Massachusetts has released guidelines meant to help students get back into the classroom this fall. WGBH Morning Edition Host Joe Mathieu disucssed the state's plans with Dr. Lloyd Fisher, incoming president of the American Academy of Pediatrics' Massachusetts chapter, who helped review the guidelines from a medical perspective. The transcript below has been edited for clarity.
Joe Mathieu: You broke the guidance into three models: allowing for in-person learning with students actually in school buildings, remote learning, like we all had to get used to earlier this year, and then hybrid learning. Do you feel like, at this point, one is more likely than another?
Dr. Lloyd Fisher: The goal of the Department of Elementary and Secondary Education and the Massachusetts chapter of the American Academy of Pediatrics is to bring children back to in-person learning to all extents possible. These guidelines were really written with that in mind.
Mathieu: Now, the idea of in-person learning, we can kind of get our heads around it. Let's say things are good enough — the systems are in place, kids going to school every day. What would the hybrid look like? Are we considering one or two days a week, an every other day type of thing or only a couple of hours within a day?
Fisher: The general recommendation of the hybrid model is there would be one week of in-person learning alternated with one week of remote learning. The idea for that is to be able to reduce the class sizes if, in fact, we get to a point where the spread of the virus among the community is higher, and we feel that we really do need to pare back the amount of children that are in the building at any one time.
Mathieu: So when you consider that model, that brings the numbers down from your viewpoint, from a scientific viewpoint, brings the numbers for each classroom down to a manageable point?
Fisher: Exactly. And at this point where the community spread is so low, we do feel that there is a safe and effective way to bring all the children back, but we wanted the schools to have a plan in place. So if, in fact, we do need to shift the model, they can do so quickly.
Mathieu: Masks will be required, yes?
Fisher: They will be required for any child second grade and above, and they will be recommended for children younger than second grade.
Mathieu: One thing that got some attention, doctor, is that you will not require temperature checks. How come?
Fisher: So it's interesting, when you look at the science and the data behind temperature checks, they're really a very insensitive measure. There are many things that can cause a child to have a fever that are not COVID-19. And there are many children — in fact, most children — that do have COVID [that] aren't necessarily going to mount a fever, especially early on. So what's much more important is that parents and students are diligent about keeping their children home when they are feeling ill.
Mathieu: I don't think a lot of people know that, you know. You see and hear reports of temp checks at so many different places as we try to figure out the best way to manage all of this. But to your point, I guess it would be kind of a waste of time in this case?
Fisher: It really would be very difficult from a logistical standpoint and it does not add any benefit to the situation. Really, symptom monitoring is the way to do that. And we've seen mass temperature checks that just have not added a lot to the reduction of the spread of this illness.
Mathieu: I feel like we should all remember that as adults, as well. That's being conducted in a lot of workplaces, that's maybe creating a false sense of security. Getting kids to school, doctor, is an issue when you consider crowded school busses. Are you still working on guidelines for busses?
Fisher: So the guidelines for the school busses have not been released yet. Those are in the works. Clearly, the school bus issue is challenging and is going to take a lot of careful thought. We are looking at various methods to try to reduce the risk. One of the things that will be required is masking for all children on a school bus regardless of age. And we have good evidence that even the children down to kindergarten or even some of the preschoolers who need to take public transportation can wear masks effectively, at least for short periods of time, such as a bus ride.
Mathieu: And we still do not know exactly when schools will open, assuming they do in the fall. What will go into that decision?
Fisher: At this point the plan is to open schools this fall on time. There [is] lots of new evidence that's coming out every day. We are carefully monitoring the rate of spread and severity of illness in the community, but at this point, the intention is for all schools within the commonwealth to open in-person on time. That is the goal and we hope we can meet that.
Mathieu: Can you bring us in the room, Dr. Fisher, for meetings? I figure it's a Zoom room, by the way. As part of this working group, [you] are helping to consult the Baker administration on best practices. Is it a big conversation? Do you guys write white papers and share them? How is this done, I'm assuming, remotely?
Fisher: Yes, absolutely. All of these meetings are done remotely, and I think as everybody is learning what we can do remotely. So the working group had about 45 members. I personally am not a member of the core working group. I came in later as a medical expert to review the guidelines and to give feedback, but I've had multiple conversations with other medical experts who were involved and were more core to the working group, as well as some of the other people within the Department of Education and other stakeholders that are involved.
