A Look at DESE's Cited Sources: Results of a Critical Look at the Initial Reopening Guidance References

Note: I've been doing a lot more work around education safety lately, but moved it away from this blog. I founded Massachusetts Education Safety Advocacy Group (MESAG) and you can find up-to-date research on the website, Twitter, and Facebook. Please follow, like, and share!

I read and analyzed all of the sources cited in the DESE document released 6/25. You can see my write-ups of all of the sources here.

Here's what I found:

The report has 84 citations of 53 unique sources:

• 8 of the 53 sources are public-facing CDC web pages
• 2 of the 53 sources are state school reopening plans (California and Oregon)
• 4 of the 53 sources are from government sources in non-USA countries. The reports are from Australia, Denmark, France, and Hong Kong.
• 2 of the 53 sources are WHO (World Health Organization) web pages.
• 1 of the 53 sources is a public-facing guidance document from a Toronto Children's Hospital
• 3 of the 53 sources are Massachusetts public-facing state web pages.
• 4 of the 53 sources are news articles
• 18 of the 53 sources are peer-reviewed scientific journal articles.
• 5 of the 53 sources are pre-print (not yet peer reviewed) scientific journal manuscripts
• 6 of the 53 sources were scientific journal articles/manuscripts for which peer review status was unclear

Many of the studies cited have an extremely small sample size.

• This study looked at 13 family clusters in Israel.
• This study looked at 39 households in Switzerland. 
• This study looked at 11 people, only one child, in the French Alps.
• This study looked at 18 COVID-19 cases in schools in New South Wales, Australia.
• This study focused on 6 COVID-19 cases in schools in Ireland.

Several locations where studies took place or for which guidelines were written have much lower COVID-19 infection rates than Massachusetts.

• Oregon's infection rate per 100,000 people is over 9 times lower than that of Massachusetts.
• California's infection rate per 100,000 people is less than half of that of Massachusetts.
• France's infection rate per 100,000 is over 6 times lower than Massachusetts.
• New South Wales, Australia's infection rate per 100,000 is over 37 times lower than that of Massachusetts.

Additionally, some of the sources did not prove the claim that DESE attempted to make with them. Of 81 claims made: 

• 7 are not supported by the source cited
• 59 claims are supported by the source cited
• 4 claims have partial support
• 1 claim is somewhat supported
• 4 claims have limited support 
• 4 claims have extremely limited support

Here are some of the unsupported claims (all quotes from DESE guidance):

• "In NYC, in households with at least one COVID-19 case, prevalence of infection for children 5-≤18 was 31.9% vs. overall prevalence 52.5%."
• "Whereas for COVID-19 it appears children are less likely to be infected with and to transmit COVID-19, this is not the case for influenza, where children are frequent transmitters."
• "As noted in previous guidance, temperature checks are not recommended as screening for all students due to the high likelihood of potential false positive and false negative results"
• "Finally, this guidance is for fall reopening and is predicated on the Commonwealth continuing to progress through the phases of reopening with low COVID-19 public health metrics"
• "Mask breaks should occur throughout the day."
• Schools do not appear to have played a major role in COVID-19 transmission. In a review of COVID clusters, only 4% (8 of 210) involved school transmission."
•  "If infected, it appears children may be less likely to infect others with COVID-19."

It appears that DESE cherry-picked data that supported a return to school, rather than looking critically at all available evidence to make a science-based decision about school safety. Inconsistencies in the report, such as inconsistent citation formatting and claims which do not align with the geographical facts of a study, raise concern as to the accuracy of the report. Additionally, the fact that none of the medical professionals involved are named raises questions as to why they do not want their work recognized.

The DESE report also leaves out important research on adult COVID-19 infection risk and transmission data. For schools to open for in-person schooling, numerous adults will need to be in school buildings. There was a recent outbreak in a school in North Carolina amongst the staff. To ignore the data on adult transmission when adults must be present for schools to re-open, is irresponsible. I will write a separate post with some studies about COVID-19 in adults, and school-related COVID-19 cases.

I urge you to contact state level education officials to urge them to reconsider this guidance in light of the dangers to school staff safety. 

• Massachusetts Board of Education: boe@doe.mass.edu
• Massachusetts Secretary of Education James Peyser: eoe@massmail.state.ma.us
• Massachusetts Return to School Working Group: RTSWG@mass.gov
• Massachusetts Governor Charlie Baker contact form or constituent.services@state.ma.us

A Look at DESE's Cited Sources: Footnote #83 - How can airborne transmission of COVID-19 indoors be minimised?

DESE Claim: "Consider ways to increase facility ventilation (e.g., open windows through fall, perform an HVAC inspection)"

Cited Source: Morawska, Lidia, et al. "How can airborne transmission of COVID-19 indoors be minimised?." Environment International (2020): 105832.

Note: no link provided in DESE report citation, I found the article here using Google.

Peer Reviewed?: yes

Study Methodology: unclear

Notes: There may be risk of airborne transmission. "Ventilation airborne protection measures which already exist can be easily enhanced at a relatively low cost to reduce the number of infections and consequently to save lives." This paper gives recommendations of different ways to increase ventilation.

Supports DESE Claim?: Yes

A Look at DESE's Cited Sources: Footnote #82 - Stronger Together A Guidebook for the Safe Reopening of California's Public Schools

DESE Claim: "Where physical distancing is difficult to implement (e.g., office space, reception desks), consider installing barriers or changing the configuration to support student/staff health and safety."

Cited Source: California Department of Education, Stronger Together

A Guidebook for the Safe Reopening of California's Public Schools. (2020, June 8). Available at https://www.cde.ca.gov/ls/he/hn/documents/strongertogether.pdf.

Peer Reviewed?: No - government guidance

Study Methodology: N/A - government document

Notes: This is the California plan to reopen schools. "Install physical barriers, such as sneeze guards and partitions, at point of sale and other areas where maintaining physical distance of 6 feet is difficult." There are provisions for illness, busing, and most other aspects of reopening. "If physical distancing between workspaces or between employees and students and visitors is not possible, add physical barriers that cannot be moved to separate workspaces." California's plan seems to be based primarily on a hybrid model to support physical distancing.

Supports DESE Claim?: Yes

A Look at DESE's Cited Sources: Footnote #80 - How To Clean and Disinfect Schools To Help Slow the Spread of Flu

DESE Claim: "Please refer to the federal guidance related to cleaning of facilities for more information regarding appropriate cleaning supplies, protocols, and frequency (e.g., wear appropriate protection such as gloves, wash hands often, follow instructions on all cleaning products, handle waste properly)."

Cited Source: CDC, How To Clean and Disinfect Schools To Help Slow the Spread of Flu. (2018, July 31). Available at https://www.cdc.gov/flu/school/cleaning.htm

Peer Reviewed?: no - public health guidance on government website.

Study Methodology: N/A - public health guidance

Notes: This page is flu specific, and does not suggest cleaning for COVID-19. 

Supports DESE Claim?: N/A - this is the federal guidance mentioned that schools should refer to.

A Look at DESE's Cited Sources: Footnote #79 - Cleaning and Disinfecting Your Facility

DESE Claim: "Please refer to the federal guidance related to cleaning of facilities for more information regarding appropriate cleaning supplies, protocols, and frequency (e.g., wear appropriate protection such as gloves, wash hands often, follow instructions on all cleaning products, handle waste properly)."

Cited Source: CDC, Cleaning and Disinfecting Your Facility. (2020, April 14). Available at https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility.html

Peer Reviewed?: No - public health guidance

Study Methodology: N/A - public health informational website

Notes: This page contains recommendations on cleaning and disinfecting. It suggests wearing gloves to disinfect, using soap and water before disinfectant, and other measures. There are specific measures for cleaning the facility if someone is sick.

Supports DESE Claim?: N/A - footnote is a reference for where to find federal guidance to be used for cleaning

A Look at DESE's Cited Sources: Footnote #78 - How Denmark got its children back to school so soon after lockdown

DESE Claim: "Prepare for frequent cleaning and sanitization of facilities and surfaces, especially high-touch surfaces (e.g., doorknobs, hand rails)."

Cited Source: How Denmark got its children back to school so soon after lockdown (2020, May 28). Available at https://www.thelocal.com/20200528/how-denmark-got-its-children-back-to-school

Peer Reviewed?: no - news article

Study Methodology: N/A news article

Notes: This article explains the steps being taken as schools reopen in Denmark. "At kindergarten, my four year-old can’t hug or hold hands with her friends but adults can comfort them with cuddles whenever needed." Masks are not common in Denmark, according to the article. "New hygiene guidelines stated that children should wash their hands at least every two hours. Surfaces also needed to be cleaned twice a day." 

Supports DESE Claim?: Yes

A Look at DESE's Cited Sources: Footnote #75 - COVID-19 in Children and the Dynamics of Infection in Families

DESE Claim: "In Switzerland, a study of household clusters found that only 8% had a child as the index case. In nearly 80% of the cases, the child got COVID-19 from an adult family member"

Cited Source: Posfay Barbe, C., Wagner, N., Gauthey, M., Moussaoui, D., Loevy, N., Diana, A., & L'Huillier, A. (2020). COVID-19 in Children and the Dynamics of Infection in Families. Pediatrics, e20201576. Available at https://pediatrics.aappublications.org/content/early/2020/05/22/peds.2020-1576

Peer Reviewed?: yes

Study Methodology: "chart reviews were used to retrieve clinical data and parents were called for patients and household contacts (HHC) follow-up"

Notes: This is a study of COVID-19 cases in Geneva, Switzerland. "Adult HHC [household contacts] were suspected or confirmed with COVID-19 prior to the study child in 79% (31/39) of cases. In only 8% (3/39) of households did the study child develop symptoms prior to any other HHC". There were "confinement measures" in place at the time, though it is unclear if school closures were a part of those measures. 

Supports DESE Claim?: Yes

A Look at DESE's Cited Source: Footnote #72 - The Role of Children in the Dynamics of Intra Family Coronavirus 2019 Spread in Densely Populated Area

DESE Claim: "A study in Israel found that children 5-17 were 61% less likely to have positive COVID-19 tests compared with adults in the same household."

Cited Source: Somekh, E., Gleyzer, A., Heller, E., Lopian, M., Kashani-Ligumski, L., Czeiger, S., ... & Stein, M. (2020). The Role of Children in the Dynamics of Intra Family Coronavirus 2019 Spread in Densely Populated Area. The Pediatric Infectious Disease Journal. Available at https://journals.lww.com/pidj/Abstract/9000/The_Role_of_Children_in_the_Dynamics_of_Intra.96128.aspx

Peer Reviewed?: unclear (DESE linked source is not published article)

Study Methodology: "Clusters of infections within families living in Bnei Brak were identified and investigated."

Notes: There were 13 family clusters investigated. "Children 5–17 years of age were about 61% and children 0–4 years were 47% less likely to have positive PCR results compared with adults older than 18 years of age residing in the same household." Notably, Bnei Brak has a very high population of young people. "Our results do not necessarily indicate that reopening school is safe regarding the potential of re-emergence of Covid-19 spread since various rates of transmission are expected to occur also in school (as occurred in a family set up) and therefore reopening school should be practiced with caution and with close monitoring of Covid-19 spread." (emphasis is my addition). 

Supports DESE Claim?: Yes (but the fact that DESE doesn't account for the author's statement that results don't mean school is safe is alarming) 

A Look at DESE's Cited Sources: Footnote #70 - New York State Coronavirus 2019 Response Team, COVID-19 Testing, Epidemic Features, Hospital Outcomes, and Household Prevalence, New York State—March 2020

DESE Claim: "In NYC, in households with at least one COVID-19 case, prevalence of infection for children 5-≤18 was 31.9% vs. overall prevalence 52.5%."

Cited Source: Eli S Rosenberg, Elizabeth M Dufort, Debra S Blog, …, New York State Coronavirus 2019 Response Team, COVID-19 Testing, Epidemic Features, Hospital Outcomes, and Household Prevalence, New York State—March 2020, Clinical Infectious Diseases, https://doi.org/10.1093/cid/ciaa549

Peer Reviewed?: unclear - "accepted manuscript"

Study Methodology: "epidemiological investigations and hospital record-linkage"

Notes: This is a study of household infection, not overall infection rates. It looks at infections of people in New York State outside of New York City. A total of 138 children ages 5 to <18  with a household member who had COVID-19 were tested, and 44 tested positive. 

Supports DESE Claim?: No - this is not a New York City study. The data is from New York State excluding NYC.

A Look at DESE's Cited Sources: Footnote #69 - Age specificity of cases and attack rate of novel coronavirus disease (COVID-19)

DESE Claim: "In one study from Japan, 7.2% of exposed male children ages 0-19 and 3.8% of exposed female children tested positive for COVID-19, compared to 22.2% of exposed males ages 20-59 and 21.9% of exposed females ages 20-59"

Cited Source: Mizumoto, K., Omori, R., & Nishiura, H. Age specificity of cases and attack rate of novel coronavirus disease (COVID-19). medRxiv 2020. Available at https://www.medrxiv.org/content/10.1101/2020.03.09.20033142v1

Peer Reviewed?: No - pre print letter to the editor

Study Methodology: Analysis of public health data

Notes: The study examined domestically acquired cases of COVID-19 in Japan. "What our short analysis shows is that children are less likely to be diagnosed as cases, and moreover, the risk of disease given exposure among children appears to be low." 

Supports DESE Claim?: Yes.

A Look at DESE's Cited Sources: Footnote #68 and #74 - Household secondary attack rate of COVID-19 and associated determinants

DESE Claim 1 (footnote #68): "In another study from China, exposed children less than 19 years of age became infected at a rate of 5.3%, vs. 13.7% for 20-59 and 17.7% for 60+."

DESE Claim 2 (footnote #74): "In a study from China, only 5% of household clusters were found to have a child <20 as the index patient"

Cited Source: Jing, Q. L., Liu, M. J., Yuan, J., Zhang, Z. B., Zhang, A. R., Dean, N. E., ... & Lu, Y. (2020). Household secondary attack rate of COVID-19 and associated determinants. medRxiv. Available at https://www.medrxiv.org/content/10.1101/2020.04.11.20056010v1

Peer Reviewed?: No - preprint

Study Methodology: " Based on a comprehensive contact-tracing dataset from Guangzhou, we estimated

both the population-level effective reproductive number and individual-level secondary attack

rate (SAR) in the household setting."

Notes: This study studies transmission in the household setting. "Case finding and isolation alone may be inadequate to contain the pandemic and need to be used in conjunction with heightened restriction of human movement as implemented in Guangzhou." There were fewer household secondary cases in young people.

Supports DESE Claim 1?: Yes, for household exposed children.

Supports DESE Claim 2?: Yes

A Look at DESE's Cited Sources: Footnote #64 - Suppression of COVID-19 outbreak in the municipality of Vo, Italy

DESE Claim: "After an outbreak in Italy, no children under 10 were infected and children 11-20 were infected at half the overall rate."

Cited Source: Lavezzo, E., Franchin, E., Ciavarella, C., Cuomo-Dannenburg, G., Barzon, L., Del Vecchio, C., ... & Abate, D. (2020). Suppression of COVID-19 outbreak in the municipality of Vo, Italy. medRxiv. https://www.medrxiv.org/content/10.1101/2020.04.17.20053157v1

Peer Reviewed: No - preprint

Study Methodology: "We collected information on the demography, clinical presentation, hospitalization, contact network and presence of SARS-CoV-2 infection in nasopharyngeal swabs"

Notes: The municipality was locked down upon the first death from COVID-19. A large percentage of the population was tested for SARS-CoV-2. 73 cases (out of 2,812 subjects) were found. Of those, none were kids under 10. The positive rate for people 11-20 was 1.2%, compared to an overall infection rate of 2.6%.

Supports DESE Claim?: Yes. In this particular outbreak, there were not any infected children under 10, and a lower infection rate in people 11-20.

A Look at DESE's Cited Sources: Footnote #63 - Coronavirus Disease-19: The First 7,755 Cases in the Republic of Korea

DESE Claim: "In a South Korea study, children under 20 only accounted for 6.2% of all positive cases."

Cited Source: Coronavirus Disease-19: The First 7,755 Cases in the Republic of Korea. Osong Public Health Res Perspect. 2020;11(2):85-90. Published online April 30, 2020. DOI: https://doi.org/10.24171/j.phrp.2020.11.2.05

Peer Reviewed?: unclear

Study Methodology: Epidemiological investigation of public health data

Notes: This is a summary of the demographic characteristics of the cases in Korea. 

Supports DESE Claim?: Yes

A Look at DESE's Cited Sources: Footnote #56 - Massachusetts Child and Youth Serving Programs Reopen Approach: Minimum Requirements for Health and Safety

DESE Claim: "This list focuses on establishing processes and communication structures; future guidance will have more details about concrete operational planning."

Cited Source: For example, see: Massachusetts Department of Early Education and Care, Massachusetts Child and Youth Serving Programs Reopen Approach: Minimum Requirements for Health and Safety (pg. 6-8) https://eeclead.force.com/resource/1592325278000/Min_Req

Peer Reviewed?: no - government document

Study Methodology: N/A - policy document

Notes: The cited "example" source is a Massachusetts Early Education and Care reopening document. It includes much more specific detail than the DESE document. 

Supports DESE Claim?: N/A - cited source is an exemplar

A Look at DESE's Cited Sources: Footnote #55 - Thinking Outside The Box: Adaptive Reuse For Education

DESE Claim: "Schools should consider engaging community partners to find spaces outside the school (e.g., libraries, community centers) to set up additional classrooms"

Cited Source: Spaces4learning, Thinking Outside The Box: Adaptive Reuse For Education (November, 2019). Available at https://spaces4learning.com/Articles/2019/11/01/Adaptive-Reuse-For-Education.aspx?Page=2

Peer Reviewed?: No.

Study Methodology: N/A - news style article 

Notes: Pre-COVID pandemic (November 1, 2019) article. The article is about reuse of non-school space for school facilities needs. It discusses a specific case of a big box retail store being repurposed into district offices and an early childhood center. Notably, both cases discussed required substantial construction and renovations, which may not be practical in the two months until school reopens.

Supports DESE Claim?: Yes

A Look at DESE's Cited Sources: Footnote #54 - Ready Schools, Safe Learners, Guidance for School Year 2020-21 (June 10, 2020)

DESE Claim: "Utilizing external facility spaces: Schools should consider engaging community partners to find spaces outside the school"

Cited Source: Oregon Department of Education, Ready Schools, Safe Learners, Guidance for School Year 2020-21 (June 10, 2020). Available at https://www.oregon.gov/ode/students-and-family/healthsafety/documents/ready%20schools%20safe%20learners%202020-21%20guidance.pdf

Peer Reviewed?: No

Study Methodology: N/A - school opening guidance from the state of Oregon.

Notes: This source is Oregon's school reopening plan. As of June 26, 2020 Oregon has 7,083 cases of COVID-19 in a population of 4.218 million, a rate of 168 cases per 100,000 people. Massachusetts has 108,443 COVID-19 cases in a population of 6.893 million, a rate of 1,573 cases per 100,000 people. In other words, this guidance document is intended for a state with a case rate nearly 10 times lower than the one in Massachusetts. Oregon released their guidance on June 10. Page 13 of the plan does include the suggestion of considering other spaces. "Consider utilizing outdoor spaces, common areas, and other buildings in planning." The guidance also recommends/requires masks, physical distancing, cohorting, and hand washing. 

Supports DESE Claim?: Partial - supports use of other buildings, does not mention community partners

A Look at DESE's Cited Sources: Footnote #53 - Seasonal incidence of symptomatic influenza in the United States

DESE Claim: "Whereas for COVID-19 it appears children are less likely to be infected with and to transmit COVID-19, this is not the case for influenza, where children are frequent transmitters."

Cited Source: Tokars, J. I., Olsen, S. J., & Reed, C. (2018). Seasonal incidence of symptomatic influenza in the United States. Clinical Infectious Diseases, 66(10), 1511-1518. Available at https://academic.oup.com/cid/article/66/10/1511/4682599

Peer Reviewed?: Yes

Study Methodology: Literature review and statistical analysis

Notes: This is a 2018 (pre-COVID) study of the flu. The incidence of the flu can only be estimated because there are so many cases. Kids were estimated to have the flu more than adults. No claims about transmission to others are included.

Supports DESE Claim?: No. The study does not discuss transmission rates of the flu, but does indicate that children are more likely to have the flu.

A Look at DESE's Cited Sources: Footnote #52 - Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014

DESE Claim: "Whereas for COVID-19 it appears children are less likely to be infected with and to transmit COVID-19, this is not the case for influenza, where children are frequent transmitters."

Cited Source: Caini, S., Spreeuwenberg, P., Kusznierz, G. F., Rudi, J. M., Owen, R., Pennington, K., ... & Njouom, R. (2018). Distribution of influenza virus types by age using case-based global surveillance data from twenty-nine countries, 1999-2014. BMC infectious diseases, 18(1), 1-10. Available at https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-3181-y

Peer Reviewed?: yes

Study Methodology: "random-effects meta-analysis models" and "meta-regression and sub-group analyses"

Notes: Influenza infection rate study. "young children are the age group most affected by influenza in relation to their size in the country’s population" 

Supports DESE Claim?: Partial (influenza part of the claim only)

A Look at DESE's Cited Sources: Footnote #51 - Determining the dynamics of influenza transmission by age

DESE Claim: "Whereas for COVID-19 it appears children are less likely to be infected with and to transmit COVID-19, this is not the case for influenza, where children are frequent transmitters."

Cited Source: White, L. F., Archer, B., & Pagano, M. (2014). Determining the dynamics of influenza transmission by age. Emerging themes in epidemiology, 11(1), 4. Available at https://link.springer.com/article/10.1186/1742-7622-11-4

Peer Reviewed?: Yes

Study Methodology: data analysis

Notes: This study looks at transmission patterns of H1N1 influenza. Children spread influenza more than other age groups.

Supports DESE Claim?: Partial (influenza part of the claim only)

A Look at DESE's Cited Sources: Footnote #50 - On the relative role of different age groups in influenza epidemics

DESE Claim: "Whereas for COVID-19 it appears children are less likely to be infected with and to transmit COVID-19, this is not the case for influenza, where children are frequent transmitters."

Cited Source: Worby, C. J., Chaves, S. S., Wallinga, J., Lipsitch, M., Finelli, L., & Goldstein, E. (2015). On the relative role of different age groups in influenza epidemics. Epidemics, 13, 10-16. Available at https://www.sciencedirect.com/science/article/pii/S1755436515000511

Peer Reviewed?: Yes

Study Methodology: Mathematical modeling and simulation

Notes: This is a 2015 (pre-COVID-19) article. It looks at which age groups are most important in the spread of influenza. Children were more likely to spread the flu. The study had "consistent evidence for a leading role of school age children in propagating the major influenza A epidemics."

Supports DESE Claim?: Partial (influenza part of the claim only)

A Look at DESE's Cited Sources: Footnote #49 - The Dual Epidemics of COVID-19 and Influenza: Vaccine Acceptance, Coverage, and Mandates

DESE Claim: "In addition, health providers strongly recommend all students and staff get their regular flu vaccine."

Cited Source: Gostin L. O., Salmon D. A. The Dual Epidemics of COVID-19 and Influenza: Vaccine Acceptance, Coverage, and Mandates. JAMA. Published online June 11, 2020. doi:10.1001/jama.2020.10802

Peer Reviewed?: Yes, JAMA is a peer reviewed journal

Study Methodology: N/A - viewpoints article rather than a study 

Notes: This paper examines what a COVID-19 outbreak during flu season could look like. "The Centers for Disease Control and Prevention (CDC) recommends that every person 6 months and older get vaccinated for seasonal influenza, with rare exceptions for persons with medical contraindications."  

Supports DESE Claim?: Yes

A Look at DESE's Cited Sources: Footnote #45 - Hand Sanitizer Use Out and About

DESE Claim: "As has always been the case, handwashing should be used whenever hands are visibly soiled and after using the bathroom"

Cited Source: CDC, Hand Sanitizer Use Out and About. (2020, April 13). Available at https://www.cdc.gov/handwashing/hand-sanitizer-use.html

Peer Reviewed?: No - government website

Study Methodology: N/A - public health guidance

Notes: The website includes information on when to use hand sanitizer vs. soap and water. The guidance suggests that soap and water should be used before eating, after using the bathroom, and after touching garbage. It also says that if hands are soiled they should be washed.

Supports DESE Claim?: Yes.

A Look at DESE's Cited Sources: Footnote #44 - Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols

DESE Claim: "While handwashing with soap and water is the best option, alcohol-based hand sanitizer (at least 60 percent ethanol or at least 70 percent isopropanol) may be utilized when handwashing is not available."

Cited Source: Kratzel, A., Todt, D., V'kovski, P., Steiner, S., Gultom, M., Thao, T. T. N., ... & Dijkman, R. (2020). Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols. Emerg Infect Dis, 26. Available at https://wwwnc.cdc.gov/eid/article/26/7/20-0915_article

Peer Reviewed?: yes

Study Methodology: experimental study of chemicals' efficacy of inactivating SARS-CoV2 virus particles. 

Notes: This study indicates that alcohol-based hand sanitizer is effective in inactivating the COVID-19 virus.

Supports DESE Claim?: Yes, hand sanitizer works.

A Look at DESE's Cited Sources: Footnote #43, #46, and #47 - Hand Hygiene Recommendations

DESE Claim 1 (footnote #43): "While handwashing with soap and water is the best option, alcohol-based hand sanitizer (at least 60 percent ethanol or at least 70 percent isopropanol) may be utilized when handwashing is not available"

DESE Claim 2 (footnote #46): "When handwashing, individuals should use soap and water to wash all surfaces of their hands for at least 20 seconds, wait for visible lather, rinse thoroughly, and dry with an individual disposable towel"

DESE Claim 3 (footnote #47): "If handwashing is not feasible, hand sanitizer with at least 60 percent ethanol or at least 70 percent isopropanol content can be used."

Cited Source: CDC, Hand Hygiene Recommendations. (2020, May 17). Available at https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html

Peer Reviewed?: no - government recommendations

Study Methodology: N/A - public health guidance

Notes: This is the CDC's guidance for hand hygiene to prevent the spread of COVID-19. "Hand hygiene is an important part of the U.S. response to the international emergence of COVID-19. Practicing hand hygiene, which includes the use of alcohol-based hand rub (ABHR) or handwashing, is a simple yet effective way to prevent the spread of pathogens and infections in healthcare settings. CDC recommendations reflect this important role." In a medical setting, the CDC recommends hand sanitizer over hand washing due to better compliance. 

Supports DESE Claim 1?: Somewhat. The CDC guidance encourages sanitizer over hand washing in healthcare settings, while the DESE document seems to favor hand washing as the preference.

Supports DESE Claim 2?: Yes. 20 seconds is the recommended amount of time for hand washing on the site.

Supports DESE Claim 3?: Yes

A Look at DESE's Cited Sources: Footnote #42 - Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients

DESE Claim: "As noted in previous guidance, temperature checks are not recommended as screening for all students due to the high likelihood of potential false positive and false negative results"

Cited Source: Asadian, Simin, et al. "Accuracy and precision of four common peripheral temperature measurement methods in intensive care patients." Medical Devices (Auckland, NZ) 9 (2016): 301.

Note: the DESE citation does not list a web address to access the source. I used Google to find this online version of the article.

Peer Reviewed?: Yes

Study Methodology: "observational prospective study" of 237 ICU patients' temperatures.

Notes: This study is about body temperature taking methods in ICU patients. It does not mention schools or children. This study is not COVID-19 specific (it was done in 2016). The study compares the precision and accuracy of different temperature taking methods: tympanic (ear), axillary (armpit), oral cavity (under the tongue), and forehead.  "The results showed that all the methods have enough precision for measuring body temperature. With regard to accuracy, tympanic and forehead approaches showed the highest

and lowest accuracy compared to the standard method, respectively." No conclusions about false positive and false negative results for fevers in ambulatory children are made in the article. Yes, there were some erroneous readings of thermometers, but this does not make taking temperatures useless. Most schools already have guidance in place (pre-COVID-19) saying students are to stay home if they have a fever.

Supports DESE Claim?: No. 

A Look At DESE's Cited Sources: Footnotes #40, #41, #48, #77, #81, and #84 - Considerations for Schools

DESE Claim 1 (footnote #40): "Classroom and facility configuration: To the extent possible, desks should be spaced six feet apart (but no fewer than three feet apart) and facing the same direction."

DESE Claim 2 (footnote #41): "Checking for symptoms each morning by families and caregivers is critical and will serve as the primary screening mechanism for COVID-19 symptoms."

DESE Claim 3 (footnote #48): "A student who shows COVID-19 symptoms during the school day should be moved to the specific room pre-designated for medical-related isolation until they can be picked up by a family member."

DESE Claim 4 (footnote #77): "Prepare for frequent cleaning and sanitization of facilities and surfaces, especially high-touch surfaces (e.g., doorknobs, hand rails)."

DESE Claim 5 (footnote #81): "Prepare an “medical isolation room” for students/staff who exhibit COVID-19 symptoms during the school day."

DESE Claim 6 (footnote #84): "Prepare to hold breakfast and/or lunch in classrooms, instead of the cafeteria or common areas.

Cited Source: CDC, Considerations for Schools. (2020, May 19). Available at https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/schools.html

Peer Reviewed?: No - public health agency guidance

Study Methodology: N/A - government website

Notes: This document is intended as guidance for schools in the USA. The document encourages distancing, face masks, avoiding sharing of supplies, hand washing, and cleaning. It also encourages symptom monitoring and staying home when sick. "Space seating/desks at least 6 feet apart when feasible. Turn desks to face in the same direction (rather than facing each other), or have students sit on only one side of tables, spaced apart." There is also guidance for preparing for when someone becomes sick in school, including isolating those with COVID-19 symptoms from others.

Supports DESE Claim 1?: Yes

Supports DESE Claim 2?: Yes, though the document does not specifically support families and caregivers being the ones doing the health checks. 

Supports DESE Claim 3?: Yes. 

Supports DESE Claim 4?: Yes.

Supports DESE Claim 5?: Yes

Supports DESE Claim 6?: Yes

A Look at DESE's Cited Sources: Footnote # 38 - Reopening Massachusetts plan

DESE Claim: "Finally, this guidance is for fall reopening and is predicated on the Commonwealth continuing to progress through the phases of reopening with low COVID-19 public health metrics"

Cited Source: Reopening Massachusetts plan, https://www.mass.gov/info-details/reopening-massachusetts

Peer Reviewed?: No - government website

Study Methodology: N/A - government website

Notes: There is no mention of progress through phases to reopen schools, or of health metric thresholds for re-opening. There is a link to the DESE guidance on the page, but no mention of specific health criteria that need to be met or which phase schools fall into.

Supports DESE Claim?: No. The information in the claim is not on this website.

A Look at DESE's Cited Sources: Footnote #37 - 'One metre plus', the new rule that will reopen UK

DESE Claim: "The United Kingdom is also changing its guidance to one meter of distance beginning July 4, replacing previous guidance of two meters."

Cited Source: Telegraph. 'One metre plus', the new rule that will reopen UK. (2020, June 20). Available at https://www.telegraph.co.uk/politics/2020/06/20/one-metre-plus-new-rule-will-reopen-uk/

Peer Reviewed?: No. Newspaper article

Study Methodology: N/A secondary news source

Notes: I cannot access the full article due to a paywall. However, the brief part I can see before the paywall mentions that Boris Johnson will announce a one meter plus rule for social distancing.

Supports DESE Claim?: Yes. UK guidance is changing.

A Look at DESE's Cited Sources: Footnote #36 - Two meters? One meter plus? Social distancing rules prompt fierce debate in U.K.

DESE Claim: In addition to the WHO, several other countries including Denmark, France, China, and Hong Kong recommend one meter (approximately three feet) distance in schools.

Cited Source: Washington Post. Two meters? One meter plus? Social distancing rules prompt fierce debate in U.K. (2020, June 22). Available at https://www.washingtonpost.com/world/europe/covid-social-distancing-one-meter-plus/2020/06/22/7614418a-afe0-11ea-98b5-279a6479a1e4_story.html

Peer Reviewed?: No, newspaper article

Study Methodology: N/A - newspaper article/secondary source

Notes: The article discusses debate in the United Kingdom about whether 1 meter or two meters should be used as a social distancing standard. Britain was using a two meter rule, but was expected to change to one meter with infections under control.  

Supports DESE Claim?: Yes. The article lists all four countries from the claim as countries who are using the one meter standard for social distancing.

A Look at DESE's Cited Sources: Footnote #35 - Guidelines to Schools on Class Resumption

DESE Claim: "In addition to the WHO, several other countries including Denmark, France, China, and Hong Kong recommend one meter (approximately three feet) distance in schools."

Cited Source: Hong Kong Education Bureau. Guidelines to Schools on Class Resumption. (2020, June 16). Available at https://www.edb.gov.hk/attachment/en/sch-admin/admin/about-sch/diseases-prevention/Guidelines%20to%20Schools%20on%20Class%20Resumption%20(E).pdf

Peer Reviewed?: No (public health guidance)

Study Methodology: N/A - public health guidance

Notes: This document is guidance for the return to school in Hong Kong. It suggests symptom monitoring, distancing, hand washing, and masks. For physical education, "Masks should be worn as far as feasible and keep social distancing at least 1 metre. If the mask cannot be tolerated, keep social distancing for at least 1.5 metres." 

Supports DESE Claim?: Yes. Hong Kong recommends 1 meter distancing.

A Look at DESE's Cited Sources: Footnote #34 - Accueil de tous les élèves des écoles et collèges. (2020, June 22)

DESE Claim: "In addition to the WHO, several other countries including Denmark, France, China, and Hong Kong recommend one meter (approximately three feet) distance in schools."

Cited Source: France Ministère de l'Éducation Nationale et de la Jeunesse, Accueil de tous les élèves des écoles et collèges. (2020, June 22). Available at https://www.education.gouv.fr/22-juin-accueil-de-tous-les-eleves-des-ecoles-et-colleges-303546

Peer Reviewed?: No, government health guidance

Study Methodology: N/A - public health guidance

Notes: This is France's guidance on the return to school. I did a Google Translate to English of the web page since my French reading is not at a native speaker level. Parents are expected to keep children home if they are sick. Physical distancing is required in elementary school and older, but not in nursery schools. Hand washing and mask guidance are also included in the document.  

Supports DESE Claim?: Yes. France recommends one meter physical distancing.

A Look at DESE's Cited Sources: Footnote #33 - COVID-19: Prevention of infection spread

DESE Claim: "In addition to the WHO, several other countries including Denmark, France, China, and Hong Kong recommend one meter (approximately three feet) distance in schools."

Cited Source: Denmark National Board of Health, COVID-19: Prevention of infection spread. (2020, May 10). Available at https://www.sst.dk/da/Udgivelser/2020/COVID-19-Forebyggelse-af-smittespredning

Peer Reviewed?: No (government public health guidance)

Study Methodology: N/A (government document)

Notes: I used Google Translate on the page since I do not speak Danish. However, I could not translate the PDF document referenced. On this page on the English version of the site, there is mention of 1-2 meters of social distancing. 

Supports DESE Claim?: Yes, it seems Denmark recommends 1 meter distancing.

A Look at DESE's Cited Sources: Footnote #31 - Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China

DESE Claim: "There is no precise threshold for safety; indeed, studies suggest that physical distancing of three feet or more leads to reduced transmission, with additional distance providing additional protection"

Cited Source: Zhang, J., Litvinova, M., Liang, Y., Wang, Y., Wang, W., Zhao, S., ... & Ajelli, M. (2020). Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China. Science. Available at https://science.sciencemag.org/content/early/2020/05/04/science.abb8001

Peer Reviewed?: Yes

Study Methodology: Mathematical modeling and contact tracing "we analyze contact survey data for Wuhan and Shanghai before and during the outbreak and contact-tracing information from Hunan province"

Notes: This study determined that during the outbreak, people in Wuhan and Shanghai had contact with fewer people than they did before the outbreak. Schools were closed during the study period in these cities, so most children were only in contact with members of their households. During the study, people "decreased daily contacts, essentially reducing them to household interactions. This led to a dramatic reduction of SARS-CoV-2 transmission." 

Supports DESE Claim?: Limited. The study says strict stay-home and physical distancing help reduce the spread of COVID-19. They do not address the specific parameters distancing.

A Look at DESE's Cited Sources: Footnotes #29 and #39 - Considerations for school-related public health measures in the context of COVID-19

DESE Claim 1 (footnote #29): "the World Health Organization’s guidance states approximately three feet" of physical distancing is advisable.

DESE Claim 2 (footnote #39): "Distancing requirements: As reviewed and advised by the Massachusetts COVID-19 Command Center Medical Advisory Group, schools should aim for a physical distance of six feet when feasible, and three feet is the minimum distance allowed"

Cited Source: WHO, Considerations for school-related public health measures in the context of COVID-19. (2020, May 10). Available at https://www.who.int/publications/i/item/considerations-for-school-related-public-health-measures-in-the-context-of-covid-19

Peer Reviewed?: No. Public health guidance.

Study Methodology: N/A. Public health guidance.

Notes: This report acknowledges that risk to all stakeholders must be considered in school reopening decisions. "Deciding to close, partially close or reopen schools should be guided by a risk-based approach to maximize the educational and health benefit for students, teachers, staff, and the wider community, and help prevent a new outbreak of COVID-19 in the community". DESE does not address this part of the article, however. The WHO article also indicates that physical distancing can be hard for younger students. This is especially concerning when coupled with the no mask requirement for kindergarten and first graders. "Younger children may find it more difficult to adhere to physical distancing of at least 1 metre." The report recommends at least 1 meter of space (about 3 feet) between individuals at school.

Supports DESE Claim 1?: Yes, WHO suggests about three feet of physical distancing.

Supports DESE Claim 2?: Yes

A Look at DESE's Cited Sources: Footnote #28 - Social Distancing, Quarantine, and Isolation

DESE Claim: "While the U.S. federal CDC has recommended maintaining a physical distance of six feet between individuals"

Cited Source: CDC, Social Distancing, Quarantine, and Isolation. (2020, May 6). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html

Peer Reviewed?: No, government information site

Study Methodology: N/A - public health guidance

Notes: This page gives guidance for the public on how to social distance. It advises staying 6 feet apart, and limiting close contact with others.

Supports DESE Claim?: Yes. CDC guidance says 6 feet distancing.

A Look at DESE's Cited Sources: Footnote #26 - COVID-19: Recommendations for School Reopening

DESE Claim: "Students in grade 2 and above are required to wear a mask/face covering that covers their nose and mouth. Students in kindergarten and grade 1 should be encouraged to wear a mask/face covering."

Cited Source: http://www.sickkids.ca/PDFs/About-SickKids/81407-COVID19-Recommendations-for-School-Reopening-SickKids.pdf (if masks are worn incorrectly, they may increase infection risk). See also: https://www.publichealthontario.ca/-/media/documents/ncov/covid-wwksf/what-we-know-public-masks-apr-7-2020.pdf?la=en

Peer Reviewed?: No (hospital publication)

Study Methodology: N/A - public-aimed health information from a hospital.

Notes: This document is comprised of the medical guidance from one hospital in Canada for the return to school. " [...] it is anticipated that there will likely be an increase in cases of COVID-19 upon the resumption of school and as such, the appropriate measures should be proactively put in place to mitigate the effects of such an increase." In other words, all the recommended safeguards can mitigate but not eliminate an increase in cases from the return to school. The document recommends scheduling at least 5 hand hygiene times per day. This particular hospital is not recommending that children wear face masks in school. " It is recognized that some parents and children may choose to wear masks. This is a personal choice and should not be discouraged. To this end, equitable access to non-medical masks in the school setting is an important consideration." The document says staff should not be required wear masks either, contradicting many of the other DESE sources which state that masks are highly effective. 

Supports DESE Claim?: Evidence is not grade level specific and no sources are given for some of the medical claims in the source.

A Look at DESE's Cited Sources: Footnote #22, #27, and #30 - Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

DESE Claim 1 (footnote #22): "Masks/face coverings protect the general public against COVID-19 infection"

DESE Claim 2 (footnote #27): "Mask breaks should occur throughout the day."

DESE Claim 3 (footnote #30): "There is no precise threshold for safety; indeed, studies suggest that physical distancing of three feet or more leads to reduced transmission, with additional distance providing additional protection."

Cited Source: Chu, D.K., Akl, E.A., Duda S., Solo K., Yaacoub S., Schunemann H.J. (2020) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet

Note: no link is provided in the DESE citation. I used Google to find this link to the study. 

Peer Reviewed?: Yes

Study Methodology: "systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses"

Notes: The review of 172 studied indicated that physical distancing, face masks, and eye protection were all protective against COVID-19. Different types of masks offered different levels of protection. "[...]our findings continued to support the ideas not only that masks in general are associated with a large reduction in risk of infection from SARS-CoV-2, SARS-CoV, and MERS-CoV but also that N95 or similar respirators might be associated with a larger degree of protection from viral infection than disposable medical masks or reusable multilayer (12–16-layer) cotton masks." Mask efficacy is supported by the study. Physical distancing efficacy is also supported with moderate confidence.

Supports DESE Claim 1?: Yes.

Supports DESE Claim 2?: No. There is no mention of mask breaks in the article. 

Supports DESE Claim 3?: Yes.

A Look at DESE's Cited Sources: Footnote #21 and #25 - The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2

DESE Claim 1: "masks or face coverings are among the most critical components of risk reduction"

DESE Claim 2: "community-wide mask/face covering usage contributed to control of COVID-19 in Hong Kong."

Cited Source: Cheng, V. C., Wong, S. C., Chuang, V. W., So, S. Y., Chen, J. H., Sridhar, S., ... & Yuen, K. Y. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of Infection. Available at https://www.journalofinfection.com/article/S0163-4453(20)30235-8/pdf

Peer Reviewed?: yes

Study Methodology: "Epidemiological analysis was performed for confirmed cases, especially persons acquiring COVID-19 during mask-off and mask-on settings. The incidence of COVID-19 per

million population in HKSAR with community-wide masking was compared to that of non-mask-wearing

countries which are comparable with HKSAR in terms of population density, healthcare system, BCG vaccination and social distancing measures but not community-wide masking."

Notes: This study looks at Hong Kong (where universal masking was required) compared to countries where masks were not worn community-wide. "Community-wide mask wearing may contribute to the control of COVID-19 by reducing the amount of emission of infected saliva and respiratory droplets from individuals with subclinical or mild COVID-19." Masks were effective in reducing the spread of COVID-19.

Supports DESE Claim 1?: Yes.

Supports DESE Claim 2?: Yes.

A Look at DESE's Cited Sources: Footnote #20 and #24 - Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US

DESE Claim 1: "masks or face coverings are among the most critical components of risk reduction"

DESE Claim 2: "In the United States, states advising face masks/face coverings be worn in public saw a decline in their COVID-19 growth rates"

Cited Source: Lyu, W. and Wehby, G. L. (2020). Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Health Affairs. Available at https://doi.org/10.1377/hlthaff.2020.00818

Peer Reviewed?:Yes. "Editor’s Note: This Fast Track Ahead Of Print article is the accepted version of the peer-reviewed manuscript. The final edited version will appear in an upcoming issue of Health Affairs"

Study Methodology: "event study examining changes in the daily county-level COVID-19 growth rates"

Notes: Face masks have reduced the growth rate of COVID-19. "Mandating face mask use in public is associated with a decline in the daily COVID-19 growth rate by 0.9, 1.1, 1.4, 1.7, and 2.0 percentage-points in 1–5, 6–10, 11–15, 16–20, and 21+ days after signing, respectively." The study does not that it does not attempt to measure compliance with face masks orders. 

Supports DESE Claim 1?: Yes.

Supports DESE Claim 2?: Yes.

A Look at DESE's Cited Sources: Footnote #19, #23, and #32 - Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China

DESE Claim 1 (footnote #19): "[...]masks or face coverings are among the most critical components of risk reduction."

DESE Claim 2 (footnote #23): "Masks/face coverings protect the general public against COVID-19 infection, with a recent retrospective study estimating near 80% effectiveness in reducing COVID-19 transmission, especially when worn prior to symptom onset."

DESE Claim 3 (footnote #32): "For instance, in a study of household transmission in China, keeping at least three feet of distance was associated with one-fourth the number of transmissions."

Cited Source: Wang, Y., Tian, H., Zhang, L., Zhang, M., Guo, D., Wu, W., ... & Liu, B. (2020). Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China. BMJ Global Health, 5(5), e002794. Available at https://gh.bmj.com/content/bmjgh/5/5/e002794.full.pdf

Peer Reviewed?: Yes

Study Methodology: "A retrospective cohort study of 335 people in 124 families"

Notes: This study looks at household face mask use as a risk reduction measure in families who have a member that is COVID-19 positive. "The study confirms the highest risk of transmission prior to symptom onset, and provides the first evidence of the effectiveness of mask use, disinfection and social distancing in preventing COVID-19." Masks were effective in reducing transmission. While household settings are different than schools, other evidence from outside of household settings also supports mask use.

Supports DESE Claim 1?: Yes.

Supports DESE Claim 2?: Yes.

Supports DESE Claim 3?: Yes.

A Look at DESE's Cited Sources: Footnote #18 - Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations: scientific brief

DESE Claim: "As the primary route of transmission for COVID-19 is respiratory"

Cited Source: World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations: scientific brief, 27 March 2020. No. WHO/2019-nCoV/Sci_Brief/Transmission_modes/2020.1. World Health Organization, 2020. Available at: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations

Peer Reviewed?: No (public health organization information)

Study Methodology: N/A (public health information)

Notes: This is a summary of WHO's understanding of how COVID-19 is transmitted. 

Supports DESE Claim?: Yes

A Look at DESE's Cited Sources: Footnote #16 - Identifying airborne transmission as the dominant route for the spread of COVID-19

DESE Claim: "As the primary route of transmission for COVID-19 is respiratory"

Cited Source: Zhang, Renyi, et al. "Identifying airborne transmission as the dominant route for the spread of COVID-19." Proceedings of the National Academy of Sciences (2020).

Note: the DESE report citation does not include a link or DOI to find the article I was able to Google my way to the digital version of the source here.

Peer Reviewed?: Yes (2 reviewers listed in article)

Study Methodology: Data analysis of public health data 

Notes: This study looks at trends in public health data in different disease epicenters over time. The data shows that certain public health measures, such as face coverings, altered the course of outbreaks. "Our work also highlights the necessity that sound science is essential in decision-making for the current and future public health pandemics." Based on the impact different mitigation measures had on the outbreak, the researchers were able to determine that airborne transmission is dominant, and face coverings work to reduce the spread.

Supports DESE Claim?: Yes.

A Look at DESE's Cited Sources: #15 - How COVID-19 spreads

DESE Claim: "As general background, COVID-19 spreads when people are in relatively close proximity, through respiratory droplets generated through coughing, sneezing, or talking to an infected person. Among the most effective preventive measures – when used consistently and in combination – are masks/face coverings, physical distancing, handwashing, and cleaning frequently touched surfaces."

Cited Source: CDC, How COVID-19 spreads. (2020, June 16). Available at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html

Peer Reviewed?: no -government document

Study Methodology: N/A - government information without a study attached.

Notes: This is a general information page about how COVID-19 spreads. The information listed in the DESE claim is all included on the page. DESE did not cite the bolded sentence "The virus that causes COVID-19 is spreading very easily and sustainably between people" which seems an important point. General background information given by DESE is aligned with this source. 

Supports DESE Claim?: Yes.

A Look at DESE's Cited Sources: Footnote #14, #65, and #76 - Characteristics of Hospitalized Pediatric COVID-19 Cases—Chicago, Illinois, March–April 2020

DESE Claim 1 (footnote #14): "If infected, it appears children may be less likely to infect others with COVID-19. [...] In a U.S. study of 15 households, 73% of transmissions were from adult to child (the remaining were child-to-child or child-to adult)."

DESE Claim 2 (footnote #65): "In a Chicago study, only 1% of COVID-19 cases in Chicago were in children 0-17."

DESE Claim 3 (footnote #76): "In a Chicago study, for 15 households where data was available, 73% of transmissions were from adult to child (the remaining 27% was due to two child-to-child and two child-to adult transmissions)."

Cited Source: Mannheim, J., Gretsch, S., Layden, J. E., & Fricchione, M. J. (2020). Characteristics of Hospitalized Pediatric COVID-19 Cases—Chicago, Illinois, March–April 2020. Journal of the Pediatric Infectious Diseases Society. Available at https://academic.oup.com/jpids/advance-article/doi/10.1093/jpids/piaa070/5849922

Peer Reviewed?:  Yes

Study Methodology: "This was a case series of Chicago COVID-19 patients aged 0–17 years reported to the Chicago Department of Public Health (CDPH) from March 5 to April 8, 2020. Enhanced case investigation was performed"

Notes: This study is not primarily focused on investigation related to the DESE claim about household infection rates. The study examined hospitalization of pediatric patients. It also notes a limitation due to school closure (thus most children being home and only in contact with household members). "[...]school closures and shelter-in-place directives were instituted during this time period." Additionally, a look at hospitalized cases may not be representative of all COVID-19 cases.

Supports DESE Claim 1?: Extremely limited support in a non-school environment. Again, no conclusion about adult transmission can be drawn from pediatric studies. The fact that the study is not actually attempting to prove or support the DESE claim means it may not have been scrutinized in the same way as the main part of the study around hospitalization.

Supports DESE Claim 2?: Yes. 

Supports DESE Claim 3?: Yes, though school closures are a limiting factor.

A Look at DESE's Cited Sources: Footnote #13 and #73 - Children are unlikely to have been the primary source of household SARS-CoV-2 infections

DESE Claim 1 (footnote #13): "If infected, it appears children may be less likely to infect others with COVID-19. Most transmissions are from adults to children, rather than vice versa; this is different from some other respiratory viruses (note: pre-print study)."

DESE Claim 2 (footnote #73): "Analysis of clusters of patients with COVID-19 indicates that most transmissions are from adults to children, rather than vice versa. This is different from some other respiratory viruses."

Cited Source: Zhu, Y., Bloxham, C. J., Hulme, K. D., Sinclair, J. E., Tong, Z. W. M., Steele, L. E., ... & Gilks, C. (2020). Children are unlikely to have been the primary source of household SARS-CoV-2 infections. Available at https://www.medrxiv.org/content/10.1101/2020.03.26.20044826v1

Peer Reviewed?: No. Preprint study.

Study Methodology: Meta-analysis "observational study analysing literature published between December 2019 and March 2020"

Notes: The analysis only includes data from 40 of the 166 studies found in their data search. Most household transmission clusters had an adult index case. The study mentions that fewer contacts outside the home may be a factor in less children as index cases within households. "It is also possible that children simply have fewer interactions outside of the home than adults and are therefore less likely to be index cases. This may be magnified in countries which have implemented school closures in an attempt to control the outbreak." Testing limitations may influence the data contained in the studies analyzed.

Supports DESE Claim 1?: Limited support. This study looks only at household transmission; with no attempts to generalize to other community spread. Additionally, children's transmission rates do not predict the safety of opening schools for adult staff.

Supports DESE Claim 2?: Limited support. This study looks only at household transmission; with no attempts to generalize to other community spread.

A Look at DESE's Cited Sources: Footnote #12 and #67 - Characteristics of Household Transmission of COVID-19

DESE Claim 1 (footnote #12): "If exposed, children may be less likely to become infected with COVID-19. [...] In China, in households with COVID-19 exposure, children under the age of 18 were infected at a rate of 4% compared with 17% for adults."

DESE Claim 2 (footnote #67): "In China, in households with COVID-19 exposure, children under the age of 18 were infected at a rate of 4% compared with 17% for adults."

Cited Source: Wei Li, Bo Zhang, Jianhua Lu, Shihua Liu, Zhiqiang Chang, Cao Peng, Xinghua Liu, Peng Zhang, Yan Ling, Kaixiong Tao, Jianying Chen, Characteristics of Household Transmission of COVID-19, Clinical Infectious Diseases, , ciaa450, https://doi.org/10.1093/cid/ciaa450

Peer Reviewed?: yes

Study Methodology: Data collection and analysis from COVID-19 patients and their household contacts in China. Data included PCR testing, medical records analysis, and telephone interviews

Notes: The study looks at who within a household becomes infected with COVID-19 after an index case (family member) brings the virus into the home. The rate of secondary infection was 17% for adults and 4% for children in this study from the beginning of the pandemic in Wuhan. 

Supports DESE Claim 1?: Yes. Children may be less likely to get COVID-19. This does not indicate that schools are safe for adults, nor does it indicate that the infection rate within households would be similar to the infection rate in schools.

Supports DESE Claim 2?: Yes.

A Look at DESE's Cited Sources: Footnote #11 and #71 - Susceptibility to and transmission of COVID-19 amongst children and adolescents compared with adults: a systematic review and meta-analysis

DESE Claim 1 (footnote #11): "If exposed, children may be less likely to become infected with COVID-19. A meta-analysis of studies from several countries found that children were only 44% as likely as adults to become infected after exposure (note: pre-print study)."

DESE Claim 2 (footnote #71): "A meta-analysis of studies from several countries found that children were only 44% as likely as adults to become infected after exposure."

Cited Source: Viner, R. M., Mytton, O. T., Bonell, C., Melendez-Torres, G. J., Ward, J. L., Hudson, L., ... & Panovska-Griffiths, J. (2020). Susceptibility to and transmission of COVID-19 amongst children and adolescents compared with adults: a systematic review and meta-analysis. medRxiv. Available at https://www.medrxiv.org/content/10.1101/2020.05.20.20108126v1

Peer reviewed?: no, preprint

Study Methodology: Study meta-analysis "rapid systematic review of contact-tracing studies and population-screening studies"

Notes: This study examines 18 studies. "Studies were of predominantly low and medium quality." Children seemed to have less susceptibility to COVID-19 infection in the studies examined. However, they were more likely to be asymptomatic and the true infection rate likely isn't fully understood because of lack of testing for asymptomatic people who have not have known close contact with someone who has COVID-19.

"The role that children and young people play in transmission of SARS-CoV-2 by is dependent upon multiple factors, including their risk of exposure to potential infection, their probability of being infected upon exposure (susceptibility), the extent to which they develop symptoms upon infection or remain asymptomatic, the extent to which they develop a viral load sufficiently high to transmit and their propensity for making potentially infectious contact with others, dependent upon numbers of social contacts across age-groups and behaviour during those contacts."

One of the most important statements in the report is "Few studies have examined transmission in school settings." There are a lot of unknowns about COVID-19 transmission in schools. COVID-19 amongst children is important to understand, but so is the specific impact of schools on COVID-19 transmission among children and adults.

 

Supports DESE Claim 1?: Yes. Again, this does not predict adult safety in the school environment at all. Only one infected adult or child exposes a lot of people to COVID-19 in a school.

Supports DESE Claim 2? Yes

A Look at DESE's Cited Sources: Footnote #9 and #66: Massachusetts Coronavirus Data

DESE Claim 1 (footnote #9): "In general, rates of COVID-19 infection are lower for children than for adults. [...] In Massachusetts, children under the age of 19 were about four times less likely than the population at large to be diagnosed with COVID-19."

DESE Claim 2 (footnote #66): "In Massachusetts, children under the age of 19 were about four times less likely than the population at large to be diagnosed with COVID-19."

Cited Source: https://www.mass.gov/info-details/covid-19-response-reporting

Peer Reviewed?: no (government informational site)

Study Methodology: public health data release

Notes: Extensive data on Massachusetts COVID-19 data. The June 25 dashboard linked to the page indicates 5,715 cases of COVID-19 in Massachusetts children. The rate in children is 357 per 100,000, compared to 2,223.7 per 100,000 in adults (average of rates for 20-80+). This aligns with the four times likelihood claim. However, it is important to note schools in Massachusetts have been closed for the duration of the widespread pandemic in Massachusetts, meaning that most children have been isolated in small family groups at home.

Supports DESE Claim 1?: Yes. However, the DESE claim about lower infection rate for children does not indicate the safety of a school environment for adults. The infection rate in children being lower has also been during school closures in Massachusetts, which means many children may be in full isolation and this data may not indicate the infection rate that would occur when schools reopen.

Supports DESE Claim 2?: Yes.

A Look at DESE's Cited Sources: Footnote #8, #17, and #62 - Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020

DESE Claim 1 (footnote #8): "In general, rates of COVID-19 infection are lower for children than for adults. [...] Furthermore, although children under the age of 18 make up 22% of the U.S. population, they account for less than 2% of all cases of COVID-19."

DESE Claim 2 (footnote #17): "As the primary route of transmission for COVID-19 is respiratory"

DESE Claim 3 (footnote #62): "Although children under the age of 18 make up 22% of the U.S. population, they account for less than 2% of all cases of COVID-19.62"

Cited Source: 

Note: the same source is cited differently in the different footnotes. No explanation is provided for this inconsistency.

Footnote #8 and #62 citation: Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep 2020;69:422–426. DOI: http://dx.doi.org/10.15585/mmwr.mm6914e4

Footnote #17 citation: CDC., et al. "Coronavirus Disease 2019 in Children—United States, February 12–April 2, 2020." Morbidity and Mortality Weekly Report 69.14 (2020): 422.

Peer reviewed?: unclear (government report from CDC)

Study Methodology: analysis of public health data

Notes: There seem to be fewer COVID-19 infections in children in the USA and China. Some cases of COVID-19 in children can be serious. "Whereas most COVID-19 cases in children are not severe, serious COVID-19 illness resulting in hospitalization still occurs in this age group." The report advocates social distancing and precautions for all ages, since children likely play a role in some transmissions.

Supports DESE Claim 1?: Yes. Again, rates of infection and transmission in children say absolutely nothing about the safety for adults in schools.

Supports DESE Claim 2?: Yes.

Supports DESE Claim 3?: Yes

A Look at DESE's Cited Sources: Footnote #7, #10, and #61 - Age-dependent effects in the transmission and control of COVID-19 epidemics

DESE Claim 1 (footnote #7): "In general, rates of COVID-19 infection are lower for children than for adults. Based on an analysis of data from six countries, children under 20 are half as susceptible to COVID-19 infection than adults."

DESE Claim 2 (footnote #10): "In general, rates of COVID-19 infection are lower for children than for adults. [...] Children are more likely to be asymptomatic, however, which underscores the importance of health behaviors for everyone (masks/face coverings, distancing, handwashing, surface cleaning).

DESE Claim 3 (footnote #61): "Based on data from six countries, children under 20 are half as susceptible to COVID-19 infection than adults."

Cited Source: Davies, N.G., Klepac, P., Liu, Y. et al. Age-dependent effects in the transmission and control of COVID-19 epidemics. Nat Med (2020). https://doi.org/10.1038/s41591-020-0962-9

Peer Reviewed?: not double-blind peer review (editor's name is listed)

Study Methodology: mathematical modeling and statistical analysis

Notes: Less cases of COVID-19 have been seen in children. "The distribution of confirmed COVID-19 cases has shown strong age dependence, with notably few cases in children. This could be because younger ages are less susceptible to infection and/or are less prone to showing clinical symptoms when infected." However, reported cases may not align with the number of children infected with SARS-CoV-2, the infection that causes COVID-19 "If infected children are less likely to show clinical symptoms, then the number of cases reported among children would be lower, but children with subclinical symptoms could still be capable of transmitting the virus to others, potentially at lower rates than fully symptomatic individuals, as has been shown for influenza." 

DESE Claim 1 Supported?: Yes. However, lower rates of COVID-19 in children does not account for the danger of adult to adult transmission in schools. The study does not speak to adult infections and transmission within schools. Lower rates do not mean no infections.

DESE Claim 2 Supported?: Yes. Again, childhood infection rates do not account for adult safety in schools. However, all the precautions suggested in the DESE document are supported by many other sources and public health recommendations.

DESE Claim 3 Supported?: Yes.

A Look at DESE's Cited Sources: Footnote #4 and #60 Cluster of coronavirus disease 2019 (Covid-19) in the French Alps, 2020

DESE Claim 1 (footnote #4): “Furthermore, based on available data and effective implementation of critical health and safety practices, the rate of in-school transmissions has been low” (same claim as #1-3)

DESE Claim 2 (footnote #60): "One infected student (9 years old) in the French Alps attended three schools while symptomatic; none of 112 contacts became infected."

Cited Source: Danis, K., Epaulard, O., Bénet, T., Gaymard, A., Campoy, S., Bothelo-Nevers, E., ... & Boudalaa, Z. (2020). Cluster of coronavirus disease 2019 (Covid-19) in the French Alps, 2020. Clinical Infectious Diseases. Available at https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa424/5819060

Peer Reviewed?: unclear

Study Methodology: case study with contact tracing

Notes: The sentence DESE likely latched on to about child transmission indicates that the one child who was infected at a resort in the French Alps did not pass the disease on to many others. "The fact that an infected child did not transmit the disease despite close interactions within schools suggests potential different transmission dynamics in children." That is a huge conclusion to attempt to draw from one case, especially since the child in question had other diseases at the same time. A single child not spreading a disease does not mean children in general do not spread the disease. The study also notes, "It is also possible that the very low viral load of the pediatric case and the subsequent lack of transmission might be related to his coinfection and the co-circulation of respiratory viruses." A child who has just COVID-19 may spread the virus differently than one who also has other infections. 

DESE Claim 1 Supported?: extremely limited (1 case does not make a rule).

DESE Claim 2 Supported?: Yes

A Look at DESE's Cited Sources: Footnotes #3, #6, and #59 - COVID-19 in schools – the experience in NSW

DESE Claim 1 (footnote #3): “Furthermore, based on available data and effective implementation of critical health and safety practices, the rate of in-school transmissions has been low” (same claim as #1-2, 4)

DESE Claim 2 (footnote #6): "Schools do not appear to have played a major role in COVID-19 transmission. [...] In a case study from New South Wales Australia, after 18 cases were found in schools (12 in high schools and 6 in primary schools), only 0.3% of student contacts were infected (1 in 695 individuals in 10 high schools and 1 in 168 individuals in primary schools). No teachers or staff were infected."

DESE Claim 3 (footnote #59): "In a case study from New South Wales Australia, after 18 cases were found in schools (12 in high schools and 6 in primary schools), only 0.3% of student contacts were infected (1 in 695 individuals in 10 high schools and 1 in 168 individuals in primary schools). No teachers or staff were infected."

Cited Source: National Centre for Immunisation Research and Surveillance (NCIRS) (2020). COVID-19 in schools – the experience in NSW. Available at http://ncirs.org.au/sites/default/files/2020-04/NCIRS%20NSW%20Schools%20COVID_Summary_FINAL%20public_26%20April%202020.pdf

Peer Reviewed?: No - government report, peer review for publication in process

Study Methodology:  case study with contact tracing follow-up

Notes: Report involves 18 cases of COVID-19 in 15 schools and their close contacts. Again, a small sample size. "No teacher or staff member contracted COVID-19 from any of the initial school cases. One child from a primary school and one child from a high school may have contracted COVID-19 from the initial cases at their schools."

This Australian report's definition of close contact is different than the one I've seen being used most in the USA (the report calls 2 hours in the same room or 15 minutes face to face close contact, most in the USA say only the latter). Additionally, close contact isolation protocols were used: "Once the close contacts are identified, they are required to isolate themselves at home for 14 days from the date of last exposure to the infectious case, watch for any symptoms and if they become unwell, go to the doctor or a fever clinic to get a nose/throat swab to test for COVID-19". Notably, 12 of the 18 cases were in high schools.

Schools during this study were likely at lower occupancy than usual. "on 23 March 2020 the NSW Premier advised that although schools remained open, parents were encouraged to keep their children at home for online learning." This is critical, since MA is looking at a full-capacity reopen, without urging parents to keep children home to learn online. 

DESE Claim 1 Supported?: Extremely limited - low number of cases studied, and in schools functioning at less than full-capacity 

DESE Claim 2 Supported?: Again, extremely limited support. Low number of cases studied, and schools were not at full capacity during the study (parents encouraged to keep kids home).

DESE Claim 3 Supported?: Yes. 

A Look at DESE's Cited Sources: Footnote #2 and #58 - No evidence of secondary transmission of COVID-19 from children attending school in Ireland, 2020

DESE Claim 1 (footnote #2): “Furthermore, based on available data and effective implementation of critical health and safety practices, the rate of in-school transmissions has been low” (same claim as #1, 3-4)

DESE Claim 2 (footnote #58): "In a case study from Ireland, after six school cases involving three students ages 10-15 and three adults, there were no confirmed transmissions despite there being over 1,000 school contacts of these individuals (students and staff)."

Cited Source: Heavey, L., Casey, G., Kelly, C., Kelly, D., & McDarby, G. (2020). No evidence of secondary transmission of COVID-19 from children attending school in Ireland, 2020. Eurosurveillance, 25(21), 2000903. Available at https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2020.25.21.2000903

Peer reviewed?: Yes, double-blinded peer reviewed

Study methodology: case study (6 cases) with contact tracing and follow up

Notes: For the six cases of COVID-19 in the study, school was not the source of infection. In the child contacts of these cases (over 1000) there were no cases of COVID-19. In this small case study, schools were not a location of transmission of COVID-19.

There are major limitations to this study. "This study is limited by small numbers of cases. Not all age ranges are represented since all children are older than 10 years." Additionally, asymptomatic contacts were not tested, so it is possible that some asymptomatic transmission occurred, but went undetected. Schools closing when a case was discovered also limit the application of study conclusions. "Prior to the nationwide closure of schools on 12 March, when a case was identified within a school, either all children and staff within the school or all children and staff involved with an individual case were excluded. This limited the potential for further transmission within the school setting once a case was identified." In other words, it's possible transmission didn't happen because schools closed when there were cases, rather than because cases don't tend to be transmitted within schools.

In the conclusion, the authors acknowledge that the small number in this case study provide limited information. "While this study, based on small numbers, provides limited evidence in relation to COVID-19 transmission in the school setting, it includes all known cases with school attendance in the Republic of Ireland. The results moreover echo the experience of other countries, where children are not emerging as considerable drivers of transmission of COVID-19." This speaks only to children transmitting in schools, not adult to adult transmission. 

DESE Claim 1 Supported?: limited support with caveats 

DESE Claim 2 Supported?: Yes - in this case study there were no confirmed transmissions.

A Look at DESE's Cited Sources: Footnotes #1, #5, and #57 - What settings have been linked to SARS-CoV-2 transmission clusters?

DESE Claim 1 (footnote #1): “Furthermore, based on available data and effective implementation of critical health and safety practices, the rate of in-school transmissions has been low”

DESE Claim 2 (footnote #5): "Schools do not appear to have played a major role in COVID-19 transmission. In a review of COVID clusters, only 4% (8 of 210) involved school transmission."

DESE Claim 3 (footnote #57): "In a review of COVID-19 clusters, only 4% (8 of 210) involved school transmission."

Cited Source: Leclerc, Q. J., Fuller, N. M., Knight, L. E., Funk, S., Knight, G. M., & CMMID COVID-19 Working Group. (2020). What settings have been linked to SARS-CoV-2 transmission clusters?. Wellcome Open Research, 5(83), 83. Available at https://wellcomeopenresearch.org/articles/5-83/v2

Peer reviewed: one “invited peer reviewer” of updated article (no blind peer review as is standard in most journals)

Study methodology: “We performed a systematic review of available literature and media reports to find settings reported in peer reviewed articles and media with these characteristics. These sources are curated and made available in an editable online database.”. The study only looked at abstracts and articles published in English, which means omission of some clusters has likely occurred.

Notes: Virus is most likely (not exclusively) to be transmitted in hospital and elder care settings. It is important to note that many schools were closed during the period of the study, and three clusters linked to schools were found. “The vast majority of these clusters were associated with indoor or indoor/outdoor settings (21/22).” Schools, as largely indoor settings, could have outbreaks. The authors do not address the fact that schools were largely closed during the study period.

The school clusters, according to the linked data table in the article, had a wide range in the number of cases. “We found only a small number of clusters linked to schools (8/201), and there the SARS-CoV-2 cases reported were most often in teachers or other staff.“ The article notes that in two of the smaller clusters, 7/8 and 16/26 cases were staff. The article also references a French school cluster that included more children than staff.

The study does note that asymptomatic cases are likely underreported. “In many settings, only symptomatic cases of disease severe enough to require hospitalization are tested and ultimately reported. This misses those infections that result in mildly symptomatic or asymptomatic symptoms, although there is mounting evidence for a significant proportion of infections to remain asymptomatic .“ The authors do acknowledge that school data especially may not be complete. “Nor do we have universal screening for detection of all infections, many of which will be asymptomatic. The importance of such universal testing for infection in interpreting whether transmission has occurred in a setting is highlighted by the difference between the low number of clusters linked to schools and the high level of infection reported in one French high school study.”

DESE seems to have missed part of the article towards the end. “More generally, the role of children in widespread transmission of the virus is unclear, and whether reopening schools could trigger increased introductions of the virus into households and further within-household spread will have to be carefully monitored.” In other words, there needs to be more research.

DESE Claim 1 Supported?: No. The authors of the study make no claim about the risk of transmission in schools, only note that so far there have not been a ton of school clusters.

DESE Claim 2 Supported?: No. Limited open schools during the time of the study make the data unable to support or refute the initial claim. The second quoted sentence is true, for the limited dataset which the source works from. However, that doesn't prove that schools won't spread COVID-19 at full capacity when they're open.

DESE Claim 3 Supported?: Yes. However, schools were closed during many of the studies, so this data i not predictive. 

New Series: A Look at DESE's Cited Sources

I'm still livid about that DESE document. Here's my plan to systematically dismantle its claims through science and fact:
1. Read each of the sources they cite
2. Write a brief summary of what they say
3. See if they support the conclusion they're cited for.

So you'll see a bunch of blog posts coming... I'll publish as I finish. I'm still planning to do a deep dive into the COVID-19 research they ignored, but I'm going to go through what they've put out first.

Thoughts on DESE 6/25 reopening guidance

Note: I've been doing a lot more work around education safety lately, but moved it away from this blog. I founded Massachusetts Education Safety Advocacy Group (MESAG) and you can find up-to-date research on the website, Twitter, and Facebook. Please follow, like, and share!

Today (6/25/2020), DESE released initial guidance on school reopening. Here is the link to the full report. Yes, most of this is guidance rather than mandates, but the document is still incredibly problematic.

First, I want to address the obvious: yes, remote learning was challenging for kids, parents, and teachers. Remote learning this year happened with no real transition time, planning time, or coordination between districts. It was chaos. But that's not a reason to send people back into schools when we can't do so safely. There's planning time now. Things can be improved. Remote learning does not have to be a last choice, a disaster, or a problem.

I'll cite multiple studies that DESE left out in a separate post, but for now I'll just say that the DESE report ignored multiple high quality peer-reviewed research studies about COVID-19 transmission. Most of the studies they cite as "proof" are small case studies. Generally, case studies are not generalizable. The report left out many studies in adults. Schools need adults in them. Those adults need to interact (in a physically distanced manner) in order for schools to function. Adult to adult transmission should be a major concern and element of the plan, and it isn't.

This plan has one goal: justify a return to school in the fall. Not use science to determine if a return to school is safe, but justify a conclusion already made. The fact that the medical professionals supposedly consulted for this report have largely not been named speaks volumes.

I did a Twitter thread breaking down issues with the guidance line-by-line with screenshots. The guidance is a mess. So many issues. The largest issue, in my opinion, is the total lack of acknowledgement of the risk staff would face if schools reopen. Teachers did not get into teaching to be exposed to dangerous diseases. It isn't a part of our job. There are no answers in the report about what will be done to protect staff, especially staff who are more vulnerable to COVID-19. The rhetoric is student- and family-centered not because science says it should be, but to appeal to the voting public. This DESE document is political. The press conference today selling the guidance was even more political pandering (Twitter thread on the press conference is here).

Additionally, the guidance is full of unfunded mandates. Yes, it's encouraging to hear that districts can plan on "level services plus" funding, but the reality is that depends on legislature budgets and it may still not be adequate to truly maintain level services and provide all necessary PPE and equipment. Additional training time (which may require adding days to teacher contracts) also add up quickly, and cash-strapped districts are unlikely to be able to shoulder this expense)

The timing of the guidance is also problematic. Most schools are done for the year, meaning that school-year staff (teachers, principals, paraprofessionals, and others) are by contract not currently working. Putting together some semblance of a functional district plan requires input from these groups. They'll now be asked to work unpaid on reopening plans, or districts will have to somehow find the money to pay them for their work. Money that could go towards effective remote learning software, PPE, school staffing, or other things that impact student learning.

Massachusetts can do better. Massachusetts should do better. How can we make them do better? Contact the people in charge! Here's a short list:

Contact Governor Baker's Office (linked form)
Massachusetts Secretary of Education James Peyser: eoe@massmail.state.ma.us
Massachusetts Board of Education: boe@doe.mass.edu
Massachusetts Return to School Working Group: RTSWG@mass.gov

If you're a member of a teacher's union, contact them and demand that they push for staff safety to be a primary concern as more reopening plans are made at the state and local level.

Local level decisions will matter a lot based on this guidance. Pay attention to what school committees and superintendents do in the next two months. Their actions - not their words - are literally a matter of life or death.