As previously posted, the Appleton Area School District Board of Education voted 5-2 to reinstate the November 22nd Covid mitigation plan, effective 02/28/2022. This change includes optional masking for all students and staff at the kindergarten and above level so long as the schools maintain less than a 2% positive case rate among their student populations.
Prior to making that decision, the board received and asked questions about a couple of reports. Prior to receiving those reports AASD Superintendent Judy Baseman reminded the Board of the three areas they had committed to prioritize.
- Mitigate the spread of Covid-19 utilizing layered strategies.
- Prioritize the continuity of in-person, academic, and social-emotional learning for all students five days a week.
- Minimize social disruption for students, families, and staff
The first report was presented by the City of Appleton’s new Health Officer Chuck Sepers. He had only occupied that role for the last 3 days, although he had been a local health director in Nebraska for the previous three years.
He reviewed the various slides showing case numbers and burden rates in the City of Appleton.
Appleton’s current 2-week case count was 142 and the burden was 612. He noted that there had been a math error that had been caught after the slide had already been produced, so the slide incorrectly stated the case rate was 152 and the burden was 625, but for all intents and purposes the numbers were very close.
For the first time in over 10 weeks the city had moved down from being in the “Critically High” burden category to the “Very High” category. The slope was trending downward which was positive, but he did not that looking simply at the absolute values they were still comparable to where the city was at the week of 12/28/2021. [I think he may have meant 12/28/2020 when the burden rate was 668.] Things were moving in the right direction but were still in the “very high” category.
He brushed over the slide explaining the burden, trajectory, and composite indicators. [Honestly, this slide is just a mass of data that doesn’t seem very useful and is routinely jumped over. I don’t get the impression that anyone finds is very useful. I could certainly be reading more into his reaction to the slide than was there, but, as the new guy, this was how Health Officer Sepers responded to the slide. I can’t say that I find fault in this reaction…]
“And…oop, let’s see here…and, uh, what this is—you’ve all seen this slide several times so I won’t spend too much time on it, but, uh, next slide.”
He reviewed the City of Appleton’s case rates for residents under 18. For the week of 01/26/2022 – 02/08/2022 Appleton had 224 cases in people under 18. That calculated out to 1,318 per 100,000 people which was still in the “Critically High” burden category.
In the 4–17-year-old age range, there had been 174 positive cases during that time frame which worked out 1319.6 per 100,000 people and was also in the “Critically High” burden category.
He did note that they were seeing the same sort of trend in the cases in these age groups as in the population overall—i.e., 4 weeks in a row of dramatic drops. That was exactly what they wanted although there was a little bit of a lag from this group as compared to overall residents.
The city’s current transmission rate was 202.7. The CDC’s current mask guidelines call for masking when the transmission rate is 50 or above, but he stressed that was the current guidance and stated, “I’m sure everyone has seen the national conversations, and we do expect to have some fresh CDC guidance here rather shortly.”
He reviewed the vaccination rates as of 02/14/2022. The City of Appleton had a vaccination rate of 68.1% which was a little higher than Wisconsin or the United States. He noted that the number of fully vaccinated 5–11-year-olds was only 25.9% “So some opportunities in that age group for sure.”
He reviewed the hospitalization numbers for the Fox Valley HERC Region, and said, “Part of the changes in the new CDC guidelines will really focus on the overall hospital capacity. That’s something that we expect is something that’s gonna be part of those new data calculations. And so just wanted to orient folks to that and begin to think about what that looks like.”
The information on the slide was from 02/16/2022. At that time there were 53 current hospitalized patients down by 25 from the week before, but, when they looked at the total bed count, out of 66 ICU beds only 1 was open and of the 266 Medical Surgical beds which was the other number they would pay close attention to there were only 4 out of 266 available. He said on Monday there had been 0. “Still that hospital capacity is something that we’re really looking at and what the CDC is going to be paying close attention to in the new masking guidance.”
He said it was also important to note that Covid-19 hospitalization rates lag behind daily new case counts by about two weeks.
He threw up another slide giving another kind of view of bed usage over time then opened things up for questions.
Board member Deb Truyman asked if he could clarify if people were in the hospital because of Covid or for other things and just happened to have Covid.
Health Officer Sepers went back to the WHA hospitalization slide and said there were two different ideas on the slide. One the bottom right was a table showing bed counts. Those were total hospitalizations that included everybody, not just those with Covid. Then the table above it showed people who were hospitalized and had Covid, but that was just for informational purposes. The bed count table was what they look at for a total snapshot of what is going on with the area’s healthcare resources, and he said that was what the CDC is going to really look at.
Board member Jim Bowman wanted to clarify the point of Deb’s question. Was it that a person may have been hospitalized for reasons other than Covid and would possibly not have been hospitalized just for Covid?
Deb responded that people have been closed in for a long time and she was wondering if they were finally going to get some of the procedures that they may have needed for a while. She also wondered about the number of beds and wondered if staffing shortages were the reason that there were fewer beds available currently and if there would have been more beds available if there weren’t staffing shortages and if people hadn’t quit their jobs because of mandates.
Jim Bowman wondered if she was trying to ask if the number of hospitalized patients might be over stated because they might have been in the hospital for other reasons and if so, the hospitalization numbers wouldn’t be reduced by lowering Covid numbers.
Deb agreed with that and also wondered if the hospital beds were full because people were finally starting to get the treatment they needed for other conditions now that things were opening up a little bit.
Board member Ed Ruffolo wanted some clarification on the case numbers of 4–17-year-olds. When he looked at the District’s covid tracker there were 18 students currently positive. When he looked at the CDC’s county tracker for Outagamie County that morning, it showed 206 cases county wide and a case rate of 109 per 100,000 which was the lowest it had been in a long time. But earlier in the presentation Health Officer Sepers had indicated that there were 174 cases among 4–17-year-olds. He didn’t understand how the school district had 18 positive students and 174 school aged children positive. He thought most of the school aged children attended AASD. It seemed there was a discrepancy.
Health Officer Sepers was so new to his position and didn’t have the history with the school district to be able to answer that question satisfactorily. He did note that the 174 cases spanned the entire week of 01/26/2022 to 02/08/2022.
There was some discussion about the numbers and speculation as to what might be going on. It was noted that the city’s numbers included students in private schools and home schools as well as those in AASD. [For that matter, they would have also included students who lived in Appleton but were open enrolled into other school districts.]
Assistant Superintendent Polly VandenBoogaard was in charge of monitoring and entering the Covid dashboard data so she looked through the District’s historical data and, later on in the meeting was able to tell Ed that between 01/26/2022 and 02/08/2022 the District had 145 cases of positive students. [That’s only 29 fewer than the 174 total school aged children who had been identified during that time frame, and the rest could easily have been made up by students not attending AASD.]
Board President Kay Eggert noted that the county data Ed had mentioned included more than just the Appleton Area School District. She thought the discussion was a good reminder to really be grounded in the parameters of the data sets they looked at and what was included in them.
They moved on to the report regarding internal data for students and staff.
Assistant Superintendent VandenBoogaard said that they were seeing a downward trajectory and had fewer cases among students and staff. There had been a peak in January and now a steady decline.
She showed two slides, the first which illustrated the number of students over time who were either positive (red) or quarantined (yellow) and the second which showed that data for staff. [As you may recall, quarantined student and staff are not positive but are quarantined due to close contact with a household member who has tested positive.]
If they used the 2% threshold for school masking that had been approved back in November, as of Wednesday 02/16/2022 none of their elementary, middle, or high schools would have been masking.
She then reported on the Covid testing the District had been providing. They had tried to be responsive to the needs of staff, students, and families. They moved from providing PCR tests to doing antigen tests only on 12/13/2021. Then on 01/03/2022 they opened testing up and offered it not only to staff and students who were symptomatic but also to those who were asymptomatic because they had the availability and resources to do that. On 02/07/2022 they also opened testing up to the immediate family members of staff and students.
She then turned things over to Chief Human Resources Officer Julie King to share about staffing.
She showed a slide comparing absence trends from the 2021-22 year to the trends from the 2019-20 school year which was the last year when the District was in-person during the first semester.
In mid-January of this year, they had a peak of absences following the trend of Covid cases at that time, then they had a dip coming back on the 18ths. She noted that was a shorter week because of MLK Day but they did have a significant drop and then lower absences continuing for the next few weeks.
She showed another slide that illustrated the data in another way. She noted that in addition to Covid they have traditional illnesses they have to deal with, and their flu season is generally December through March. In past years they have seen a significant drop in absences starting around mid-January, and that trend has continued to the present.
She reviewed some of the strategies that they put in place to deal with staffing shortages because they have had more absences for several reasons, including Covid, this year than they have had in previous years.
- Dedicated substitutes were extended through end of year
- Defined coverage options were put in place to allow licensed paraprofessionals, coaches, and staff to cover during prep time and things of that nature.
- District coaches and district administrators served on substitute rotations to help out on days where there were extreme needs
- School business was paused which reduced the number of absences.
- They were continuing to recruit new substitutes.
- The internal substitute pay rate was increased.
She then opened things up for questions.
Board member James Bacon asked if they tracked the number of absences that were Covid-related and not Covid-related.
Ms. King answered that on a week of peak absences about 120 absences had been Covid related as opposed to the last two weeks where they dropped down to 33 and 19. She said they had to multiply those numbers by 5 due to the number of days the teachers were out.
James Bacon said, “I would assume though it’s safe to say that the vast majority of absences as of late are somewhat due to Covid—you know, I mean whether it’s an actual quarantine of a staff member, you know, having it, or potentially a staff member who has a member in their household or something like that happening. [That] is at least how I’m interpreting the data that is presented. I’m just making sure that that is a true assumption.”
Julie responded, “So, if I extrapolate that out, Mr. Bacon, it would be about 25%. 20-25% of the absences are Covid related positive cases or quarantine for the last two weeks. That is about the percentage that we’re experiencing right now.”
He thanked her and said that was helpful because it was a little lower than he had anticipated. He then asked her if she had a sense of what the staff thought about masking and the impact it was having, especially staff that was in schools and classrooms.
Julie answered, “I would not say we have any data points that determine where our staff are on that level of comfort with masks or non-masks based on their individual situations. I would assume just as our parents and families and community are different that we have people on all ends of that spectrum.”
Board member Kris Sauter wondered if there was any data on substitutes and their feelings regarding masking vs. not masking and how that would affect their willingness to take positions in the future.
Julie answered, “the only point we would have would be the information when we surveyed our substitutes who are not taking jobs, who are not actively subbing. And I would say that was kind of the same spectrum. We had people that were not taking sub jobs because they had to mask or people who were not taking sub jobs because they were fearful of catching Covid at this time. So, it was kind of a 50-50 split in different reasons why people weren’t taking positions. We saw that same trend with our substitutes just in the data that they shared back.”
Kris asked if that included substitutes who were currently taking positions.
Julie responded, “That only included the 35% of substitutes that were not actively taking assignments as of first semester.” It was not a full sampling of all the substitutes and whether they would sub with the mask mandate or without it.
Kris asked if they had any data regarding sub failures during this time period.
Julie said that they changed their process regarding coverage in their systems so that added a layer of complexity. Back in January they had about a 27% unfilled rate. The change in their process had been that as they had administrators doing sub rotations and building coverage plans, the school sited had switched to changing those jobs as “no sub needed” because they were covered internally. That skewed the data. That was why they transitioned to looking at their actual absences instead.
What happens on a daily basis is they see the truly unfilled jobs but the system doesn’t delineate how many are filled internally and how many go unfilled. If she had to speculate, she thought they would probably be right now very similar to how they were prior to the surge with around a 17% unfilled rate when they looked at how many positions were truly going unfilled.
Kris said she had indicated that they currently had support staff who were filling those sub positions, but those support staff position had been created to increase student success and achievements in a variety of academic, social, and emotional areas. It left her wondering what the implications were for student learning when those staff members were no longer filling their intended roles because they were subbing.
Superintendent Baseman said that for a month and a half (with the winter break in the middle) it had been an all-hands-on-deck situation to keep the classrooms open. She noted that there had been some area districts that did have to close for a period of time because they lacked staff. She appreciated all the people who stepped up, but said it had been done as a last resort. There had been a point at which they had been at a 25% unfilled rate. As that percentage as gone down to a more manageable level, the district coaches and other positions have been able to transition back into their normal roles.
Kris appreciated that answer and the efforts of the staff and said, “I guess I want the community too to appreciate the fact that a lot of people are taking on different roles, but that that also means that there are some areas where, you know, for the last month and a half, they may not have been in the roles that they were hired for.”
James Bacon had a question for Assistant Superintendent VandenBoogaard regarding the slide that had shown that none of the schools currently met the 2% masking threshold. When that masking threshold was hit schools needed to mask for 14 days. He wondered if all of the schools on the slide were out of that 14-day window or if some of them would have still needed to require masks due to still being within that 14-day period.
Assistant Superintendent VandenBoogaard said the slide was just a snapshot the district at that time and the 14-day window had not been taken into consideration.
He asked if she knew how many schools would have still been in that 14-day window.
She thought it would have been minimal. They have had very few classes or buildings that have had multiple cases in them for the last couple of weeks. It would have been very different in January, but at this point in time it was minimal.
James stated that in February they had started to see fewer and fewer schools meet that 2% threshold to the point where they started to get to the 0 level pretty consistently.
She agreed.
With those questions answered Superintendent Baseman showed a slide reminding the Board what the Covid mitigation measures were that they had approved back on 11/22/2021. Those included:
- Optional masks/face coverings for Elementary, Middle and High School staff/students beginning January 18, 2022
- Continue required masks/face coverings for EC/4k students/staff
- Continue required masks/face coverings for all students on public or school transportation per CDC Order
- A 2% threshold for positive student cases in schools to be used for requiring masks/face coverings for 14 days.
She then opened things up for questions again.
James Bacon said that he had a question for Health Officer Sepers based on some of the different data points they were looking at. “I believe that broadly, as a system, we should be following the guidance of the public health institutions that are charged with giving recommendations for this, and so based on what I see, our community transmission risk level is still high, and we’re very high though dramatically dropping, so positive outlook for the future thought we’ve also learned—we’ve been in that world before and then been very quickly out of that world. But we’re also seeing in our district and with our children, even across the board, that it’s also trending downward even more quickly in some cases, and so do you believe—I guess since the CDC is a national organization, is there any reason locally from your vantage point as our local health professional that we should consider not following the masking recommendation from the CDC given the local data here? And/or what is the data points that we should consider, noting that we are still at that high level but also dropping? And how to contextualize that from a timing perspective, because I do believe that from an educational perspective, which is what we’re experts in, that having some clarifications and consistencies and predictability around our educational circumstances is very important for our staff and students to do their jobs well. So, I’m just interested in your opinion to help contextualize this from a local perspective if you’re able to.”
Health Officer Sepers answered, “So there’s a little bit to unpack I think in the multipart question, but thank you for that. So, to the broader question, you know, what sort of guidance—all things being equal, what sort of guidance should we be looking towards? All things being equal, the CDC guidance is sort of the gold standard in terms of, if you look nationally, there—it’s not true in our state but in other states the CDC guidance is locked in in terms of state statutes and that sort of things in terms of what that guidance is.
“And so, but the national tone is knowing that the CDC has resources beyond any of us—always looking at the latest evidence and the current data. Those recommendations are born from that collective knowledge gathering, right, and so in an ideal context the CDC federal public health guidance is that sort of north star if you will.
“That being said, I know that the CDC hasn’t always been as nimble I think as we all would have liked. I know that the federal school guidance certainly going in to the 2020-2021 school year was lagging. I think things still weren’t as refreshed and updated for going into 2021-22. And I think that there’s been a lot of criticism of the CDC and probably rightly so in some cases.
“That being said, we are expecting a fresh CDC mask guideline update, so a lot of national coverage yesterday on some of those public comments, knowing that it’s not all just about transmission rates. There are other things to consider and as we think about those other variables that are very important. And I hate the term ‘new normal’ but as you’ve stated, Mr. Bacon, we need some predictability. We need to be able to get into a state of societal functioning that works well for all of us.
“And so, some of those variables that are important to consider are the local hospital capacity first and foremost. That’s one of the things that we consider if we look at what the school’s role is in the multiple layered infrastructure that is our modern society. You know, keeping kids in school in a safe and, uh, in a safe classroom and able to learn that’s where we all want them, right? And so, thinking about what that looks like and those absences affect the entire chain of things, and so if there are healthcare workers in the home, Covid-19 sort of devastates that system even further, right, in some cases.
“But that hospital capacity at a broader level is one of the things that we fully expect will be part of the CDC guidance as I stated and I think that’s one of the things that we’ve considered. Again, [I’m] brand new, but when I met with the school district yesterday—some of these, or the, that criteria piece, so looking at that building level sort of data driven measures is something that I, we have done in our health district prior to, you know, me coming here and so that’s something that worked well.
“But there’s a couple different things. So, at what point do we go from this sort of transition to, you know, where it’s safe to wear a mask and where it’s not? At this point we are looking very curiously, as you all are, at what that new CDC guidance is, and it’s kind of hard to put the cart before the horse at this exact moment in time but if this new CDC guidance includes variables like—you know what that local hospital capacity is in terms of the calculation of risk level, ’cause that’s what we’re really talking about is that risk vs of reward, right? And so, we know that there’s going to be risk but if we’re considering things like rate of transmission, we’re looking at test positivity, if we’re looking at the local hospital capacity, if we are looking at, you know, vaccine uptake, total vaccinations, that kind of thing, we’re in a much different place here in February 2022 than we were February of 2021. We have vaccines for school-aged kids and so there’s a level of safety that parents can provide at that level that was not even possible last year.
“So, all of those factors are things to consider as part of the broader picture when we think about risk, and I fully expect that the new CDC guidance—which, again was mentioned—would probably come about within the next week. If it’s longer than that I would be surprised. But the next week or two at least will take into account everything that I’ve just talked about. This is part of the national conversation, every state conversation I’ve been a part of now in two states. So, I fully expect that those are some of the things that are gonna be considered which are what those of us on the ground have thought about for quite a while.”
[I thought it was interesting that one of the main things he mentioned as being an influencing factor on student masking recommendations was not student safety or staff safety or quantifiable transmission rates but rather hospital capacity. It would be nice to have a little more information on how much impact masking in schools affects hospitalizations rates in the regional community. His statements also did not give me the impression that the Appleton Health Department or the CDC have any plans to start viewing Covid the way they do influenza, which calls into questions Superintendent Baseman’s suggestion that in the fall AASD will respond to Covid like it responds to the flu.]
Ed Ruffolo said that he could look at the statistics on hospitalizations in the Fox Valley but he didn’t know how to interpret the data and didn’t know if the hospitals were or were not under stress.
Health Officer Sepers answered that they were definitely still under stress. Part of the conversation with Deb earlier had been whether those numbers reflected staffing issues, and they absolutely do. Capacity was only capacity if had enough staff to run the beds. It didn’t matter why the staff wasn’t there. What mattered was that they had a certain number of beds and a certain number of staff members to manage them. It did, however, appear that things were moving rapidly in the right direction. They weren’t there this week, but things were moving quickly.
Kay asked if someone could explain why early childhood and 4k sites needed to follow different guidelines than the other grades.
Assistant Superintendent Nan Bunnow worked directly with those grades so answered. There were a number of reasons for requiring students and staff in the 3- and 4-year-old programs to continue masking. (1) The vaccine is not available to students that age. (2) Current CDC recommendations for early care and education centers is for students to mask given that children have difficulty with physical distancing and place is part of their learning. They’re recommending that all early childhood students mask even if they can be vaccinated in the future, although they don’t know if the CDC’s recommendations will change. But they do know that there is still not a vaccine available for 3- and 4-year-olds. (3) Because AASD works with community sites, they need to consider licensing requirements and state licensing does recommend that sites follow CDC guidelines.
Kay asked if state licensing “required” they follow the CDC.
Nan answered, “It does not require but the wording from them is ‘strongly recommends’ that CDC guidelines are followed.”
Kay asked what would stimulate the thought of changing guidelines for 4k and early childhood sites and what organizations were in charge of that.
Nan said the Wisconsin Department of Public Instruction (DPI) and Department of Children and Families communicate with each other. Their advice does not always work in the same direction, and schools have had to wait for additional guidance from them as they’ve met with each other to talk through their recommendations. AASD is connected with those state agencies as well as with the Appleton Health Department and the Menasha Health Department. (AASD has some 4k sites in Menasha.)
Thus concluded the presentation portion of the meeting.
View full meeting details here: http://go.boarddocs.com/wi/aasd/Board.nsf/goto?open&id=CAUW3D836FE6
View full video here: https://www.youtube.com/watch?v=pvYHS_B7h0g
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