With all the attention on the Wellesley Public Schools reopening plan, a proposal by a group of local scientists, medical professionals and educators to institute a COVID-19 testing pilot for WPS faculty, staff and students has yet to gain much public notice. It’s an ambitious concept that aims to make school reopening safer, but it raises a slew of public health, ethical and legal questions.
Wellesley’s Board of Health has been discussing it in conjunction with other town and school officials for at least the past couple of weeks. Wellesley Public Schools Superintendent David Lussier and Director of Nursing for WPS Linda Corridan are among those supporting such a plan, which would complement existing hygiene, social distancing, and other safety protocols being implemented throughout the school system.
You can catch up on the discussions by reviewing the last two recorded Board of Health meetings (July 29 and Aug. 5) and the most recent School Committee meeting (Aug. 6), videos of which are embedded below. (Other meetings and discussions have taken place involving town and school officials and those involved in the proposal, but they weren’t published publicly).
This exploratory concept appears to be something Wellesley is dealing with in the first place in part because it is Wellesley. It has lots of scientists and medical professionals living here (BU Medical Center, Tufts, UMass Medical Center, etc.), at least some of whom have kids in the school system. Such an effort could include partnering with the Broad Institute, a genomics-focused Harvard and MIT outfit researching human disease that is working with higher education institutions, including Babson College and Wellesley College, as well as with the Commonwealth of Massachusetts at its Stop the Spread testing sites in high-risk communities. Though Broad has yet to commit to testing at the K-12 public school level.
Safer Teachers, Safer Students plan
The “Safer Teachers, Safer Students: SARS CoV-2 testing to support school reopening” proposal calls for a 3-month pilot that would involve sub-24-hour turnarounds on test results for students, faculty, staff, and close contacts to help the community isolate those infected early and help reduce transmission. The so-called surveillance aspect of the program would include the regular testing of asymptomatic individuals to gauge whether the approach is working.
The group’s recommendations include using data from the program to generate a publicly accessible COVID-19 dashboard to inform local decision making. Ideally, the group would like to test everyone in the school system weekly, but for starters would settle for everyone in late August before school starts, then testing of faculty/staff weekly during the pilot program.
Those proposing this concept urge a quick turnaround of figuring out financing and logistics/operations, the former of which they suggest could be supported in part through the CARES Act and local COVID-19 funding programs.
The hope is that Wellesley could take part in a possible coalition of communities and this would serve as a model for others that might want to adopt such a system if it proves effective in supporting safe schooling and relatively low-cost testing ($45-$60).
The plan has intrigued Wellesley’s Board of Health and Health Department, but members have lots of questions.
Wellesley Director of Community & Public Health Lenny Izzo, speaking at the July 29 Board of Health meeting, summed up his initial reaction to the proposal as “struggling with how this could be pulled off without it being rolled into a function of my department and how we could absorb this function… this is a huge undertaking.” (Note: As of the initial public meeting on the topic, town officials had only had a few days or less to digest the proposal.)
Marcia Testa Simonson, vice chair of the Wellesley Board of Health, raised risk-benefit analysis and legal/jurisdictional concerns over what she described as an untested screening program. On the risk-benefit front, she said the proposal needed to more clearly outline what the benefits would be in a community where only a handful of young people have tested positive for COVID-19. The town would need to figure out whether possible benefits, such as reducing anxiety among teachers/staff and students/parents/guardians, would be more valuable than other benefits that might be achieved for the same cost, such as outfitting kids with masks daily, installing more hand-washing stations, or boosting the ventilation systems.
She deferred to town counsel Tom Harrington on legal matters at the July 29 Board of Health meeting, and he ticked off a list of possible issues, including whether the Board of Health or schools would need a clinic license to administer tests. Having school-age kids do self-swab tests would raise liability issues, such as getting parent consent for each test administered, Harrington said. Privacy concerns regarding positive tests are also a concern, as are town procurement rules. “It kind of comes to the interplay between this as a testing process and this as a study,” he said.
Board of Health member Linda Oliver Grape added concerns about who would actually run such a program that would be “monumental to implement” in light of the Health Department and school nursing corps being stretched thin already. Board Chair Shep Cohen went further: “You would need a contingent of a small battalion of national guard folks to operationalize it.”
One reason Supt. Lussier favors something like this is that the current delays in testing results could “potentially immobilize us” if students or adults show symptoms. “If they have to wait a week to receive testing results I could easily see across a school or across the district the fear that could create and that really shutting down our operations,” he said at the July 29 meeting. A proactive approach, where even the asymptomatic are tested, could allow the school to act swiftly if tests come back positive. Members of the School Committee have also expressed support for continued discussion on such a concept.
Jesse Boehm, a Wellesley resident who is scientific director for the Cancer Dependency Map at the Broad Institute, joined the July 29 Board of Health meeting about midway through to weigh in, and agreed that legal, financial and privacy concerns expressed by the Board of Health would need to be addressed (are being addressed via additional memos). He also clarified that the epidemiological benefit of such a program would be outbreak prevention.
“What none of us know is what’s the shape and scope of the outbreak going to be a week from now, a month from now, three months from now,” said Boehm, whose wife Julie teaches biotechnology and AP biology at Wellesley High, and is also a supporter of the proposal.
About 20 communities in the state are now exploring advanced testing approaches against a backdrop of a constantly evolving testing landscape, Boehm said. “If there are bottlenecks today, in three weeks they may not be bottlenecks,” he said during the Aug. 6 School Committee meeting, describing the challenges facing decision makers.
School testing can’t be looked at in a vacuum either for Wellesley, which already handles its own contact tracing and has managed to keep its COVID-19 infection numbers relatively low. Board Chair Cohen noted at the Aug. 5 meeting: “As the community goes, so go the schools.”
In fact, those behind the proposal have in mind a testing infrastructure that goes well beyond Wellesley schools and that could apply to schools across the state if successful.
(COVID-19 testing discussion starts at about 2-hour, 15-minute mark of School Committee meeting)
BoH and School Committee meeting recordings courtesy of Wellesley Media