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- Hello. I'm Dr. Ron Ron MacTaylor,

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chair of the department
of chemistry and physics

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at Salem State University.

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We welcome Dr. Kristin Pangallo

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who joined the department
of chemistry and physics

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at Salem State almost 10 years ago now.

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First as a full-time
temporary faculty member

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before coming on board tenure track.

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Kristin earned her bachelor's
degree in chemistry

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from Bates College.

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She did her graduate work

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at MIT Woods Hole Oceanographic Institute,

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earning her PhD in chemical oceanography.

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Kristin was a post-doctoral
fellow at Rutgers

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and was a tenure track faculty
member at Colgate University,

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before the irresistible
pull of Salem, Massachusetts

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brought her to us.

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Now a tenured associate
professor at Salem State,

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Kristin responded to another call

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to serve on school committee,

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at the time of her candidacy
a simple time in hindsight,

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her focus was on supporting and
improving our public schools

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for her own children
and all of the city's;

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students, teachers and families.

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Dr. Pangallo has worked tirelessly

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to keep up with the current
research on virus transmission,

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and shares her unique perspective
as a scientist, educator,

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parent, and school committee member.

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Welcome, Kristin, we look
forward to your presentation.

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- Thank you.

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Thank you, Ron for that introduction.

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And now it's my turn to share my screen.

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So, when I was first approached
about doing this webinar

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and doing this presentation,

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I was really flattered and
I wanna thank my department

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and thank Ron MacTaylor for
requesting, but I also was like,

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"Well, what is it that you
wanted me to talk about?"

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And when he suggested the
pandemic response, I thought,

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oh yeah, I could probably
put together a talk on that.

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And they quickly realized

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that I had a lot to say
(chuckles) on this topic.

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And so I appreciate the
opportunity for reflection,

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which I hadn't yet had and the
opportunity to speak today.

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I think it's been quite
a ride as you'll see.

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And I'm just really grateful
for this opportunity.

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So thank you.

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I also wanted to invite
everyone to put in this URL.

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So https://tinyurl.com/PangalloCovidTalk

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and that will bring you
to a Google document

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that has all of the references
that I discuss in this talk,

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as well as a whole bunch of other ones.

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Because as I said, I had a lot to say,

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and I think I ended up,

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hiding or deleting more
of my slides than I kept.

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So let's jump right into it.

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Before we get started,

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I do wanna say that this talk
is given from my perspective

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as a school committee member,

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but it's really only that
role is only one part

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of a much larger group that
work to make this happen.

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And that goes from the city of Salem

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and the mayor's administration
through the district leaders,

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our superintendent, as well
as our building leaders,

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our unions, our staff, our families,

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and of course our students
in our entire community.

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And I think one of the
reasons we've been successful

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is that we share a common goal.

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We share similar mindset

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and we've all really
been pulling together.

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And that's really allowed
us to find success

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in our pandemic response.

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So I just wanna really make
that clear that my role here

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has been a small part
of a much larger whole.

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And as Ron was saying,

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when I first ran first school committee,

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I did include my
perspective as a scientist,

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as part of my pitch for why
people should vote for me.

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But really I emphasized my roles
as a parent and an educator

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because at the time those
seemed much more relevant

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to the service that I would
provide on the school committee.

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Being a scientist kind
of helped me stand out.

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I do think it gives...

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I thought then, I obviously think now,

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it gives me a valuable perspective,

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but I don't think I realized
how integral it would be

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and how I would draw on
my scientific training

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on a day to day basis.

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Because of course, I didn't
see this pandemic coming.

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I don't think any of us really did.

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And I got elected in the fall of 2019.

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And during that election,

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the thing that we were asked a lot about

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is what is the most important thing

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the schools are going to
face over the next few years?

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And I think we all said,

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we have to hire the right superintendent.

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And fortunately we did.

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And the first few months that
I was in office was focused on

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finding and hiring the
superintendent who we did hire.

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And we did find the right person.

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I think Dr. Stevens Zrike
has been an incredible leader

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and partner in this work

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and really grateful that we hired him.

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We selected him in mid-February

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and we signed his contract on March 6th.

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So he has been right in the thick of it,

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along with the rest of us.

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And that date March 6th sticks out

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because I remember after
we signed that contract,

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we sat around in school committee chambers

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with a few other people from the district

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and from the school committee saying,

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we've gotta be ready because
this illness is coming,

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this corona virus thing,

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and the schools need
to be ready to respond.

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Like we had the hand sanitizer,

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but I don't think we knew quite the impact

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it was going to have over the long term.

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As a scientist, I had been
following the emerging science,

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and I'm gonna talk a lot about that.

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And I was starting to see,

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and it was actually after that weekend

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that I really started to realize,

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we're gonna have to shut down our schools.

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And that was a shock

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because I didn't run for school committee

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to close down our school
buildings, quite the opposite.

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But the thing was, is in
March, as we all remember,

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things changed really fast.

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And so I'm showing you
Boston globe headlines

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from the beginning of
March to the end of March.

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And you can see at the beginning,

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it's like all about politics.

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And then it really shifts and
we have the pandemic, it hits,

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we have the outbreaks,
we have the shutdowns,

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we have the states of emergency

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and it happened really, really fast.

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And that's because of exponential growth,

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which is the first topic that
I'm going to discuss here

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because exponential growth

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is something that's not
particularly intuitive.

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We're really used to linear
growth in our day to day lives,

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where you're just like adding
a certain number each time,

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maybe it's slow, maybe it's
fast, but it's predictable.

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Exponential growth is predictable,

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but it's just less intuitive

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and that's because we're multiplying.

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And in this case, I'm forming
exponential growth by doubling

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by multiplying by two.

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But you can obviously do it in other ways.

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And because of my comfort,

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I think with math and Excel
in late February, early March,

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I was able to sit down and
look at some of the information

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coming out about the coronavirus,

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about the pandemic and say, okay,

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if we had this Biogen event,
which you'll all remember,

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probably at the end of February,

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there was a big conference

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and there was a super spreader event.

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And we had from that conference,

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we knew we had a group of people.

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We had actual, we knew who was infected.

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And so we could kind of
predict how many people

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that was going to grow to
if we used the doubling rate

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that the World Health
Organization was providing.

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And so I just kind of plugged that

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into an exponential growth
calculation in Excel.

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And I wanna be really clear.

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This is not a model.

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This is just me playing around in Excel

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and using exponential growth

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and my understanding of Excel and math

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to kind of see where things were headed

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and like start to understand
it and wrap my head around it.

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And what this showed me is
that although the numbers

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were very small in early March,

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they were going to grow incredibly
rapidly to the point that

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they were, we're gonna
have to do something

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and we're probably not gonna be able

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to keep our school buildings open,

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that we knew that this was not
going to exactly come to pass

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because people's behavior would change.

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This doubling rate would change,

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but it actually mimics it

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in the early weeks of the pandemic.

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And this was important because

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when we shut down the schools,
which happened on March 12th,

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there was a lot of talk at that time,

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about two weeks from now,

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this is two weeks, two weeks, two weeks.

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And you could see it really clearly,

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if you looked at the
math that in two weeks,

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things were just gonna be worse

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and on track to be much worse.

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And it was only gonna
get worse after that.

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So I remember at that
meeting on March 12th

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saying repeatedly, this is not two weeks,

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we need to be thinking over the long term.

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And that came from the fact
of just looking at the math

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and understanding that this was already,

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the die was cast and
this was going to happen.

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So there we go.

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Between March 6th and March 11th,

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I worked on a summary document

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to share with my school
committee colleagues

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because we had scheduled
this meeting for March 12th.

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And I initially went into it thinking

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that I was gonna have to convince them

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that we needed to close our schools,

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but by March 10th or 11th, I
think everybody was on board.

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We all knew by that point

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that we would have to close the buildings.

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But what I was still able
to do with that document

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was kind of summarize what
we knew about the virus

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and what was coming out of
the scientific community

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and put it into a form

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that I hoped was easily
accessible for them,

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but also had a bunch of references

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in case they wanted to explore further.

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So here you can see some
things that bubbled up

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out of that research and
these are direct quotes

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from that document that
I sent my colleagues.

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And you can see at this point,

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scientists were already trying
to get people's attention

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that this virus was an aerosolized form,

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that there could be
asymptomatic transmission,

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and that people didn't have fevers.

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So temperature checks might not work,

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that the fatality rate was
obviously higher than flu,

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which I think people
accepted pretty quickly,

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but that people could be infectious

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prior to having symptoms, which
was really, really important

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because that meant that running schools

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was gonna be really tricky.

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But when I was thinking
about this document

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that sent out to my colleagues

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and trying to remember how it was

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that I came up with these
points, these key pieces,

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it was really because of
my scientific training

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in grappling with emerging science.

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And I wanna spend some
time talking about that

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'cause that really come
into play throughout.

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So the thing about emerging science

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is that it's really messy,

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but that's not how science seems

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when you're learning it as a student.

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So we're used to things
like these big textbooks

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that are extremely well organized.

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They're highly edited.

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Things are put into a
very digestible format.

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They make sense.

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One thing follows another,

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and we understand what
we're talking about.

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And that is great.

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And that's also not how

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the process of science actually works.

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00:12:12,680 --> 00:12:17,680
Science is messy and we don't always know

258
00:12:19,864 --> 00:12:21,610
what the end result was going to be.

259
00:12:21,610 --> 00:12:24,800
So I like to think about
emerging science as a puzzle,

260
00:12:24,800 --> 00:12:26,400
and it's a puzzle where you don't know

261
00:12:26,400 --> 00:12:28,190
what that final picture is.

262
00:12:28,190 --> 00:12:32,370
So you're just kind of
trying to figure it out

263
00:12:32,370 --> 00:12:36,290
as you go, further, you
don't have all the pieces yet

264
00:12:36,290 --> 00:12:38,560
because you don't even know

265
00:12:38,560 --> 00:12:41,190
what it is that you're
looking for in some cases,

266
00:12:41,190 --> 00:12:44,730
you're just trying to
figure out what is missing

267
00:12:44,730 --> 00:12:47,680
and what you might wanna explore next.

268
00:12:47,680 --> 00:12:49,940
But in addition to not
having all the pieces,

269
00:12:49,940 --> 00:12:51,730
you have pieces that are raw

270
00:12:51,730 --> 00:12:54,220
mixed in with the pieces that you do have,

271
00:12:54,220 --> 00:12:59,220
because you may have scientific
studies that show something,

272
00:13:00,290 --> 00:13:03,590
but maybe you set out to measure X,

273
00:13:03,590 --> 00:13:05,220
but you actually measured Y

274
00:13:05,220 --> 00:13:07,880
because of some confounding variable.

275
00:13:07,880 --> 00:13:10,310
And that happens in science all the time.

276
00:13:10,310 --> 00:13:13,190
And it doesn't mean that
people did a bad job

277
00:13:13,190 --> 00:13:14,450
or bad science.

278
00:13:14,450 --> 00:13:17,900
It's just the nature of emerging science.

279
00:13:17,900 --> 00:13:22,900
Further because of how
science can be probabilistic,

280
00:13:23,930 --> 00:13:27,320
there can be times when there
are certain sets of studies

281
00:13:27,320 --> 00:13:32,270
or individual studies where
you get a wrong conclusion

282
00:13:32,270 --> 00:13:35,640
and it's not because it was done poorly,

283
00:13:35,640 --> 00:13:40,550
it's just because of the
probabilistic nature of science.

284
00:13:40,550 --> 00:13:42,600
So you've got some wrong pieces

285
00:13:42,600 --> 00:13:46,770
mixed into the incomplete
pieces that you do have.

286
00:13:46,770 --> 00:13:49,040
And finally, when you have this puzzle,

287
00:13:49,040 --> 00:13:52,070
the pieces actually fit
together in different ways.

288
00:13:52,070 --> 00:13:56,010
And until you have the final
puzzle all figured out,

289
00:13:56,010 --> 00:13:59,030
and you understand the system as a whole,

290
00:13:59,030 --> 00:14:00,700
you don't always know

291
00:14:00,700 --> 00:14:03,160
how those pieces are gonna fit together.

292
00:14:03,160 --> 00:14:05,530
So as somebody trained in science,

293
00:14:05,530 --> 00:14:07,790
as somebody who's worked
in emerging science,

294
00:14:07,790 --> 00:14:10,060
who has been part of creating knowledge,

295
00:14:10,060 --> 00:14:13,740
as any scientist will tell
you, this process can be messy,

296
00:14:13,740 --> 00:14:15,980
but when you've been a part of it,

297
00:14:15,980 --> 00:14:17,750
you are more comfortable with it,

298
00:14:17,750 --> 00:14:20,310
and you're more able to digest it

299
00:14:20,310 --> 00:14:22,250
and kind of keep things in perspective

300
00:14:22,250 --> 00:14:26,320
and understand how that system
and how that process works.

301
00:14:26,320 --> 00:14:28,720
And so that was really
one of the key things

302
00:14:28,720 --> 00:14:31,920
that I think I was able to
provide to my colleagues

303
00:14:31,920 --> 00:14:33,323
during this process.

304
00:14:34,220 --> 00:14:38,090
And what I did is, I
would first had questions.

305
00:14:38,090 --> 00:14:40,690
I did what I think most
scientists do, most academics do,

306
00:14:40,690 --> 00:14:42,250
I go to the primary literature

307
00:14:42,250 --> 00:14:46,000
and I wanna read the studies
and see what is coming out,

308
00:14:46,000 --> 00:14:47,830
what people are finding.

309
00:14:47,830 --> 00:14:50,120
And because when you read
the primary literature,

310
00:14:50,120 --> 00:14:52,460
not only do you get to see the data,

311
00:14:52,460 --> 00:14:53,930
you can read the methods

312
00:14:53,930 --> 00:14:55,500
and you can see what the scientist

313
00:14:55,500 --> 00:14:57,680
are saying about their data.

314
00:14:57,680 --> 00:15:00,230
However, when it came to
this primary literature,

315
00:15:00,230 --> 00:15:02,920
I was reading things in
fields of epidemiology,

316
00:15:02,920 --> 00:15:07,920
infectious disease, virology,
areas that I lack expertise.

317
00:15:09,840 --> 00:15:11,650
That means I don't know the context.

318
00:15:11,650 --> 00:15:13,390
I can't always evaluate

319
00:15:13,390 --> 00:15:16,080
whether the method that
they chose was appropriate.

320
00:15:16,080 --> 00:15:18,760
I don't always know the limitations

321
00:15:18,760 --> 00:15:22,190
or whether their interpretations
always follow precisely

322
00:15:22,190 --> 00:15:24,130
from the past data.

323
00:15:24,130 --> 00:15:25,570
So, because I knew that,

324
00:15:25,570 --> 00:15:29,660
and I knew that I was getting
out of my area of expertise.

325
00:15:29,660 --> 00:15:33,050
I really relied on experts in the fields

326
00:15:33,050 --> 00:15:35,710
to help provide that context.

327
00:15:35,710 --> 00:15:39,040
And so expert opinion can
be incredibly valuable

328
00:15:39,040 --> 00:15:41,320
because they are going
to provide the nuance

329
00:15:41,320 --> 00:15:44,890
and perspective that you need
in interpreting these studies

330
00:15:44,890 --> 00:15:47,540
and understanding how
they all fit together

331
00:15:47,540 --> 00:15:50,000
and what they're telling us as a whole.

332
00:15:50,000 --> 00:15:53,230
And I was able to find
through Twitter feeds

333
00:15:53,230 --> 00:15:55,240
and I provide a lot of
different Twitter feeds

334
00:15:55,240 --> 00:15:57,060
on that set of resources.

335
00:15:57,060 --> 00:15:59,110
I'm a big fan of podcasts.

336
00:15:59,110 --> 00:16:02,460
Also grand rounds and
webinars are excellent sources

337
00:16:02,460 --> 00:16:05,810
in information, and often provided

338
00:16:05,810 --> 00:16:09,870
as a form of ongoing learning,
which can be really helpful.

339
00:16:09,870 --> 00:16:11,250
And they're also summaries

340
00:16:11,250 --> 00:16:13,970
and newsletters that people would put out.

341
00:16:13,970 --> 00:16:16,330
So expert opinion was really critical,

342
00:16:16,330 --> 00:16:18,440
but it's important to
remember that experts

343
00:16:18,440 --> 00:16:20,170
are going to have different opinions

344
00:16:20,170 --> 00:16:22,050
and they can both be valid.

345
00:16:22,050 --> 00:16:25,160
You can have two different
people with valid opinions

346
00:16:25,160 --> 00:16:26,520
that don't agree.

347
00:16:26,520 --> 00:16:28,850
And it's really important to see

348
00:16:28,850 --> 00:16:31,710
a lot of different
perspectives and understand

349
00:16:33,280 --> 00:16:35,640
that everybody has their own perspective

350
00:16:35,640 --> 00:16:38,740
based on their training, based
on their area of expertise,

351
00:16:38,740 --> 00:16:40,810
based on their life experience.

352
00:16:40,810 --> 00:16:45,010
And so understanding that
individual experts can be biased.

353
00:16:45,010 --> 00:16:49,040
It's also important to look
for the scientific consensus.

354
00:16:49,040 --> 00:16:52,250
And that means, if you've
got a lot of different people

355
00:16:52,250 --> 00:16:54,030
from lots of different perspective,

356
00:16:54,030 --> 00:16:55,640
lots of different fields,

357
00:16:55,640 --> 00:16:59,800
all converging on this general conclusion,

358
00:16:59,800 --> 00:17:04,800
then you can be much more
confident that that information

359
00:17:05,240 --> 00:17:06,850
is going to be correct.

360
00:17:06,850 --> 00:17:08,060
You've got multiple studies,

361
00:17:08,060 --> 00:17:10,160
you've got multiple specialties,

362
00:17:10,160 --> 00:17:15,160
that gives you a much
stronger faith and knowledge

363
00:17:15,230 --> 00:17:16,880
that that is going to be correct.

364
00:17:18,060 --> 00:17:20,660
The problem here is that
scientific consensus

365
00:17:20,660 --> 00:17:22,920
can also get entrenched.

366
00:17:22,920 --> 00:17:26,910
And we've seen this in
the journey with COVID

367
00:17:26,910 --> 00:17:28,650
in the form of our understanding

368
00:17:28,650 --> 00:17:31,460
of airborne transmission of viruses.

369
00:17:31,460 --> 00:17:33,910
And I'm gonna talk a little
bit about that today.

370
00:17:35,190 --> 00:17:37,780
And that gets me to my
final point on this slide,

371
00:17:37,780 --> 00:17:42,780
that individually all of
these pieces can be wrong.

372
00:17:43,530 --> 00:17:47,100
And so you have to keep in
mind with emerging science

373
00:17:47,100 --> 00:17:49,910
that you might be wrong about something

374
00:17:49,910 --> 00:17:52,120
that seems to be coming up

375
00:17:52,120 --> 00:17:54,170
and if you're wrong, what does that mean?

376
00:17:55,080 --> 00:17:58,330
And I think keeping that
in mind at all times

377
00:17:58,330 --> 00:18:02,120
is also really important
and helps you sort through

378
00:18:02,120 --> 00:18:04,250
what's most likely to be true.

379
00:18:04,250 --> 00:18:06,073
What's a little bit more tenuous.

380
00:18:07,810 --> 00:18:09,520
So excuse me one minute,

381
00:18:09,520 --> 00:18:13,420
little bit of a runny nose
from being out in the cold.

382
00:18:13,420 --> 00:18:16,600
So in the summer of 2020,

383
00:18:16,600 --> 00:18:20,130
we were faced with figuring
out how to return to school.

384
00:18:20,130 --> 00:18:22,890
So this was, we had a closed schools

385
00:18:22,890 --> 00:18:25,390
and now we are shifting towards reopening.

386
00:18:25,390 --> 00:18:28,440
And while I was very focused
on the scientific part,

387
00:18:28,440 --> 00:18:30,600
I think it's really critical to understand

388
00:18:30,600 --> 00:18:33,750
that this was part of a much larger effort

389
00:18:33,750 --> 00:18:37,080
and that the other
aspects of this process,

390
00:18:37,080 --> 00:18:40,810
the logistical aspects,
the communication aspects,

391
00:18:40,810 --> 00:18:42,860
these were absolutely crucial

392
00:18:42,860 --> 00:18:46,010
in the success of bringing
kids back to school.

393
00:18:46,010 --> 00:18:48,950
And so I want to be really
clear on that is that again,

394
00:18:48,950 --> 00:18:51,503
this is one piece of a much larger whole.

395
00:18:53,760 --> 00:18:58,270
All of our work around returning
to our school buildings

396
00:18:58,270 --> 00:19:01,400
was guided by our four
core values of wellness,

397
00:19:01,400 --> 00:19:04,560
equity, community, and flexibility.

398
00:19:04,560 --> 00:19:08,560
And while all of them
are critical and crucial,

399
00:19:08,560 --> 00:19:11,130
I did wanna highlight
in terms of this talk,

400
00:19:11,130 --> 00:19:13,210
the one about flexibility,

401
00:19:13,210 --> 00:19:18,140
because the thing that
understanding emerging science

402
00:19:18,140 --> 00:19:22,300
brought to this particular
discussion was that it was,

403
00:19:22,300 --> 00:19:25,280
the science was going
to continuously change

404
00:19:25,280 --> 00:19:27,110
and that it was going to evolve

405
00:19:27,110 --> 00:19:29,930
and we were going to need
to be responsive to that.

406
00:19:29,930 --> 00:19:34,160
If we wanted to implement
best strategies, we could,

407
00:19:34,160 --> 00:19:37,490
we needed to be responsive to changes

408
00:19:37,490 --> 00:19:41,040
in our understanding of the
virus and its transmission.

409
00:19:41,040 --> 00:19:43,570
And so we were able to emphasize

410
00:19:43,570 --> 00:19:46,100
the importance of flexibility
from the beginning

411
00:19:49,210 --> 00:19:54,210
and that because science changes
over time, it's not a flaw,

412
00:19:54,260 --> 00:19:56,563
it's actually its greatest strength.

413
00:19:58,570 --> 00:20:01,330
So my process through the summer of 2020

414
00:20:01,330 --> 00:20:04,470
and ongoing to today, is to
gather all that information

415
00:20:04,470 --> 00:20:05,750
that I talked about

416
00:20:05,750 --> 00:20:08,720
and then to put it into a
form that would be accessible.

417
00:20:08,720 --> 00:20:11,290
In March, I did that for my
school committee colleagues,

418
00:20:11,290 --> 00:20:12,560
over the summer of 2020,

419
00:20:12,560 --> 00:20:15,880
I did it or my colleagues
on Salem returns.

420
00:20:15,880 --> 00:20:19,850
And specifically I had a
running annotated bibliography

421
00:20:19,850 --> 00:20:24,720
for myself, which is a
strategy I teach my students,

422
00:20:24,720 --> 00:20:27,910
DESE, the department of
elementary and secondary education

423
00:20:27,910 --> 00:20:30,570
released guidelines that I read through.

424
00:20:30,570 --> 00:20:33,650
And I wrote a response
to them for our team,

425
00:20:33,650 --> 00:20:37,780
because I also read through
all of the literature

426
00:20:37,780 --> 00:20:39,290
that they cited in their guidelines.

427
00:20:39,290 --> 00:20:41,980
So I could understand where
they were coming from.

428
00:20:41,980 --> 00:20:43,790
And because I was able to do that,

429
00:20:43,790 --> 00:20:46,010
I could then write a response that said,

430
00:20:46,010 --> 00:20:48,040
in addition to this guidance,

431
00:20:48,040 --> 00:20:49,840
I think we should do these things.

432
00:20:49,840 --> 00:20:52,460
And you'll see how our
implementation differed

433
00:20:52,460 --> 00:20:54,560
than the DESE recommendations.

434
00:20:54,560 --> 00:20:57,050
And I put it all into a four page summary

435
00:20:57,050 --> 00:20:58,800
to make it more digestible.

436
00:20:58,800 --> 00:21:01,940
That was only a piece again of the puzzle.

437
00:21:01,940 --> 00:21:05,460
From there we had to actually
figure out how to implement it

438
00:21:05,460 --> 00:21:09,080
because it's one thing to know
what would be ideal to do.

439
00:21:09,080 --> 00:21:12,520
It's quite another to be
able to make it happen

440
00:21:12,520 --> 00:21:16,810
and figure out the
logistical components there.

441
00:21:16,810 --> 00:21:18,600
And I'll give an example of testing.

442
00:21:18,600 --> 00:21:22,820
In the summer of 2020 I
knew testing was important,

443
00:21:22,820 --> 00:21:25,210
but we had no way to put it in place

444
00:21:25,210 --> 00:21:27,850
because testing was not really available.

445
00:21:27,850 --> 00:21:29,650
And it was when you could get it,

446
00:21:29,650 --> 00:21:33,073
it was incredibly expensive
and we didn't have any money.

447
00:21:34,240 --> 00:21:36,350
So the thing that we were focused on,

448
00:21:36,350 --> 00:21:41,350
where we could make decisions
and really have an effect,

449
00:21:41,830 --> 00:21:45,453
a positive impact, was focused
around keeping the air clean.

450
00:21:49,520 --> 00:21:51,400
So this is getting at...

451
00:21:53,410 --> 00:21:55,480
So while I was saying that
we were really focused

452
00:21:55,480 --> 00:21:56,320
on getting the air clean,

453
00:21:56,320 --> 00:21:59,410
I have to explain too why
this was so important.

454
00:21:59,410 --> 00:22:02,250
And it was because there was
some entrenched knowledge

455
00:22:02,250 --> 00:22:04,090
about how viruses were transmitted.

456
00:22:04,090 --> 00:22:06,820
If you remember wiping down surfaces,

457
00:22:06,820 --> 00:22:10,220
washing hands, all the hand sanitizer,

458
00:22:10,220 --> 00:22:13,070
those things are important in
terms of disease prevention,

459
00:22:13,070 --> 00:22:15,380
but not necessarily the specific way

460
00:22:15,380 --> 00:22:17,260
that this virus transmits,

461
00:22:17,260 --> 00:22:20,930
this virus seems to primarily
transmit through the air

462
00:22:20,930 --> 00:22:22,300
and through aerosols,

463
00:22:22,300 --> 00:22:24,010
which are these tiny little particles

464
00:22:24,010 --> 00:22:27,420
that can stay suspended
in air over the long term.

465
00:22:27,420 --> 00:22:30,610
And prior to COVID, I think many people,

466
00:22:30,610 --> 00:22:35,330
most people didn't appreciate the extent

467
00:22:35,330 --> 00:22:39,760
that viruses could transmit
via the airborne route.

468
00:22:39,760 --> 00:22:42,460
And there's actually been quite a change

469
00:22:42,460 --> 00:22:46,500
in how we view this as a community.

470
00:22:46,500 --> 00:22:48,780
And within the scientific community

471
00:22:48,780 --> 00:22:50,210
and the medical community,

472
00:22:50,210 --> 00:22:52,190
there's been a change in that too.

473
00:22:52,190 --> 00:22:56,790
And there were a number of
specialists in indoor air quality

474
00:22:56,790 --> 00:23:00,260
and aerosol science and viral transmission

475
00:23:00,260 --> 00:23:03,840
who worked diligently through
the spring and summer of 2020,

476
00:23:03,840 --> 00:23:08,290
and continue to this day to
make sure that people understand

477
00:23:08,290 --> 00:23:10,590
how this virus is actually transmitting.

478
00:23:10,590 --> 00:23:14,490
And it is through the
air, COVID is airborne.

479
00:23:14,490 --> 00:23:18,050
And so in order to prevent
transmission in a space,

480
00:23:18,050 --> 00:23:20,650
we need to ensure a few things,

481
00:23:20,650 --> 00:23:23,943
ventilation, filtration, and masks.

482
00:23:25,310 --> 00:23:28,070
Obviously we would also
ideally like to keep out

483
00:23:28,070 --> 00:23:29,980
anybody who is infected,

484
00:23:29,980 --> 00:23:33,700
but we're recognizing that
that might not be possible,

485
00:23:33,700 --> 00:23:36,570
that inevitably there are
going to be some people

486
00:23:36,570 --> 00:23:40,363
who are asymptomatic and who
are infected and don't know it.

487
00:23:42,120 --> 00:23:43,650
In order to keep the air clean,

488
00:23:43,650 --> 00:23:46,550
we need to work on these three components.

489
00:23:46,550 --> 00:23:47,670
So with ventilation,

490
00:23:47,670 --> 00:23:50,010
you are removing particles from the air,

491
00:23:50,010 --> 00:23:53,740
you're removing dirty air and
replacing it with clean air

492
00:23:53,740 --> 00:23:56,910
that can be done through HVAC systems

493
00:23:56,910 --> 00:23:58,350
or even through open windows,

494
00:23:58,350 --> 00:24:00,650
as you'll see, they can
make a big difference.

495
00:24:00,650 --> 00:24:05,450
Filtration, you clean the air
through filters and masks,

496
00:24:05,450 --> 00:24:07,690
which we've all heard about quite a bit.

497
00:24:07,690 --> 00:24:09,310
And I'll talk even more about

498
00:24:09,310 --> 00:24:11,593
'cause everybody loves masks, I'm sure.

499
00:24:13,710 --> 00:24:18,560
One of the things that I was
able to use right off the bat

500
00:24:18,560 --> 00:24:23,560
was this idea that we can use
CO2 or carbon dioxide as a way

501
00:24:23,720 --> 00:24:26,540
of assessing ventilation in a space.

502
00:24:26,540 --> 00:24:30,180
And that's because carbon
dioxide can be a proxy

503
00:24:30,180 --> 00:24:33,213
or a standing for aerosolized particles.

504
00:24:34,490 --> 00:24:39,170
This proxy relies on
mass balance equations

505
00:24:39,170 --> 00:24:42,210
to make some calculations around

506
00:24:42,210 --> 00:24:43,880
what the final concentration would be.

507
00:24:43,880 --> 00:24:45,900
I'm not gonna get into all those details.

508
00:24:45,900 --> 00:24:48,410
But my training in chemical oceanography

509
00:24:48,410 --> 00:24:52,350
actually prepared me really
well for this particular area

510
00:24:52,350 --> 00:24:54,850
because I'm very
accustomed to using proxies

511
00:24:54,850 --> 00:24:58,020
and also very accustomed to
using mass balance calculations.

512
00:24:58,020 --> 00:25:00,270
So all of this made a lot of sense to me

513
00:25:00,270 --> 00:25:02,410
and I could see its power immediately,

514
00:25:02,410 --> 00:25:04,950
as soon as I first read about it.

515
00:25:04,950 --> 00:25:08,200
And here's how it works,
in our exhaled breath,

516
00:25:08,200 --> 00:25:09,480
when we breathe out,

517
00:25:09,480 --> 00:25:14,260
there's about 35 to 50,000
thousand parts per million

518
00:25:14,260 --> 00:25:16,730
of carbon dioxide in our breath.

519
00:25:16,730 --> 00:25:18,860
There's also the aerosols

520
00:25:18,860 --> 00:25:21,570
that if we're infected
can contain the virus.

521
00:25:21,570 --> 00:25:24,173
So in a closed space over time,

522
00:25:25,170 --> 00:25:27,060
when you have more people in a space

523
00:25:27,060 --> 00:25:28,970
and over a longer period of time,

524
00:25:28,970 --> 00:25:32,450
the amount of carbon dioxide
in that space will rise

525
00:25:32,450 --> 00:25:35,220
as will the amount of aerosols.

526
00:25:35,220 --> 00:25:37,520
And so carbon dioxide is telling us

527
00:25:37,520 --> 00:25:39,410
when we have a lot of aerosols around

528
00:25:39,410 --> 00:25:42,660
because the physics is
kind of similar of the two.

529
00:25:42,660 --> 00:25:45,910
And when you ventilate that
room or you remove the old air

530
00:25:45,910 --> 00:25:47,820
and replace it with fresh air,

531
00:25:47,820 --> 00:25:50,620
the carbon dioxide concentration will fall

532
00:25:50,620 --> 00:25:53,443
and the aerosols will also be removed.

533
00:25:54,420 --> 00:25:58,430
And so we can ventilate
our rooms with HVAC systems

534
00:25:58,430 --> 00:26:02,800
or by opening windows to
replace that re breathed air

535
00:26:02,800 --> 00:26:06,610
with fresh air and lower those
carbon dioxide concentrations

536
00:26:06,610 --> 00:26:11,100
which tells us at the aerosol
concentrations are also lower.

537
00:26:11,100 --> 00:26:14,480
And so a good rule of thumb
that I like comes from a webinar

538
00:26:14,480 --> 00:26:18,430
given last summer from an
expert in indoor air quality,

539
00:26:18,430 --> 00:26:20,950
and aerosols is that if
you can keep that CO2

540
00:26:20,950 --> 00:26:23,820
under 900 parts per million, that's great.

541
00:26:23,820 --> 00:26:25,940
It should not exceed
1200 parts per million.

542
00:26:25,940 --> 00:26:27,400
And there's a lot of research showing

543
00:26:27,400 --> 00:26:30,660
that classrooms can
have CO2 concentrations

544
00:26:30,660 --> 00:26:33,510
of 2,000, 4,000 parts per million,

545
00:26:33,510 --> 00:26:35,260
which is really very high

546
00:26:35,260 --> 00:26:38,633
and explains a lot of
respiratory virus transmission.

547
00:26:40,150 --> 00:26:42,330
So we wanna keep it under
900 parts per million,

548
00:26:42,330 --> 00:26:44,150
but closer to four parts per million

549
00:26:44,150 --> 00:26:47,143
or outside air is better here.

550
00:26:47,143 --> 00:26:50,640
Here you can see, this is
my trustee CO2 monitor.

551
00:26:50,640 --> 00:26:52,270
It's an Aranet4, I really like it.

552
00:26:52,270 --> 00:26:54,500
It's small and easy to use.

553
00:26:54,500 --> 00:26:56,870
But you can see that
the values I have here

554
00:26:56,870 --> 00:26:59,700
that I'm registering in
classrooms are relatively low.

555
00:26:59,700 --> 00:27:02,570
Well under 900 parts per million,

556
00:27:02,570 --> 00:27:03,530
and this is what we found

557
00:27:03,530 --> 00:27:05,540
in most of our classrooms with windows.

558
00:27:05,540 --> 00:27:09,310
So you get a classroom, the windows open,

559
00:27:09,310 --> 00:27:11,500
the carbon dioxide is usually fine,

560
00:27:11,500 --> 00:27:13,990
showing absolutely great ventilation.

561
00:27:13,990 --> 00:27:15,520
There were some classrooms,

562
00:27:15,520 --> 00:27:17,420
especially if the windows were closed,

563
00:27:17,420 --> 00:27:21,820
where we saw that they were had
higher concentrations of CO2

564
00:27:21,820 --> 00:27:24,040
indicating that there
could be more aerosols.

565
00:27:24,040 --> 00:27:26,890
And so when I opened one of those windows

566
00:27:26,890 --> 00:27:30,180
and came back 10 minutes later,
I was able to see that yep,

567
00:27:30,180 --> 00:27:34,170
that concentration fell and
was into a better range,

568
00:27:34,170 --> 00:27:37,360
but you can also see
that that range is still

569
00:27:37,360 --> 00:27:40,440
kind of on the high side, closer to 900.

570
00:27:40,440 --> 00:27:43,110
And that's probably because we were using

571
00:27:43,110 --> 00:27:46,360
some amount of recirculated
air in our buildings,

572
00:27:46,360 --> 00:27:49,350
meaning the air was not
replaced with fresh air,

573
00:27:49,350 --> 00:27:51,980
but was passing through
filters and being reclaimed.

574
00:27:51,980 --> 00:27:55,620
And those filters were not
MERV 13, which is the threshold

575
00:27:55,620 --> 00:27:58,210
that we really want to see for viruses.

576
00:27:58,210 --> 00:28:01,320
But that was because of the
systems that we had in place.

577
00:28:01,320 --> 00:28:03,560
So in addition to opening windows,

578
00:28:03,560 --> 00:28:06,170
which aren't always is
an option in every room,

579
00:28:06,170 --> 00:28:08,930
you can clean the air with filters.

580
00:28:08,930 --> 00:28:12,200
And so what we are looking for in filters,

581
00:28:12,200 --> 00:28:14,913
you wanna have a HEPA-based air purifier,

582
00:28:14,913 --> 00:28:19,600
a HEPA filter is the kind of
filter that you want to have

583
00:28:19,600 --> 00:28:22,020
and you wanna have it as
part of an air purifier.

584
00:28:22,020 --> 00:28:23,440
So what you're looking for is something

585
00:28:23,440 --> 00:28:25,950
with a high clean air delivery rate,

586
00:28:25,950 --> 00:28:27,380
that's size appropriate,

587
00:28:27,380 --> 00:28:30,917
and they're all rated for
a certain square footage

588
00:28:30,917 --> 00:28:32,440
and also something that's quiet.

589
00:28:32,440 --> 00:28:34,700
'Cause we're talking about classrooms.

590
00:28:34,700 --> 00:28:36,600
You don't want the
teacher having to compete

591
00:28:36,600 --> 00:28:38,360
with the air purifier.

592
00:28:38,360 --> 00:28:40,830
You want to avoid things
that have ionizers

593
00:28:40,830 --> 00:28:43,200
and ozone and other bells and whistles.

594
00:28:43,200 --> 00:28:44,850
For one thing, they're more expensive.

595
00:28:44,850 --> 00:28:47,560
You don't want to have to pay for that.

596
00:28:47,560 --> 00:28:52,000
But also those are putting
things into the air

597
00:28:52,000 --> 00:28:54,580
and we don't wanna have
to think about the safety

598
00:28:54,580 --> 00:28:57,480
of the ions or the ozone,
that that could be a problem.

599
00:28:57,480 --> 00:29:01,400
So we really wanna focus on
HEPA-based air purifiers.

600
00:29:01,400 --> 00:29:03,830
And if you can't get
commercially available ones,

601
00:29:03,830 --> 00:29:05,530
you can actually make your own.

602
00:29:05,530 --> 00:29:10,530
These DIY HEPA purifiers are
incredibly, incredibly good.

603
00:29:11,370 --> 00:29:13,810
In fact, in preparing for this talk,

604
00:29:13,810 --> 00:29:16,480
I was seeing some research
showing that these have better

605
00:29:16,480 --> 00:29:19,740
clean air delivery rates
than many commercial devices.

606
00:29:19,740 --> 00:29:22,410
So I'm actually thinking
that we need to install

607
00:29:22,410 --> 00:29:26,300
some of these in our cafeterias

608
00:29:26,300 --> 00:29:28,480
to are really help clean
the air in the cafeterias,

609
00:29:28,480 --> 00:29:30,210
especially in these cold winter months,

610
00:29:30,210 --> 00:29:31,900
when we do have kids eating indoors,

611
00:29:31,900 --> 00:29:34,340
which is the most risky time,

612
00:29:34,340 --> 00:29:38,100
because that is of course,
when they take off their masks.

613
00:29:38,100 --> 00:29:41,380
And I don't wanna spend too
much time talking about masks.

614
00:29:41,380 --> 00:29:43,560
I am keeping my eye on the time,

615
00:29:43,560 --> 00:29:45,670
we have already talked about them a lot,

616
00:29:45,670 --> 00:29:49,280
but I do wanna talk a little
bit about filtration with masks

617
00:29:49,280 --> 00:29:54,280
and why melt blown
materials are so helpful.

618
00:29:54,740 --> 00:29:56,240
Oops.

619
00:29:56,240 --> 00:30:01,200
So melt blow, these surgical
masks and N95, KN95s.

620
00:30:01,200 --> 00:30:04,310
They are made out of material
that's not a woven material,

621
00:30:04,310 --> 00:30:07,550
but it's actually this
thing called melt blown.

622
00:30:07,550 --> 00:30:10,010
And it results in these layers of fibers

623
00:30:10,010 --> 00:30:11,840
that are interlocking and intersecting,

624
00:30:11,840 --> 00:30:16,770
making up kind of like a
funnel web of these fibers.

625
00:30:16,770 --> 00:30:21,730
And they don't work just by
sieving out for particles.

626
00:30:22,570 --> 00:30:24,780
They actually are sticky.

627
00:30:24,780 --> 00:30:27,170
And so when the particles hit the fibers,

628
00:30:27,170 --> 00:30:28,823
they're going to stick to it.

629
00:30:30,170 --> 00:30:31,790
And it's from dispersion forces

630
00:30:31,790 --> 00:30:33,960
or Van der Waals forces.

631
00:30:33,960 --> 00:30:36,370
They're also electrostatically charged.

632
00:30:36,370 --> 00:30:39,610
And so as the particle is
moving through the mask,

633
00:30:39,610 --> 00:30:43,230
it's gonna get attracted to
the fibers that are charged.

634
00:30:43,230 --> 00:30:44,910
And then of course they'll stick.

635
00:30:44,910 --> 00:30:49,910
And so these type of material
is much more effective

636
00:30:50,480 --> 00:30:52,083
than any cloth mask.

637
00:30:52,980 --> 00:30:57,980
However, N95, KN95s are disposable masks

638
00:30:58,170 --> 00:31:01,360
that even though they're
disposable, they can be reused.

639
00:31:01,360 --> 00:31:03,170
What you wanna, you wanna let them dry.

640
00:31:03,170 --> 00:31:05,520
You can hang them or
place them in a paper bag

641
00:31:05,520 --> 00:31:08,420
and you can use them until
they're soiled or they break.

642
00:31:08,420 --> 00:31:11,970
So this is kind of the setup
that we have in my house,

643
00:31:11,970 --> 00:31:14,410
my children, however, this was a Wednesday

644
00:31:14,410 --> 00:31:15,270
when I took the picture

645
00:31:15,270 --> 00:31:17,110
and you can see they took
from the Monday hook.

646
00:31:17,110 --> 00:31:20,563
So we're getting there, but
we're not quite there yet.

647
00:31:22,110 --> 00:31:25,719
So coming back in the fall of 2020,

648
00:31:25,719 --> 00:31:30,040
DESE guidance was kind of,
it was based on these myths

649
00:31:30,040 --> 00:31:31,870
of airborne transmission that we now know,

650
00:31:31,870 --> 00:31:34,050
aren't really true,

651
00:31:34,050 --> 00:31:36,700
that we hadn't really
grappled with this idea

652
00:31:36,700 --> 00:31:38,890
of aerosolized virus yet.

653
00:31:38,890 --> 00:31:40,960
And so they said consider different ways

654
00:31:40,960 --> 00:31:42,610
to increase ventilation.

655
00:31:42,610 --> 00:31:44,930
They didn't really talk about filtration.

656
00:31:44,930 --> 00:31:47,813
And for masking, they
recommended second grade and up.

657
00:31:48,780 --> 00:31:51,630
We in Salem, however, we made sure

658
00:31:51,630 --> 00:31:54,870
that all of our HVAC systems
were repaired and upgraded.

659
00:31:54,870 --> 00:31:56,940
We made sure that all of our classrooms

660
00:31:56,940 --> 00:32:00,470
where we had students
had HEPA air purifiers

661
00:32:00,470 --> 00:32:03,133
and we had universal
masking from the get go.

662
00:32:04,840 --> 00:32:07,160
So, as I said earlier in the talk,

663
00:32:07,160 --> 00:32:09,030
one thing that I wanted to put in place

664
00:32:09,030 --> 00:32:10,450
right away was testing.

665
00:32:10,450 --> 00:32:12,720
I teach analytical chemistry.

666
00:32:12,720 --> 00:32:14,100
I love testing.

667
00:32:14,100 --> 00:32:15,990
I think it's really critical,

668
00:32:15,990 --> 00:32:18,163
but it was really hard to put in place.

669
00:32:19,430 --> 00:32:22,340
And that's probably why
DESE didn't recommend it.

670
00:32:22,340 --> 00:32:25,090
It's guidance actually said
testing is not recommended.

671
00:32:26,880 --> 00:32:30,310
However, based on what
I know about testing

672
00:32:30,310 --> 00:32:33,410
and what we were reading
from epidemiologists

673
00:32:33,410 --> 00:32:34,820
and other experts,

674
00:32:34,820 --> 00:32:37,220
is that testing was a
really important part

675
00:32:37,220 --> 00:32:40,560
of bringing students back into classrooms

676
00:32:40,560 --> 00:32:43,450
and that you could use
different strategies

677
00:32:43,450 --> 00:32:45,600
and different techniques
to make it happen.

678
00:32:46,720 --> 00:32:50,320
But first let's talk about
why testing was so necessary.

679
00:32:50,320 --> 00:32:53,830
And this gets into the
dynamics of this virus.

680
00:32:53,830 --> 00:32:58,600
So when you are infected with a virus,

681
00:32:58,600 --> 00:33:01,130
it goes into your cells and it replicates.

682
00:33:01,130 --> 00:33:04,070
And it takes a while this incubation time

683
00:33:04,070 --> 00:33:06,690
between when you're infected or exposed

684
00:33:06,690 --> 00:33:09,730
and when you actually
become infectious to others.

685
00:33:09,730 --> 00:33:11,220
So you have to reach some point

686
00:33:11,220 --> 00:33:12,700
of having enough virus in you

687
00:33:12,700 --> 00:33:15,940
that you can start to
give it to somebody else.

688
00:33:15,940 --> 00:33:18,500
And so then you have
this infectious period

689
00:33:18,500 --> 00:33:19,860
where your virus overload goes up

690
00:33:19,860 --> 00:33:22,660
and your immune system kicks
in and then gets rid of it.

691
00:33:23,720 --> 00:33:25,830
But you have an infectious period

692
00:33:25,830 --> 00:33:27,870
and that doesn't necessarily overlap

693
00:33:27,870 --> 00:33:29,150
with the symptomatic period.

694
00:33:29,150 --> 00:33:32,190
And we know that we have this window

695
00:33:32,190 --> 00:33:36,170
where you are infectious, but
you're not yet symptomatic.

696
00:33:36,170 --> 00:33:41,050
And further we know that some
people never are symptomatic.

697
00:33:41,050 --> 00:33:45,460
And so if you don't have
testing, that's a problem.

698
00:33:45,460 --> 00:33:48,940
However, testing and at the time,

699
00:33:48,940 --> 00:33:52,310
all that we really had
access to is PCR testing,

700
00:33:52,310 --> 00:33:55,920
requires trained analysts,
expensive instrumentation,

701
00:33:55,920 --> 00:34:00,020
multiple reagents, and a lot of time.

702
00:34:00,020 --> 00:34:02,840
And so that's a bit of a conundrum

703
00:34:02,840 --> 00:34:07,190
because as trying to provide
testing for public schools,

704
00:34:07,190 --> 00:34:10,870
we don't have a lot of time,
we don't have a lot of money.

705
00:34:10,870 --> 00:34:13,820
It was a bit of a problem,
but again, without it,

706
00:34:13,820 --> 00:34:17,263
we don't know who's
infected and who's not.

707
00:34:19,020 --> 00:34:21,940
So what we did is we joined
up with a collaborative

708
00:34:21,940 --> 00:34:24,950
that was working on implementing
testing in the schools.

709
00:34:24,950 --> 00:34:27,890
And this originally formed
from parent scientists

710
00:34:29,491 --> 00:34:34,491
in Wellesley and Newton, and
some of those other districts

711
00:34:34,870 --> 00:34:37,600
in the Metro west part of the state.

712
00:34:37,600 --> 00:34:41,990
But they very quickly started
reaching to other districts.

713
00:34:41,990 --> 00:34:45,520
And we worked up with
them in October of 2020.

714
00:34:45,520 --> 00:34:48,800
And we modeled our initial
program on that of Wellesley.

715
00:34:48,800 --> 00:34:51,740
And Wellesley was incredibly
generous in helping us

716
00:34:51,740 --> 00:34:53,610
get that initial program off the ground.

717
00:34:53,610 --> 00:34:58,070
So that by November, we were
offering testing for our staff

718
00:34:58,070 --> 00:35:01,080
and then our high school students.

719
00:35:01,080 --> 00:35:04,410
And we used pooled testing to do this.

720
00:35:04,410 --> 00:35:09,270
So pool testing works by
having multiple people

721
00:35:09,270 --> 00:35:11,300
all take their sample.

722
00:35:11,300 --> 00:35:13,240
And then for example, here it's swabs.

723
00:35:13,240 --> 00:35:16,950
So nasal swabs, putting
the swabs into one tube,

724
00:35:16,950 --> 00:35:21,950
that tube is the pool and you
test the pool for the virus.

725
00:35:22,230 --> 00:35:26,310
If the pool is negative,
that means that those people

726
00:35:26,310 --> 00:35:28,130
don't have the virus in their nose.

727
00:35:28,130 --> 00:35:30,130
And then you know.

728
00:35:30,130 --> 00:35:32,520
If the pool is positive, then you say, ah,

729
00:35:32,520 --> 00:35:36,730
at least one of those people
who put their swab in there,

730
00:35:36,730 --> 00:35:38,530
at least one of them must be positive.

731
00:35:38,530 --> 00:35:41,570
So then you have to use reflex testing.

732
00:35:41,570 --> 00:35:43,790
You go back and you
find that positive case.

733
00:35:43,790 --> 00:35:47,173
And we often use rapid
tests for reflex testing.

734
00:35:48,672 --> 00:35:52,490
So pool testing allows us
to test a lot of people

735
00:35:52,490 --> 00:35:56,290
in a short amount of time
with a lot less money.

736
00:35:56,290 --> 00:35:58,690
Further, it allowed, at the time testing

737
00:35:58,690 --> 00:36:00,547
was kind of a limited resource

738
00:36:00,547 --> 00:36:03,380
and it allowed us to use those resources

739
00:36:03,380 --> 00:36:05,493
much more efficiently.

740
00:36:06,530 --> 00:36:09,340
So we started off with that
saliva based testing program

741
00:36:09,340 --> 00:36:12,220
in November for staff
and then our high school.

742
00:36:12,220 --> 00:36:15,450
We also used it when we
returned from winter break,

743
00:36:15,450 --> 00:36:18,080
that first week after break,
we kept everybody remote

744
00:36:18,080 --> 00:36:19,750
and made testing available.

745
00:36:19,750 --> 00:36:22,150
And we made it available to our staff,

746
00:36:22,150 --> 00:36:23,970
our students and their families.

747
00:36:23,970 --> 00:36:27,550
We did over 2000 tests and caught 30 cases

748
00:36:27,550 --> 00:36:29,670
that we were able to keep
out of our school buildings,

749
00:36:29,670 --> 00:36:30,983
just in that one week.

750
00:36:32,140 --> 00:36:35,450
We also had a citizen science
program, which was awesome,

751
00:36:35,450 --> 00:36:38,530
where our middle school students
worked with Gingko Bioworks

752
00:36:38,530 --> 00:36:41,700
on their pool testing program
before they rolled it out.

753
00:36:41,700 --> 00:36:43,350
It's now a national program.

754
00:36:43,350 --> 00:36:46,560
And there's a video in my Google Doc

755
00:36:46,560 --> 00:36:49,100
with a link that they made,

756
00:36:49,100 --> 00:36:50,860
link to the video that
Gingko Bioworks made,

757
00:36:50,860 --> 00:36:51,823
that's really cool.

758
00:36:52,680 --> 00:36:55,300
And we also put in place
testing in our elementary

759
00:36:55,300 --> 00:36:56,340
and middle schools.

760
00:36:56,340 --> 00:36:58,830
So this pool testing,
initially independent.

761
00:36:58,830 --> 00:37:01,500
And then when the state decided

762
00:37:01,500 --> 00:37:05,320
to put in place their own
testing program, which was great,

763
00:37:05,320 --> 00:37:07,550
we started to do the state program

764
00:37:07,550 --> 00:37:10,610
because they provided
resources to do that.

765
00:37:10,610 --> 00:37:14,170
Our initial investments here
came from the city of Salem

766
00:37:14,170 --> 00:37:16,250
and so big shout out to Mayor Driscoll

767
00:37:16,250 --> 00:37:18,960
and her administration
for helping to fund this

768
00:37:18,960 --> 00:37:20,053
and make this happen.

769
00:37:22,192 --> 00:37:24,400
The past school year,

770
00:37:24,400 --> 00:37:27,740
we've had an increasing
reliance on rapid antigen tests.

771
00:37:27,740 --> 00:37:28,770
And I'm gonna talk about those

772
00:37:28,770 --> 00:37:30,610
'cause they're really important.

773
00:37:30,610 --> 00:37:33,960
We have continued to
do pooled PCR testing,

774
00:37:33,960 --> 00:37:36,510
and now we're doing
once a week rapid tests

775
00:37:36,510 --> 00:37:38,593
where students get them to do at home.

776
00:37:39,810 --> 00:37:42,330
We also used rapid test
as part of our test

777
00:37:42,330 --> 00:37:43,990
and stay program in the fall.

778
00:37:43,990 --> 00:37:46,830
So that was a great program
that allowed students

779
00:37:46,830 --> 00:37:48,320
to avoid quarantining.

780
00:37:48,320 --> 00:37:51,390
So if you were exposed
to somebody with COVID,

781
00:37:51,390 --> 00:37:53,990
but you didn't have COVID,

782
00:37:53,990 --> 00:37:56,430
you did a rapid test each morning

783
00:37:56,430 --> 00:37:58,340
for your quarantine period.

784
00:37:58,340 --> 00:38:00,190
And if your rapid test was negative,

785
00:38:00,190 --> 00:38:03,350
you could just go about
your school day as normal.

786
00:38:03,350 --> 00:38:05,730
Obviously if positive, you went home,

787
00:38:05,730 --> 00:38:07,790
but this allowed students to be in school

788
00:38:07,790 --> 00:38:08,890
rather than in quarantine,

789
00:38:08,890 --> 00:38:12,960
which got us back so many in person days.

790
00:38:12,960 --> 00:38:13,793
It was wonderful.

791
00:38:13,793 --> 00:38:14,813
Thousands of days.

792
00:38:15,910 --> 00:38:19,050
Finally, in January of 2022,

793
00:38:19,050 --> 00:38:21,680
we implemented a test to return program.

794
00:38:21,680 --> 00:38:23,700
And I'm gonna talk about
that in a little bit,

795
00:38:23,700 --> 00:38:28,500
but first I want to
talk about rapid tests.

796
00:38:28,500 --> 00:38:33,380
Rapid tests are amazing
tools in our COVID toolbox.

797
00:38:33,380 --> 00:38:35,650
I think they're a little
bit maligned though.

798
00:38:35,650 --> 00:38:38,740
So I wanna make sure that
everybody understands

799
00:38:38,740 --> 00:38:43,740
why rapid tests are incredibly
useful and powerful tools.

800
00:38:47,700 --> 00:38:50,640
So this article that I have an image from

801
00:38:50,640 --> 00:38:52,900
and I'm studying here is by Michael Minna,

802
00:38:52,900 --> 00:38:55,160
who is probably the
person who's done the most

803
00:38:55,160 --> 00:38:58,490
to get the word out about
the power of rapid tests.

804
00:38:58,490 --> 00:39:00,880
He published this in the summer of 2020,

805
00:39:00,880 --> 00:39:03,980
and it's continues to be really helpful.

806
00:39:03,980 --> 00:39:07,300
So what we have to think
about with rapid tests is that

807
00:39:07,300 --> 00:39:09,900
we think about PCR as the gold standard,

808
00:39:09,900 --> 00:39:13,920
but we know that with
PCR, it takes you a while.

809
00:39:13,920 --> 00:39:17,000
If you're not gonna probably
go and get a PCR all the time,

810
00:39:17,000 --> 00:39:18,470
if you start to feel sick,

811
00:39:18,470 --> 00:39:21,450
then you'll schedule your PCR
and then you go to your PCR

812
00:39:21,450 --> 00:39:23,580
and then you get your PCR data back.

813
00:39:23,580 --> 00:39:25,960
It could be a week between

814
00:39:25,960 --> 00:39:28,260
when you first start to feel a little off

815
00:39:28,260 --> 00:39:30,950
and when you finally learn
if you have the virus or not.

816
00:39:30,950 --> 00:39:34,840
Rapid antigen tests allow us
to make decisions in real time

817
00:39:34,840 --> 00:39:37,230
and are incredibly powerful for that.

818
00:39:37,230 --> 00:39:40,830
They also are able to be,

819
00:39:40,830 --> 00:39:43,840
they turn positive in
that infectious window

820
00:39:43,840 --> 00:39:45,500
that I talked about before.

821
00:39:45,500 --> 00:39:49,890
Now that overlap isn't perfect
but it's really, really good.

822
00:39:49,890 --> 00:39:54,807
And it can tell you if you
are infectious with the virus.

823
00:39:54,807 --> 00:39:55,640
And the thing is,

824
00:39:55,640 --> 00:39:59,540
is that the rapid antigen
test are incredibly accurate

825
00:39:59,540 --> 00:40:03,910
at these high viral loads
when you are most infectious.

826
00:40:03,910 --> 00:40:05,530
Another piece that's really helpful

827
00:40:05,530 --> 00:40:07,460
with the rapid antigen tests

828
00:40:07,460 --> 00:40:09,750
is that they stop being positive

829
00:40:09,750 --> 00:40:12,253
at the end of that infectious window.

830
00:40:13,340 --> 00:40:15,940
And that's really important
for this idea behind tests

831
00:40:15,940 --> 00:40:19,670
to return, because with the DESE guidance,

832
00:40:19,670 --> 00:40:22,950
which is based on the CDC, it
said to isolate for five days,

833
00:40:22,950 --> 00:40:26,400
and then you can return as long
as your symptoms are absent

834
00:40:26,400 --> 00:40:28,600
or resolving and you mask.

835
00:40:28,600 --> 00:40:31,233
Well coming in a school situation,

836
00:40:32,845 --> 00:40:35,450
saying, symptoms are resolving,
that's really nebulous.

837
00:40:35,450 --> 00:40:36,720
How do we determine that?

838
00:40:36,720 --> 00:40:40,700
How do we know if students
symptoms are better

839
00:40:40,700 --> 00:40:42,150
or resolving or not.

840
00:40:42,150 --> 00:40:46,600
Also trying to guarantee
a student using a mask

841
00:40:46,600 --> 00:40:49,490
consistently through that
period is really difficult

842
00:40:49,490 --> 00:40:52,520
because our littlest students,

843
00:40:52,520 --> 00:40:55,790
they do a great job with the
masks but they're not perfect.

844
00:40:55,790 --> 00:40:58,330
Further they can't wear N95 masks

845
00:40:58,330 --> 00:41:01,370
because N95 masks don't
exist for students,

846
00:41:01,370 --> 00:41:03,813
KN95s do, but not N95s.

847
00:41:04,780 --> 00:41:07,460
Finally, this was in January

848
00:41:07,460 --> 00:41:10,090
and we knew that students would
be needing to eat indoors,

849
00:41:10,090 --> 00:41:13,060
meaning they would have to
take their masks off indoors.

850
00:41:13,060 --> 00:41:15,060
So this was gonna be a problem for us.

851
00:41:15,060 --> 00:41:18,030
And so we were able to use tests to return

852
00:41:18,030 --> 00:41:20,900
and what we is asked our students

853
00:41:20,900 --> 00:41:24,020
that if they were going
to return prior to day 10

854
00:41:24,020 --> 00:41:25,854
of their isolation period,

855
00:41:25,854 --> 00:41:30,854
they needed to test out
using a rapid antigen test.

856
00:41:31,050 --> 00:41:34,240
So if you took a test and it
was negative, you could return.

857
00:41:34,240 --> 00:41:36,670
And here you can see why,
how this is so powerful.

858
00:41:36,670 --> 00:41:38,520
So these are from my own daughter.

859
00:41:38,520 --> 00:41:41,760
Unfortunately, Lucy
contracted COVID in January,

860
00:41:41,760 --> 00:41:42,810
she's doing great.

861
00:41:42,810 --> 00:41:43,680
She's totally fine.

862
00:41:43,680 --> 00:41:44,743
She's vaccinated.

863
00:41:46,240 --> 00:41:48,470
But you can see on day six,

864
00:41:48,470 --> 00:41:51,100
when DESE guidelines
said she could go back,

865
00:41:51,100 --> 00:41:53,920
she was still positive, still infectious.

866
00:41:53,920 --> 00:41:55,600
Same on day seven.

867
00:41:55,600 --> 00:41:58,880
Day eight and nine you can
barely make out that test line,

868
00:41:58,880 --> 00:42:00,350
but it is there.

869
00:42:00,350 --> 00:42:04,120
And then finally on day
10, that was a clear day.

870
00:42:04,120 --> 00:42:05,950
That was a day where she passed the test.

871
00:42:05,950 --> 00:42:07,170
The test was negative.

872
00:42:07,170 --> 00:42:10,300
And so she was able to return to school.

873
00:42:10,300 --> 00:42:14,290
And so the power of these
antigen tests is excellent.

874
00:42:14,290 --> 00:42:19,290
So just in January, this data
is from Collins Middle School.

875
00:42:19,370 --> 00:42:22,180
You can see that we had 39 students

876
00:42:22,180 --> 00:42:24,170
who were able to return to school

877
00:42:24,170 --> 00:42:27,750
and get back some of those in person days,

878
00:42:27,750 --> 00:42:30,110
they were feeling fine,
they tested negative.

879
00:42:30,110 --> 00:42:32,170
They were able to go back to school.

880
00:42:32,170 --> 00:42:35,750
We had other students who
either decided not to return

881
00:42:35,750 --> 00:42:36,583
to the buildings

882
00:42:36,583 --> 00:42:39,380
because maybe they weren't
feeling better yet,

883
00:42:39,380 --> 00:42:41,320
or perhaps they were
still testing positive.

884
00:42:41,320 --> 00:42:43,830
So we had 24 students
who didn't come in early

885
00:42:43,830 --> 00:42:48,230
and then 10 students who thought
that they were good to go,

886
00:42:48,230 --> 00:42:51,150
but they actually were
positive when they tested

887
00:42:51,150 --> 00:42:52,730
and they went home

888
00:42:52,730 --> 00:42:55,170
and we were able to keep
people out of the building

889
00:42:55,170 --> 00:42:56,723
who were still infectious.

890
00:42:59,310 --> 00:43:02,460
So I wanna talk a little bit
about variance and vaccination,

891
00:43:02,460 --> 00:43:04,790
but I'm very aware of my time.

892
00:43:04,790 --> 00:43:07,343
So I'm gonna go a little quickly here.

893
00:43:08,390 --> 00:43:11,150
And the thing that I
really wanna emphasize here

894
00:43:11,150 --> 00:43:15,250
is that with the variance
of Delta and Omicron

895
00:43:15,250 --> 00:43:19,500
or Alpha two to some degree,
but they were more contagious.

896
00:43:19,500 --> 00:43:22,080
And that means that there
was less room for error.

897
00:43:22,080 --> 00:43:26,880
So the '21, '22 school year
looked a little bit different.

898
00:43:26,880 --> 00:43:29,760
We had these more contagious
variants, but at the same time,

899
00:43:29,760 --> 00:43:34,060
we also had more normal
school and more normal lives.

900
00:43:34,060 --> 00:43:35,850
And there were more cases of COVID

901
00:43:35,850 --> 00:43:38,070
because they were more contagious.

902
00:43:38,070 --> 00:43:41,440
However, we also had more immunity

903
00:43:41,440 --> 00:43:45,060
because thankfully we had a lot
of our population vaccinated

904
00:43:45,060 --> 00:43:47,590
very high vaccination
rates among our staff,

905
00:43:47,590 --> 00:43:50,370
and we have vaccination requirements.

906
00:43:50,370 --> 00:43:53,350
And unfortunately we do
also have prior infection.

907
00:43:53,350 --> 00:43:55,330
So we have a bunch of different things

908
00:43:55,330 --> 00:43:58,700
that made the '21, '22 school
year look a little different

909
00:43:58,700 --> 00:44:00,453
than that first school year.

910
00:44:01,590 --> 00:44:03,490
Additionally, we were able to have

911
00:44:03,490 --> 00:44:07,830
vaccine requirements put in
place, including a vax or test

912
00:44:07,830 --> 00:44:10,150
at the beginning of
the year for our staff.

913
00:44:10,150 --> 00:44:13,340
And now that's turning
into a mandate for staff.

914
00:44:13,340 --> 00:44:15,450
We have vaccine requirements
for our students.

915
00:44:15,450 --> 00:44:18,720
If they want to do extracurriculars,

916
00:44:18,720 --> 00:44:20,913
high respiratory extracurriculars.

917
00:44:21,780 --> 00:44:23,590
We also put in place more HEPA units

918
00:44:23,590 --> 00:44:26,580
because these variants were contagious.

919
00:44:26,580 --> 00:44:28,500
And we had a strong emphasis on masking

920
00:44:28,500 --> 00:44:31,920
and we're on can KN95s to our kids.

921
00:44:31,920 --> 00:44:34,120
The other things that we were emphasizing,

922
00:44:34,120 --> 00:44:35,300
I forgot to write it down here,

923
00:44:35,300 --> 00:44:37,310
but really stressing the importance

924
00:44:37,310 --> 00:44:38,820
of keeping those windows open.

925
00:44:38,820 --> 00:44:42,140
And that CO2 monitor was I
was able to show teachers

926
00:44:42,140 --> 00:44:44,570
in real time how important that was,

927
00:44:44,570 --> 00:44:47,960
and also emphasizing the
importance of outdoor lunch

928
00:44:47,960 --> 00:44:50,740
and eating outside that when
we have those masks down

929
00:44:50,740 --> 00:44:54,850
in order to keep the air clean,
which is really the goal,

930
00:44:54,850 --> 00:44:56,943
it's still really all about clean air.

931
00:45:00,790 --> 00:45:03,700
We wanna eat lunch
outdoors as much as we can.

932
00:45:03,700 --> 00:45:05,460
Vaccines too.

933
00:45:05,460 --> 00:45:06,810
These are my daughters.

934
00:45:06,810 --> 00:45:08,900
They both got vaccinated in November

935
00:45:08,900 --> 00:45:11,300
and I was so, so grateful

936
00:45:11,300 --> 00:45:15,350
and continue to be a big
proponent of vaccines.

937
00:45:15,350 --> 00:45:17,893
And it is one of my
favorite cartoons where,

938
00:45:20,500 --> 00:45:22,400
the ideal scientific experiment

939
00:45:22,400 --> 00:45:24,090
is one where you don't need the statistics

940
00:45:24,090 --> 00:45:25,313
to prove that it works.

941
00:45:26,830 --> 00:45:29,373
But when we're thinking about vaccines,

942
00:45:32,743 --> 00:45:33,850
a lot of stuff comes up.

943
00:45:33,850 --> 00:45:35,630
People get very nervous.

944
00:45:35,630 --> 00:45:39,590
And I think it's mirrored
in any sort of intervention,

945
00:45:39,590 --> 00:45:42,200
whenever we're thinking about
the risks that we're facing

946
00:45:42,200 --> 00:45:43,970
and we're trying to make decisions,

947
00:45:43,970 --> 00:45:47,060
we have to think about the risks of COVID

948
00:45:47,060 --> 00:45:49,290
as well as the risks of the response.

949
00:45:49,290 --> 00:45:50,810
And they're pushing against each other.

950
00:45:50,810 --> 00:45:53,000
And we have to consider both.

951
00:45:53,000 --> 00:45:54,950
And with vaccines,

952
00:45:54,950 --> 00:45:58,830
what we need to remember is
that vaccines prevent infection.

953
00:45:58,830 --> 00:46:01,430
I know that we hear that,
you can still get it.

954
00:46:01,430 --> 00:46:03,500
And like my daughter did get COVID,

955
00:46:03,500 --> 00:46:05,820
but the thing is it prevents infections.

956
00:46:05,820 --> 00:46:07,370
It doesn't prevent it entirely.

957
00:46:07,370 --> 00:46:08,710
They're not magic.

958
00:46:08,710 --> 00:46:10,587
But they do prevent a lot of infection.

959
00:46:10,587 --> 00:46:14,580
And we can see this here where
people who are unvaccinated

960
00:46:14,580 --> 00:46:17,470
had a far higher predominance of infection

961
00:46:17,470 --> 00:46:19,580
than people who are partially vaccinated

962
00:46:19,580 --> 00:46:21,610
or fully vaccinated.

963
00:46:21,610 --> 00:46:23,900
Vaccines also prevent severe illness,

964
00:46:23,900 --> 00:46:26,570
as we know, they're incredibly effective.

965
00:46:26,570 --> 00:46:30,003
And of course, they also prevent
people from dying of COVID.

966
00:46:30,870 --> 00:46:33,280
And so when we're thinking about vaccines,

967
00:46:33,280 --> 00:46:36,270
we have to remember how
incredibly powerful they are,

968
00:46:36,270 --> 00:46:38,740
but also how safe they are.

969
00:46:38,740 --> 00:46:41,670
Vaccines are remarkably safe.

970
00:46:41,670 --> 00:46:46,070
And this slide is focused on
the five to 11 demographic.

971
00:46:46,070 --> 00:46:49,060
This is where we are really
now trying to increase

972
00:46:49,060 --> 00:46:50,890
our rates of vaccination.

973
00:46:50,890 --> 00:46:52,860
And this slide is made in December.

974
00:46:52,860 --> 00:46:56,230
So the not 8.7 million is
probably closer to 9 million

975
00:46:56,230 --> 00:46:59,050
at this point, might be over 9 million,

976
00:46:59,050 --> 00:47:00,840
but millions and millions

977
00:47:00,840 --> 00:47:03,580
of these vaccines have been provided

978
00:47:03,580 --> 00:47:05,940
and they are incredibly safe.

979
00:47:05,940 --> 00:47:08,500
There really are not
some of the side effects

980
00:47:08,500 --> 00:47:10,620
that people were worried
about, like myocarditis.

981
00:47:10,620 --> 00:47:13,440
They're incredibly rare.

982
00:47:13,440 --> 00:47:16,970
And vaccines are incredibly
safe for our kids.

983
00:47:16,970 --> 00:47:18,640
They're also in effective.

984
00:47:18,640 --> 00:47:20,660
When I think about the risks of COVID

985
00:47:20,660 --> 00:47:22,550
versus the risk of vaccination,

986
00:47:22,550 --> 00:47:25,530
the risks of kids getting
COVID is not zero.

987
00:47:25,530 --> 00:47:28,320
Yes, the risks are
lower, but it's not zero.

988
00:47:28,320 --> 00:47:30,480
We know that kids can get acutely ill.

989
00:47:30,480 --> 00:47:33,370
We also know that kids can
have long term complications

990
00:47:33,370 --> 00:47:36,060
from COVID, including MIS-C

991
00:47:36,060 --> 00:47:38,720
and the pediatric vaccines has been shown

992
00:47:38,720 --> 00:47:42,420
to reduce MIS-C remarkably.

993
00:47:42,420 --> 00:47:45,023
And they're incredibly
effective at that as well.

994
00:47:46,710 --> 00:47:49,900
So we're now moving
towards a new equilibrium

995
00:47:49,900 --> 00:47:52,583
and I'm choosing that
word very specifically.

996
00:47:54,880 --> 00:47:56,400
We're looking at,

997
00:47:56,400 --> 00:47:59,190
this is a slide that I
just changed yesterday

998
00:47:59,190 --> 00:48:02,270
because Massachusetts decided to remove

999
00:48:02,270 --> 00:48:04,590
its statewide mask mandate for schools.

1000
00:48:04,590 --> 00:48:07,470
And we're looking at this
happening throughout the country.

1001
00:48:07,470 --> 00:48:10,850
People easing mask rules
and wanting to move on

1002
00:48:10,850 --> 00:48:12,400
because people are tired

1003
00:48:12,400 --> 00:48:14,840
and they want to just get back to normal.

1004
00:48:14,840 --> 00:48:16,700
And I think that's really understandable.

1005
00:48:16,700 --> 00:48:18,100
I'm tired of COVID.

1006
00:48:18,100 --> 00:48:20,530
And I would love to get back to something

1007
00:48:20,530 --> 00:48:24,160
that resembled normal in the year 2019.

1008
00:48:24,160 --> 00:48:26,290
The thing is though, is that right now,

1009
00:48:26,290 --> 00:48:29,080
this pandemic is not over. (chuckles)

1010
00:48:29,080 --> 00:48:31,840
We want it to be, but it's not.

1011
00:48:31,840 --> 00:48:34,940
And although our case counts are far lower

1012
00:48:34,940 --> 00:48:37,650
than they were just a few weeks ago,

1013
00:48:37,650 --> 00:48:39,260
they're still pretty similar

1014
00:48:39,260 --> 00:48:42,230
to what they were at
their highest a year ago.

1015
00:48:42,230 --> 00:48:45,903
And that's the same with
deaths and hospitalizations.

1016
00:48:49,120 --> 00:48:51,780
Despite that, I think it's also critical

1017
00:48:51,780 --> 00:48:54,960
that we re the pandemic is now different.

1018
00:48:54,960 --> 00:48:58,300
We have incredibly safe
and effective vaccines.

1019
00:48:58,300 --> 00:49:02,970
We have access to testing
both PCR and home-based tests

1020
00:49:02,970 --> 00:49:04,580
that are excellent.

1021
00:49:04,580 --> 00:49:08,160
We also have new pharmaceuticals
that are being developed,

1022
00:49:08,160 --> 00:49:10,330
access to these is a
little iffy right now,

1023
00:49:10,330 --> 00:49:13,240
but we have them, we
will have them very soon.

1024
00:49:13,240 --> 00:49:16,280
So I think saying when
can we get back to normal

1025
00:49:16,280 --> 00:49:19,000
is a reasonable question to ask,

1026
00:49:19,000 --> 00:49:21,570
but working on this presentation

1027
00:49:21,570 --> 00:49:24,120
has also prompted me to ask a few more.

1028
00:49:24,120 --> 00:49:27,950
And one of them is, can
we get back to normal?

1029
00:49:27,950 --> 00:49:29,753
And the reason why,

1030
00:49:29,753 --> 00:49:32,803
we have to think back
to what our normal was.

1031
00:49:33,650 --> 00:49:37,330
This is the flu burden by season.

1032
00:49:37,330 --> 00:49:39,890
So by year, for the past 10 years,

1033
00:49:39,890 --> 00:49:42,420
we had millions of cases of flu each year

1034
00:49:42,420 --> 00:49:46,370
resulting in hundreds of
thousands of hospitalizations,

1035
00:49:46,370 --> 00:49:49,610
which is in blue and tens
of thousands of deaths,

1036
00:49:49,610 --> 00:49:51,290
which is in red.

1037
00:49:51,290 --> 00:49:55,410
On top of that every year,
there's an RSV epidemic

1038
00:49:55,410 --> 00:49:58,200
that blows through resulting in

1039
00:49:58,200 --> 00:50:00,270
over 10,000 deaths each year,

1040
00:50:00,270 --> 00:50:03,010
and hundreds of thousands
of hospitalizations,

1041
00:50:03,010 --> 00:50:07,830
and those who are most
vulnerable to RSV and to flu

1042
00:50:07,830 --> 00:50:11,210
are often also the most
vulnerable to COVID.

1043
00:50:11,210 --> 00:50:13,750
So when we're thinking about
getting back to normal,

1044
00:50:13,750 --> 00:50:16,670
we need to reckon with what normal was.

1045
00:50:16,670 --> 00:50:20,210
I think most of us didn't
realize quite how bad

1046
00:50:20,210 --> 00:50:23,250
this annual epidemic of flu in RSV was.

1047
00:50:24,620 --> 00:50:28,550
And even if we did know
how that it was a problem,

1048
00:50:28,550 --> 00:50:31,320
and it was important
to get those flu shots,

1049
00:50:31,320 --> 00:50:33,050
I don't think we thought
there was much more

1050
00:50:33,050 --> 00:50:34,350
that we could do about it.

1051
00:50:36,150 --> 00:50:39,030
And now we're looking at, on top of that,

1052
00:50:39,030 --> 00:50:42,560
putting on top of that, all
of these hospitalizations

1053
00:50:42,560 --> 00:50:44,713
and death and illness from COVID,

1054
00:50:45,955 --> 00:50:48,070
and I don't think that's acceptable.

1055
00:50:48,070 --> 00:50:49,920
I'm not not ready to accept that

1056
00:50:49,920 --> 00:50:52,123
as the price of getting back to normal.

1057
00:50:53,100 --> 00:50:56,610
I also don't think it's
going to be manageable

1058
00:50:56,610 --> 00:50:59,110
because one of the things
that we found in January

1059
00:50:59,110 --> 00:51:02,650
with our schools was one
major challenge was staffing.

1060
00:51:02,650 --> 00:51:07,080
We had so many staff out
sick that it became difficult

1061
00:51:07,080 --> 00:51:09,600
in some cases to run schools,
we were able to do it,

1062
00:51:09,600 --> 00:51:11,560
but it was a real challenge.

1063
00:51:11,560 --> 00:51:14,000
We also had so many students out sick

1064
00:51:14,000 --> 00:51:16,130
that it became difficult to run schools

1065
00:51:16,130 --> 00:51:18,370
because how do you have a curriculum

1066
00:51:18,370 --> 00:51:19,560
that's flowing from day to day

1067
00:51:19,560 --> 00:51:21,300
when you have a different
batch of students

1068
00:51:21,300 --> 00:51:23,010
in class each day?

1069
00:51:23,010 --> 00:51:25,870
So I think we need to
find this new equilibrium.

1070
00:51:25,870 --> 00:51:30,730
And I choose this word very
carefully because in equilibrium

1071
00:51:30,730 --> 00:51:35,290
is a dynamic state that's
predictable and stable,

1072
00:51:35,290 --> 00:51:39,540
but it's constantly
balancing opposing forces.

1073
00:51:39,540 --> 00:51:42,770
And the thing about equilibrium
and that I teach my students

1074
00:51:42,770 --> 00:51:47,770
all the time is that it
changes as conditions change.

1075
00:51:48,100 --> 00:51:51,060
So new conditions result
in a new equilibrium.

1076
00:51:51,060 --> 00:51:54,700
Our choices are going to
determine the new state

1077
00:51:54,700 --> 00:51:55,840
that we find ourselves in.

1078
00:51:55,840 --> 00:51:57,060
It's not inevitable.

1079
00:51:57,060 --> 00:51:58,880
We have a say in that.

1080
00:51:58,880 --> 00:52:01,770
And as we're thinking through
what our goal should be,

1081
00:52:01,770 --> 00:52:05,330
I go back to the equity
statement that we've written

1082
00:52:05,330 --> 00:52:09,050
over the past year as part of
the work with the district.

1083
00:52:09,050 --> 00:52:11,760
And as I read through this,
looking at each bullet,

1084
00:52:11,760 --> 00:52:14,750
each one of these bullets gets back

1085
00:52:14,750 --> 00:52:19,020
at to why we need to
create a school environment

1086
00:52:19,020 --> 00:52:22,890
that can be safe and accessible
to all of our community.

1087
00:52:22,890 --> 00:52:25,880
Whether you are immunocompromised

1088
00:52:25,880 --> 00:52:28,320
or you have a family member who's ill,

1089
00:52:28,320 --> 00:52:30,390
you have a newborn brother at home,

1090
00:52:30,390 --> 00:52:32,410
or you live with an older relative,

1091
00:52:32,410 --> 00:52:35,110
that everybody has access to school,

1092
00:52:35,110 --> 00:52:37,153
that's not going to make them sick.

1093
00:52:38,410 --> 00:52:39,770
So I think we need to think about

1094
00:52:39,770 --> 00:52:41,790
a new equilibrium for schools.

1095
00:52:41,790 --> 00:52:43,870
We have new tools in our tool box

1096
00:52:43,870 --> 00:52:46,140
that we now know can work.

1097
00:52:46,140 --> 00:52:48,410
Before, we didn't
realize what we could do.

1098
00:52:48,410 --> 00:52:50,860
And now we know we can do things.

1099
00:52:50,860 --> 00:52:54,110
So as we have these
pathogens that circulate,

1100
00:52:54,110 --> 00:52:56,210
we know we'll have waves of infection,

1101
00:52:56,210 --> 00:52:58,430
we'll know we'll have new variants.

1102
00:52:58,430 --> 00:53:01,040
We also will probably
have new spillover events

1103
00:53:01,040 --> 00:53:02,770
and new pathogens,

1104
00:53:02,770 --> 00:53:04,510
but we have things that we can do

1105
00:53:04,510 --> 00:53:06,010
to help keep the air clean.

1106
00:53:06,010 --> 00:53:08,120
And I am quickly running out of time.

1107
00:53:08,120 --> 00:53:10,310
So I'm not gonna go into detail here,

1108
00:53:10,310 --> 00:53:12,970
but I think we can
divide them up to things

1109
00:53:12,970 --> 00:53:14,790
that are always in place

1110
00:53:14,790 --> 00:53:17,410
and then things that we
can apply as necessary

1111
00:53:17,410 --> 00:53:20,930
and deciding when we put in
place, which mitigation effort,

1112
00:53:20,930 --> 00:53:22,350
I think depends.

1113
00:53:22,350 --> 00:53:24,723
And that's a discussion
that we need to have.

1114
00:53:26,170 --> 00:53:27,080
When I started this,

1115
00:53:27,080 --> 00:53:31,820
I talked about being an elected
official and as a scientist,

1116
00:53:31,820 --> 00:53:33,090
and I wanna end there too.

1117
00:53:33,090 --> 00:53:35,940
This was something I actually
said on election night, 2019,

1118
00:53:35,940 --> 00:53:37,670
and I believe it more than ever

1119
00:53:39,032 --> 00:53:41,340
and it's not that I was
always right, I wasn't

1120
00:53:41,340 --> 00:53:44,870
and it's not that
science is the only thing

1121
00:53:44,870 --> 00:53:46,160
that can give you insight.

1122
00:53:46,160 --> 00:53:48,140
It definitely doesn't,
as I've said throughout,

1123
00:53:48,140 --> 00:53:49,800
there are other factors that you need,

1124
00:53:49,800 --> 00:53:52,510
we always need to be working on too,

1125
00:53:52,510 --> 00:53:55,130
but scientists are
incredibly underrepresented

1126
00:53:55,130 --> 00:53:57,260
among our elected officials.

1127
00:53:57,260 --> 00:54:02,170
And science has given me
so much help in grappling

1128
00:54:02,170 --> 00:54:05,210
with very difficult decisions
that I've had to make.

1129
00:54:05,210 --> 00:54:09,820
And I think that we need
more scientists in office.

1130
00:54:09,820 --> 00:54:12,370
So if anybody out there who
wants to run for office,

1131
00:54:12,370 --> 00:54:14,403
I really encourage you to do so.

1132
00:54:15,610 --> 00:54:19,443
And finally, I wanna thank
everybody on this slide.

1133
00:54:20,440 --> 00:54:23,750
And particularly I wanna
highlight Chelsea Banks,

1134
00:54:23,750 --> 00:54:26,010
who is the chief of
Opportunity and Response

1135
00:54:26,010 --> 00:54:28,290
and headed up our Salem returns efforts.

1136
00:54:28,290 --> 00:54:30,210
She's been an incredible
partner to work with,

1137
00:54:30,210 --> 00:54:32,510
and I feel fortunate to
count her as a friend.

1138
00:54:34,288 --> 00:54:35,930
I don't have time, I wanna take questions.

1139
00:54:35,930 --> 00:54:40,180
So I'm just gonna move on
and just thank my family.

1140
00:54:40,180 --> 00:54:45,180
And also just leave you on this slide.

1141
00:54:47,600 --> 00:54:51,410
So I am going to leave
to slide up for a second,

1142
00:54:51,410 --> 00:54:54,830
urge people to become vaccine ambassadors.

1143
00:54:54,830 --> 00:54:57,383
And I'm happy to take some questions.

1144
00:55:00,500 --> 00:55:02,410
- Thank you so much, Dr. Pangallo.

1145
00:55:02,410 --> 00:55:04,540
That was a wonderful talk.

1146
00:55:04,540 --> 00:55:07,143
And I'm sorry for your loss.

1147
00:55:09,310 --> 00:55:12,470
I'd like to ask you a
question from a student

1148
00:55:12,470 --> 00:55:13,553
to start us off.

1149
00:55:15,500 --> 00:55:17,510
The student says, I'd
like to pursue involvement

1150
00:55:17,510 --> 00:55:18,980
with helping schools with clean air

1151
00:55:18,980 --> 00:55:20,280
is their contact information?

1152
00:55:20,280 --> 00:55:21,940
That's one part.

1153
00:55:21,940 --> 00:55:23,820
And then the second is
what are the next steps

1154
00:55:23,820 --> 00:55:26,160
that will be taken as of yesterday?

1155
00:55:26,160 --> 00:55:29,240
Charlie Baker announced K-12
will not have to wear masks.

1156
00:55:29,240 --> 00:55:30,910
What do we do?

1157
00:55:30,910 --> 00:55:33,620
- I had no idea that
question would come up,

1158
00:55:33,620 --> 00:55:35,647
that's a real topic.

1159
00:55:35,647 --> 00:55:37,500
(Ron and Kristin laughing)

1160
00:55:37,500 --> 00:55:40,660
So the first one, in Salem,

1161
00:55:40,660 --> 00:55:43,250
we have functioning ventilation systems.

1162
00:55:43,250 --> 00:55:46,710
We have filtration, we have
carbon dioxide monitors,

1163
00:55:46,710 --> 00:55:48,110
so we're in good shape.

1164
00:55:48,110 --> 00:55:50,710
But if you wanna help out other districts,

1165
00:55:50,710 --> 00:55:55,140
I don't think at other districts
all have the same access

1166
00:55:55,140 --> 00:55:56,570
to the same information.

1167
00:55:56,570 --> 00:55:57,540
I mean, we've been trying to,

1168
00:55:57,540 --> 00:56:00,070
I try to share it with
as many people as I can,

1169
00:56:00,070 --> 00:56:01,090
but get the word out,

1170
00:56:01,090 --> 00:56:04,877
explain what a CO2 monitor
is is and how it can help.

1171
00:56:04,877 --> 00:56:08,360
Do some DIY Corsi-Rosenthal boxes.

1172
00:56:08,360 --> 00:56:10,300
And I think that's a great thing

1173
00:56:10,300 --> 00:56:11,810
that we can do with students.

1174
00:56:11,810 --> 00:56:12,770
And I think that that's something

1175
00:56:12,770 --> 00:56:14,403
I'd like to see us do in Salem.

1176
00:56:15,370 --> 00:56:17,460
As for the mask mandates,

1177
00:56:17,460 --> 00:56:19,620
that's a discussion that we will be having

1178
00:56:19,620 --> 00:56:21,230
on the school committee.

1179
00:56:21,230 --> 00:56:24,320
I don't think that we
can remove masks yet.

1180
00:56:24,320 --> 00:56:26,980
Given our current vaccination rates,

1181
00:56:26,980 --> 00:56:30,860
given the amount of COVID
that we have in our community,

1182
00:56:30,860 --> 00:56:33,240
the fact we have preschool classrooms

1183
00:56:33,240 --> 00:56:36,540
and not all of our preschoolers
are eligible for vaccines.

1184
00:56:36,540 --> 00:56:37,700
So in my opinion,

1185
00:56:37,700 --> 00:56:42,080
I don't think we're ready
to remove masks yet.

1186
00:56:42,080 --> 00:56:43,940
However, as I said,

1187
00:56:43,940 --> 00:56:47,600
I think we do need to have a
very in depth discussion about

1188
00:56:47,600 --> 00:56:49,990
when we apply these mitigation measures

1189
00:56:49,990 --> 00:56:51,650
and when we relax them.

1190
00:56:51,650 --> 00:56:55,713
And that conversation
needs to occur in concert.

1191
00:56:56,840 --> 00:56:57,673
- Cool.

1192
00:56:58,870 --> 00:56:59,720
Dr. (indistinct).

1193
00:57:08,070 --> 00:57:10,933
While she's getting ready, I'm
gonna ask another question.

1194
00:57:12,820 --> 00:57:14,540
There was a question, from your research,

1195
00:57:14,540 --> 00:57:18,380
how effective do you think
that aerosol disinfectants are?

1196
00:57:18,380 --> 00:57:20,686
- Oh, like the Lysol that you spray?

1197
00:57:20,686 --> 00:57:21,816
- I guess that's what
they're talking about.

1198
00:57:21,816 --> 00:57:22,649
I don't know.

1199
00:57:22,649 --> 00:57:25,953
- Yeah, I have not looked into those.

1200
00:57:27,128 --> 00:57:30,710
So I can't give you like
lots of evidence on that,

1201
00:57:30,710 --> 00:57:32,670
but my gut instinct on that

1202
00:57:32,670 --> 00:57:34,740
is that when you're adding
more things to the air,

1203
00:57:34,740 --> 00:57:37,180
that's more stuff you
are going to breathe in.

1204
00:57:37,180 --> 00:57:40,150
And I usually air on the side

1205
00:57:40,150 --> 00:57:42,696
of not breathing excess material.

1206
00:57:42,696 --> 00:57:43,690
(Ron and Kristin laughing)

1207
00:57:43,690 --> 00:57:45,090
It doesn't tend to go well.

1208
00:57:45,090 --> 00:57:47,510
So I mean, I don't know for sure,

1209
00:57:47,510 --> 00:57:49,570
but I certainly would
have lots of questions

1210
00:57:49,570 --> 00:57:51,410
about the health implications

1211
00:57:51,410 --> 00:57:53,240
of spraying disinfect into the air.

1212
00:57:55,800 --> 00:57:57,270
Especially at scale,

1213
00:57:57,270 --> 00:57:59,930
applying that to lots of
classrooms with little kids

1214
00:57:59,930 --> 00:58:02,280
that doesn't seem like
maybe the best strategy.

1215
00:58:06,520 --> 00:58:08,010
- Dr. (indistinct) are you...

1216
00:58:17,480 --> 00:58:18,313
Another question.

1217
00:58:18,313 --> 00:58:19,900
Can you talk about the need to tie

1218
00:58:19,900 --> 00:58:22,940
as needed mitigations
strategies to clear metrics,

1219
00:58:22,940 --> 00:58:26,210
especially institutional
vaccination rates?

1220
00:58:26,210 --> 00:58:28,020
- Yeah, I mean, I think that's critical.

1221
00:58:28,020 --> 00:58:29,800
We know that these vaccines work

1222
00:58:29,800 --> 00:58:31,937
and something that I didn't
have time to talk about,

1223
00:58:31,937 --> 00:58:34,570
I've said a lot about,

1224
00:58:34,570 --> 00:58:36,610
going forward, what does this look like?

1225
00:58:36,610 --> 00:58:39,800
Because although there
are risks with COVID,

1226
00:58:39,800 --> 00:58:44,800
it's also, so while we can
reduce our risk on a day to day

1227
00:58:45,320 --> 00:58:47,450
over the course of our lifetime,

1228
00:58:47,450 --> 00:58:50,100
that risk builds up to some degree

1229
00:58:50,100 --> 00:58:52,050
and we're going to be exposed,

1230
00:58:52,050 --> 00:58:54,460
and most of us will at
some point be infected.

1231
00:58:54,460 --> 00:58:57,424
So we do need to be cognizant of that.

1232
00:58:57,424 --> 00:59:02,290
However, we can also by
having vaccination rates

1233
00:59:02,290 --> 00:59:05,720
that actually helps to keep
COVID out of the schools

1234
00:59:05,720 --> 00:59:07,950
and out of an institution.

1235
00:59:07,950 --> 00:59:11,860
So I think it makes a lot of
sense to tie it to case counts,

1236
00:59:11,860 --> 00:59:14,780
vaccination rates, and
as case counts fall,

1237
00:59:14,780 --> 00:59:16,690
I actually think wastewater surveillance

1238
00:59:16,690 --> 00:59:18,470
would be an excellent tool

1239
00:59:18,470 --> 00:59:21,210
because case counts might end up falling

1240
00:59:21,210 --> 00:59:24,110
because we have more people
using rapid tests at home.

1241
00:59:24,110 --> 00:59:28,320
Rapid tests are great, but
they aren't as easy to count.

1242
00:59:28,320 --> 00:59:31,080
So wastewater surveillance
allows us to understand

1243
00:59:31,080 --> 00:59:34,353
what the burden of infectious
diseases in the community.

1244
00:59:37,830 --> 00:59:38,740
- Another question,

1245
00:59:38,740 --> 00:59:41,970
and I think this is gonna
have to be our last one,

1246
00:59:41,970 --> 00:59:46,970
understanding your desire for
more scientists in office,

1247
00:59:48,890 --> 00:59:52,950
is Salem has one health idea
of being able to put together

1248
00:59:52,950 --> 00:59:55,610
various field positions
in a single committee

1249
00:59:55,610 --> 00:59:58,380
to overlap scientists,
politicians, doctors, vets,

1250
00:59:58,380 --> 01:00:00,020
and social workers?

1251
01:00:00,020 --> 01:00:03,010
So trying to melt everybody
together, I think.

1252
01:00:03,010 --> 01:00:05,423
- I mean, I really love that idea.

1253
01:00:06,415 --> 01:00:10,020
Having lots of different
scientific perspectives

1254
01:00:10,020 --> 01:00:11,330
in a community, and in fact,

1255
01:00:11,330 --> 01:00:14,120
I'm participating in something
like that this afternoon.

1256
01:00:14,120 --> 01:00:16,600
In Salem, we have a
medical advisory committee

1257
01:00:16,600 --> 01:00:19,350
for the public schools
for the past two years,

1258
01:00:19,350 --> 01:00:22,680
and we have a public health specialist.

1259
01:00:22,680 --> 01:00:25,380
We have area doctors.

1260
01:00:25,380 --> 01:00:28,040
I contribute from my perspective,

1261
01:00:28,040 --> 01:00:29,250
we have somebody from the schools

1262
01:00:29,250 --> 01:00:30,840
contributing their perspective

1263
01:00:30,840 --> 01:00:33,890
and that has helped give us
a variety of perspectives

1264
01:00:33,890 --> 01:00:34,750
on these issues.

1265
01:00:34,750 --> 01:00:36,520
And I do think that that's useful.

1266
01:00:36,520 --> 01:00:37,810
We're doing that with our schools

1267
01:00:37,810 --> 01:00:40,200
and I think it can be
useful in other areas.

1268
01:00:40,200 --> 01:00:41,800
And I know that the city already does that

1269
01:00:41,800 --> 01:00:44,470
in areas of like climate
and sustainability,

1270
01:00:44,470 --> 01:00:45,303
stuff like that.

1271
01:00:45,303 --> 01:00:46,420
And on the board of health.

1272
01:00:47,930 --> 01:00:49,690
- I shouldn't, but I
there's one more question,

1273
01:00:49,690 --> 01:00:52,320
somebody just asks and
I think it's worth you

1274
01:00:52,320 --> 01:00:55,190
getting your perspective and
then we'll have to say goodbye.

1275
01:00:55,190 --> 01:00:58,640
What do you think about people
refusing to get vaccines

1276
01:00:58,640 --> 01:00:59,643
and wear masks?

1277
01:01:01,720 --> 01:01:05,170
- Another thing that I
was unable to fit in in,

1278
01:01:05,170 --> 01:01:06,343
maybe another talk,

1279
01:01:08,440 --> 01:01:11,070
we need to approach all
of these conversations

1280
01:01:11,070 --> 01:01:13,040
with compassion and empathy,

1281
01:01:13,040 --> 01:01:16,670
because that's the only way
to successfully communicate

1282
01:01:16,670 --> 01:01:17,810
for one thing.

1283
01:01:17,810 --> 01:01:22,810
But also, I think you have
to assume best intentions

1284
01:01:22,870 --> 01:01:25,230
in most of your conversation partners.

1285
01:01:25,230 --> 01:01:27,040
Nobody will wants to get sick.

1286
01:01:27,040 --> 01:01:30,610
Nobody wants to die from
COVID and everybody,

1287
01:01:30,610 --> 01:01:33,990
even scientists, we choose who we trust,

1288
01:01:33,990 --> 01:01:36,843
we choose to trust other scientists.

1289
01:01:37,760 --> 01:01:39,510
And I mean, we even choose to trust

1290
01:01:39,510 --> 01:01:41,130
that these textbooks are correct.

1291
01:01:41,130 --> 01:01:42,270
They might not be, right?

1292
01:01:42,270 --> 01:01:43,900
- Right, they may not be.

1293
01:01:43,900 --> 01:01:47,943
- So we're all making choices
and about who we trust.

1294
01:01:49,110 --> 01:01:52,480
And what you would find on
the COVID ambassador training

1295
01:01:52,480 --> 01:01:55,410
is that the most important thing

1296
01:01:55,410 --> 01:01:57,110
about changing somebody's mind

1297
01:01:57,110 --> 01:01:59,420
is listening to what they have to say.

1298
01:01:59,420 --> 01:02:01,730
It's not giving them new information.

1299
01:02:01,730 --> 01:02:03,620
It can be answering their questions,

1300
01:02:03,620 --> 01:02:05,623
but it's listening to people.

1301
01:02:06,949 --> 01:02:09,800
And this is not to say
that some of the political

1302
01:02:09,800 --> 01:02:12,210
and media leaders who are exposed

1303
01:02:12,210 --> 01:02:15,370
and espousing anti-vaccination positions

1304
01:02:15,370 --> 01:02:17,730
are to be assumed that they
have the best intentions.

1305
01:02:17,730 --> 01:02:18,680
I don't think that they do.

1306
01:02:18,680 --> 01:02:20,990
And I think that I hold
them to a different,

1307
01:02:20,990 --> 01:02:22,840
they're in a different category,

1308
01:02:22,840 --> 01:02:24,683
but the people around you,

1309
01:02:26,052 --> 01:02:27,840
I think everyone's
making the best decisions

1310
01:02:27,840 --> 01:02:29,960
with the information that they have.

1311
01:02:29,960 --> 01:02:33,480
And we have to be really cognizant of that

1312
01:02:33,480 --> 01:02:35,180
as we enter these conversations.

1313
01:02:35,180 --> 01:02:37,880
And as someone who's had a
few of these conversations,

1314
01:02:38,870 --> 01:02:39,703
I think the goal,

1315
01:02:39,703 --> 01:02:42,240
a good goal for a
conversation like that can be

1316
01:02:42,240 --> 01:02:43,810
to strengthen the relationship.

1317
01:02:43,810 --> 01:02:45,470
It's not to change their mind.

1318
01:02:45,470 --> 01:02:47,940
Hopefully over time you will,

1319
01:02:47,940 --> 01:02:50,070
but strengthen the relationship,

1320
01:02:50,070 --> 01:02:52,170
give people a chance to be heard

1321
01:02:52,170 --> 01:02:56,420
and then help, you'll
understand them better.

1322
01:02:56,420 --> 01:02:58,560
And hopefully they'll
understand you better.

1323
01:02:58,560 --> 01:03:00,540
And hopefully we'll all
get to a better place

1324
01:03:00,540 --> 01:03:02,020
because of that.

1325
01:03:02,020 --> 01:03:02,853
- Thank you so much.

1326
01:03:02,853 --> 01:03:04,950
We have definitely run out time.

1327
01:03:04,950 --> 01:03:09,123
We very much appreciate your
talk and your expertise.