The Appleton Area School District Board of Education met 10/11/2021. The big item on the agenda which took up the most time was the discussion and vote surrounding mandatory masking while inside school facilities. There was nearly 1 hour and 45 minutes of public comment, the majority of which came from people opposed to mandatory masking, then the bulk of the rest of the meeting was taken up with a presentation by the Leadership Team regarding masking and then the discussion and vote by the Board of Education.
Superintendent Judy Baseman started off the presentation by saying that when they introduced their mitigation protocol for the 2021-22 school year “we were clearly articulating three major goals in our plan.” Those goals were (1) Mitigate the spread of Covid-19 utilizing a layered approach, (2) Prioritize the continuity of in-person learning, and (3) Minimize social disruption for students, families, and staff.
She continued by saying “as we have proceeded through this year, we have definitively seen benefits of that layered approach.” [The term “layered approach” has been used several times in board meetings when discussing Covid mitigation. Honestly, I don’t understand what they mean by it because as far as I can tell, their approach doesn’t seem to have layers. Back in July when they announced that masks would be optional for the year, my impression in watching that meeting was that masks would be optional but then they might have to bring them in only in certain situations as an additional measure temporarily layered on top of their normal measures such as increased air flow and increased sanitizing. At this point, it doesn’t seem like they have measures that they are taking on and off, so in that respect it doesn’t seem like they have any layers. It would be nice if they would give a clear explanation as to what they mean when they use that terminology. What are the different layers?]
Appleton’s Interim Health Officer Sonja Jensen was not able to be at the meeting so Polly Vanden Boogaard, the Assistant Superintendent of Student Services at AASD, ran through the Power Point slides she would normally have presented.
She stated that the district’s medical team was rooted in medical science and public health and that the advisory committee based all their recommendations on the analysis of science and facts given from their professional organizations, medical connections, and expertise.
She reviewed the slides showing the City of Appleton weekly case counts and burden rates. Appleton is currently in the “Very High” burden category, and she noted that in August when the district voted to require it was only in the “High” category. [When they voted to make masks be optional, Appleton was in the “Moderately High” category and entered the “High” category the week after the vote. They held off on voting to require masks for 3 more weeks.]
She showed a slide showing what the case rates were for people under 18 in Appleton. Between 9/22/2021 and 10/05/2021 Appleton had 128 cases in people under 18.
There was also a slide showing vaccination rates in Appleton both for the total population and then broken out by certain groups.
Dr. Lee Vogel, Geriatrician and member of the Appleton Board of Health, then spoke.
She showed a slide of current hospitalizations. She stated the slide was from September 1st which didn’t make any sense to me because it’s clearly labelled at being from 10/8/2021.
She said that the area was in the middle of a significant surge which has resulted in a significant amount of cases and burden to hospitals. She said that things probably peaked last week when around 110 beds were occupied by Covid patients. She seemed to suggest that there were more hospitalizations this year than last year but I didn’t understand exactly what she was saying so I’m just going to transcribe it: “We actually peaked probably last week, maybe at about 110 occupied beds with Covid although we had a much lower rate in comparison to case positivity outside. So fewer cases but climbing and fewer than in the past winter has resulted in many more hospitalizations because people are sicker, fighting longer, and able to actually get out of the hospital but after about 20-30 days.” [I don’t understand her numbers or why she seemed to be suggesting that we have more people hospitalized this year than last year. If you go to the WHA.org website and check the hospitalizations in the Fox Valley HERC region, there are 101 people as of October 11, 2021 hospitalized with coronavirus as compared to 131 on October 11th last year. On October 8, the date of the slide Dr. Vogel showed, there were 109 hospitalized people as compared to 139 hospitalized Covid patients on that day last year.]
She did go on to say that the burden being placed on the hospitals was partially related to the coronavirus surge, but it was also due to a lack of nursing staff and personnel which could be taken a number of different ways. “Part of it at least is that there are people that are leaving the profession of nursing relative to the stressors of taking care of persons with Covid.” She noted that bed capacity was not the only concern, and that staffing levels mattered. [She didn’t touch on whether any hospital employees were leaving due to vaccination requirements.]
She said, “I do want to say that my observation of persons tonight, that we have parents who care very deeply about their children and their personal choice, but I also want to say that the decisions of the advisors as covered by the prior comments in the presentation are really rooted in science—not in politics. I don’t have a personal friendship with a party leader. We really are following public health. And there’s differences of opinion. There shouldn’t be differences of fact, and we do our best to kind of accumulate the data and sift through the science. There was a lot of misinformation presented tonight, and I’m stating that without any sort of judgement, but it is what it is, and I think that the school board has made some difficult decisions because they do care about children and personal experiences.”
[For context, I took her comment about politics and about not having a personal friendship with a party leader to be a veiled response to a recent post from the Blueprints For Excellence-Reform Appleton Area School District page publicizing the fact that that she had donated money to recently appointed Board of Education member Amanda Stuck’s 2020 Congressional campaign.]
She then moved on to discussing vaccinations for children ages 5-11. She said, “I wouldn’t expect it much sooner than early November. It does take about 5 weeks for process. It’s been long in the arrival compared with the vaccination science for the adults because we really do need to check out the dosages and the anti-body levels and make sure that it’s specific to children in terms of their sizes, their weights, their experiences; it looks promising. I own a viewpoint of being a grandmother and a mother as well as a physician and somebody who’s worked in public health for over 30 years that vaccines work. And this is one of the most effective and safe vaccines despite the misinformation provided tonight.”
[I would have appreciated a more extensive discussion and explanation into what factors prompted her to label the Covid vaccine as one of the most effective vaccines. Looking only at the numbers presented to us by Appleton’s own Interim Health Officer, the rate of breakthrough cases in fully vaccinated individuals seems to have precipitously increased to the point that fully vaccinated individuals appear to have accounted for 30% of the Covid cases in the first half of September. I would have liked to have heard Dr. Vogel’s thoughts on that.]
The final slide in her presentation showed the weekly statewide number of children who tested positive for Covid going back to the middle of August. The slide also included a link to a statement on the Children’s Hospital of Wisconsin website in which various child health organizations stated that “Children’s hospitals across the country and here in Wisconsin are seeing an alarming increase of patients with COVID-19 and other respiratory illnesses.” And they urged Wisconsin communities to “Keep kids safe and keep schools open” by “Follow[ing] public health measures to prevent the spread of COVID-19.” The graphic, however, only showed the number of positive cases in children not the number of hospitalizations.
Polly Vanden Boogaard then took up the presentation specifically regarding masking and started out by saying, “So, we know that masking is a mitigation strategy that has many feelings associated with it.” The Board had already heard from advocates and parents on all sides of the issue and the Leadership Team “also consulted with our medical healthcare professionals and also reached across to the consultant at the state level to make sure our information is consistent and that we’re doing our best to be able to give [the Board] the information needed here tonight to make those decisions that we have to make.”
She did not read each slide, but she said that, per their consultations with their advisors, masking is safe for more adults and students.
She said that some families had some specific questions regarding facemasks for children, so they had a couple links to a resources the district’s advisors had led them to which addressed those specific questions. She said the essence of those links was that mask wearing was safe for most children.
She said the one question she didn’t have listed was masking for immunocompromised individuals. She asked Dr. Vogel to speak to that.
Dr. Vogel said an immunocompromised child in a classroom was at increased risk for Covid and serious consequences of Covid and that they know that currently covid deaths, hospitalizations, and prolonged illness are more likely to occur in people who are immune compromised. So, a child who’s in a classroom where everyone else has optional masking or no masking would be at increased risk and “I don’t think we can say to what degree risk that is ’cause it’s individual depending upon the particular situation and would best be advised by that child’s doctor as to whether or not some accommodation would have to be made including being at home rather than in the classroom if the child can’t be protected. There’s some protection from wearing a mask, but mask–you know, we wear masks to do source control to prevent sending out virus so it’s a two-way street, and if everybody else isn’t masked that child’s at an increased risk.”
Polly then briefly reviewed the AASD Covid tracking dashboard.
She finished up by saying that when AASD implemented the masking mandate Appleton was in the “High” burden category and it is now in the “Very High” category, “So, we do believe that masking is one mitigation strategies that is working to support our students to be in-person and experiencing what we would say is, I guess, somewhat traditional experience such as having sports, partaking in field trips, those kinds of things. Again, I recognize that they’re masked so that is different but it is leading to us to create an environment where students are able to be in person and experiencing some of those successes or joys that a student does receive.”
Superintendent Baseman then said that “given the external review of data and also our internal data, the success of the required masking as one of our layered mitigation strategies, and also that there’s been no change in guidance from the CDC or the American Academy of Pediatrics, the DHS, or the Wisconsin Department of Public Instruction, we really believe that we need to continue our current practice of requiring masks or face coverings for all students EC-12, all district staff, and all visitors while indoors within district facilities and while on district transportation. And we believe we have been successful as having this is one of our layered mitigation practices. For one thing as evidenced by the fact that we have only had to have one classroom in our entire district have a time period where they’ve been fully virtual for a very short amount of time and that has not been the case by other districts in our area or other areas of the country that have had optional masking, so we do consider that to be an important piece of our mitigation strategies. It’s not the only one but it is a very important piece of what we’re doing to keep our kids as safe as possible. We would recommend that we would look at this again—a review date potentially November 22. It is approximately 6 weeks. It gives us a chance to see if we can get past the top of this current surge of the Delta virus and see some consistent trend data that is closer to where we were when we were successful with optional masks in the summer.”
She then opened things up for questions.
Board member Amanda Stuck said that Appleton had been in the High level and now the Very High burden level, but the Leadership Team was saying they felt using the masks was successful. She asked if they could define what that meant. Were they saying they were successful because they’ve only had to quarantine one class even though the numbers have been going up?
Superintendent Baseman said that was correct. “That despite the rise in numbers in our community, especially among that younger age group—school age group—despite that, our numbers within our school classrooms and programs have been very low.”
There was then a somewhat drawn-out discussion about burden rate. Amanda wanted to know the burden rate either for the community or for the student population—it wasn’t clear to me exactly which she wanted. She wasn’t clear on the terminology to use and she didn’t have her notes from the previous meeting where this information had been given. She was probably referencing the September 16 Board of Education meeting in which Dr. Vogel did discuss the burden rate for the AASD student population specifically.
Dr. Vogel had not calculated out the current burden rate for the student population.
Amanda could not remember whether the number she was thinking of had been for the district specifically for all of Appleton. She just remembered that she had asked for a recommendation regarding what the numbers needed to look like for the Board to discuss having masks come off.
Dr. Vogel answered, “Well, if you’re talking about when could the masks come off, if you look at the original CDC recommendations around in-person school they had different levels, and I think—and times have changed, right? But if you look back to where we were in our community back in summer when it was really clearly fairly safe, we were down into rates of 47 out of 100,000 was at the end of summer school and prior to that it had ranged between 10 and 17 and that’s when we were safely doing optional. Low transmission is the level that was previously recommended by the CDC which is actually 10 or less but around, you know, in the 40, um, 10-40 range is probably the moderate range when we would probably still be considering masking in schools. What changes all of this is actually vaccination because if you have 80-85% of children and employees and staff vaccinated, you can start masks off or optional.”
[She didn’t provide a reference for where she got that 80-85% vaccinated rate for masks to come off. While I don’t doubt a source exists, I was not able to find that source when I did an internet search.]
Amanda said she thought it was important for the district to provide good communication about what the metrics are they’re looking at. She said it sounded like a 10-40 burden rate was where they needed to be to take masks off and right now Appleton was at 600-700.
Dr. Vogel cautioned against setting an absolute number because “it’s rarely black and white or this level or not. It really is influenced by a number of different things, so if the community level is going way down and we can have a number, and if behaviors in our school district are a certain way with all other mitigations and if we have certain vaccination rates, that all makes—that all factors in, so keeping some open mindedness.”
Board President Kay Eggert agreed. “As much as people want a number, I don’t know that we can put a number up here.”
Board member Deb Truyman hoped that if vaccination rates were going to be a factor in whether masks could come off that immunity acquired through infection could be included in those numbers.
The Board had no further questions regarding the presentation and then moved on to discussing and voting on whether to continue the mask requirement.
Board member Jim Bowman said he thought the data they received (he referenced not only the presentation they had just listened to but also a memo from Sarah Campbell which does not appear to have been attached to Board Docs) were both convincing to him. He thought masking should stay in place, but he also liked the idea of a periodic review. He was glad they weren’t doing an indefinite extension. He made a motion to continue requiring masking until November 22.
Board member James Bacon seconded it.
They then opened things up for discussion.
Amanda started things off by saying, “I do understand obviously wanting to be somewhat careful about saying ‘we’re gonna get this number and that’s when masks come off’ but I do think it would be good if we could give better guidance just on metrics, and I think part of the confusion or frustration on some people’s mind is just that they feel like they don’t understand why we made the decision or how we’re—what data we’re using. So, I just think that even if we could give some simple guidance like the ‘in general this many cases pers 100,000 or this vaccination rate’ if we could give, I don’t know, just some more guidance around that, be more clear. Might be helpful.”
Kay answered, “That is always the big—that is the big question. And that was the big question all last year as well and I know that I, I, I, I hear what you’re saying, but something more specific than ‘we’ll continue to look at the community data, vaccination data, I mean, our internal data.’ So you think it would be helpful if there were actually maybe parameters or…?”
Amanda responded that she understood it was struggle and there were several different factors including the vaccination rate, the case load, etc. But if they could give some kind of general idea of, in an ideal world, what they were looking at and wanted to see she thought that would be helpful.
Board member Ed Ruffolo thought that was a good idea and thought it was important to communicate to the community what factors the district is looking at and what success looks like. At what point can they say masks are optional again? In addition to vaccinations rates and community cases per 100,000, he thought testing was a big thing. He thought they may even consider the impact on the local healthcare systems. Having that information would be very helpful to him in making a decision on November 22 and it would also take some of the angst and concerns out of it.
Deb also thought it would be good to start looking at some numbers like that. She reiterated her concern about vaccination rates being a metric if naturally acquired immunity was not also included in that number.
Regarding masking in general, she expressed concerns that there was inconsistency in when students were allowed to take their masks off. They could take them off to eat but then couldn’t when they were running around for 45 minutes in a hot gym for physical education class. She wanted to know if there were any other times students could take their masks off other than during lunch.
Polly said they will continue to work on consistency of the mask breaks that are occurring in the school buildings. They have schedule mask breaks and also encourage outdoor classrooms and holding physical education outside as much as possible.
Kay asked Deb if she wanted to modify the motion.
Deb said she just wanted clarification on whether mask breaks were being encouraged and physical education classes being encouraged to be outside. She had heard of situations where that was not happening and students were running around in hot gyms with their masks on and that didn’t sound healthy to her. She didn’t think an amendment was necessary, but she thought maybe staff should be reminded that mask breaks and outdoor classes were part of the conditions of masking.
Polly was asked to give some examples of guidance they were following. She said that She said they give kids space in the lunch room area. If they don’t have enough space, they pod students which looks different at the middle vs high school level. They also continue hand hygiene. As soon as students are done eating, they put their masks back on and either head out for recess or go back to their classrooms. Each school looked a little different but all operated under the premise that the students were physically distancing or podded if they couldn’t get 3 feet between them.
Kay asked if anyone had any other comments or questions.
James Bacon expressed his support of Amanda’s desire for more clarity on the metrics the being considered. He understood they couldn’t have a magic number, but he supported the idea of at least naming the different factors being considered whether they were internal metrics or community-wide. He thought they could also potentially list some unknown factors that might impact things in the future such as a new strain. He thought that naming all of those things would help both the board members in making the decisions and the public in understanding them.
The Board then voted 6-1 to keep masking in place through November 22. Deb Truyman was the lone nay vote. [After that meeting and the fact that, in spite of having had masking in place since the beginning of the school year, they don’t even know what factors might lead them to make masking optional, I think it unlikely that they will vote on November 22 to make masking optional.]
View full meeting details here: http://go.boarddocs.com/wi/aasd/Board.nsf/goto?open&id=C7BLXA58A9B8
View full meeting video here: https://youtu.be/8zsmBWNeRPc
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