ELY – “Don’t let wearing a mask wag the dog,” local physician Joseph Bianco told the Ely school board this week at a study session concerning metrics for ISD 696 COVID-19 mitigation efforts.
After nearly two months of the school year and a face mask mandate for all students, staff and visitors in the Ely school buildings, the administration and a community advisory group have been working on a strategy to dial back the mitigation efforts put in place due to rising coronavirus pandemic numbers.
Responding to a petition drive calling for the end of the face mask mandate, along with other pushback in the community, the school board rescinded the authority they granted to the superintendent to make campus-wide COVID-19 health decisions and will now vote by majority rule on efforts to keep kids safe.
Superintendent Erik Erie and the Ely Safe Learning Plan Advisory Council (ESLPAC) continue to work on recommendations for the school board to consider when local transmission rates and positive COVID-19 cases reach a level where face masks won’t be mandated in the school buildings but just recommended.
Bianco, an ESLPAC member and Ely Essentia Clinic Director of Primary Care, presented a 16-page COVID-19 metric recommendation to the school board Monday night. He noted that because of the responsibilities of his day job as a doctor, the research paper took longer than he anticipated to develop. It was not discussed by the advisory council prior to the school board study session.
As COVID-19 transmission rates and local case rate data remain elevated in the Ely area, any face mask mandate adjustments are unlikely anytime soon. ELSPAC planned to review Bianco’s metric recommendations at their meeting this week and could be ready to submit a plan to the school board at its Nov. 8 meeting.
“I encourage you not to back into this,” Bianco said, referring to dumping the face mask mandate. “Look and see what the risk is. Don’t try to find a way to not have masks anymore. That is the idea of having the science behind it. You are going to get there. We’ll get to these numbers. If you want to go faster, then you can change whatever you do, but you’ll have to explain why you want to do it that way, and it may put you in a high transmission rate. That is your choice.”
Bianco has been a family physician in Ely for 28 years. He was director of primary care for 15 years for the entire Essentia Clinic system, overseeing 65 clinics and more than 500 physicians.
“Never during this time have we had a pandemic like we have right now. This is unprecedented. We’re also learning as we go along with this, so it is important for people to take big breaths and learn together as we go forward,” he said.
Bianco stressed that together face masking and vaccines are “synergistic” or cumulative in reducing the amount of transmission in a community.
“Vaccines are your most effective approach, but the combination (with face masks) also leads to an additive effect in preventing community transmission,” he said.
He admitted that most patients infected with COVID-19 will recover fully from their illness. One in four will have long-term symptoms with pain and suffering for years to come, he said.
“But most important, the reason we do this is to protect the vulnerable in our community,” he said.
In discussing metrics for dialing back the face mask mandates, Bianco suggested considering COVID-19 case rates, testing, vaccination rates and resource availability (access to ICU beds, health care, etc.).
“We’ve been getting cases from Hibbing every week, referring to Ely, because Hibbing is full. We are getting COVID patients transferred here,” he said. “And 90 percent of those are unvaccinated. God forbid any of us get sick and have nowhere to go.”
In making his recommendations, Bianco noted that none of them are perfect.
“Watch for trends in surrounding communities,” he said. “Mask recommendations will be different for Memorial versus Washington school buildings until vaccinations are available for all students.”
The CDC-developed transmission level should be at the moderate level for school officials to consider having face masks recommended rather than mandated, he suggested. Right now, the Ely community is at the “high” transmission rate level.
“If the vaccination rate is at 80 percent by attribution of staff and students, I would remove the mask mandate,” Bianco said. The current vaccination rate among the eligible Ely students is at about 40 percent.
“This is probably not achievable due to vaccine resistance,” he added. “However, more than 90 percent of Ely community members over the age of 65 are vaccinated for COVID.”
He noted that he would not recommend the vaccine rate as a primary measure in a mitigation strategy.
The bottom line in Bianco’s recommendations showed that a moderate transmission level of 10 to 50.total new cases per 100,000 in a seven-day average could be a benchmark for establishing a face mask recommendation policy. The Northern St. Louis County region was above 400 last week. “CDC recommends using case rates to evaluate spread of the disease in your area because a case rate will more accurately reflect what is happening in your community by accounting for population size,” he said.
He also suggested considering a case positivity rate of less than eight percent for two consecutive weeks. St. Louis County was at 7.21 percent last week and increased slightly to eight percent on Monday, according to Bianco.
“These things are trending down,” he added.
He asserted that school officials consider tracking trends over a couple of weeks when looking at case rates. “You don’t want to be taking masks off then putting masks back on. You want to be sure that you are following trends,” he said.
“It is difficult to know where the trends are going, but if the state is going down, we will go down,” he said. “We will get to the point where we can get to mask recommendations rather than masks mandates.”