Dr. Cara Christ

As state health director Dr. Cara Christ discusses the change in school closing guidelines last Thursday. Gov. Doug Ducey looked on.

As COVID-19 cases start to rise across Arizona and the nation, Mesa Public Schools Governing Board members last week implored parents to do their part to keep campuses open.

Board members stressed that parents must follow guidelines – such as teaching their kids to wash their hands frequently, maintaining social distance and keeping their children at home when sick, among others.

“We need to stay focused on keeping schools open,” board President Elaine Miner said. “That is our focus. …The holidays are coming. Gatherings are going to occur. We know that people are having plans. Please keep in mind as you go to these kinds of functions that you are putting keeping the schools open at risk and there’s only so much that we can do as a district to keep those schools open.”

To those who are buoyed by the hope that COVID-19 will disappear after spring, Miner added, “That seems like forever, but if we close schools, that’ll be more than forever.”

The pleas by Miner and some of her colleagues came on the same day that the Arizona Department of Health Services quietly changed its advice to school officials on deciding when to close schools in the event of an outbreak.

Gone is the advice to consider online learning if any one of three benchmarks is in the “red” zone signifying substantial virus spread. Now, the state health department is advising districts should consider closing campuses only if ZIP codes within their boundaries show that all three benchmarks indicate substantial COVID-19 spread.

Those benchmarks include percent of patient hospital visits with COVID-like symptoms, the percentage of new positive tests and COVID-19 cases per 100,000 people.

According to data released by the county health department on Thursday, two of the three benchmarks in MPS were in the “moderate” virus spread category – positive tests and cases per 100,000 people.

Both those indicators were up from the previous week, according to the data – which are 12 days old when posted by the county every Thursday morning.

The benchmarks in individual ZIP codes within the district varied, in some cases greatly.

While all ZIP codes were within the “minimal range” of virus spread for the hospital visits metric, the percentages of positive new tests varied from 4.96 percent in 85205 to 10.23 percent in 85204.

ZIP code 85204 is home to Mesa High School, where the highest number of COVID-19 cases was reported by the district. Twelve cases were reported at Mesa High. 

But illustrating the unpredictability of the virus, the second highest number of cases in an individual MPS school was reported in a ZIP code where two metrics are in the minimal spread category and the other indicating moderate spread.

Mountain View High, with nine cases, and Highland Elementary, with four – the highest number among elementary schools – are in 85213.

In that ZIP, hospital visits and test results are in the minimal virus spread range. Cases per 100,000 in that ZIP code were in the yellow, or moderate spread category.

Overall, MPS reported that out of more than 67,000 students and employees, there are 80 virus cases – including 58 students and 22 adults.

MPS Associate Superintendent Holly Williams noted the district-wide increases in positive test results and cases per 100,000 to plead with the community.

“We need your help,” Williams said, imploring the community “to stay vigilant when it comes to the mitigation strategies.”

“We believe that if we stay vigilant with our making sure that we’re doing our daily health assessments and keeping our children home when they are showing symptoms, that we wear our masks with great fidelity, that we stay physically distant in every opportunity possible, that we keep our hand-washing and our hand sanitizer and avoid large gatherings, we can keep our schools open.”

Those pleas came the same day the state Department of Health Services quietly changed its voluntary guidelines for keeping schools open – apparently with a belated notification to county health officials.

After media reports emerged about those changes, state health director Dr. Cara Christ wrote a blog that said districts should work with local health officials if ZIP codes within their boundaries reached red levels in all three benchmarks.

Will Humble, executive director of Arizona Public Health Association and former state health director, was critical of the change, arguing it puts too much weight on the “COVID-like symptoms” metric.

“I do still think they’re good metrics, especially the percent positivity and the number of cases per 100,00. Those are solid metrics,” Humble said. “I’ve always been less enthusiastic about that third metric, which is COVID-like illness reported by hospitals because it’s what we call it in the business ‘syndromic surveillance.’”

Humble said that metric is subjective and voluntarily reported, making a poor indicator for public health decisions.

“I didn’t have a problem with the way the guidance was written before because you could have two out of the three indicators – meaning the two good educators regardless of what happened with the bad indicator – and once you got into the red zone, then you need to start thinking about going back to a virtual instruction,” Humble said.

Humble continued, “But now when you say…you should include the third metric, which is a flimsy metric, then you’re putting (Governing Boards) in the position of not understanding that two of the three metrics are good and one is bad, and they may start to change their decisions based on a metric that is poor.”

Humble agreed that local control was appropriate but still had concerns about how the guideline change would impact local decision makers.

“Somebody who’s on a governing board or even a superintendent is unlikely to understand that COVID-like illness reports from hospitals is not a solid indicator; yet they will be making recommendations to their boards thinking that it’s equal importance to these other two indicators.”

Exactly why the department changed its guidelines – which could potentially allow many schools to stay open that might have closed under the old guidance – is the subject of some debate.

In a press conference on Oct. 29, Gov. Doug Ducey said the changes were made “at the request of public education leaders in coordination with public health officials.”

But shortly after that statement, Arizona Superintendent of Public Instruction Kathy Hoffman took to Twitter and stated “The Arizona Department of Education did not request or recommend any changes to the AZDHS school benchmarks.”

Chris Kotterman, lobbyist for the Arizona School Boards Association, said the way board members around the state found out about it was through the media.

“We weren’t consulted on it,’’ he said. “We don’t like it when fundamental policy changes that impact the operation of public schools are not communicated clearly.’’

The surprise, however, is only part of the problem.

 Kotterman said school board members “absolutely’’ see the change as having political overtones.

“There definitely are groups out there that believe that schools should be open and are pressuring their local governing boards to just reopen the schools and everything will be fine if only vulnerable people stay home and all that sort of stuff,’’ he said.

 Add to that, Kotterman said, are statements by President Trump saying that the closures are “all politics.’’

And when the health department suddenly changes the guidelines, he said, board members “tend to assume the worst, unfortunately.’’

 Christ wrote that her department has been working on the changes since Oct. 2 after hearing concerns from the members of its Schools Reopening Workgroup, which includes representatives from county health departments and the Department of Education.

But ADHS still has not answered why it did not announce the change more publicly. 

An ADHS spokesman did not respond when asked how the department informed the public of the change, directing the Progress to Christ’s blog post.

That post only states that ADHS informed members of the Schools Reopening Workgroup on Oct. 16.

Ducey said too much was being made of the change.

“These adjustments are just that,’’ he said. “They are guidance.’’ 

The governor said he understands there are teachers with underlying health conditions who may not want to be in school and parents who don’t want their children in a classroom. He said, though, that should be the exception, not the rule.

“Where it is possible and safe, we want our schools open and we want our kids inside a classroom, with a teacher at the front of the classroom, and them getting the best, safest education possible,’’ Ducey said.

Humble was critical of the way the department handled the roll out.

He said county health officials “should’ve seen it at least a week ago and had a time to digest it, because it’s the county health departments that are working with the school districts and it’s their responsibility; the state is like the ivory tower.”

Humble said the state also has a responsibility to be transparent and honest about these type of changes with residents or it risks losing public trust.

“And the best way to keep trust is be honest with them and be truthful and be transparent,” Humble said. “And if one of those three things breaks down, then you start to lose trust and you can’t afford to lose trust anytime, and in particular during a pandemic when you’re asking people to participate in this grand emergency response in various different ways.” 

Howard Fischer with Capitol Media Services contributed to this report 

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