Saturday, March 5, 2022

On Masks, Ventilation, and Contact Tracing - Yes, Again!

On Monday I presented to my school board to try to persuade them to keep masks even if (when) Ford removes mandates and to allow me to keep my Corsi-Rosenthal filtration unit in my classroom, dammit! Here's my 8 minute presentation/plea. They said "thanks" very politely, then the Associate Director started talking about nearing endemicity (at 101:15-23 here), which isn't remotely the case but more on that later, and then a trustee reported on the harm caused by masks both from the ingredients in the material and the restrictions on talking while eating during lunchtime, as they harkened to our pre-pandemic lives. 


But at least I tried. I don't mind trying and failing, but nothing feels worse to me than not trying at all then always wondering what might have happened had I done a little more or at least done something. Nobody tried to suggest it's a mental health problem to wear masks this time, although I was prepared for it since that was the Associate Director argument at a previous meeting. Current studies show that the strongest correlation to mental health isn't tied to mask wearing but to levels of the virus in the community. If we wear masks to keep levels low, then it will improve mental health in the region! 

Corsi-Rosenthal boxes work like a charm, and are so cheap and easy to use that somebody must be getting enough of a kickback from the sale of HEPA filters in our province or board to prevent the homemade filters from coming anywhere near our buildings. I managed to have one for most of the winter until a VP noticed it in my room. She was good enough to replace it with a HEPA, but I soon discovered that it's absolutely impossible to be heard by someone inches away from me with the costly unit running, rendering them completely ineffective since they're often turned off. The CR boxes are virtually silent when they run, and they outperform most other filtration units! (Effectiveness along the side, and cost along the bottom.)

After my video played, I commented that I realize the board might have its hands tied if we go the route of Alberta, in which case let's focus on the right kind of messaging when mandates are lifted to have an impact in the right direction. In Alberta, Kenney has removed any power from the school boards to provide rules around masks in their buildings since he believes kids pose no danger to adults, and we should just let them be kids! MoE LaGrange informed boards they don't have power to order students to wear masks on buses, either. And now they're working on removing power from Public Health Units as well. Even a class action lawsuit launched on behalf of parents of immunocompromised children was tossed out as the judge ruled that the removal of the mandate in schools shows "no evidence of irreparable harm" to the children. So there's that. It doesn't help that even Cambridge Analytica is in on the game of disinformation around Covid. 

AN EQUITY ISSUE

It's frustrating to see the parallels between Covid denial and climate denial. First they said it's not real. Then they insisted it's real, but not that bad. Then they said it's real and pretty bad for some, but there's nothing we can do about it. And now they realize that we could do something, but it would be really inconvenient and mainly help people who are compromised in some way, and we don't really care about them much anyway. 

Like climate change, Covid affects marginalized groups more than the white and wealthy making most of the decisions, so it's possible for far too many to just not care about these deaths and disabilities for far too long. Hospitalizations are highest in low-income, Indigenous, Black, and Brown communities, and even worse for people with a disability. Every time we remove a protection, we're letting people know that their lives don't matter to us. 

Saying we want to go back to normal is a statement of privilege, not freedom. People want the right to do anything they want without concern for their effect on others. Removing masks so people can feel normal ignores the people who will have to stay home because of this decision. Letting them know that they can still wear masks doesn't help at all. The vulnerable need two-way masking to be protected. It's like saying "You're free to stop at a red light if that makes you feel safer." It's unleashing chaos to suggest that it's merely a preference and not a responsibility and a rule that's necessary for us to protect one another. We need everyone on board with masking (and following traffic signals). When people tell us to just stay home, it's forcing people with invisible disabilities and anxieties into disclosing conditions, which is straight up ableism.

If someone in my class says something prejudiced, I shut that down immediately. I know it has potential to harm even though I don't always know who will be harmed or to what extent. I shut it down regardless who's in the room because allowing one comment makes it seem acceptable, and it can reproduce outside my room if ignored. We know covid has the potential to be disabling and deadly. We might have a fully vaccinated room of kids, but we never know who they might bring a virus home to, so we really have to shut down all potential transmission. 

Back in the mid-90s, when our city was one of the first to make smoking illegal in restaurants, we made the decision to protect people from the harm of second-hand smoke and insisted that people can be free to smoke outside. There were lots of fights about it, but the powerful stood on the right side of history on that one, and smokers got used to the inconvenience, and the rest of us breathed cleaner air. Since there are far more non-smokers than smokers, it was good for business too. It's easy to protect others from the harm of potentially carrying a fatal virus with a simple N95 mask, but our society has become so much less compassionate and community-minded. As a result, long covid will deny many kids access to the kind of education they expect as many will end up no longer able to do the work or any work. People in power are making decisions that will create more people with physical and cognitive disabilities. Do they not see how this will impact the economy? 

ANGER FROM GUILT, FEAR, AND GRIEF

Most bizarre to me is how baffled people are that I'm worried about my students' well-being. When I mentioned all the things I do to prevent transmission in my classroom to my family doctor, he said, "You're triple vaxxed, so why do you care?!" It's as if some people are completely unable to understand concern for others. A parent of one of my students who called about my windows being open a crack, told me to stay home if I'm so worried. I need to wear this on a t-shirt: There are 3-4 kids in each room without any protection from vaccines. It's my responsibility as their teacher to do everything in my power to make my classroom a safe space for ALL students. 

The anger I've faced seems to be around the perception that my actions criticize the choice of others not to act to protect others. Wearing a mask in public reminds people that the pandemic isn't over and that they're selfish for not wearing one to protect others. It makes them feel guilty for putting their desire for dinner parties ahead of the very survival of other human beings.

The anti-mask/anti-vax movement isn't about choice and freedom. It's about normalizing selfishness and a lack of regard for others. The anger they express towards others can only be explained as a crabs in a bucket effect: "I don't want to do the right thing, so instead I'll stop others from doing it, and then we'll all be wrong together, and I'll feel better about my choices." Masks serve as a reminder that there is still an ongoing global pandemic, and it forces people to confront any fear they have around that reality. It prevents their denial from being fully realized. Denial is a stage of grief that some people never resolve, and we need to address the collective grief caused by this massive change in our lives. Removing masks won't make things normal again. Things won't ever be the anything like they were for most of us.   

MASK MANDATES

We know from wastewater surveillance that our situation in Ontario is getting worse, but that won't stop Ford from celebrating the end of Covid just in time for the election. 

(How is he still polling so high? And how do we get Del Duca and Horwath to join forces for this one? We are so screwed!)

I've surveyed my classes anonymously about how they feel about the mask mandates likely being lifted this month. In each class, about 70% plan to keep wearing a mask; 20% will wear one if asked; 5% are excited to never wear one again, and 5% won't come unless everyone's wearing one. I think more of the teachers in my wing will ditch the masks faster than my students. It makes me think of smokers who keep smoking despite all the warnings until they themselves get cancer - and even then there are some that still won't quite. Some people need to see the effect of this virus in their own family before they'll really care about taking any precautions.

The survey raises an interesting ethical question: Who's needs should matter more: the 5% dying to get rid of the masks or the 5% leaving the class to avoid dying? It's very clear to teenagers that this decision rests on the level of harm that could affect each party. So, when deciding between the joy of demasking and the potential lack of access to education, they leaned heavily on persuading the class in general to keep masks on for the benefit of the few who won't come otherwise. So I got them to workshop some posters to put on my door, and here's what we came up with so far (nothing fancy because the colour printer isn't working):


Students are also quick to realize we need something in place to stop any bullying around masks. Our city is one of the regular pit stops for Maxime Bernier, and our last Student Vote showed about a 6% PPC following in our schools. If we're not ready with rebuttals that soothe the anger of anti-mask advocates, then we'll easily get taken out one by one, shamed into removing our masks like the kids in Florida were when faced with their asshole Governor (all but that one kid on the very left - he's my hero!).

NONE of these decisions should be on the shoulders of students. NO student should be trying to think up ways to wear a mask in school without being ridiculed or worse. Our leaders are failing us so massively right now!!

CONTACT TRACING 

A friend of mine tested positive on Wednesday. She eats lunch with about 10-12 colleagues every day, but since she spends less than 15 minutes with her mask off, Public Health doesn't count any of the people she eats with as high risk contacts, so NONE have to isolate. What concerns me more is that none seem to have any interest in isolating just in case, despite having generous paid sick days at their work. Public Health has convinced them that they're safe as long as they're not exposed for more than 15 minutes within 6' AND with masks off at the same time. All three have to happen for it to be considered worthy of isolating a few days or taking a test. 

It's clear that my local Public Health really stopped caring about stopping the spread of this virus!

Their conditions comes from this CDC report that came out in October 2020, long before Omicron was a gleam in Delta's eye. Since then, we know that the virus can cross a room in minutes, and that it hangs in the air for hours. A more recent CDC report (January 2021) says that "transmission was observed in persons who had cumulative interactions of less than 15 minutes' duration," and a Government of Canada report from June 2021 says, "people inhaled the virus at distances beyond two metres." We know that Omicron is a much faster spreader, so why use information that's two years old? Unless, of course, it's just more convenient for businesses to keep people at work.

An aerosol travels like smoke, right? Imagine sitting 7' away from someone smoking a cigarette, which takes less than 10 minutes to finish. With a crappy surgical mask, you'll likely still smell the smoke, and if you take off your mask after 15 minutes, after the smoker leaves the room, you'll likely still be breathing in the fumes. If you were seriously allergic to cigarette smoke, there's no way you'd stay in the same room with someone smoking, amirite?? But somehow Public Health thinks that's not how aerosol transmission works with this extremely contagious virus, and all those contacts were advised to remain at work to potentially infect more people. PH also fails to acknowledge that people pick up the virus through their eyes! They assume that a mask is all that's necessary to protect us when an infectious person is right next to us eating and talking with their mask off. Don't get me wrong, masks are great, and the lower the amount inhaled, the less severe the case. But we should still isolate and test people who have been in the same room with an infected, unmasked person.

Since it's not possible to be considered a high risk contact with masks, I thought, just maybe, once we lose the masks, that we'd contact trace again! But Manitoba has now said that even confirmed cases are no longer required to isolate. They're moving to an endemic response despite the fact that Covid is NOT endemic at this point, and that endemic doesn't mean harmless; it just means that it's limited to a particular region and/or at a specific time. Less than 2 months ago (Jan. 19), the most recent WHO report said, "The Director-General determined that the Covid-19 pandemic continues to constitute a PHEIC [public health emergency of international concern]," and he recommended that scientists investigate transmission between humans and animals because the Omicron variant "may have evolved independently in an animal host." Yikes. More transmission --> more mutations, and the new variants are more effective at transmission. They're not getting milder. 


When Covid becomes endemic, if it ever does, it might mean specific areas will lock down as the virus flares there until numbers are manageable. We might see Covid cases spiking every winter until we dramatically improve indoor ventilation systems in every single public and private building. (This might become a lucrative time to get into an HVAC trade or environmental engineering!) Or we might extend the winter break to keep more people at home during the peak times of the virus, and shorten the summer break. Time will tell, but we're really not close to being there yet with most of Ontario still showing case counts above the peak of the Delta wave, another variant on the horizon, and massive death counts rising in Hong Kong and Denmark. When all of Ontario is testing at near or over 10% positivity, how anyone can say we're nearing endemicity is beyond me.


ETA: The red dot on this graph below is February 28th, the day the Associate Director at WRDSB rolled her eyes and suggested we needn't worry about masks or ventilation because Covid is practically endemic! Hospitalization rates were higher than at any time before January 3, 2022, but okay. 

In the UK, 1% of primary kids and 3% of secondary kids have long covid, which can present as a permanent disability. That's not 1 and 3 percent of kids with covid, but 1 and 3 percent of ALL kids. That's their life now. In my school, that would translate to over 50 students with significant cognitive impairment and fatigue and a long list of physical ailments that will keep them unable to graduate. We don't have to let that happen here! We can keep wearing masks and ventilating our rooms. We know what needs to happen, and we have the tools to do it! We just need the political will to save our kids or else face a tsunami of disability! 

I gently suggested to one of my friend's colleagues that they consider taking a test before going to work on Monday. We'll see how well that sits with them. I can't just do nothing!  [ETA: They said "good idea" and forwarded it to all their colleagues!]

ACCOUNTABILITY

Public health units and school boards and governments are making choices right now that we KNOW will create more spread. They must all be held accountable for any deaths or disabilities that are a direct result of these increased transmission. Too many of their decisions appear to be made based on focus groups instead of science. I expect leaders to use their power and agency to make decisions to protect the health and safety of the public based on the best available science. This isn't that.

Just 89 days left until we actually have a say in all this. Well, as much of a say as possible at least. 


2 comments:

Bill Malcolm said...

I'm 100 percent on board with your take.

Here in my province of Nova Scotia, where we once led in contact tracing and trending to zero Covid, Omicron turned our Chief Public Officer of Health into an excuser in only about four weeks. Contact tracing ended before Xmas because it overwhelmed the system. And besides -- vacations! I personally was reduced, like many many others, to hunting for RAT kits at public libraries (where they always seemed to have just run out) which for some unknown reason/logic were the distribution points. Our CMOH just gave up and let 'er rip. No point keeping case count or looking for hotspots, because "it" was everywhere, he said. "Keep your eye on hospitalizations instead." So I have, and it's been BAD.

Similarly, here's the situation in the People's Republic of Alberta where I have relatives -- tent care!:

https://www.thestar.com/opinion/contributors/2022/03/04/the-pandemic-is-not-over-and-the-inside-of-my-hospital-has-the-proof.html

By March 21, all restrictions in Nova Scotia will be gone. All of 'em. Despite the hospitalization facts. Informal polls at radio and TV stations show that over half the people think the ending of restrictions is too early. And mention of the BA2 variant has been nil.

Essentially what has happened is that we've caved to the greaseball antivax truckers, and their extreme right-wing handlers. No doubt for reasons of perceived "societal cohesion" on the part of politicians, which I call fear of non-re-election. Such great leaders! The tail successfully wagged the dog, and who cares about seniors and the under 5 year-olds, anyway?

This past Friday, we knocked off another four poor old unfortunates here, and had a 18% positivity rate on PCR testing. That testing, which used to be up to and over 10,000 per day, was down to a paltry 1600. What the hell are the lab staff doing? Obviously not much compared to what can now be termed as "the days of yore". So almost 300 people tested positive on Friday, when a year ago, before vaccinations began in earnest in late March, we were talking a few cases per day, and I mean half a dozen. Population is exactly one million here, for reference.

So now we have vaccines and yet have experienced thousands upon thousands of cases. It takes little intellect to adjudge that the vaccines don't prevent catching Omicron -- one is left to ponder whether vaccinations really do lessen the severity, because the old folk croaking are triple vaxxed. Survival seems to be down more to one's inner vitality and luck, and whether you copped a big viral load at time of infection or not.

Some analysis here:

https://www.halifaxexaminer.ca/featured/nova-scotia-has-the-highest-weekly-covid-death-count-of-the-entire-pandemic/

158 people caught Covid in hospital!

So dystopianly, our CMOH proclaimed ten days ago, using the same words every province uses: "We're going to have to learn to live with Covid. Older people will have to take precautions and be especially careful. Blah, blah, blah". Gee, thanks so much, Doc! Consigned forever to stay home is what it amounts to for us oldsters, with furtive forays to grab grub "earlie in the morning" at supermarkets when virtually nobody else is about. Beyond the 45 people admitted to hospital direct for Covid, we have 275 more who came to hospital for other reasons and were incidentally found to have the virus or caught it there! So about 320 in hospital altogether. Obviously time to ditch restrictions, eh? Illogic at its finest.

Good thing I enjoy my own company, I guess. For you, the neverending nightmare seems bureaucratized beyond reason by bland "policymakers" who never have to face the reality of a classroom, nor care about the ethics/mechanism of how infection spreads. Sure, you got a chance to speak and advise, but that was surely merely a courtesy, because policy was likely already decided in a vacuum beforehand. Amirite, in your opinion?

Marie Snyder said...

I hear ya, Bill. The people in charge seem to be living in an alternative universe. I went to an online leadership conference today where everyone was saying things like, "Now that Covid is behind us..." and I wondered what on earth they were reading (or avoiding) to give them that rosy view, and whether or not I'd have to drink their koolaid to join the group. Hannah Arendt wrote about hope being a "dangerous barrier to life" when it prevents action. She was talking about people in concentration camps dreaming of life before the war, unable to face the reality that their old lives were gone and rise to action. We can't act on reality if we refuse to look at it. When so many premiers in our country are banking on hope and creating images of our lives returning to normal, it extinguishes humanity. We're not authentic beings when we live in denial; they've already decided to live a facade of a life. Same thing happens with climate change. We can't do anything productive so long as we keep one foot in the before times.