School Districts Present TX Town With Duelling Mask Policies

School Districts Present TX Town With Duelling Mask Policies

The two school districts in this Central Texas town headed in opposite directions after Gov. Greg Abbott ended the statewide mask mandate, sparking heated debates over safety and government responsibility.

For locals and tourists, it’s hard to overstate the charm of New Braunfels, a place of spring-fed rivers, dance halls and German festivals.

Yet against this idyllic backdrop, the nation’s ongoing fight over mask-wearing has pitted neighbor against neighbor and put the region’s schoolchildren squarely in the middle of an overheated argument.

In what quickly became a conversation about science, personal liberty and the role of government, the town’s two school boards, New Braunfels Independent School District and Comal Independent School District, landed on opposite sides of the face-covering debate earlier this month after Gov. Greg Abbott announced the statewide mask mandate would end March 10.

In New Braunfels ISD, which serves more low-income and Latino students, the school board opted to survey parents, resulting in a vote to keep the school mask mandate. The Comal ISD board, representing whiter, more rural parts of Comal county, voted 5-2 in an eleventh-hour meeting to make masks voluntary after members touted personal responsibility and parental choice. One Comal ISD board member, Marty Bartlett, cited the arguments of well-known conspiracy theorists and vaccine skeptics who say masks are government overreach, not sound science.

The mask battle in New Braunfels clearly has political overtones, but this isn’t your typical liberal versus conservative fight. New Braunfels sits on the southeastern edge of Comal County, whose residents gave former President Donald Trump 70% of the vote in November.

In this case the fight is more about moderate conservatives versus those on the far right.

And Comal ISD’s political leanings are already affecting students and teachers in a big way as masks disappear from classrooms, Comal ISD parents and teachers say.

Students are facing peer pressure to abandon masks. Teachers don’t know whose parents prefer for them to wear the masks. Parents who don’t want their children in class or crowded hallways with unmasked people must decide whether to go back to remote learning.

“Teachers had no time to prepare,” said Comal ISD middle school teacher and parent Kate Fraser, adding that students showed up without masks the day after the board meeting. “You feel as a teacher you can’t do what you need to do to protect the kids.”

The fast-growing suburbs and exurbs of San Antonio and rural areas of the Texas Hill Country where children attend Comal ISD schools have pulled the county further to the right, while more moderate conservatives struggle to hold on to the city of New Braunfels.

“I’ve always been a conservative, still am, still vote the Republican party. But the shift has been further and further and further to the right,” said Doug Miller, who represented Comal County in the Texas Legislature before losing his seat to state Rep. Kyle Biedermann, a far-right conservative who attended the Trump rally in Washington, D.C., on the day of the Jan. 6 insurrection.

Trump won all but one precinct in Comal County in 2020, capturing up to 79% of the vote in some precincts. His margins were widest in the rural areas in Comal ISD and smaller in New Braunfels ISD.

The two districts, both headquartered in New Braunfels, the largest city in the county, have subtle but important differences: New Braunfels ISD is majority students of color (54%) to Comal ISD’s 48%; 38% of New Braunfels ISD students qualify for free and reduced lunch, while 30% qualify in Comal ISD.

The demographic differences between the two districts may seem small, but parents say Trumpism has had an impact on the county, and the way the two boards settled the mask debate is the perfect example. Anti-mask beliefs have become synonymous with far-right conservatism.

“I really think it was ideology and not anything else,” Valerie Garza Estes, a Comal ISD parent, said of the board vote. “Listening to the board meeting, that’s perfectly clear.”

After Trump, Comal parents and students with “privilege,” Estes said, “are willing to be louder and meaner and push their ideas or views without even feeling there would be consequences.”

Board members who voted to remove the mandate cited parental choice, while the two dissenting votes argued masks were critical for safe in-person learning.

“What the data shows is that after every break from school we have a lot of kids who come back who get exposed outside the school,” said trustee Russell Garner. The number goes down once kids are in school. With masks, the transmission rate is “almost zero,” he said.

During the board meeting, trustee Jason York argued it should be up to parents to decide how best to keep their children safe and voted to lift the mandate.

His daughter, York said, would be wearing one. If other parents want their children attending prom, graduation and other activities, he said, “then they’re going to continue to send their children with a mask.”

That may not be true.

Sandy Mathis, a parent of three elementary school students in Comal ISD, said her family respectfully complied with the mask requirement, even though they believed that wearing masks all day had a negative effect on their children’s health and distracted them from learning.

“Now that we have been given the gift of parental choice, my kids will no longer be wearing a mask to school,” Mathis wrote in a message to The 74. Some at her children’s school have kept the masks; others have not. Some children are wearing them for a few weeks out of caution as spring-breakers return.

Removing the mask mandate gives parents a choice, but not teachers who may now have to spend entire days with maskless students, trustee Tim Hennessee argued during the board meeting. He voted to keep the mask mandate. “I think this shows a total lack of respect to the teachers.”

Of the schools he represents — in a suburban part of the district with the highest population of people of color — three quarters wanted to keep the mask mandate, he said. York countered by saying three quarters of the campuses he represents — which are in the most rural part of the district with the highest white population — wanted to be able to choose.

A Facebook group called Open Comal County Schools Safely conducted its own survey and plans to present the results to the board at its Thursday meeting.

When asked about the overall preferences of the district, Superintendent Andrew Kim said most teachers and principals indicated they would continue to wear masks.

“It varies by certain areas of our school district, I will say that,” Kim said.

His comment — and the feedback from Hennessee’s and York’s districts — suggests the tension between conservative and ultraconservative viewpoints exists not just between New Braunfels ISD and Comal ISD, but within Comal ISD as well.

Estes said that Trump’s racist and xenophobic rhetoric immediately showed up in Comal ISD schools in 2016, when classmates began to taunt her son about his Latina mother. During the pandemic, some students echoed Trump’s cavalier attitude, she said.

In August, board President David Drastata referred to COVID-19 using Trump’s racist “China virus” epithet in an athletic booster club email. He later apologized.

Miller described the new conservatism as uncompromising and domineering. “Their position is: If you disagree with me, you’re wrong.”

Kim expressed concern that emboldened parents with strong anti-mask views would become a distraction for teachers and principals if the district kept its own mandate without the state mandate backing it up.

“I think the last thing I would like to see is our administrators having a protracted philosophical conversation with our parents in the hallways,” Kim said.

The answer, the board decided, was simply to let those parents have their way.

Why You Should Take Periodic “Pandemic News” Breaks

Why You Should Take Periodic “Pandemic News” Breaks

Since the pandemic began, anxiety rates in the U.S. have tripled; the rate of depression has quadrupled. Now research is suggesting the media is part of the problem. Constantly watching and reading news about COVID-19 may be hazardous for your mental health. 

We are professors who study the psychological effects on people caught up in crisis, violence and natural disasters. COVID-19 surely qualifies as a crisis, and our survey of more than 1,500 U.S. adults clearly showed that those experiencing the most media exposure about the pandemic had more stress and depression. 

It’s understandable. The intimations of death and suffering, and the images of overwhelmed hospitals and intubated patients can be terrifying. COVID-19 has created an infodemic; members of the public are overwhelmed with more information than they can manage. And much of that information, especially online, includes disturbing rumors, conspiracy theories and unsubstantiated statements that confuse, mislead and frighten. 

Stress worse for some than others

A June 2020 study of 5,412 U.S. adults says 40% of respondents reported struggling with mental health or substance use issues. This finding did not address whether respondents had COVID-19. Since then, some people who had COVID-19 are now reporting mental health issues that appeared within 90 days after their illness subsided. 

Taking care of a relative or friend with the virus might result in mental health problems, and even just knowing someone with COVID-19 can be stressful. And if a family member or friend dies from it, anxiety and depression often follow the grief. This is even more likely if the individual dies alone – or if a memorial isn’t possible because of the pandemic.

Essential workers, from hospitals to grocery stores, have a higher risk for COVID-related mental health problems. This is particularly true for health care workers caring for patients who ultimately died from the virus. 

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Black and Hispanic adults also report more mental health issues, including substance abuse and thoughts of suicide. Having access to fewer resources and experiencing the systemic racism running through much of U.S. health care may be two of the factors. The COVID-19 pandemic also intersected with episodes of police violence toward Black Americans. This alone may have exacerbated mental health problems.

Children, young adults and college students also show comparatively worse mental health reactions. This could be due to the disconnect they feel, brought on by the isolation from peers, the loss of support from teachers and the disappearance of daily structure. 

Setting limits essential

Staying informed is critical, of course. But monitor how much media you’re consuming, and assess how it affects you. If you are constantly worrying, feeling overwhelmed, or having difficulty sleeping, you may be taking in too much COVID media. If this is happening to you, take a break from the news and do other things to help calm your mind

Parents should frequently check in with children to see how they are affected. Listening to and validating their concerns – and then providing honest responses to their questions – can be enormously helpful. If a child is having difficulty talking about it, the adult can start with open-ended questions (“How do you feel about what is happening?”). Reassure children that everything is being done to protect them and discuss ways to stay safe: Wear a mask, socially distance, wash hands. 

Finally, you can model and encourage good coping skills for your children. Remind young people that good things are still happening in the world. Work together to list healthy ways to cope with COVID-19 stress. Then do them. These activities will help your children cope – and it will be good for you too.

UAB House Calls Program Vaccinates Homebound Locals.

UAB House Calls Program Vaccinates Homebound Locals.

Some of the people most vulnerable to COVID-19 are those who are unable to leave their homes due to an illness or physical condition yet are at risk of contracting the disease if a caregiver or health care provider inadvertently brings it into their home. To protect this vulnerable population of people in the Birmingham area, members of the House Calls team at the University of Alabama at Birmingham are bringing the vaccine to their patients and to eligible caregivers.

So far, the House Calls program has vaccinated 30 patients and eligible caregivers and plans to administer up to 130 doses by mid-April. The program provides care to patients who cannot travel to their doctor’s office for appointments. The House Calls providers work together as part of an interdisciplinary team made up of a physician, nurse practitioners, medical assistants and a social worker.

“The vast majority of our patients never leave their home due to extreme frailty, multiple chronic conditions, and functional and/or cognitive limitations. They are among the most vulnerable people in our population and are at the highest risk of serious illness and death from COVID and other infectious diseases,” said Marianthe Grammas, M.D., associate professor in UAB’s Division of Gerontology, Geriatrics and Palliative Care. “Many of them are exposed to a number of different caregivers coming in and out of the home, all of whom have the potential to spread infection to the patient.”

“Our patients have been very happy and very grateful to receive the vaccine,” said Chaeli Lawson, the lead nurse practitioner for the House Calls program. “They are so grateful to have the opportunity to receive the vaccine just as you or I would.”

According to Grammas, vaccinating the caregivers is equally important as many are homebound as they cannot leave their loved one alone. Grammas says bringing the vaccine to eligible patients and caregivers is a key part of preventing a COVID-19 infection. It is a lifesaving intervention.

“The caregivers do not have to worry about how they would get their loved one to a vaccine site for inoculation. In many of their situations, this would be nearly impossible,” Grammas said. “This not only protects them but further enhances the protection to our patient, the recipient of their care.”  

Lawson says vaccinating their patients at home has been a team effort, with help from members of the pharmacy, resource utilization and vaccine distribution teams at UAB. 

The House Calls program cares for patients within a 30-mile radius of UAB. For more information about the novel coronavirus, visit uab.edu/fightcovid19.

3 Medical Innovations Fueled by COVID-19

3 Medical Innovations Fueled by COVID-19

A number of technologies and tools got a chance to prove themselves for the first time in the context of COVID-19. Three researchers working in gene-based vaccines, wearable diagnostics and drug discovery explain how their work rose to the challenge of the pandemic, and their hopes that each technology is now poised to continue making big changes in medicine.


Genetic vaccines

Deborah Fuller, Professor of Microbiology, University of Washington

Thirty years ago, researchers for the first time injected mice with genes from a foreign pathogen to produce an immune response. Like many new discoveries, these first gene-based vaccines had their ups and downs. Early mRNA vaccines were hard to store and didn’t produce the right type of immunity. DNA vaccines were more stable but weren’t efficient at getting into the cell’s nucleus, so they failed to produce sufficient immunity.

Researchers slowly overcame the problems of stability, getting the genetic instructions where they needed to be and making them induce more effective immune responses. By 2019, academic labs and biotechnology companies all over the world had dozens of promising mRNA and DNA vaccines for infectious diseases, as well as for cancer in development or in phase 1 and phase 2 human clinical trials.

When COVID-19 struck, mRNA vaccines in particular were ready to be put to a real-world test. The 94% efficacy of the mRNA vaccines surpassed health officials’ highest expectations.

DNA and mRNA vaccines offer huge advantages over traditional types of vaccines, since they use only genetic code from a pathogen – rather than the entire virus or bacteria. Traditional vaccines take months, if not years, to develop. In contrast, once scientists get the genetic sequence of a new pathogen, they can design a DNA or mRNA vaccine in days, identify a lead candidate for clinical trials within weeks and have millions of doses manufactured within months. This is basically what happened with the coronavirus.

Gene-based vaccines also produce precise and effective immune responses. They stimulate not only antibodies that block an infection, but also a strong T cell response that can clear an infection if one occurs. This makes these vaccines better able to respond to mutations, and it also means they could be capable of eliminating chronic infections or cancerous cells.

The hopes that gene-based vaccines could one day provide a vaccine for malaria or HIV, cure cancer, replace less effective traditional vaccines or be ready to stop the next pandemic before it gets started are no longer far-fetched. Indeed, many DNA and mRNA vaccines against a wide range of infectious diseases, for treatment of chronic infections and for cancer are already in advanced stages and clinical trials. As someone who has been working on these vaccines for decades, I believe their proven effectiveness against COVID-19 will usher in a new era of vaccinology with genetic vaccines at the forefront.

Wearable tech and early illness detection

Albert H. Titus, Professor of Biomedical Engineering, University at Buffalo

During the pandemic, researchers have taken full advantage of the proliferation of smartwatches, smart rings and other wearable health and wellness technology. These devices can measure a person’s temperatureheart ratelevel of activity and other biometrics. With this information, researchers have been able to track and detect COVID-19 infections even before people notice they have any symptoms.

As wearable usage and adoption grew in recent years, researchers began studying the ability of these devices to monitor disease. However, although real-time data collection was possible, previous work had focused primarily on chronic diseases.

But the pandemic both served as a lens to focus many researchers in the field of health wearables and offered them an unprecedented opportunity to study real-time infectious disease detection. The number of people potentially affected by a single disease – COVID-19 – at one time gave researchers a large population to draw from and to test hypotheses on. Combined with the fact that more people than ever are using wearables with health monitoring functions and that these devices collect lots of useful data, researchers were able to try to diagnose a disease solely using data from wearables – an experiment they could only dream of before.

Wearables can detect symptoms of COVID-19 or other illnesses before symptoms are noticeable. While they have proved to be capable of detecting sickness early, the symptoms wearables detect are not unique to COVID-19. These symptoms can be predictive of a number of potential illnesses or other health changes, and it is much harder to say what illness a person has versus simply saying they are sick with something

Moving into the post-pandemic world, it’s likely that more people will incorporate wearables into their lives and that the devices will only improve. I expect the knowledge researchers have gained during the pandemic on how to use wearables to monitor health will form a starting point for how to handle future outbreaks – not just of viral pandemics, but potentially of other events such as food poisoning outbreaks and seasonal flu episodes. But since wearable tech is concentrated within pockets of affluent and younger populations, the research community and society as a whole must simultaneously address the disparities that exist.

A new way to discover drugs

Nevan Krogan, Professor of Cellular Molecular Pharmacology and Director of the Quantitative Biosciences Institute, University of California, San Francisco

Proteins are the molecular machines that make your cells function. When proteins malfunction or are hijacked by a pathogen, you often get disease. Most drugs work by disrupting the action of one or several of these malfunctioning or hijacked proteins. So a logical way to look for new drugs to treat a specific disease is to study individual genes and proteins that are directly affected by that disease. For example, researchers know that the BRCA gene – a gene that protects your DNA from being damaged – is closely related to the development of breast and ovarian cancer. So a lot of work has focused on finding drugs that affect the function of the BRCA protein.

However, single proteins working in isolation are usually not solely responsible for disease. Genes and the proteins they encode are part of complicated networks – the BRCA protein interacts with tens to hundreds of other proteins that help it perform its cellular functions. My colleagues and I are part of a small but growing field of researchers who study these connections and interactions among proteins – what we call protein networks. 

For a few years now, my colleagues and I have been exploring the potential of these networks to find more ways drugs could ameliorate disease. When the coronavirus pandemic hit, we knew we had to try this approach and see if it could be used to rapidly find a treatment for this emerging threat. We immediately started mapping the extensive network of human proteins that SARS-CoV-2 hijacks so it can replicate.

Once we built this map, we pinpointed human proteins in the network that drugs could easily target. We found 69 compoundsthat influence the proteins in the coronavirus network. 29 of them are already FDA-approved treatments for other illnesses. On Jan. 25 we published a paper showing that one of the drugs, Aplidin (Plitidepsin), currently being used to treat cancer, is 27.5 times more potent than remdesivir in treating COVID-19, including one of the new variants The drug has been approved for phase 3 clinical trials in 12 countries as a treatment for the new coronavirus.

But this idea of mapping the protein interactions of diseases to look for novel drug targets doesn’t apply just to the coronavirus. We have now used this approach on other pathogens as well as other diseases including cancer, neurodegenerative and psychiatric disorders.

These maps are allowing us to connect the dots among many seemingly disparate aspects of single diseases and discover new ways drugs could treat them. We hope this approach will allow us and researchers in other areas of medicine to discover new therapeutic strategies and also see whether any old drugs might be repurposed to treat other conditions.


Vaccination, American Style: A “Crazy Quilt” of Policies

Vaccination, American Style: A “Crazy Quilt” of Policies

In North Carolina, the nation’s leading tobacco producer, any adult who has smoked more than 100 cigarettes in their lifetime can now be vaccinated against covid.

In Florida, people under 50 with underlying health conditions can get vaccinated only if they have written permission from their doctor.

In Mississippi, more than 30,000 covid vaccine appointments were open Friday — days after the state became the first in the contiguous United States to make the shots available to all adults.

In California — along with about 30 other states — people are eligible only if they are 65 or older or have certain health conditions or work in high-risk jobs.

How does any of this make sense?

“There is no logical rationale for the system we have,” said Graham Allison, a professor of government at Harvard University. “We have a crazy quilt system.”

Jody Gan, a professional lecturer in the health studies department at American University in Washington, D.C., said the lack of a national eligibility system reflects how each state also makes its own rules on public health. “This hasn’t been a great system for keeping, you know, the virus contained,” she said.

The federal government bought hundreds of millions of doses of covid vaccines from Pfizer, Moderna and Johnson & Johnson — as well as other vaccines still being tested — but it left distribution largely up to the states. Some states let local communities decide when to move to wider phases of eligibility.

When the first vaccines were cleared for emergency use in December, nearly all states followed guidance from the federal government’s Centers for Disease Control and Prevention and restricted use to front-line health workers and nursing home staffs and residents.

But since then states have gone their own way. Some states have prioritized people age 75 and older, while others have also allowed people who held certain jobs that put them at risk of being infected or had health conditions that put them at risk to be included with seniors for eligibility. Even then, categories of jobs and medical conditions have varied across the country.

As the supply of vaccines ramped up over the past month, states expanded eligibility criteria. President Joe Biden promised that by May 1 all adults will be eligible for vaccines and at least a dozen states say they will beat that date or, as in the case of Mississippi and Alaska, already have.

But the different rules among states — and sometimes varying rules even within states — created a mishmash. This has unleashed “vaccine jealousy” as people see friends and family in other states qualify ahead of them even if they are the same age or have the same occupation. And it has raised concerns that decisions on who is eligible are being made based on politics rather than public health.

The hodgepodge mirrors states’ response overall to the pandemic, including wide disparities on mask mandates and restrictions for indoor gatherings.

“It’s caused a lot of confusion, and the last thing we want is confusion,” said Harald Schmidt, an assistant professor of medical ethics and health policy at the University of Pennsylvania.

As a result, some Americans frantically search online every day for an open vaccine appointment, while vaccines in other states go wanting.

The assorted policies have also prompted thousands of people to drive across state lines — sometimes multiple state lines — for an open vaccine appointment. Some states have set up residency requirements, although enforcement has been uneven and those seeking vaccines are often on the honor system.

Todd Jones, an assistant professor of economics at Mississippi State University near Starkville, said the confusion signals a need for a change in how the government handles the vaccine. “The Biden administration should definitely be thinking about how it might want to change state allocations based on demand,” Jones said. “If it does become clear that some states are actually not using lots of their doses, then I think it would make sense to take some appointments from these states to give to other states that have higher demand.”

Jagdish Khubchandani, a professor of public health at New Mexico State University, said no one should be surprised to see 50 different eligibility systems because states opposed a uniform federal eligibility system.

“Many governors don’t want to be seen as someone who listens to the federal government or the CDC for guidance,” he said. Florida Gov. Ron DeSantis, a Republican, has boasted of ignoring the CDC advice when he opted to make anyone 65 and older eligible beginning in December.

“There is a lot of political posturing in deciding eligibility,” Khubchandani said.

To be sure, governors also wanted the flexibility to respond to particular needs in their states, such as rushing vaccines to agricultural workers or those in large food-manufacturing plants.

Jones said the decision to open vaccines to all adults in the state may sound good, but Mississippi has one of the nation’s lowest vaccination rates. Part of that is attributed to hesitancy among some minority communities and conservatives. “It’s good news everybody can get it, but there doesn’t seem to be a whole lot of demand for it.”

Jones, 34, was able to go online for a shot on Tuesday and was vaccinated at a large church a short drive from his home on Thursday morning. “I was very happy,” he said.

Published courtesy of KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

ICN Warns “COVID Effect” Could Drive Millions of Nurses to Leave Profession

ICN Warns “COVID Effect” Could Drive Millions of Nurses to Leave Profession

You can mark the toll of the COVID pandemic on nursing in multiple ways, from the tragic loss of nursing lives to the impact on nurses’ mental health. You can also count the impact in the number of nurses leaving the profession, a trend that may have long-lasting effects on nursing.

In a new study, the International Council of Nurses (ICN) says that 20% of its National Nurses Associations (NNAs) reported an increased rate of nurses leaving the profession in 2020. Some 90% of the NNAs are somewhat or extremely concerned that heavy workloads, insufficient resourcing, burnout, and stress related to the pandemic response are among the drivers, according to a policy brief.

The ICN warns that "Covid Effect" could drive over 10 million of the world's nurses to leave the profession.
Nurses and other HCPs–some wearing only gauze masks–treat Covid patients in Brazil.

ICN Chief Executive Officer Howard Catton said in a press release that the new data shows that difficulty in retaining experienced senior nursing staff, an effect of the pandemic that was expected to occur in the long term, is happening right now.

“The COVID Effect on the global nursing workforce, coupled with the current shortage of six million nurses and a further four million heading for retirement by 2030, could see the global nursing workforce of 27 million nurses being depleted by ten million, or even halved,” Catton is quoted as saying. ICN refers to the COVID-19 Effect as a form of mass trauma affecting the world’s nurses.

The ICN says it has recorded nearly 3,000 COVID-related deaths among nurses in 60 countries.  In all likelihood, says ICN, that figure underestimates the death toll due to incomplete monitoring.

On a positive note, in the ICN survey 74% of NNAs reported their countries have committed to increasing the number of nurses, and 54% of countries have committed to improving the retention of currently employed nurses.

Identifying Burnout

At the same time, a new study published in JAMA Network Open finds that burnout represents a significant problem among U.S. nurses who leave or are considering leaving their job.  The research used data from the 2018 National Sample Survey of Registered Nurses, well before the pandemic.

The study (“Prevalence of and Factors Associated with Nurse Burnout in the U.S.”) discovered that among the roughly 420,000 nurses who reported leaving their job in 2017, 31.5% reported burnout as a reason. Working in a hospital, as opposed to other settings, was associated with higher odds of identifying burnout in a decision to leave or consider leaving.

“Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift,” the article notes. Further, with the increasing demands placed on frontline nurses during the pandemic, “these findings suggest an urgent need for solutions to address burnout among nurses,” the report warns.

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