Expert Advisory Panel 4 discusses new obstacles of four day in-person attendance

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GRAPHIC BY JEREMIAH LEVY

Expert Advisory Panel 4: Public Health, Safety and Logistics discussed new challenges to four day in-person learning. Personal protective equipment (PPE) played a crucial role in the discussion in what is necessary to ensure safety for students and staff.

Expert Advisory Panel 4: Public Health, Safety and Logistics convened via Zoom on Mar. 5 at 3 p.m. to discuss important information about the Public Schools of Brookline (PSB) pooled testing program and the current transition into adding a four day in-person learning option.

Co-Chair of Expert Advisory Panel 4 David Gacioch gave a brief overview of the current metrics and statistics pertaining to COVID-19 cases in Brookline. This past week, the average daily case count and test positivity rate both increased slightly. These numbers are consistent with the trends seen in the metropolitan area as well as the full state.

The panel proceeded to discuss the PSB pooled testing program, and more specifically the asymptomatic testing of staff being conducted.

Panel members recognized that this program, developed by the Massachusetts Department of Elementary and Secondary school Education (DESE) and adapted for PSB, is not extremely convenient to teachers. Additionally, for all these pool tests, people must be able and willing to come back for the follow-up reflex testing. Jenny Tam, Senior Staff Scientist at the Wyss Institute, Harvard University
 has been working closely with this program to make the process smoother and increase participation.

The panel also addressed the recent email that was sent out to PSB parents about student testing. Interested students at the high school can get tested in school on Tuesdays and Thursdays, beginning March 9 and March 11. The following week, grades six through eight will have this option, and the week after, Pre-K through fifth grade as well.

This past summer, Brookline joined the Safer Teachers, Safer Students collaborative program. The program serves as a safe space to discuss challenges and logistics with remote and hybrid learning, along with plans to move forward with testing in schools. It includes a public dashboard from various districts that includes their strategies this year along with their results. Tram announced that Brookline’s public data will begin to be shared on this website.

Medical Director at MassHealth and pulmonary and critical care physician at Cambridge Health Alliance, Lakshman Swamy spoke in depth about potential new personal protective equipment (PPE) recommendations. Currently, over $30,000 has been committed by community members to help pay for enhanced PPE.

Swamy said though N-95 masks are considered the gold standard, they are not necessarily appropriate.

“An N-95 mask is what you use when you are around known COVID. In order to start that discussion, we have to be clear that that’s really not necessary,” Swamy said. “Not only is it not necessary, but it is really uncomfortable, and when it is uncomfortable, it leads to less adherence.”

Benjamin Linas, Associate Professor of Infectious Diseases and Medicine at the Boston University School of Medicine, agreed with Swamy about KN-95 masks.

“If you are wearing a KN-95 mask and a face shield, you are basically in ICU quality safety,” Linas said.

With more students in school, there has been an inevitable relaxation of six foot distancing, but the panel continued to feel confident in the ventilation within schools to keep students and staff safe.

The five air changes per hour being executed are considered excellent for full room occupancy according to Harvard studies. According to David Gacoich, PSB schools never reach full room occupancy and hybrid learning has given us even more built-in margin.

In addition, panel members have been visiting the K-8 schools to help map out safe spacing in classrooms.

According to Serena Rajabiun, Assistant Professor of Public Health at UMass Lowell, unmasked times to eat have sparked a variety of questions regarding distance, ventilation, and barriers. Several opinions have been voiced and have gained support from panel members and members of the Brookline School Committee (BSC), thus a final decision has not been made.

Sarita Chung, Associate Physician in Medicine and Division of Emergency Medicine at Boston Children’s Hospital and Assistant Professor of Pediatrics and Emergency Medicine at Harvard Medical School, explained that barriers are only protective of large droplets, so they are not essential but could provide some protection in certain situations.

Gacioch clarified the use of barriers would never be relied on to mitigate aerosol transmission.

Gacioch gave three possible options for unmasked times: be outside and try to keep six feet as much as possible, maintain six foot distance inside in a well ventilated space with limited duration, or maintain between three to six feet inside a well ventilated space with physical droplet barriers and limited duration. No panelists had any objections to these options.

If you are wearing a KN-95 mask and a face shield, you are basically in ICU quality safety”

— Benjamin Linas, Associate Professor of Infectious Diseases and Medicine at the Boston University School of Medicine

The other main challenge, cohorting and contact tracing, also caused many concerns for panelists and attendees. Inevitably, more in-person school means less distancing and less cohorting, making contact tracing significantly more difficult. With more students in each classroom closer together, Linas questioned if it would still be safe not to consider classmates close contacts of a positive case.

Linas proposed the idea of keeping the class with a positive case remote for a week in order for everyone to get tested to try to lower the risk of the spread. This idea was not well received by all the panelists because some articulated that students should not lose any more in-person learning time than they already have.

Pollock, who has been following recent research and information about the variants, said our protocols are still safe so far.

“From what I have been reading and polling my colleagues, there is not yet a sense that the variants require any specific change in our mitigation measures,” Pollock said.