My thoughts on the study from Wisconsin schools- a 🧵
"COVID-19 Cases and Transmission in 17 K–12 Schools — Wood County, Wisconsin, August 31–November 29, 2020 | MMWR"…
About a week ago I mentioned that the studies we have on Covid in schools were not well done.
The recent CDC study based on Wisconsin schools is the best I've seen so far.
It describes mitigation strategies & tracks community positivity rates & school positivity rates.
Mitigation- mask wearing in & outdoors, not just cohorting children, but basically assigning close contacts and keeping those as the only close contacts throughout the entire day (I'm imagining this means you sit in class and lunch next to the same person).
I really liked that the school provided masks to everyone, instead of people using their own of varying quality. I do wish they reported on mask wearing of teachers and staff. 
And need to point out that only about half the schools shared data on consistent mask use.
This point is important because they also relied on schools for some contract tracing. Could we be seeing a reporting bias here? Reporting just the good data? but I'll get back to that.
I'm wondering why the contract tracing was not solely conducted by an independent group, like the health department, or maybe even the researchers that implemented the study.
As well done as this study was, here's some other concerns.
1. 191 cases, 7 linked to schools. Where's the distribution showing what the others were linked to?
Yesterday news report said a) 7 people got it in schools, b) too much community spread to know where 184 others got it.
So can we rule out schools? You may say contact tracing.
By not treating the entire cohort as contacts, are we ignoring the studies that found substantial spread within short periods of unmasked time, further distance than 6 feet? So maybe this 184 were not seen as close contacts, but we're exposed…
I would be most concerned about that happening during meal times and would broaden who is considered a contact to match what we've learned from restaurant studies.
2. What's the testing rate of people in schools compared to the community? We saw the postivity rates, but did we have undertesting in the school group?
3. why not incentivize testing of those quarantined so we can answer the question of asymptomatic kids deflating the rates?
4. While I feel this was a better conducted study than all others to date, I haven't come to the conclusion that schools can reopen safely. That conclusion doesn't seem to take into account the ridiculously high rates of covid reported in the study's schools.
Yes, it was lower than the community, but that can't be our threshold. How does that fly? Are we really willing to say the community rates are horrendous, but in school rates are just horrible, so let's open up?
This is not an approach to reduce or prevent Covid-19, related illnesses, or death. This is an approach driven by numbness. We're numb to high rates of Covid, overcrowded hospitals, and rising death tolls.
As I stated a few days ago, we shouldn't be asking should schools open, we should be asking why aren't we shutting things down while providing massive financial and mental health support to all.

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More from @Theresa_Chapple

18 Jan
My thoughts about Covid in schools-
Our studies are crap. We haven't put appropriate resources into studying this. Merging "in-person school" v "remote school" across the country makes little sense since there's so much heterogeneity in what "in-person school" looks like. 🧵
A teacher in Louisiana in an area with high rates of covid & in-person school, has a class with just 2 students in it. The entire school has 37 students and 12 staff, in a building that can hold hundreds.
Should this school's data be merged with a school that's fully open?
How would merging such disparate data, and everything in-between impact our understanding of Covid in schools? What about when we compare it to the rates in children who are in virtual school?
Read 11 tweets
17 Jan
My daughters have been begging to go to the pool. The hotel I'm at is at 3% capacity this week, but the indoor pool has been too crowded for my comfort.
But then I remembered this phenomenon that happens when Black people join white spaces, white people tend to leave.
Don't believe me, Google "white flight". White people will sell their homes and move, if too many Blacks move to their neighborhoods. The same thing happens when we get in the pool. Every time. My entire life. White people tend to leave, and we get the entire pool to ourselves.
I decided to test it this time. When White people leaving would no longer be offensive, but the safest thing to happen during a pandemic.
And yup, within 7 minutes, we went from sharing a pool with 12 other families, to down to 2 families.
Read 4 tweets
4 Jan
There's good reason to pushback hard against delaying the second dose of the vaccine like we did when people suggested skipping phase 3 trials.

1- we promised a scheduled second dose to the millions already vaccinated

2- there's millions of dosages awaiting distribution
we haven't figured out how to maximize distribution to the current priority group, not a great idea to increase the number of people were trying to vaccinate without a good plan to get it to them.
3. Science.
We didn't test this method in any trial, we shouldn't push an untested model. Just like we were right to pushback on skipping phase 3 trials.
Correctly doing science matters.
Read 4 tweets
4 Jan
"Nearly 950 new cases of COVID-19 were reported in the past week among students and staff in Massachusetts schools.
Districts announced 552 of the new cases were diagnosed in students, while the other 397 cases of the virus were among staff members. Dec. 17 through Dec. 23...
The 949 cases is a slight decrease from last week's 1,009 -- which set a record as the most coronavirus cases announced in a single week since students returned to class in the fall. The state estimates there are about 450,000 students and 75,000 staff in-person learning"
Read 4 tweets
2 Jan
right before reading Dr. Coleman's story about her Black Husband not recieving the standard of care after an horrific car accident, I was listening to Drs @CamaraJones and @doccrearperry discuss Dr. Moore's death. Bottom line- Black people aren't valued.…
Dr. Coleman's story made me think about the White and Asian people in my family, and how being Black adjacent, they still live in a different world than the rest of us. Once, my daughter (when 5) took a pair of sunglasses from the dollar store. My husband and I noticed ...
We were in the car outside of the store. Our first time dealing with this, so we did what we always do when faced with new parenting challenges, posed the question to our family group text. 'Should we take the glasses back? Go pay for them? Have her apologize?"
Read 6 tweets
15 Dec 20
As you're contemplating getting the vaccine or not, there's 3 important people I'd like you to learn more about. 🧵
1. The first person to introduce vaccines to the United States was a West African born, American enslaved man name Onesimus. He introduced a West Africa custom where you introduce a little bit of the virus to your body to help your body learn to fight off the virus...
At the time, people in Boston were dying left and right from smallpox. He saved lives by teaching those around him about inoculations. This is the basis of modern day vaccines.
Read 10 tweets

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