Medical experts, educators concerned about mandatory in-person learning

With a pandemic far from under control, Iowans are unsurprisingly concerned about the newest legislation signed into law by Gov. Kim Reynolds last week, that requires all school districts, public and private, have a model for 100 percent in-person learning and provide that option to parents.

The debate was divided between Democrats speaking for teachers and administrators and Republicans focusing on parents who want to decide how their children are educated.

The debate for both bills consisted of Democrats and Republicans talking past each other when explaining the benefits or pointing out the downsides. 

In the Senate, the bill passed along party lines (29-18). In the House, it passed 59-39.

Jan. 26, before the bill was signed, Senate Democrats on the education committee hosted a town hall to explore and address those concerns through expert commentary.

Dr. Megan Srinivas, an infectious disease expert, spoke about the medical risks and potential consequences of this policy. 

Research is finding that children and other asymptomatic carriers may suffer long-term effects like lung and heart damage. -Dr. Megan Srinivas

When it comes to the students, she reminded people that, though children have lower mortality from COVID and their symptoms are often less severe, they still get infected and get sick. 

Srinivas also said research is finding that children and other asymptomatic carriers may suffer long-term effects like lung and heart damage. 

People also need to remember the teenagers, Srinivas said, whose bodies are more similar to adults’ when it comes to COVID, which must be accounted for in any back-to-school plans.

She also pointed out that community spread in Iowa hasn’t gotten better than last summer.

“If we look at our 14-day statewide positivity, in July they were far lower than they are today,” she said. “Today, our state-wide 14-day positivity average is ranging in the 30 percent. That is more than double what our department of education even stated was too high six months ago, seven months ago.”

Last year, Iowa set a threshold of 15 percent positivity in a community to justify schools not teaching in person, a threshold higher than other states in the country.

Entities like the CDC, the WHO and the Harvard Global Health Institute have said 5 percent is a sign that community transmission is under control, Srinivas said.

The most recent CDC guidelines are that schools can operate and reopen safely if the proper precautions like social distancing, classroom ventilation, mask-wearing and regular disinfecting. The agency maintains these measures are the way for schools to reopen safely. 

Srinivas cited a recent study published in the Journal of the American Medical Association (JAMA) that estimated more than half of all COVID transmission comes from people without symptoms, both asymptomatic carriers and people who spread it before they show symptoms (pre-symptomatic carriers).

Thus, they wrote, “The findings of this study suggest that the identification and isolation of persons with symptomatic COVID-19 alone will not control the ongoing spread.”

In addition, JAMA found last year that school closures contributed to reduced mortality and community spread.

“This legislation is making several different dangerous assumptions,” Srinivas said. “Bottom line, there’s a lot to learn and we shouldn’t be using our children as guinea pigs.”

Dr. Eli Perencevich, an infectious disease expert and epidemiologist in Iowa City, focused on the often-cited research suggesting that schools aren’t responsible for most of the COVID spread because it’s usually more complicated than that.

“You have to know that data is incredibly biased,” he said. “We’re not testing kids, and even when we are testing kids almost all the schools they looked at are in some sort of hybrid or reduced attendance model.”

The key to opening schools, Perencevich said, is maintaining social distancing and wearing masks in schools. 

“Unfortunately we know that kids of all ages, particularly probably over the age of six, get equally infected to adults, it’s just subclinical and so they can silently spread the infection,” he said. “We know they bring viruses home. Anyone who’s had little kids knows that they bring it home.”

Subclinical means the disease isn’t severe enough to present symptoms.

This week, the state opened the next phase of vaccinations, which includes educators through the high school level.

In his opening and closing remarks during floor debate on Jan. 28, Sen. Brad Zaun said children benefit from in-person school and many are struggling to keep up with online learning.

“It gives parents the choice, based on what you think is in the best interest of your children,” he said. “Parents are upset. Parents want their kids back in class. They recognize that their kids are falling behind.”

Zaun said he trusts CDC guidance, and understands there are times when a child shouldn’t be in the classroom. 

But ultimately, he said parents should be able to make the decision.

“Who I trust is the parents. I trust their judgement. There’s nothing more local than allowing parents to decide what’s in the best interest of their kids. And we are hurting our kids for not allowing them the option to be in school.”

Senate Democrats mostly talked about the risk to vulnerable school staff and shared stories from schools that already operate in hybrid models or in-person.

The stories featured immunocompromised school staff, parents who had to take off work when their children had to quarantine because of exposure, and threats to students and administrators from other students and parents about not getting tested so sports teams could still play.

Sen. Sarah Trone Garriott read a letter from school nurses who said they missed dealing with lice outbreaks, that their resources are stretched, and that staff is stretched to the point of crying and having panic attacks.

“If we have to be in school, the community has to behave,” she read from the letter. “If we really want to prioritize education then we have to prioritize it. But it’s just about putting bodies back in classrooms.”

Democrat Liz Mathis said this bill presents a timing problem, mostly that this isn’t the right time to talk about bringing all children back to the classroom when most teachers and school staff haven’t been vaccinated.

“Senator Zaun, you are right when you say kids belong in school. You really are,” Mathis said. “But these are very different times.”

She suggested that instead of pushing for in-person instruction now, that the legislature consider special class sessions for this summer, when more people will be vaccinated.

Sen. Zach Wahls also read comments from some of his constituents, including a principal and a teacher who both said each district should be able to decide what learning model works best for their area of Iowa, their buildings and their student and staff population.

They also mentioned the disruption of people being in and out of quarantine protocols and that vaccines for teachers would ease some of the worry.

“Mr. President, there’s a very serious concern in a lot of the districts that have a hybrid model that this bill will actually result in more students learning online than fewer,” Wahls said. 

Andrew Rasmussen, a history teacher at Harding Middle School in Des Moines, explained the difficulties of that. He teaches in a hybrid model and he talked about having a room big enough to fit 16 desks barely six feet apart and being uncertain about its ventilation. Right now, he opens his single window and door to ventilate the room during lunch or breakfast, and hopes it’s enough.

He said this bill could put 25-30 students in his classroom, eliminating the ability to social distance.

“Every week that we’ve been in the hybrid model, we’ve had at least one or two students that are in quarantine protocol because of exposure at home. So that’s even what’s considered a safe model,” Rasmussen said.

The school also lacks substitutes, meaning teachers frequently have cover for absences.

“If we’re going to have full face-to-face, we do not have the staff or the space in that building to be able to spread kids out if we are back in the building full time,” he said.

Ideally, Rasmussen said he’d like to see a push for all school staff to be vaccinated, for increased PPE and more funding toward increasing school staff.

“I would like our governor and our lawmakers to finally take control in this state and promote the stop of the community spread which I’ve seen happening since last March,” Rasmussen said.