Thread by @AbromeEd

Here's a recap of our COVID-19 mitigation efforts for the 2022-23 academic year, in the hopes that it may support school leaders and decision makers who want to keep their students, staff, and local communities safe. I’ve broken this into 10 videos. Abridged text included.

For most families with children or adolescents, the greatest risk of bringing a COVID-19 infection into the home does not come from the workplace or recreational activities, it comes from their kids’ school.

But for most of the families at Abrome, school was typically the safest place anyone in the family went.

We've had zero known cases of COVID-19 in our shared spaces over four years.

We were able to accomplish this by focusing on two priorities since the spring of 2020.

Our first priority was holding true to our commitment to community care.

Community care means centering the needs of those who would be most impacted by our decisions and actions, and leveraging our privilege to support them.

COVID is still disproportionately harming low-income; elderly; disabled and immunocompromised people, Black, Indigenous, and Latinx communities; and the unvaccinated.

The young are also particularly vulnerable. Over 90% of children under the age of 5 remain unvaccinated, and 100% of children under the age of six months are unvaccinated.

We understand that even one infection at Abrome can lead to untold downstream infections, and the aforementioned groups would be those most likely to be harmed by such infections, so all of our COVID-related decisions centered them.

Our second priority was applying layers of protection. No single layer of protection on its own is perfect at preventing COVID-19 spread when people come together. But when we combine layers of protection, the chances of spread happening decrease substantially.

Because of the ill effects of COVID-19 that we know of, to include long COVID, disability, and death; and the long-term effects that we do not yet know of; it makes sense to use every layer of protection possible.

For layers of protection we used 5 general categories: masking, physical distancing, air quality, vaccines, and testing. I will briefly touch upon some our most effective or relevant strategies for the 2022-2023 academic year, but you can find all of our COVID protocols online.

We mandated universal masking in all indoor spaces, and when we were close to one another outdoors.

Masking not only helps protect someone from inhaling infectious particles, it helps to contain infectious particles if someone were to unknowingly come into the space infected.

The only options for masks at Abrome were KF94s, KN95s, N95s, or higher filtration masks or respirators.

The only exception to masking indoors was for brief sips of water—meanwhile all snacks and meals had to be taken outside.

It’s a shame that masking was made into a culture war issue since universal masking would effectively stop community spread.

We used physical distancing to reduce the number of contacts with people who may be infectious, and reduce the infection risk of interactions if they did happen.

We set a maximum density of people indoors, as well as in each room, and decreased density as cases rose.

We also refused to participate in the premature loosening of quarantine and isolation periods, keeping ours at seven and ten days, respectively, while also requiring a test out for both the impacted individual as well as their household.

Finally we had unlimited paid sick time for staff to ensure that they would stay home if needed for precautionary reasons, quarantine, isolation, and recovery.

We implemented a COVID-19 vaccination mandate except in very rare cases of medical necessity, which we acknowledge exist. However, no one asked or qualified for an exemption. Everyone who was eligible for a booster received one at the beginning of the academic year.

While vaccination does not prevent infection or all complications, it helps protect against severe disease and death should one get infected.

And while not everyone who is hesitant about COVID-19 vaccines is unconcerned about the spread of the disease, our mandate helped filter out those least interested in the harm that spread may have on others. So in this way, this layer of protection did reduce the risk of spread.

We focused on air quality to clean and clear viral particles out of the air via filtration and ventilation, respectively.

To filter the air we used a variety of HEPA purifiers and Corsi-Rosenthal boxes that produced, from filtration alone, at least 13 effective air changes per hour in each room, with a minimum of 47 cubic feet per minute per person in each room.

This chart shows the quality of filtration in each room at Abrome this past year.

According to Indoor Air Care Advocates, our filtration efforts alone exceeded "the most aggressive recommendations from ASHRAE-ACGIH and from AIHA as well as the EOAi rate in ASHRAE Standard 241."

To ventilate the air we cracked or opened doors and windows as necessary to create crossflows of fresh air, and used fans to increase the outflow of air.

We also used CO2 monitor readings as a proxy for ventilation.

If the reading in any room hit 650ppm we would crank the air conditioning, open windows further, and reposition fans as needed. If the reading hit 800 ppm we would vacate the room until it dropped back below 650ppm.

Here are some graphs of different rooms at Abrome with their CO2 readings over time. As you can see, our CO2 readings were kept low despite not having an expensive HVAC system. [image from @maddeldad]

@maddeldad Filtration and ventilation improvements are unobtrusive layers of protection that institutions can use to greatly reduce the risk of spread while also sidestepping most of the culture war attacks on COVID prevention.

@maddeldad Side note, we have a standing agreement to add far-UVC to further clear the air of pathogens if and when we reopen in a new facility.

@maddeldad And we used regular screening and testing to identify potential infection risks early.

Each member of the Abrome community was required to complete a quick symptom and exposure screening each morning before arriving.

@maddeldad This resulted in people staying home when they were feeling off, whereas in pre-pandemic times it would have been common for folks to power through such feelings.

In at least one instance it prevented a young person from coming in after a parent brought COVID home.

@maddeldad In multiple instances it also kept people home whose family members had contracted the flu.

@maddeldad And this year we added daily LAMP molecular surveillance testing, which required the household of every enrolled person and staff member to pool their samples each morning at home, so that the pooled sample could be tested after drop-off.

@maddeldad Twice we received a positive result, which, in both cases, after follow up diagnostic testing, revealed a parent had contracted COVID-19, which allowed for the immediate quarantine of the student before they had the potential to get infected and expose other members of Abrome.

@maddeldad None of the aforementioned layers of protection are sufficient on their own.

Some layers of protection help prevent COVID-19 from entering into any space where people congregate, and other layers of protection help to prevent the spread of COVID-19 even if it does come indoors.

@maddeldad Some layers of protection help do both.

Our layers of protection, along with some luck, allowed us to achieve zero COVID-19. Zero flu and zero RSV, as well.

That means we had zero “learning loss.”

@maddeldad More importantly that means we protected each other from getting sick, meaning no one developed long COVID. It means nobody downstream ended up dying or being orphaned.

@maddeldad And while many schools are prevented from applying all layers of mitigation, no school is prevented from applying at least some of them.

@maddeldad If all institutions committed to doing so, the effective reproduction number of COVID-19 would plummet, and society could actually “go back to normal,” in some sense, in a way that does not harm or leave people behind.

I hope these videos were helpful.

@maddeldad I won't be replying to responses to this thread. Everything is posted online.

If you've made it this far, thank you for listening.

Thanks to all who continue to prioritize others in their decision making.

#ZeroCovid #LeaveNoOneBehind #communitycare

Lastly, special thanks to the @TheWHN and @PeoplesCDC for all their great work, advocacy, and support, as well as the many other individual and organizations who have been so helpful. Also to the Balvi Fund for providing us the financial support needed to make this happen.

/end