“The Height of Ridiculosity”
“The Height of Ridiculosity”
I "finally" got COVID. Happy holidays!
Updated 1/1: I speculated that it would be difficult for my county to meet the CDC threshold for universal masking, given that South Carolina no longer has widespread testing. However, as of New Year’s Eve, my county, Richland, and other counties in the state are at a “high COVID-19 community level”. You can see your county’s level here. At this level, CDC recommends that everyone “Wear a high-quality mask or respirator” in public. Specific school-level guidance from CDC recommends: “At a high COVID-19 Community Level, universal indoor masking in schools and ECE programs is recommended, as it is in the community at-large.” Other updates with newer data on the drug Paxlovid are included in the body of the essay.
They should not be forced to wear a mask in school against the wishes of the parents. I think again it is the height of ridiculosity [sic] for a school district to make that decision for the parents, particularly since we know that even when the virus was rampant that the schools, the classrooms were the safest places of all.
-South Carolina Governor Henry McMaster, April 2021
The findings also expose a fundamental logical flaw of individual masking: assuming that individual persons will fully absorb the costs of their own masking decisions, rather than assuming that such costs will be shifted onto others and society.
-Julia Raifman, Sc.D., and Tiffany Green, Ph.D, “Universal Masking Policies in Schools and Mitigating the Inequitable Costs of Covid-19,” New England Medical Journal, November 2022
This one is a little rambling, and hopefully the reasons for that will make sense as you read.
I haven’t really written about the ongoing pandemic much, but of course it has been on my mind. There were many factors in my decision to not sign my teaching contract last year, before somewhat reluctantly deciding to return to my classroom in the fall. The dysfunctional state and local responses to the pandemic were probably a close second to the intensifying campaign to use the state’s oversight power over schools— rarely exercised to protect vulnerable children— to silence the voices of marginalized people and censor content in a nakedly partisan way. Since 2020, I’ve been watching the grandstanding and cruelty of elected officials and the often inept or counterproductive responses of districts hamstrung politically and financially by those officials, and waiting to get COVID. The first week of winter break, it finally caught up with me.
Of course, it didn’t need to be this way, and many of the factors that helped me avoid infection for a long time might have helped me to continue to do so if things had been slightly different.
In an alternate timeline, maybe my state, South Carolina, wasn’t one of the first to climb aboard the politicized bandwagon that encouraged abandoning most mitigation strategies just months into the pandemic. And in that timeline, maybe I and many other teachers in SC didn’t have to drive to North Carolina, to get our first two vaccination shots when my governor, Henry McMaster, pointedly opted against prioritizing the vaccination of school employees even after demanding a return to in-person instruction earlier than most states. (He would later use the fact that teachers had been given the opportunity to be vaccinated to argue in favor of an accelerated return to in-person instruction, regardless of local disease activity and expert advice.) Maybe in that timeline my state’s attorney general and legislature (particularly SC “Freedom Caucus” types like Representative Stewart Jones) didn’t fight tooth and nail against allowing districts to require masks on the advice of healthcare professionals.
That many of these same elected officials and opponents of masking and remote learning have used the language of bodily autonomy to push against both mask and vaccination requirements for most of the pandemic
, only to embrace every opportunity to insert the state into a variety of personal health decisions, should be lost on no one. McMaster and the same legislators who most forcefully called for an end to masking requirements— notably the SC “Freedom Caucus”— have also supported moves to ban all abortions, blocked transgender students from playing sports, and introduced legislation to defund programs that offer counseling and other non-surgical services to transgender youth.To give one of many examples, Senator Josh Kimbrell, an outspoken opponent of parents’ rights to make health decisions with their transgender children and a proponent of allowing guns in schools, supported budget provisos that prohibited districts from requiring masks, saying at the start of last school year, according to WYFF News,
I’m the parent of two elementary school-age kids and so my wife and I are very concerned about making sure our kids are healthy and safe, so I say this with some skin in the game, if you will, that I don’t believe revisiting that’s necessary… I think parents are perfectly capable of making that decision on their own.
McMaster, who also has often presented mask and vaccination requirements as a government overreach, voiced support for making same-gender marriages illegal in the state during the leadup to the elections last month. Bodily autonomy, to these officials, evidently means the freedom of far-right legislators to make decisions the decisions about everyone else’s bodies, nothing more and nothing less.
Of course, the right can’t take all the blame. In that alternate timeline, maybe the Biden administration lived up to the hope of many voters that they would take mitigation more seriously, rather than seeming at times to play into the very narrative that the McMaster/ “Freedom Caucus” crowd created around the supposedly tyrannical government overreach of virtually any COVID mitigation attempt. While I’m no health expert, and am therefore reluctant to be a backseat driver on public health, it is striking how ineffective the current CDC masking guidance— which suggests requiring masks only during “high community levels”— has been for my school. My county is currently experiencing “medium” activity based on this metric, but what does that mean when tests per capita are near an all-time low? Is it possible to qualify as “high” disease activity without doing more tests? While the CDC director vaguely and tacitly seems to argue we should all be wearing masks, there is no formal guidance that doesn’t rely on that “high” metric. And formal guidance is the only kind that might make districts risk the political blowback of supporting mask requirements, even just temporarily during surges, as many districts throughout the country are currently doing.
But in our timeline, my district abandoned mask requirements in February of last year, after holding out longer than most and even going to court to try to preserve its autonomy in making the decision (they lost that case, but that Stewart Jones proviso they were challenging was later blocked in federal court). Most students at my school, from what I could tell, finished out the year in masks voluntarily, which made our school an outlier in the district and arguably kept our still-significant number of student and staff infections lower than they might have been without masks.
My best guess as to why students wore the face coverings even when the requirement was lifted was that there was community buy-in beyond the school: our zip code was one of the hardest-hit by COVID in the entire county, based on local health department data, and I assume parents and other caregivers, bolstered by the district’s requirements, had encouraged enough students to wear masks that doing so became a norm. This guess is supported by polling data: according to a study published last month in the New England Journal of Medicine, “In several studies and polls, Black and Latinx parents were more likely than White parents to support school masking requirements and less likely to have confidence that schools could operate safely without additional protections.”
But over the summer, for whatever reason, the norm changed. And for anyone who works with teenagers or children, I imagine the idea that student behavior would be driven primarily by what their parents or teachers want is fairly ridiculous. Teenagers and children generally do what their peers do— it’s what their built to do, and in many ways it’s a healthy part of development— and, for that matter, so do adults. Updated to add: “social proof,” a behavioral psychology theory based largely on the experiments of researcher Solomon Asch (who called it “herd behavior”) is the idea that people are heavily influenced in their behavior by what others around the do. Behavior Lab summarizes the theory and some relevant research here, but in short the influence of what others are doing is so powerful that it seems unreasonable and unfair to ask students or their parents to individually make decisions about collective disease mitigation strategies. We need real guidance.
(Not coincidentally, this is also why much of the “parental rights” rhetoric— which McMaster was on the cutting edge of adopting in 2021— rings so hollow: neither parents nor teachers have as much influence over the average child as the child’s peer group and the expectations of whatever popular culture they follow. The idea that they do is the snake oil the “Freedom Caucus” is selling.) Loose suggestions that must respect the individual realities and fantasies of each student or parent— or at least those students and parents deemed worthy of autonomy and protection by those in power— do not change behavior. If they did, I wouldn’t have to serve lunch duty every few weeks; we could just trust that parents would tell their students to behave during lunch, and everyone would be automatically safe. We wouldn’t have school shootings or need to argue about how to keep schools safe; parents would just teach children not to be violent. And we wouldn’t really need to spend so much time in school anyway; parents could teach kids everything they need to know.
On an average day, only about four of my students masked this semester (about 5% of my total students), which was an incredible drop-off from last year. I assume that the reason for the drop-off is that without hard-and-fast requirements, students and families were left to piece together their own ideas about whether masking was worth it. When the topic of masks came up during my English class’ unit on conspiracy theories, misinformation, and disinformation (originally the brainchild of my friend and former colleague Taryn Auerbach), some students asked me why I still masked.
One student voiced the opinion that since students weren’t masking, it wouldn’t do any good for me to mask. Although I don’t entirely agree with the student’s logic— it’s a little like arguing that since the best way to avoid a traffic fatality is for no one to get in an accident, seatbelts and airbags are useless— there is support for the idea that individual masking is not nearly as effective as community masking for “population-level transmission.” In an article published last month in the Journal of the American Medical Association, researchers Julia Raifman, Sc.D., and Tiffany Green, Ph.D. wrote,
"Universal masking and individual masking are distinct interventions. 4 Universal masking lowers the amount of virus exhaled into shared air, 5 reducing the total number of cases of Covid-19 and making indoor spaces safer for populations that are vulnerable to its complications. Individual masking lowers the amount of virus that a masked person inhales from shared air, but only in environments with a relatively high amount of circulating virus and when others are unmasked. (Footnotes are from the original article, and link to the citations the authors used.)
And, most importantly, I think the student demonstrated how important public health messaging is: he had really internalized the idea that masking was a community mitigation strategy, and in that way he was aligned with experts.
Other students made a connection with what we had learned in the unit, acknowledging that decisions about whether or not to mask, for many people, were— like decisions about whether to believe in conspiracy theories and disinformation— probably more emotional than rational. One student asked me, only half out of snark, “Were you always such a germaphobe?” When I explained that I was following the guidance of epidemiologists, and we looked at some of the most current advice from epidemiologists together (short version: many thought people should mask during the winter surge, but didn’t believe most would do so without requirements), I felt a reticence from them to talk about it more, so we moved on. There seemed to be some conflict between what they felt the data was telling them to do and what they had already decided to do. And, unsurprisingly, most continued to take their cues not from experts or teachers or parents, but from their peers sitting with them in the classroom. I saw a few more masks as we got closer to the holiday— and a few less students each week as more and more were out sick— but students shouldn’t shoulder the decision-making here, and parents alone can only ensure they are wearing a mask until they get on the bus or enter the school building. I think we owe kids better than putting them in the position to have to be more mature than the adults (elected officials, district leaders, and public health agencies) who should be leading their community.
It wasn’t just masks: this year, virtually all mitigation strategies were gone. Without clear messaging on what to do, most people did nothing. Few staff members and few students wore masks. Hand soap dispensers stopped being refilled. In-person whole-faculty and student-body events resumed, with no connection to disease activity— which is virtually impossible to determine, anyway, without widespread testing or reporting. Whole-faculty holiday parties and gatherings resumed, with not a mask in sight. COVID-19, evidently, was over.
Except, as I started to write this, it was Christmas Day and I was in quarantine. My wife thankfully has not tested positive as I finish this. My symptoms have improved a great deal, but at their worse they were a painfully sore throat, congestion, waves of fatigue, and some brain fog (this won’t seem to go away completely), all kept mostly at bay through a cocktail of over-the-counter medications and prescription antivirals. I’m very grateful to be at home, to have a place to quarantine, and to have time off from work because of the holidays, but I also regret that it came to this and know that I could have rebound infection now that I’m done with the antivirals (this seems to be relatively unlikely, but is still a risk). Updated 1/1 to add: I do seem to have at least a mild rebound, testing positive yesterday, with a few returning symptoms like congestion, after testing negative a few days before. More recent research, as described in this CNN piece, suggests this kind of rebound infection may be slightly more common than previously believed, though at least one researcher cited in the article said Paxlovid is underprescribed, and stressed that he didn’t want the results to discourage prescribing Paxlovid. Personally, I’m still glad I took Paxlovid, because my symptoms improved quickly and the drug possibly kept me from having more severe illness, but it did potentially increase the time I have to quarantine. Of course, I am not a health expert, so please talk to a health provider before making decisions about whether to take medications!
But I’ve also had a lot of time to reflect— when my head has been clear enough for reflection— about how poorly our public health decisions have reflected what we know about disease spread and about human behavior. It seems public health should exist at the Venn diagram between how people should behave and how people most often actually make decisions. In reality, our systemic pandemic responses are driven primarily by political considerations while our individual responses, as always, are mainly driven by emotion. From the earliest days of the pandemic, people who seem to have forgotten everything they ever knew about the behavior of children have been making policy decisions on behalf of schools. From pretty much the beginning, leaders have made patently dumb proclamations— kids can’t get COVID
, families will decide about masking and vaccination, there’s no point in trying to enforce mandates that not everyone will follow. (My governor has been hawking slight variations on all three of those dumb proclamations for years, telling reports in June 2020, amid "a record-high number of hospitalizations” due to the virus, “There’s no way we can make somebody do something that they just don’t want to do,” according to the Associated Press.)I don’t know where I was infected with the virus. I’m not aware of any close contacts, although there were presumably a lot of sick people around me as cold and flu season crested leading up to the holidays. Because large-scale testing has been abandoned in my state, there is really no way to estimate how much COVID is spreading in the community, but according to CDC’s Wastewater Surveillance page, all of the sites which have tested for at least a year and have recent data show a sharp recent uptick in COVID levels detected in sewage, with the majority of the sites in the state showing virus levels in the two highest categories.
I wore a KN95 mask every day this semester, and ran a Corsi-Rosenthal box in my room as much as possible when the HVAC system wasn’t circulating air in the room. Weather permitting, I often cracked the window (which are we very fortunate to have: according to an SC for Ed survey I helped conduct and analyze in September 2020, over half of teachers in South Carolina responding to the survey didn’t have windows that opened, and only 27% could control whether the HVAC system was circulating air).
My school had been on winter break for four days when my symptoms started. According to the CDC, the incubation period for COVID-19 is 2-14 days, although a research review by Yu Wu et al, published in the Journal of the American Medical Association, found that the incubation period for the Omicron variant “was significantly shorter than the other variants,” with a “pooled incubation period” of 3.42 days. I would give myself a B- for masking in general (wearing it as much as I can in public, but sometimes taking it off to eat and drink around small numbers of people), and an A- for masking at school (generally wearing a mask all day, taking it off only when there are no students or staff in the room and there is good ventilation), so it’s possible I wasn’t careful enough outside of school and was infected somewhere, but there’s also a good chance I got infected at school. In any case, I plan to be more careful in the future, and I do believe masking and being mindful about the air quality in my classroom were part of the reason I avoided infection for so long.
I was pretty sick for a few days— not sick enough to go to the hospital, but certainly not simply experiencing some kind of overhyped cold— and that was after a full course of vaccinations and boosters, including the bivalent booster, and with the aid of the antiviral. Even when my symptoms started to get better, I was at first testing positive and therefore likely shedding enough of the virus to infect others. If I hadn’t tested myself and it hadn’t been winter break, I might have been in a room all day full of different groups of students. According to the American Academy of Pediatrics, in South Carolina only 32% of children 5-11 have received two vaccination shots, and only 58% of children 12-17 have received the shots. The national averages are slightly higher, but there are still a tremendous number of unvaccinated children who have been attending schools, during a COVID surge, and who will return after the holidays to schools that largely don’t seem to have a plan or the political will to prevent more infections.
And while I don’t want anyone to feel like I have felt this week, or to have to quarantine, I’m even more concerned for those who are at even higher risk for negative outcomes, and about the risk of long COVID symptoms. As I said to my students (who immediately showed more empathy than many of our elected officials, even if that empathy didn’t lead to much of a change in behavior), when we see someone masking we should probably assume they have their reasons, and one of those reasons may be that they, or someone they love, has a serious medical issue that would make it likely for COVID-19 infection to be dangerous or life-threatening. (Of course, another reason may be that they are trying not to inadvertently spread the virus to others.)
It’s very important to know that policymakers who adopt “parental rights” and “freedom” rhetoric likely know that they are gaslighting you. McMaster supported masks until it was inconvenient, and he knows how real COVID is, because he got it, and had a serious enough case— and/ or is a special enough person— that he received a then-rare monoclonal antibody treatment. As he does on nearly every issue, he championed the advice of experts only as long as it dovetailed with what he already wanted to say, then claimed they were “exaggerating” the data when it was no longer politically expedient for him (specifically, because it supported requiring masks in schools). He singlehandedly shut down much of the state— including its schools— through executive orders in 2020, only to run on a campaign platform in 2022 that was centered around the idea that he never did any such thing.
Logical arguments and data aren’t going to persuade public officials to do the right thing, if they have already latched onto the artery of misdirected anger and conspiratorial thinking that has driven the pandemic mitigation backlash. Just as with any efforts to shore up our public infrastructure, protect our public schools, and defend intellectual and bodily freedom, we need stronger networks of natural allies— parents, teachers, school staff, public employees, sympathetic lawmakers, antiracists, civil rights activists, and civil liberty advocates— to push for rational and humane responses to the pandemic. The only silver lining I can find in the rampant homophobia, transphobia, backlash against civil rights progress, and attacks on civil liberties coming from the most far right officials and groups in our state is that it presents an opportunity for the rest of us to realize we have more in common than we might have realized.
I hope this experience will help me to be mindful of the communities and individuals who don’t have easy access to vaccines (or the kinds of good experiences with the healthcare system that make taking them an easy choice), who don’t have health insurance and easy access to healthcare— I had two virtual appointments and two prescriptions ready within hours of my positive test— and who don’t have time off from work and friends and family to support their recovery. Who haven’t been blessed by chance with immune systems capable of fighting off the virus, with bodies capable of withstanding it, or with warm homes in which to convalesce.
We need to demand better for ourselves, for our children, for our students, and for our neighbors. Sadly, there seems to be no reason to believe rational thinking will somehow prevail on its own.
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For example, in a series of posts opposing mask and vaccine requirements, Rep. Stewart Jones frequently used language painting the requirements as a violation of liberty, as a way to “coerce” and violate personal freedoms.
As an important side note, the SC House “Freedom Caucus” and other lawmakers would likely argue that it would be illegal for me to discuss the NEJM study with my research students, because it addresses data supporting the idea that “structural racism” has been a factor in the number of COVID cases in different schools. (For more on efforts by the “Freedom Caucus” to censor and punish schools and libraries, see this previous piece.) My sixteen years as a South Carolina public school teacher tell me that this data supports a pretty obvious lived experience for many students and teachers across the state. For example, the authors cite data showing that “Black, Latinx, and Indigenous children and adolescents are more likely to have had severe Covid-19, to have had a parent or caregiver die from Covid-19, and to be affected by worsening mental health and by educational disruptions than their White counterparts.” Many of my students of color over the past three years did lose family members and community members, suffer illness, and suffer impacts to their household income and standard of living— their experiences were probably very different from Josh Kimbrell’s. That it is now potentially illegal to discuss this with them because it may hurt Kimbrell’s feelings, or “Freedom Caucus” Chair Adam Morgan’s feelings, would itself be a crime in a more just society, and I hope and believe this kind of censorship will eventually be ended by the courts, as it has been in the past and in other states.
Obviously, we have long known this isn’t true, but more recent data continues to show how untrue it is. For example, Cowger et al. write, “By the end of February 2022, children and adolescents in the United States had a higher prevalence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than any other age group”.