Thursday, April 18, 2024

An image of masked and largely distanced kids outdoors was posted by the school district Dec. 8, suggesting some of the safety practices of in-person learning. (Photo: Cambridge Public Schools via Facebook)

The School Committee will discuss or vote on three key changes to its Covid-19 response at a special meeting at 6 p.m. Tuesday: to reduce social distancing requirements in kindergarten through fifth grade to 3 feet from 6 feet; change quarantine rules to conform to revised federal and state guidelines; and reassess how the metrics that measure Covid-19 in the community are used to gauge the safety of opening schools to in-person learning. 

The Cambridge Public Schools’ safety, health and facilities working group, made up of scientists, educators and parents, proposed the changes. The revisions were discussed at a Building and Grounds Subcommittee on Friday led by chair José Luis Rojas, and referred to the full committee for a vote. 

If approved, the changes are expected to be complete by early February.

Social distancing reduction

The working group voted unanimously to reduce social distancing in kindergarten through fifth grade to 3 feet, said Jim Maloney, the district’s chief operating officer. Changes for upper and high schools await further research and discussion.

Helen Jenkins, an infectious disease epidemiologist at Boston University’s School of Public Health, spoke for the working group. She noted that in the spring it became clear that the risk of severe illness from coronavirus is very low for young children. But because children are largely asymptomatic, it is possible that their rate of infection is underestimated – if a child doesn’t have symptoms, it is unlikely they would be tested.

Jenkins referred to a review of multiple studies by Mark Lipsitch, an epidemiology professor at the Harvard School of Public Health, which found that “young children are less likely to get infections and less likely to transmit.”

A study out of the United Kingdom, which opened its public schools in September with few mandatory mitigation strategies, was also noted. It saw infections among elementary- and secondary school-aged children increasing only after increases among older children, giving credence to the conclusion that young children are less likely to become infected and to transmit the disease.

Dr. Alisa Khan, an assistant professor at Harvard Medical School and a pediatrician at Boston Children’s Hospital, is not on the working group but provided insight based on her recent patient experience.

Khan referred to a Center for Disease Control and Prevention study that found in-person school and day care are not associated with increased risk of catching Covid-19, but that play dates, social gatherings, funerals and other gatherings of mixed-age groups do increase the risks.

Several attendees at the subcommittee meeting stressed that reducing social distancing will work only if current mitigation effects remain in place. “I’m quite concerned with cloth masks, especially with reduced distancing,” said Jill Crittenden, a research scientist at MIT and co-chair of the district’s Covid-19 Cambridge Expert Advisory Panel, noting that staff and students wear surgical masks in some Asian countries where schools have low distancing and low transmission, and that the district may want to follow suit.

Cambridge Education Association president Dan Monahan stressed the importance of providing the community with a clear explanation of the data and reasoning behind recommendations, emphasizing that safety will not be compromised if other mitigation strategies are strong.

Quarantine rules

The working group’s second recommendation is to change district quarantine protocols to align with one of three CDC guidelines from early December: Staff and students exposed to a positive Covid-19 case would be required to quarantine for 10 days; if there are no Covid-19 symptoms, the person would be released from quarantine but continue to monitor for symptoms until Day 14, returning to isolation if symptoms develop. 

“It’s important for people to monitor for 14 days total,” said Tracy Rose-Tynes, interim associate chief of clinical services at the city’s Public Health Department, during a subcommittee meeting Dec. 9. The Covid-19 incubation period is 12 to 14 days. 

Under these guidelines, a person may choose to be tested at Day 5, but testing is not required. The CDC estimates that this policy would reduce the risk of an infected person spreading the disease by 99 percent.

The CDC’s option to quarantine for a full 14 days was considered but not recommended, due to the added burden on caregivers, students and staff.

The shortest option offered by the CDC is a seven-day quarantine followed by Covid-19 testing. If the results are negative, the person is released from quarantine, reducing the risk of a person transmitting the disease by 95 percent, which the working groups considered too risky in the school setting.

Changing use of metrics

The working group also discussed changing its approach to measuring whether to cut off in-person learning based on three metrics created in early fall and revised in November: the number of new Cambridge Covid-19 cases per 100,000 people on a seven-day average; the rate of positive cases in the city over the past 14 days; and the level of Covid-19 detected in wastewater at the Massachusetts Water Resources Authority’s Deer Island sewage treatment plant. 

The working group’s proposal to move away from these metrics is centered on a policy paper, “Schools and the Path to Zero: Strategies for Pandemic Resilience in the Face of High Community Spread.” The research is led by Danielle Allen, a Harvard professor and director of Harvard’s Edmond J. Safra Center for Ethics and a district Covid-19 task force member, with a number of local experts in public health, ethics and public policy as co-authors.

The paper advocates opening schools even if Covid-19 rates are high, provided that robust infection controls are “implemented in a collaborative and transparent way among all stakeholders, including educators and other school personnel, administrators and district leaders, families and schools.”

The paper recommends using metrics that track community spread as “general points of information, no on-off switches for closure and opening.” The goal is “zero or near zero transmission” through measuring and monitoring in-school transmission and maintaining high quality infection control protocols.

The six central topics that the community must address to safely open schools for in-person learning are cultivating trust (including labor organizations and the greater community), providing safe transportation, practicing robust infection control, enforcing occupational health and safety standards, implementing thorough testing and administering a vaccine program.

Rojas said the advisers are discussing the policies proposed in the report. 

“I think they all agree with the report in principle, but have some slight differences on the edges,” said Rojas, adding that when the group comes to a consensus their recommendations will be brought to the committee.

No further information was released as of press time.