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Biden Ramps Up Virus Technique for Nursing Properties, Faculties

Biden Ramps Up Virus Strategy for Nursing Homes, Schools

WASHINGTON — The Biden administration moved on multiple fronts on Wednesday to fight back against the surging Delta variant, strongly recommending booster shots for most vaccinated American adults and using federal leverage to force nursing homes to vaccinate their staffs.

In remarks from the East Room of the White House, President Biden also directed his education secretary to “use all of his authority, and legal action if appropriate,” to deter states from banning universal masking in classrooms. That move is destined to escalate a fight with some Republican governors who are blocking local school districts from requiring masks to protect against the virus.

The shifts in strategy reflect the administration’s growing concern that the highly contagious Delta variant is erasing its hard-fought progress against the pandemic and thrusting the nation back to the more precarious point it was at earlier in the year.

Thus far, Mr. Biden has been reluctant to use the federal government’s power to withhold funding as a means of fighting the pandemic. But that changed Wednesday, when he said his administration would make employee vaccination a condition for nursing homes to receive Medicare and Medicaid funding. Officials said the decision would affect more than 15,000 nursing homes that employ 1.3 million workers.

“The threat of the Delta virus remains real, but we are prepared, we have the tools, we can do this,” Mr. Biden said in the East Room, adding, “This is no time to let our guard down.”

He accused politicians who were banning local school districts from requiring masks in the classroom of setting a “dangerous tone,” adding, “We’re not going to sit by as governors try to block and intimidate educators from protecting our children.” The administration is sending letters to eight states — Arizona, Florida, Iowa, Oklahoma, South Carolina, Tennessee, Texas and Utah — challenging their efforts to ban universal masking in schools.

For many Americans, the booster strategy will affect them the most. The government plans to offer third shots to adults who received the Pfizer-BioNTech or Moderna vaccines eight months after they received their second dose. About 150 million Americans have been fully immunized with one of those two vaccines.

“We are concerned that the current strong protection against severe infection, hospitalization and death could decrease in the months ahead, especially among those who are at higher risk” or who were inoculated in the early months of the vaccination campaign, Dr. Rochelle P. Walensky, the director of the Centers for Disease Control and Prevention, said.

Assuming that regulators decide third shots are safe and effective, the effort will start Sept. 20. Officials said they were waiting on more data to decide whether the 14 million Americans who received Johnson & Johnson’s single-dose vaccine should also receive an additional shot, but suggested that they would be included as well.

Although some public health experts have said booster shots were prudent and expected, not all scientists are convinced it is the right move. And advocates for global health said it was morally wrong — and shortsighted — for the administration to give booster shots to Americans when so many people around the world were still waiting to be vaccinated.

For state officials and health care providers, already exhausted from an 18-month battle against a novel virus that seems to shift its shape the moment it seems under control, the booster-vaccination campaign will bring a fresh round of logistical challenges. Some worried it could sidetrack efforts to vaccinate the roughly 85 million Americans who were eligible for shots but remained unvaccinated.

“We now have to fight a war on two fronts,” said Dr. José R. Romero, the Arkansas secretary of health. “We have to continue to press the vaccine into those groups that have not accepted it, and then have another effort to vaccinate those at high risk.”

The move to make employee vaccination a condition for nursing homes to receive Medicare and Medicaid funding reflects months of frustration with the low vaccination rates among nursing assistants and other workers who care for highly vulnerable people.

Officials described it as the first time that Mr. Biden had threatened to withhold federal funding in order to force vaccinations.

In an interview before the president spoke, Education Secretary Miguel A. Cardona described another major turning point: his department will use its civil rights enforcement arm to allow schools to require masks. The move comes as many educators and parents fear a surge in cases as the school year is about to start and as pediatric Covid cases climb.

The C.D.C. has recommended that everyone in schools wears masks, regardless of their vaccination status, but some states and localities are refusing to issue rules requiring masks or preventing schools from imposing them.

“The president is appalled, as I am, that there are adults who are blind to their blindness, that there are people who are putting policies in place that are putting students and staff at risk,” Dr. Cardona said in the interview.

“At the end of the day,” he said, “we shouldn’t be having this conversation. What we’re dealing with now is negligence.”

Administration officials made clear that booster shots would depend upon a determination by the Food and Drug Administration that third shots are safe and effective — a ruling expected in the coming weeks. Whether those under the age of 18 will be eligible will also be up to the F.D.A. and a federal advisory committee of experts, they said.

Aside from some people with weakened immune systems who have already been authorized for third shots, officials advised that fully vaccinated people wait for what they promised would be a speedy but orderly national rollout of booster shots.

Updated 

Aug. 18, 2021, 7:51 p.m. ET

“Here’s what you need to know: If you are fully vaccinated, you still have a high degree of protection from the worst outcomes of Covid-19 — severe disease, hospitalization and death,” Dr. Vivek H. Murthy, the surgeon general, said at a White House briefing. “We are not recommending that you go out and get a booster today.”

Dr. Walensky presented a series of studies at the briefing that, she said, showed the vaccines’ efficacy wanes over time. Some doctors applauded the decision to offer booster shots.

“Given the prevalence we have of the Delta variant, doing everything we can to keep people out of the hospital — especially those at high risk — does make sense,” said Dr. Paul Biddinger, the director of the Center for Disaster Medicine at Massachusetts General Hospital.

But some scientists criticized the policy as overly broad, arguing that it is not clear that the general population needs a third shot.

Jennifer B. Nuzzo, an epidemiologist at Johns Hopkins University’s Bloomberg School of Public Health, said the studies cited by administration officials showed that the vaccines were doing what they were intended to do — protect against severe disease and hospitalization.

“I don’t think the metric of, ‘We’re seeing more infection’ is the right metric to be judging the efficacy of the vaccines,” she said. “The right metric is, ‘Does it prevent severe disease?’”

The administration’s move follows similar actions by Israel, Germany and France but goes against the recommendation of the World Health Organization, which is arguing extra vaccine supply should go to countries that have vaccinated far fewer of their residents.

“Vaccine injustice is a shame on all humanity and if we don’t tackle it together, we will prolong the acute stage of this pandemic for years when it could be over in a matter of months,” Dr. Tedros Adhanom Ghebreyesus, the organization’s director general, said at a news conference before the White House’s briefing.

Jeffrey D. Zients, the White House pandemic coordinator, said the administration was already donating 600 million doses of vaccines to needy countries and would continue that effort — a point Mr. Biden reiterated in the East Room.

“We can take care of America and help the world at the same time,” Mr. Biden said.

Administration experts said the booster policy was the result of dual, disturbing trends: a decline in the vaccines’ potency over time and the apparent ability of the Delta variant to somehow bypass their protection better than its predecessors.

One study they cited found the vaccines’ effectiveness at preventing infections among nursing home residents dropped to about 53 percent from 75 percent between spring and summer, when the Delta variant became dominant.

Understand the State of Vaccine and Mask Mandates in the U.S.

    • Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
    • Vaccine rules . . . and businesses. Private companies are increasingly mandating coronavirus vaccines for employees, with varying approaches. Such mandates are legally allowed and have been upheld in court challenges.
    • College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
    • Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.  
    • Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
    • New York. On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S. city to require vaccines for a broad range of activities. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
    • At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.

Dr. Walensky said preliminary data from another study of more than 4,000 frontline workers suggested that the vaccines might not work as well against the Delta variant than against prior variants. In that study, a decline in vaccine efficacy against infection appeared related to the variant, not to how long ago the workers were vaccinated, she said.

She also cited data from Israel showing a worsening in the infection rate among vaccinated people over time. Israel vaccinated much of its population faster than other countries, making it a potential harbinger of what is to come for the United States.

Dr. Murthy said there was “nothing magical” about the eight-month timeline for allowing boosters, describing it simply as the best judgment of health experts. He and other officials emphasized that the overwhelming majority of hospitalizations and deaths from Covid continued to occur among the unvaccinated.

“Protection against severe disease and hospitalization is currently holding up pretty well,” Dr. Walensky said.

First in line for booster shots will be health care workers, nursing home residents and other older adults, followed by the rest of the general population. Officials envision offering the extra shots at pharmacies and other sites where initial vaccinations are already underway, rather than reopening mass vaccination sites. More than five million people could be eligible for the shots as of late September.

Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases and the president’s top medical adviser for the pandemic, said studies had shown that third shots of the Moderna and Pfizer vaccines could boost the levels of antibodies that fight the virus tenfold — an increase he called “remarkable.”

Although they promised the booster rollout would be orderly and thoughtful, federal officials are clearly racing against the clock to offer extra shots before those who were vaccinated earliest could be more vulnerable to the threat of severe disease.

The F.D.A. must first authorize third doses, and an advisory committee of the C.D.C. must review the evidence and make recommendations. But neither Pfizer nor Moderna has yet submitted all the necessary data showing that third shots are safe and effective.

Pfizer is expected to finish submitting its data this month. Moderna and the National Institutes of Health are studying whether a half dose or full dose works best. The company plans to submit its data next month.

On the plus side, federal and state health officials said that much of the infrastructure for a rollout was already in place. Tens of thousands of pharmacies and other sites are already offering shots on a daily basis, and many state officials said they could easily expand their work.

The nation’s vaccine surplus also makes it unlikely that Americans will experience the kind of frenzy seen in the early weeks of the vaccine effort last winter, when older Americans desperate for shots flooded mass vaccination sites. “The bottom line is that we are prepared for boosters, and we will hit the ground running,” Mr. Zients said.

Some state officials sounded less sure of a smooth operation. “It’s hard even to predict how strong the demand will be,” said Dr. Marcus Plescia, the chief medical officer for the Association of State and Territorial Health Officials, which was briefed on the administration’s plans Wednesday morning by C.D.C. experts.

“The big question is, do we do community vaccination clinics again, which worked very well in the initial run,” he said, “or is the demand going to be a little bit more spaced out over time?”

Apoorva Mandavilli and Daniel E. Slotnik contributed reporting.

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Schooling Secretary criticizes Republican governors over ban on masks in faculties.

Education Secretary criticizes Republican governors over ban on masks in schools.

WASHINGTON — The Biden administration admonished the Republican governors of Texas and Florida on Friday for blocking local school districts from requiring masks or taking other measures to protect students from the coronavirus in the coming school year.

The secretary of education, Miguel Cardona, sent a pair of letters to the governors and their education commissioners, writing that he was concerned about recent executive actions taken by both governors.

Those orders, he wrote, prohibited districts from “voluntarily adopting science-based strategies for preventing the spread of Covid-19 that are aligned with the guidance from the Centers for Disease Control and Prevention,” like universal masking. The letters were made public late Friday.

The debate over whether local school districts should be able to require masks has become highly partisan. Republicans have cast mask rules as an infringement on parental rights, while Democrats have said they are a matter of public health.

Last week President Biden also sharply criticized Republican governors like Gov. Ron DeSantis of Florida and Gov. Greg Abbott of Texas who had banned mask mandates, saying they “are passing laws and signing orders that forbid people from doing the right thing.”

“If you aren’t going to help, at least get out of the way,” Mr. Biden said.

In one letter released Friday, Dr. Cardona criticized Governor DeSantis for threatening this week to withhold the salaries of district superintendents or school board members who defied his order.

The education secretary noted that the American Rescue Plan Act passed by Congress allocated more than $7 billion to the state for safety measures. None of the money has been made available to local districts, Dr. Cardona wrote, and it could be used to pay the salaries of school officials.

“In fact, it appears that Florida has prioritized threatening to withhold state funds from school districts that are working to reopen schools safely rather than protecting students and educators and getting school districts the federal pandemic recovery funds to which they are entitled,” Dr. Cardona wrote.

In his letter to Texas officials, Dr. Cardona criticized Governor Abbott’s executive order blocking mask rules in schools as well as other state guidance that makes contract-tracing optional.

Dr. Cardona said Governor Abbott’s order “may infringe upon a school district’s authority to adopt policies to protect students and educators as they develop their safe return to in-person instruction plans required by federal law.”

The offices of Governor DeSantis and Governor Abbott did not immediately respond to a request for comment.

He suggested that the state’s actions might imperil its federal relief funding. The policies, he wrote, appeared to “restrict the development of local health and safety policies and are at odds with the school district planning process,” which are required under the Education Department’s rules for receiving the relief funding.

Dr. Cardona said his department’s rules emphasize that districts have discretion over how to use their funding, and that contact tracing, indoor masking policies, and other C.D.C recommendations are permitted and encouraged.

Dr. Cardona added that the Biden administration would “continue to closely review and monitor” whether both states were meeting requirements under federal funding laws.

Dr. Cardona also expressed support for districts in both states that have defied the governors’ orders.

“The Department stands with these dedicated educators who are working to safely reopen schools and maintain safe in-person instruction,” he wrote.

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Illinois Gov. Pritzker introduces masks mandate for colleges as Covid circumstances surge

Illinois Gov. Pritzker introduces mask mandate for schools as Covid cases surge

Illinois Gov. J.B. Pritzker

Brian Cassella | Chicago Tribune | Tribune News Service via Getty Images)

Illinois Gov. JB Pritzker announced a mask mandate for all state students regardless of their vaccination status at a news conference Wednesday, requiring facial coverings in all indoor settings from preschool through high school.

Pritzker noted that the new order would impact 1.8 million unvaccinated children under the age of 12. In addition to requiring masks in schools, Pritzker mandated facial coverings in all long-term care facilities in state, as well as in state-run corrections facilities, veterans homes, psychiatric hospitals and developmental centers.

“Preventing outbreaks from the start also prevents kids from having to stay home because they’re sick or in quarantine,” Pritzker said.

The move comes as the coronavirus delta variant spreads rapidly across the state and the nation.

Illinois experienced a 46% increase in cases last week, a seven-day average of almost 1,669 new coronavirus cases, according to data from Johns Hopkins University.

Pritzker’s announcement also comes as state and local governments continue to introduce health measures to mitigate the spread of the infectious disease. On Monday, seven counties in Northern California issued a mask mandate for all indoor settings, elevating a facial covering advisory issued in July to a requirement.

That same day, Louisiana issued a new statewide mask mandate for residents in public indoor settings until at least Sept. 1, a measure that includes students from kindergarten to college. Nevada revived its mask mandate for indoor public spaces on July 27, though it applies only to counties with elevated Covid transmission rates.

And on Tuesday, New York City mandated vaccinations for employees and patrons of the city’s restaurants, gyms, and entertainment centers, an order that will take effect in September. Mayor Bill de Blasio also said in June that city schools would keep their mask mandates in place.

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The Covid Variant in Colleges: What to Know

The Covid Variant in Schools: What to Know

Last week, the Centers for Disease Control and Prevention made a clear admission in an internal document that the highly contagious Delta variant had redrawn the lines of the coronavirus pandemic and required new public health measures such as universal masking requirements did. Or, as the agency put it in the document it received from the New York Times, “the war has changed”.

The news came as the first school districts prepared to reopen; Children in Atlanta and some of the suburbs are returning to the classroom this week.

In the past year, the extent to which schools are contributing to the spread of the virus and whether and when they should be closed has been controversial. To some parents, teachers, and officials, keeping schools open seemed like an unacceptable risk when a new, poorly understood virus was floating around. For others, however, it was school closings that were at greater risk – from learning losses, growing educational gaps, and deteriorating mental health, not to mention hardship for parents.

As the new school year begins, however, the CDC, the American Academy of Pediatrics, and many other experts agree that reopening schools should be a priority.

“We’re in a very different place than we were a year ago,” said Elizabeth Stuart, epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “We have very effective vaccines, we know a lot more about how to open schools safely, and I think we have an increased awareness of some of the challenges children face when they are not in a personal school.”

Just a few months ago, when vaccinations for people aged 12 and over were progressing steadily and new cases were falling, the stage seemed ready for an at least partial return to normal.

Delta has questioned that. Much is still unknown about the variant, including whether children are more affected than previous forms of the virus. And since vaccination rates are very uneven and most decisions are left to local officials, the variant adds new uncertainty to the upcoming school year – and makes it even more important for schools to take safety precautions when they reopen, scientists said.

“Delta, because it’s so contagious, has increased the stakes,” said Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases and vaccines expert at Vanderbilt University. “That makes all these details all the more important.”

Here you can find answers to some frequently asked questions.

Overall, studies suggest that – at least for the last year – school transmission was generally low when schools took basic precautionary measures.

Coronavirus Pandemic and Life Expectancy in the United States

“If you have masks and are even three feet apart, you will not see major outbreaks in schools,” said Dr. Yvonne Maldonado, Pediatric Infectious Disease Specialist at Stanford Medicine and Chair of the American Academy of Pediatrics Committee on Infectious Diseases. “There may be some broadcasts, but they will be relatively infrequent.”

Studies in North Carolina, Utah, Missouri, and elsewhere showed that when schools put multiple types of safety measures on top of each other – a combination of masking, symptom screening, distancing, improved ventilation, virus testing, hand washing, and dividing students into smaller groups – the transmission rates in schools were even lower than in the surrounding community.

“It’s actually safer for the kids at school than at home,” said Dr. Daniel Benjamin Jr., a pediatric infectious disease specialist at Duke University.

These low rates could be due in part to the fact that children under the age of 10 appear to be less likely to transmit the virus than older children and adults. Another factor, however, is that schools are, or can be, controlled environments and may have tighter security measures than the surrounding community, said Dr. Benjamin.

However, outbreaks have occurred in schools that have reopened without good containment measures. Israel’s first major school outbreak, which ultimately infected 260 people, came during a heatwave when officials temporarily lifted mask mandates and forced students into air-conditioned classrooms.

About twice as transmissible as the original version of the virus, Delta has led to an increase in infections and hospital stays, especially in areas of the country where vaccination rates are low. Recent data suggests that people infected with Delta may have a thousand times as many viruses – which could make them more contagious and longer – than those infected with the original version of the virus.

But many questions about the variant remain unanswered, including the exact risk in the school environment. What is clear, however, is that Delta is already fueling outbreaks in many American communities, increasing the risks for local schools.

“Schools are not islands, and if there is a large community diffusion, some of that diffusion will spill over to schools,” said Dr. Westyn Branch-Elliman, an infectious disease specialist at Harvard Medical School.

Updated

August 2, 2021, 9:20 a.m. ET

In a study conducted prior to the spread of Delta, British researchers found that the risk of school breakout increased by 72 percent for every five additional cases per 100,000 people in a community.

The good news is that since the start of last school year, the United States approved three highly effective emergency vaccines that are generally available for ages 12 and over.

The vaccines are not perfect. Some fully vaccinated people will get breakthrough infections, which are generally mild and rare. And those vaccinated people infected with Delta can carry high levels of the virus in their noses and throats, which means they can potentially easily pass it on.

But vaccines offer strong protection against the Delta variant. They reduce the chances of getting infected with the virus and protect against the worst consequences, including hospitalization and death.

Schools with high vaccination rates are likely to have far fewer people infected with the virus who carry or spread it in the classroom.

“It’s our best tool for controlling the virus,” said Justin Lessler, an epidemiologist at the University of North Carolina. “Even if it’s imperfect, it has a tremendous impact on reducing transmission and protecting people’s health.”

Initially, CDC guidelines recommended that unvaccinated people aged 2 and over wear masks in schools. And they strongly implied that vaccinated students do not need to be masked in the classroom.

But last week, over concerns about Delta, the CDC revised its guidelines, recommending that everyone, regardless of vaccination status, should wear masks in schools this fall.

The agency recommends a layered approach to Covid precautions, suggesting schools combine multiple mitigation measures and encourage anyone eligible for vaccination to get vaccinated.

However, the guidelines also leave many decisions to local officials, who are supposed to make decisions about when to tighten or relax restrictions based on data on local case and vaccination rates.

Some states, including some that are currently experiencing large surges – including Florida, South Carolina, and Texas – are making it difficult for schools to take protective measures. These three states, as well as a handful of others, have either banned or severely restricted the universal mask mandate.

That doesn’t necessarily mean that all schools in these states will have huge outbreaks, and even schools that do can have mostly mild or asymptomatic cases. But districts that open without security are at real risk, said Dr. Benjamin.

“Here’s another way of putting it,” he said. “When I grew up, I got away with driving in the back of a pickup all the time. But that doesn’t make children riding on the back of pickups a good national policy. “

With the patchwork of guidelines and uneven vaccination rates across the country, experts wouldn’t be surprised if school safety fluctuates sharply this fall. “I think there will be a risk of contagion if school districts decide not to follow recommendations,” said Dr. Maldonado.

As the pandemic continues to develop, schools and officials will have to make complicated decisions based on local conditions, including when to insist on certain precautions and when it is safe to lift them.

“We have to make nuanced decisions about what to do in schools,” said Dr. Branch-Elliman. “But that is a much more difficult public health message than polarized ‘schools are safe’ or ‘schools are unsafe’.”

Although the exact timing is unclear, vaccines for some children under the age of 12 could be approved before the end of the year. Until then, however, elementary schools will be open and practically none of their students will be vaccinated. (Children taking the exams may have received the syringes.)

However, research shows that the virus is much less likely to cause serious illness in children. You are not fully protected; a small number of children can develop a rare but severe inflammatory disease, and some children with mild infections may experience long-term symptoms.

There’s still no good, solid data on how Delta affects young children, but there’s no evidence that Delta targets them specifically.

However, because large numbers of adults have been vaccinated, children can make up an increasing proportion of Delta cases. The infectiousness of the variant can also lead to more children becoming infected with the virus. There is also some new evidence that the variant causes more severe illness in adults.

Given these observations, and out of caution, it’s especially important for schools with young, unvaccinated students to take other precautions, including universal masking, experts said.

In schools or districts that do not have a mask requirement, parents can provide some protection by ensuring that at least their children wear masks in school, said Dr. Maldonado.

And adults can help protect younger children by getting themselves vaccinated. “The most important thing any community can do to reduce the risk in schools is vaccinating the entire community,” said Dr. Conductor.

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Pediatricians Affiliation Recommends Common Masking in Faculties

Pediatricians Association Recommends Universal Masking in Schools

The American Academy of Pediatrics issued new Covid-19 guidelines for schools on Monday recommending that everyone over the age of 2 wear masks in the fall, even if they have been vaccinated. Exceptions can be made for those with medical or developmental conditions that make it difficult to wear masks, the group said.

The universal masking recommendation is a departure from the guidelines issued earlier this month by the Centers for Disease Control and Prevention that only recommend masking in schools for unvaccinated people over the age of 2. These guidelines strongly imply that fully vaccinated children and adults are not required to wear masks in the classroom – although they also said individual schools are free to implement universal masking requirements.

However, in many ways the two directives are similar. The AAP, like the CDC, stressed the importance of returning to personal learning.

“Our priority must be getting children back to school with their friends and teachers – and we are all helping to ensure that it happens safely,” said Dr. Sonja O’Leary, the chair of the AAP Council on School Health, in a statement.

Like the CDC, the AAP recommended a “layered” approach that combines a variety of measures to reduce the risk of coronavirus transmission. In addition to universal masking, these measures include vaccinations, improved ventilation, virus testing, quarantines, and cleaning and disinfection, the group said.

The AAP gave several reasons for its universal masking recommendation.

Many students are too young to be eligible for the vaccines, which are only approved for those aged 12 and over, the group found. And universal masking could reduce overall transmission of the virus and help protect those who are not vaccinated.

The group also cited concerns about more communicable virus variants and the possibility that vaccination rates could be low in the surrounding community, which could increase the risk of an outbreak at a particular school. The AAP also recommended universal masking because it can be difficult to verify that individual students or employees have been vaccinated.

Some state and local officials have already announced that they will not be calling for universal masking this fall, and at least eight states have banned such mandates.

The AAP guideline didn’t stop recommending vaccine mandates, but it said they might ultimately be needed. “It may be necessary for schools to collect Covid-19 vaccine information from staff and students and for schools to require Covid-19 vaccination for personal learning,” the guidelines say.

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Educators’ Unions Reward C.D.C. Faculties Steerage However Acknowledge Challenges

Educators’ Unions Praise C.D.C. Schools Guidance But Acknowledge Challenges

The two largest U.S. unions representing educators on Friday approved the new federal guidelines calling for schools to be fully reopened, while allowing children under 12 who are not eligible for vaccination to go ahead face further challenges.

The new recommendations, issued on Friday by the Centers for Disease Control and Prevention, come after students, teachers and parents experienced a disruptive school year marked by changing guides, school closings and hastily implemented distance learning plans to contain the coronavirus .

Education has been a focus since the pandemic broke out when many teachers and families feared in-person tuition. But distance learning has proven to be an inadequate substitute for many parents and students, and virtually all major counties are planning to reopen full-time schools this fall – though they have yet to convince some reluctant parents to return their children.

Education Minister Miguel Cardona said in a statement Friday that “our top priority is to ensure that our nation’s students can safely study in person in their schools and classrooms.”

The new CDC guidelines will help educators achieve this goal, union leaders said.

Becky Pringle, president of the National Education Alliance, the country’s largest teachers’ union, said in a statement the guidelines are an “important roadmap to reducing the risk of Covid-19 in schools.”

Randi Weingarten, president of the American Federation of Teachers, who has already pushed for schools to fully reopen this fall, said in her own statement that “The guidelines affirm two truths: that students learn better in the classroom and that vaccines are ours the best bet is to stop the spread of this virus. “

The new recommendations call for vaccinating as many people as possible, wearing masks for the unvaccinated in schools, a meter spacing between students and the superposition of various preventive tactics.

“For educators across the country, this guide sets a lower limit, not an upper limit; it builds on the evidence we have about the transmission of Covid and reminds us that we need to remain committed to other containment strategies, “said Ms. Weingarten, adding that” we address the growing concern about the Delta variant as well The evolving science around Covid share transmission among young people making it mandatory for school districts to be committed to both vaccinations and these safety protocols. “

Studies suggest that vaccines against the Delta variant remain effective.

The new guidelines also suggest that districts base their approaches on local conditions rather than general regulations, an approach that Ms. Pringle welcomed.

“It is important that we listen to the special needs of all of our schools and the communities they serve,” said Ms. Pringle. “We as a country have a responsibility to cope with the disproportionate burden that colored communities suffered during this pandemic, which has contributed to families reluctance or reluctance to allow their children to return to face-to-face education.”

Schools proved far safer than many had thought during the pandemic, and in general, serious illness and child deaths were rare. Young children are also less likely to transmit the virus to others than teenagers and adults.

Meisha Porter, the chancellor of New York Schools, the largest school system in the country, reiterated the plan to bring students back to full-time face-to-face classes in September.

“Science shows that our rigorous, multi-faceted approach has made our schools the safest places to be, and we are reviewing CDC guidelines with our health professionals,” Porter said in a statement.

However, no vaccines have been federally approved for children under the age of 12, and children have made up a larger proportion of cases over the course of the pandemic, although there are far fewer cases overall than during the winter peak.

Scientists are concerned about an inflammatory syndrome that can appear in children weeks after contracting the virus, even those who were asymptomatic with the infection, and some children experience persistent symptoms often known as long covid.

The highly communicable delta variant is spreading rapidly in areas with low vaccination rates – the CDC estimates that it is now the predominant variant in the United States.

Expert opinion on the new guidelines was mixed.

Dr. Benjamin Linas, an infectious disease specialist at Boston University, called the proposals “scientifically sound and just right”.

“For the first time, I really think they hit it in the nose,” he said.

Emily Oster, Brown University economist and parenting book author who entered the controversial school reopening debate last year and used data to argue that children should return to school in person, said they were generally comfortable with the framework of the Agency was satisfied, which it said gave the districts a roadmap for reopening without being overly prescriptive.

Despite pushing for even more relaxed leadership – for example, the complete abolition of the three-foot rule – she said the new recommendations give districts important flexibility.

“This is in some ways the most positive I have about your advice,” said Dr. Easter.

But Jennifer B. Nuzzo, an epidemiologist at Johns Hopkins University, feared the debate among local officials about the best security protocols could prove “crippling”.

Speaking at a press conference on Friday, White House press secretary Jen Psaki said that the decision on what action to take has “always been the responsibility of the local school district.”

The coverage is from Sheryl Gay Stolberg, Emily Anthes and Sarah Mervosh.

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‘It’s Powerful to Get Out’: How Caribbean Medical Colleges Fail Their College students

‘It’s Tough to Get Out’: How Caribbean Medical Schools Fail Their Students

Last summer, when Dr. Sneha Sheth went online to begin filling out applications for residency — the next stage of her training after medical school — she was hit with a jolt of disappointment.

Of the 500 residency programs she was considering, nearly half had been labeled unfriendly to international medical students, like her, by the website Match a Resident, which helps medical students abroad navigate the U.S. residency application process. Dr. Sheth submitted her applications in September and spent months on edge. Then came the distress of rejections from numerous programs, and no responses from others.

“There are 50 percent of programs that don’t want you, which is a scary feeling,” said Dr. Sheth, 28, who graduated recently from a Caribbean medical school. “It’s like, if they don’t want you, who will?”

The frustrations of the match process, which assigns graduates to programs where they can begin practicing medicine, made Dr. Sheth question whether she had been foolish to enroll in a Caribbean medical school. She had spent tens of thousands of dollars but ended up shut out of American residency programs (although she recently landed a spot in a Canadian one).

In the 1970s, a wave of medical schools began to open across the Caribbean, catering largely to American students who had not been accepted to U.S. medical schools; today there are roughly 80 of them. Unlike their U.S. counterparts, the schools are predominantly for-profit institutions, their excess revenue from tuition and fees going to investors.

Admissions standards at Caribbean schools tend to be more lax than at schools in the United States. Many do not consider scores on the standardized Medical College Admission Test as a factor in admissions. Acceptance rates at some are 10 times as high as those at American schools. They also do not guarantee as clear a career path. The residency match rate for international medical graduates is about 60 percent, compared with over 94 percent for U.S. graduates.

In 2019, Tania Jenkins, a medical sociologist, studied the composition of U.S. residency programs and found that at more than a third of the country’s biggest university-affiliated internal medicine programs, the residency population was made up overwhelmingly of U.S. medical graduates. Caribbean medical school students match into residencies at a rate 30 percentage points lower than their U.S. counterparts.

“U.S. medical school graduates enjoy tailwinds,” Ms. Jenkins said. “Caribbean medical students experience headwinds. They have a number of obstacles they have to overcome in order to be given a chance at lower-prestige and lower-quality training institutions.”

The challenges that Caribbean medical students face in career advancement have raised questions about the quality of their education. But with the rapid rise in the number of medical schools worldwide — from around 1,700 in the year 2000 to roughly 3,500 today — tracking and reporting on the quality of medical schools abroad has proved a difficult task.

In recent years, medical educators and accreditors have made a more concerted effort to evaluate the credibility of those institutions, with the goal of keeping applicants informed about subpar Caribbean schools, which charge tens of thousands of dollars in tuition and fees and sometimes fail to position their students for career success.

That effort has largely been led by the Educational Commission for Foreign Medical Graduates, which reviews and provides credentials for graduates of foreign medical schools, including documentation of their exam scores and their academic histories. In 2010, the commission announced an initiative requiring every physician applying for certification to have graduated from an accredited medical school. The group also said it would more closely scrutinize the standards for organizations that accredit medical schools around the world. The new rule will take effect by 2024.

The commission has already penalized two Caribbean medical schools — the University of Science, Arts & Technology Faculty of Medicine in Montserrat and the Atlantic University School of Medicine in Antigua and Barbuda. The group refused to grant credentials to any of those schools’ graduates, saying it had found the schools to be “egregious in terms of how they treated students and misrepresented themselves.” The medical school in Montserrat subsequently sued the commission, but the case was dismissed in a U.S. federal court. The University of Science, Arts & Technology Faculty of Medicine in Montserrat did not respond to requests for comment.

“I’m very concerned about students’ being taken advantage of by schools that may not give them proper information as to how they’re going to learn and what their opportunities are going to be when they finish school,” said Dr. William Pinsky, head of the commission.

He said he hoped that students would be better protected by 2024, when accrediting organizations plan to complete evaluations of all international medical schools through a more rigorous accreditation process.

One of the primary accrediting bodies for Caribbean medical schools is the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions, known as CAAM-HP. Lorna Parkins, executive director of the organization, said that some of the key factors the group considers in denying accreditation include high attrition rates and low exam pass rates.

Credit…via Yasien Eltigani

But Caribbean schools occasionally misrepresent their accreditation status on their websites, Ms. Parkins added. She sometimes hears from students who are struggling to transfer out of lower-quality schools.

“It’s my daily concern,” Ms. Parkins said. “I know students have very high loans, and their families make great sacrifices to educate them.”

Applying to medical school in the United States requires a certain level of know-how: how to study for the MCAT; how to apply for loans; and how to make yourself competitive for a select number of spots. Applicants with less access to resources and mentoring are at a disadvantage and are sometimes less aware of the drawbacks of international medical education.

Dr. Yasien Eltigani, 27, who is Sudanese and immigrated from the United Arab Emirates to the United States, said he had little assistance in navigating the obstacle course of medical school applications. He applied to only nine schools, all in Texas, not realizing that most U.S. students apply more widely, and was rejected from all of them. Two years later, when he saw a Facebook advertisement for St. George’s University in Grenada, he decided to apply.

Looking back, he says he wished he had reapplied to American schools instead of going the Caribbean route. Although he was able to match into a residency program, which he recently started, he found the process to be anxiety-inducing.

“If you fall behind in a U.S. medical school, your chances of matching are decent, whereas in a Caribbean medical school you’re at risk,” he said. “As an immigrant, I didn’t have much in the way of guidance.”

Caribbean medical school administrators say their intentions are straightforward: They aim to expand opportunities for students to go to medical school, especially those from racially, socioeconomically and geographically diverse backgrounds, to include people who might not have traditionally pursued careers in medicine.

“U.S. medical schools have more applicants than they know what to do with,” said Neil Simon, president of the American University of Antigua College of Medicine. “So why do they object to medical schools that have obtained approval and are educating a student population that is much more diverse? Wouldn’t you think they’d welcome us with open arms?”

Mr. Simon said that he was aware of the bias that A.U.A.’s graduates confront as they apply for residency positions in the United States and that he saw the stigma as unfounded. He added that international medical graduates were more likely to pursue family medicine and to work in underserved areas, especially rural communities.

But experts say that the proliferation of for-profit medical schools does not always serve the best interests of students. The Liaison Committee on Medical Education, which credentials U.S. schools, did not recognize any for-profit schools until 2013, when it changed its stance following an antitrust ruling mandating that the American Bar Association accredit for-profit law schools. Among medical educators, substantial skepticism still exists toward the for-profit model.

“If medical students are viewed as dollar signs rather than trainees that require lots of investment, support and guidance, that fundamentally changes the training experience of these students and the way their education pans out,” Ms. Jenkins said.

Some students at Caribbean medical schools said the quality of their education had declined even further in recent years as some campuses faced natural disasters.

In 2017 when Hurricane Maria hit Dominica, where Ross University School of Medicine’s campus was situated, the school decided to offer its students accommodations on a ship docked near St. Kitts. To some of the students, this sounded like an adventure. But as soon as they arrived on the boat, they realized that it did not lend itself to rigorous study.

With few study spots or electric outlets available on the ship, Kayla, a first-year-student, awoke each day at 2 a.m. to claim a place where she could study for the day. (Kayla asked to be identified by just her first name so that she could freely share her experience.) Her exams were held in a room filled with windows that looked out over the ocean waves. She and her classmates said that if they looked up from their tests, they had immediately felt nauseated. She couldn’t take Dramamine, she said, because that exacerbated her fatigue. Some of her classmates left before the semester ended because they could not handle study conditions on the ship.

“We understand that extenuating circumstances posed challenges for all,” a spokesman for Adtalem Global Education, the parent organization of Ross University School of Medicine, said in an email. “We took extraordinary measures to provide options for students to continue their studies or to take a leave of absence until campus facilities could be restored.”

But the combined challenges of these schools have given way to a saying: “It’s extremely easy to get into Caribbean schools,” said Dr. Abiola Ogunbiyi, a recent graduate of Trinity Medical Sciences University in Saint Vincent. “But it’s tough to get out.”

As accreditation standards evolve, Ms. Jenkins said one of the most critical ways to protect students was to ensure transparency from the schools. “People should go into their training with their eyes wide open,” she said.

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Health

New York Turns to Good Thermometers for Illness Detection in Faculties

New York Turns to Smart Thermometers for Disease Detection in Schools

And then of course there are the inevitable privacy concerns. Kinsa emphasizes that all data made available to the city is aggregated and anonymized. “None of the individual data goes to anyone other than that person,” said Mr Singh. “You have the data, and we’re really persistent with it.”

While digital privacy experts say these are important safeguards, they also point out that information about children and health is particularly sensitive. “It’s really important to weigh the benefits and needs of public health against the social or societal risks,” said Rachele Hendricks-Sturrup, health policy advisor at the Future of Privacy Forum, a think tank focused on privacy.

For example, even anonymized data can sometimes be re-identified. “Even if it turns out to be ‘A fourth grader at this school in this neighborhood,’ that might narrow it down,” said Hayley Tsukayama, a legislative activist at the Electronic Frontier Foundation, a digital privacy group. “It doesn’t take a lot of data points to identify something new.”

The data, aggregated by zip code, will also feed into disease signals that Kinsa makes available on its public HealthWeather map. The company sometimes shares this information at the postal code level with pharmacies, vaccine distributors, and other companies. For example, Clorox used Kinsa’s data to determine where to target its ads. (Lysol won’t have special access to the data, says Kinsa.)

Both Kinsa and the city need to be transparent to families about how the data is used, stored and shared, and how long it is retained, experts said. City officials “are essentially putting their stamp on,” said Amelia Vance, director of youth and education privacy at the Future of Privacy Forum. “They need to make sure they are living up to parents’ trust that this program has been fully reviewed and is safe for their children and families.”

City officials will be closely monitoring how well the program is performing over the coming months, said Dr. Varma. How do families feel about the program? Is there enough intake to produce useful data? Can they actually spot outbreaks earlier – and slow the spread of disease?

“Our goal is to see if it really has the effect we hope in the real world,” said Dr. Varma. “It is also possible that the system does not detect anything conspicuous or unusual, but still proves successful because it provides people with useful information and increases their confidence that they have their children in school.”

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Politics

Concentrating on ‘Important Race Concept,’ Republicans Rattle American Faculties

Targeting 'Critical Race Theory,' Republicans Rattle American Schools

Still, he acknowledged that Republicans had “figured out how to message this.”

The messaging goes back to Mr. Trump, who, in the final weeks of the 2020 campaign, announced the formation of the 1776 Commission, set up explicitly to link what he said was “left-wing indoctrination” in schools to the sometimes violent protests over police killings.

A report by the commission was derided by mainstream historians; Mr. Biden canceled the project on his first day in office, but its impact endures on the right.

Media Matters for America, a liberal group, documented a surge of negative coverage of critical race theory by Fox News beginning in mid-2020 and spiking in April, with 235 mentions. And the Pew Research Center found last year that Americans were deeply divided over their perceptions of racial discrimination. Over 60 percent of conservatives said it was a bigger problem that people see discrimination where it does not exist, rather than ignoring discrimination that really does exist. Only 9 percent of liberals agreed.

Some Democratic strategists said the issue was a political liability for their party. Ruy Teixeira, a senior fellow at the left-leaning Center for American Progress, recently wrote, “The steady march of ‘anti-racist’ ideology” into school curriculums “will generate a backlash among normie parents.”

In an interview, he criticized leading Democrats for not calling out critical race theory because of their fear that “it will bring down the wrath of the woker elements of the party.”

In Loudoun County, Va., dueling parent groups are squaring off, one that calls itself “anti-racist” and the other opposed to what it sees as the creep of critical race theory in the school district, which enrolls 81,000 students from a rapidly diversifying region outside Washington.

After a 2019 report found a racial achievement gap, disproportionate discipline meted out to Black and Hispanic students, and the common use of racial slurs in schools, administrators adopted a “plan to combat systemic racism.” It calls for mandatory teacher training in “systemic oppression and implicit bias.”

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Health

Air flow and Testing Can Assist Maintain U.S. Faculties Open in Fall, Research Counsel

Ventilation and Testing Can Help Keep U.S. Schools Open in Fall, Studies Suggest

Several measures to mitigate Covid-19 – including improving ventilation, requiring adults to wear face masks, and taking frequent surveillance tests – can help keep schools open and students safe, according to two new studies.

The studies, released on Friday, come as many school districts work out their plans for the fall. They also follow guidelines from the Centers for Disease Control and Prevention that all schools teaching students from kindergarten through 12th grade will continue until the end of the 2020-2021 school year following the agency’s latest move to admit vaccinated people Implement guidelines for wearing masks should not use masks indoors. The agency also upheld its proposals to monitor physical distancing and test for coronavirus infections.

In one of the new studies, researchers from the CDC and the Georgia Department of Public Health surveyed 169 elementary schools in Georgia that offered face-to-face learning last fall. The group asked schools about their pandemic responses and collected data on the coronavirus cases discovered between November 16 and December 11 before vaccines were used in the United States.

The researchers found that the incidence of the virus in schools that had improved their ventilation – by opening windows or doors or using fans – was 35 percent lower than in schools that did not use these practices. In schools that combined better ventilation with air filtration – for example through the use of HEPA filters – the fall rates were 48 percent lower.

The researchers found that all teachers and staff had to wear masks to reduce the incidence of the virus by 37 percent. Schools that required students to wear masks had a 21 percent lower incidence of the virus, but that reduction was not statistically significant, the scientists found. This may be due to the fact that adults are more likely to transmit the virus than children, or simply to a small sample size.

“Since the universal and correct use of masks can reduce SARS-CoV-2 transmission and is a relatively inexpensive and easy to implement strategy, the results of this report suggest that the universal and correct use of masks is an important Covid-19 -Prevention strategy in schools is a multi-component approach, ”write the researchers.

A second study, conducted by researchers from the Utah Department of Health and the University of Utah, tracked the implementation of two coronavirus screening programs in state schools. A program that ran in January 2021 allowed schools with outbreaks to conduct school-wide testing instead of switching to distance learning.

“The schools could either do what they did the fall, switching to remote control for two weeks to break the chains of transmission, or they could test all of them,” said Dr. Adam Hersh, one of the study’s authors and a pediatric infectious disease expert at the University of Utah. “And those who tested negative could return to face-to-face learning, and those who tested positive would obviously be isolated.”

In a second testing program, students had to be tested for the coronavirus every 14 days in order to participate in sports or other extracurricular activities. Both initiatives relied on rapid antigen tests, which are less sensitive but cheaper and faster than standard PCR tests.

That year, between January 4 and March 20, 28 high schools in the state reported sizeable outbreaks. Fifteen schools decided to switch to distance learning for two weeks, while the other 13 decided to run surveillance tests instead. Of the 13,809 students who were tested as part of this screening, only 0.7 percent were positive, the scientists reported. All 13 schools remained open.

“This is a huge achievement from a public health perspective,” said Kendra Babitz, coronavirus testing coordinator for the Utah Department of Health and one of the study’s authors. “Testing is and should be a mitigation strategy that schools use to prevent the transmission of SARS-CoV-2 in schools,” she added, referring to the virus that causes Covid-19.

Over the winter, 95 percent of school sports events took place on schedule, the researchers found, although they didn’t compare that number to a control group of schools without screening programs. “This is similar to what happens in the normal season,” said Dr. Hersh. “The show could go on.”