished the local school system for its defeatist attitude toward COVID-19.Predictably, the Boston Globe (School guidelines feel unsafe to some) used today's lead article to find fault with a wide variety of plan elements. Here are the ones I see mentioned:

• The plan doesn't set a cap on the number of students in classrooms
• COVID-19 testing is not mandated
• Daily temperature checks are not required
• It mandates only 3 feet of social distancing even though officials have been telling us 6 feet
• Superintendents need to develop 3 sets of plans (in person, hybrid, virtual)
• No clear guidance on whether state should go back to in-person classes when school reopens
• Doesn't adequately address  challenges of urban schools that serve children from disadvantaged backgrounds and have limited space
• Racism is not connected to students' mental health in the plan
• It doesn't say how many students can ride the bus
• People don't like the idea of wearing masks all day

The report itself anticipates and addresses these criticisms. The Globe notes  some but not all. Here is the reasoning

• Number of students isn't capped because the relevant constraints are adequate space between desks and proper behavior. If a room is larger it can accommodate more students. The report encourages use of new spaces like libraries and cafeterias
• No one in the country (or world?) is seriously suggesting testing all school age kids. It's expensive, slow, unpleasant, impractical and unnecessary. Maybe there will be cheap, spit tests at some point. They can be used if the need is real
• Daily temperature checks produce too many false negatives and false positives, offering a false sense of security and causing students to miss school when they don't need to. These checks are good for other illnesses, like the flu where fever is a good indication of active infection, but it's of limited use for COVID-19
• There's no magic in 6 feet. Three feet seems to work fine in other countries' schools, especially in combination with other measures, like wearing masks. Schools with 3 feet of distance abroad have not had outbreaks. Kids aren't going to be safer out of school
• Superintendents need to develop plans for different scenarios. Of course they do! If they just developed one plan it would have to be for remote instruction only. Is that what we want?
• Of course the guidelines can't be definitive in June about whether students can go back in September. But the goal is to get as many back as possible. To make that happen requires everyone to behave well over the summer (adults, especially!)
• Although the plan isn't going to eliminate disparities or solve racism, there are extra funds to help all schools and especially those with extra needs. And the best way to reduce disparities is with kids in school. Disparities widen (as I'm sure they did this spring) when normal routines are thrown off. For extra space, the guidelines suggest working with local community centers, libraries, etc.
• Kids will need to wear masks on the bus. If the bus is crowded then buses will need to be added or kids will need to get to school in other ways. They can keep windows open, too.
• It's true that people don't like wearing masks all day. The guidelines call for mask breaks and make special mention of how to work with people with breathing or communication problems. If we all behave there's a good chance we can take our masks off sooner rather than later.

Notably, these guidelines are endorsed by people who know what they're talking about and have children's interests at heart. The healthy approach is to work within the guidelines to plan a return to in-person classes this fall. We should continue to challenge the guidelines and expect them to be updated as we learn more and as the situation on the ground evolves.Meanwhile, we can all contribute to a safer back-to-school scenario by continuing to follow public health guidelines that are knocking the virus down in Massachusetts. The lower the level of community spread, the safer any reopening plan will be.

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By healthcare business consultant David E. Williams, president of Health Business Group.