Massachusetts K-12 students and staff should be tested for COVID-19 before classes resume in September, while government, education and business leaders should outline clear plans for when mask mandates would be triggered if another surge builds, a group of public health experts, labor leaders and community organizers said Monday.
Most Massachusetts residents are vaccinated against COVID-19, and precautions that defined public life during long stretches of the pandemic have faded. While the virus is still circulating, many Bay Staters are comfortable going maskless in most settings, test rates have dropped, and public activity has rebounded.
But with the impending start of the school year marking the approach of autumn, a range of speakers organized by the Massachusetts Coalition for Health Equity argued Monday that the virus continues to pose major threats, warranting additional preparation as the weather cools.
“We all want our society and our schools open. We all want this pandemic to be over,” said Katie Murphy, president of the Massachusetts Nurses Association. “But wishing it won’t make it so, and pretending that we’re doing all that needs to be done for the fall and winter seasons and what they may portend isn’t acceptable on any level.”
In the week ending Aug. 18, Massachusetts recorded 8,224 COVID-19 cases and a seven-day hospitalization average of 569 patients. That’s higher than the 8,112 cases and average hospitalization of 383 patients in the week ending Aug. 18, 2021, and the 1,817 cases and 183 average hospitalizations in the week ending Aug. 18, 2020, according to Boston University School of Public Health professor Jonathan Levy, who said regional wastewater data is also showing greater COVID-19 impact than at the same point in each of the past two summers.
Levy said the state’s position “is certainly not as good as in prior years heading into the fall,” though he added that the deployment of vaccines and boosters marks a significant improvement in protection over the past two years when those options either were not yet available or had not been adopted as widely.
“Nobody knows what this fall and winter will look like. Anyone who is confident that nothing is going to happen or we’re going to be overwhelmed is probably overstating their confidence,” he said. “We might still be dealing with BA.5, we might have BA.6, 7, 8, who knows, or we might have an entirely new variant. Remember, this time last year, no one had heard of omicron. It showed up at Thanksgiving and threw us for a loop.”
The coalition called on state government, school district leaders, local officials and employers to take steps ahead of the fall and winter. Officials should not hesitate to deploy mask mandates early on in surges rather than waiting until the strain on the health care system becomes more intense, speakers said Monday.
Coalition members urged the state to require students or workers who contract COVID to isolate for 10 days or until they no longer test positive on a rapid test, a contrast from the latest U.S. Centers for Disease Control guidance that calls for at least five days of isolation followed by masking.
They also suggested creation of options for vulnerable Bay Staters who feel more comfortable in masked settings, such as businesses offering mask-only hours and universal masking rooms in schools and workplaces.
Lara Jirmanus, a primary care physician at Cambridge Health Alliance, said masks and testing in particular should feature prominently as schools return to session over the next two weeks.
“That’s the way that we can actually prevent transmission — test everyone before they go back to school, hold school vaccine clinics, and require people to start the school year off wearing masks. [It] would keep cases at a minimum,” Jirmanus said. “I understand that is something that is not as potentially politically viable. If we feel that we can’t start the year with masks, we have to have a plan for a cutoff at which masks start, and it shouldn’t be when we’ve already hit the peak of the surge. The whole point is if you start masks beforehand, the surge is not as bad.”
Some educational settings in Massachusetts are preparing additional precautions for the fall. At UMass Amherst, all students will be expected to take a PCR test within 72 hours of arriving on campus or an at-home test within 24 hours of arriving on campus, and the university’s community can also visit University Health Services for a PCR test, officials announced in a message to families last week.
Gov. Charlie Baker lifted many COVID-19 restrictions including capacity limitations and masking requirements in some settings in May 2021, and Baker and education deputies lifted a mandate requiring face coverings in K-12 schools at the end of February.
Two districts, Boston and Chelsea, kept universal masking mandates in place in their schools through the end of the year in June, according to Tori Cowger, a postdoctoral fellow at Harvard University’s FXB Center for Health and Human Rights.
Cowger described a study she helped conduct comparing COVID-19 trends in Massachusetts districts that lifted masking requirements to those that kept them in place.
The pre-print study, which has not yet been peer-reviewed, estimated that the end of in-school masking requirements was associated with nearly 45 additional COVID-19 cases per 1,000 students and staff over a 15-week period.
“This translates to approximately 12,000 cases among students and staff in school districts that lifted their masking requirements, which is approximately 30 percent of all cases observed in schools over that timeframe,” Cowger said.
Last week, Education Commissioner Jeff Riley and Public Health Commissioner Margret Cooke told districts the state “is not recommending universal mask requirements, surveillance testing of asymptomatic individuals, contact tracing, or test-to-stay testing in schools” for the upcoming year. They also described plans to run free vaccine clinics aimed at students, teachers and families — which the administration has conducted in previous years — in August and September.
The commissioners pointed to U.S. Centers for Disease Control guidelines updated in August that scrapped a test-to-stay recommendation for anyone exposed to COVID-19 in a school setting and no longer called for people exposed to COVID-19 to quarantine.
“With COVID-19 vaccines now readily available, treatments accessible to those at higher risk for severe disease, and widespread availability of self-tests, DESE and DPH have continued to evolve our support for schools in collaboration with the medical community and in line with the most recent CDC guidance issued August 11, 2022,” they wrote.
That stance drew criticism from speakers at Monday’s event, with Jirmanus calling it “the wrong approach.”
“You don’t need an M.D. or a Ph.D. to know the new CDC guidelines and the changes in the Massachusetts state guidelines are about getting people back to work rather than to promote our health,” Jirmanus said.
Asked if there were any plans in place similar to the coalition’s recommendations or if the Baker administration is confident that the state can withstand any winter surge with the current guidelines, a Baker administration spokesperson who agreed to communicate on background only said the Department of Public Health strongly encourages families to get students vaccinated for COVID-19 before school begins and summarized options including family vaccine events and mobile clinics.