School board tables controversial contact tracing change
Emotions ran deep at a special meeting to review contact tracing for COVID-19 by the Rugby Public School District Board the evening of April 20 in the Rugby High School library.
However, after sides for and against the practice presented their arguments, the board voted to table the matter until after they had a chance to consult with attorneys.
Sarah Massey of the North Dakota Department of Health attended the meeting online to present information on contact tracing and its role in preventing the spread of the virus to the board.
“In order to have as our ultimate objective, the kids in their seats, the teachers teaching, the food service professionals providing nutritious meals, it takes a village to run a school,” Massey said. “In order to do this, we have to be able to identify those who have been exposed and get them into quarantine as soon as possible. If you think about it logically and if we don’t quarantine those who are exposed, they have the potential to continue the spread.”
“And if we don’t contact trace, that’s when we see the big outbreaks in schools and in communities,” Massey added.
Massey said she attended the meeting “to offer you guys recommendations and guidance. I’m not here to demand anything upon your district or anything like that. But it is really important that we all understand the importance of contact tracing and also case investigations.”
Massey explained the process of contact tracing, which identifies close contacts, or people “that were within six feet or less of person that was positive for a cumulative period of 15 minutes or more throughout a 24 hour duration.”
Rugby Public Schools Superintendent Mike McNeff said the process of interviewing adults and children who were close contacts to a positive case can take as little as 15 minutes. The process can be complicated when a COVID-positive student participates in sports or other activities with lots of contacts and travels to other locations.
Massey said the state Health Department and Rugby Public Schools worked closely with Lake Region District Health Unit Nurse Samantha Wentz. “We just go through and identify whoever would be in the close contact definition and we ask them to be quarantined. If both parties have masks on, there is just self-monitoring that needs to take place. You watch for signs and symptoms and then go from there.”
Massey noted, “North Dakota is one of about 10 states that have implemented a mask-to-mask contact exemption rule. So, if you’re mask to mask with a person that is positive, then that contact does not have to quarantine.”
However, since Rugby Public Schools have dropped their “mask required” policy, Massey said quarantining would be needed when positive cases are identified.
Massey said through policies requiring masking for close contacts across the state, “We’ve been able to keep 22,602 K-12 students and faculty in the building because of the mask-to-mask exemption rule.”
“I understand you have lifted the (mask) requirements and I’m here to talk about contact tracing, but contact tracing and masks and other layered strategic mitigation strategies are going to be your success to mitigate the spread of COVID-19 in your school,” Massey said.
“I guess I can’t stress enough from the Department of Health’s perspective about layered mitigation strategies,” Massey added. “That goes with contact tracing, the hand washing, the facility cleaning, and with contact tracing, that goes along with isolating and quarantining students who have been exposed to a positive case.”
Board member Brenda Heilman, who along with board member Carlie Johnson called the special meeting. Heilman said she represented the concerns of several parents in the district who had emailed her, urging an end to contact tracing.
“Can you tell me, out of all the kids who are quarantined, do you know roughly an estimate or best guess, how many of those quarantined kids turn up positive due to that quarantine event?”
“We do not have that data as far as school close contacts go,” Massey answered, noting her department lacked the personnel to track the data.
Heilman also asked McNeff to describe the steps he takes in the contact tracing process.
“I’d say it’s easier at the elementary level but to quantify that, I don’t know, sometimes, it’s as easy as getting ahold of a teacher and saying, ‘All right, I’ll look at my roster and the last two days, the kids were here,’ and it takes five to ten minutes,” he noted, adding, “It’s a little more complicated if activities were involved, sports, whatever, I’d sit and watch practice for awhile.”
“So to some degree, contact tracing is based on memory?” Heilman asked.
Massey noted students involved in activities could be more difficult to trace, however, “On average, I have one of my coordinators working with a school and it doesn’t involve like the extensive tracing like with an athlete,” she said. “On average, it would take roughly 15 minutes for one of my coordinators to work with the schools, identify them and provide the letters from the department of health and in your district, in your case, they come from Samantha Wentz and your local public health unit. So, it just really depends on how many activities the case has been involved in and where they’ve been at throughout their school days when they’re in their infectious period.”
Heilman said she was also concerned about paying for health care activities such as contact tracing with funds meant for education.
Several members of the public, including parents and staffers from Heart of America Medical Center attended the meeting. Both sides voiced opinions with emotion sometimes causing their voices to quaver. However, both sides listened respectfully to the proceedings.
“I would say 99 percent of schools, both parochial and public schools work with the department and their local public health unit to contact trace,” Massey said. “What’s really important to remember is that as I stated before, the overall objective is to get your children educated. And being a former educator, I just know that this is a public health crisis. So, whatever needs to be done to ensure that the bodies can be in person and your kids can be taught and the teachers can teach, this strategy has to take place in order for spread to be reduced in your school and in your community.”
“My other concern is, so we’re sending a lot of kids home to quarantine which I recently learned is recommended,” Heilman said. “There’s not a requirement on that. I’d like to know your perspective on how you feel about measuring and weighing that difference. Are we sending these kids home because they might get sick? Are we actually saving lives or slowing the spread by sending them home? I don’t see how those two things come together.”
“The reason behind sending those kids home and putting them in quarantine is to reduce the spread,” Massey answered. “Is there a potential that they don’t get COVID? Yes, there is a potential for that happening. But the fact is that we do not know. We do not know if they’re going to be a silent spreader. So, if we don’t quarantine kids that have been exposed, the potential of spread in your community is going to increase. There’s data behind that that says that. If we don’t quarantine those that have been exposed, the spread is likely to increase.”
Wentz, who attended the meeting online, said, “When we’re talking about these kids who are quarantined, they can come back to school if they test negative in seven days and they’re not having symptoms, but they have to wear a mask then for the remaining up to 14 days so that’s another piece to that mask puzzle that maybe we weren’t thinking about.”
Noting Massey’s assertion that contact tracing and quarantining slowed the spread of the virus, Heilman asked, “Why is this a recommendation and not a requirement?”
Massey explained that Gov. Doug Burgum and other state health officials decided to keep measures to reduce the spread of COVID in local hands.
Board President Dustin Hager, who works as a physician’s assistant at Heart of America Medical Center said not following state recommendations in health care could jeopardize funding and possibly risk fines.
During a public comment period, Heart of America Medical Center CEO told the board the hospital is fined “for not following these recommendations from the CDC so that’s definitely an issue to look at. I know (the courts) have definitely come down hard on health facilities (for not following recommendations). Second of all, OSHA has talked to us about mask wearing within our facility and they made a statement that our employees have to wear masks during this outbreak and so it’s a requirement and that is to protect the other employees so maybe you might want to contact OSHA to make sure that is not an issue to be looked at too. Just make sure you cover all your bases with this.”
“I know you say they’re just recommendations, but I don’t know if you know there was a congress bill in the state where they’re going to limit liability or provide liability protection for COVID,” Christenson added. “I have to look at the bill. I know it protects nursing homes and hospitals. As long as we’re following recommendations, we can’t be sued for COVID infection or a bad COVID outcome but if you’re not following recommendations, you might fall out of that tort.”
Massey also told the board she was unaware of any school district in North Dakota that refused contact tracing for COVID cases.
“In my opinion, it (contact tracing and quarantining) should be required,” McNeff added.
Heilman and Hager discussed legal issues connected with eliminating contact tracing. Hager said he had received a letter from the school district’s attorneys, but the contents of the letter could not be made public or discussed without an attorney’s presence, and that would occur in executive session. Hager said the school board’s attorneys were not able to attend the April 20 meeting due to scheduling conflicts.
Heilman suggested that the board invite the school district’s attorneys to their regular meeting, scheduled for May 11 at 7 a.m. at Rugby High School.
Hager closed the meeting with a heartfelt speech.
Citing exhaustion among health care workers during the first wave of the pandemic last fall, Hager said, “I would welcome you to come in and take care of those patients if a second wave (of COVID) occurs,” Hager said. And if we want to throw out the mask thing and you can be upset at me all you want for saying this, if you don’t believe in wearing a mask, feel free to come up without a mask. We were in a shortage of PPE. I feared every day when I came home from work that I was going to pass this to my family. Then, I’d come to work and work tells me I have to take my mask and put it in a bag and rotate it every five days because we can’t get masks. The degree of fear of taking that home to my five-year-old son who has a chronic medical condition is quite significant.”
“So again, I value every one of your opinions in here, but remember, we each have our own opinion and we’re all entitled to express our opinions,” Hager added. “But at the end of the day, we need to focus on what’s best for us as a community. We need to focus on love, not hate. We need to focus on our values and our morals. We can differ in policy, we can differ in our political views but at the end of the day, let’s choose kindness and figure out a way to move forward.”
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