 Thank you everyone. Thank you so much for joining us for today's COVID-19 K-12 Summit, a collaborative event and partnership with Arizona State University in the center for the future of Arizona, which we also call CFA. I'm part of the CFA team and my name is Amanda Burke and I am our managing director for strategic initiatives and impact. And we're so glad you could join us for this learning opportunity, especially on a Saturday morning. CFA is a statewide nonprofit organization whose mission is to bring Arizonans together from across the state to build a stronger and brighter future. Much of our work is in the education space and collaboration with many of your learning communities. And we have seen over the past year firsthand how K-12 districts and charter schools are adapting and implementing innovative solutions to meet the needs of kids and families in your learning communities. And we're excited to be here today with you with an incredible group of scientists, medical experts, and education leaders from across Arizona to share with their learning from the K-12 COVID-19 testing pilot with ADHS, ASU, and 14 district and charter schools, many of whom you'll have a chance to hear from a little bit later today. But first, I'd like to introduce Tamra Dooser, Associate Vice President and Chief Operating Officer for ASU's Knowledge Enterprise Operations, who will share just a little bit more about why we're gathered here today. Thank you very much for that introduction, Amanda. And good morning to everybody. Thanks so much for joining us. As Amanda mentioned, I'm a team user. I look after operations for the Knowledge Enterprise at ASU, which has meant that I've been very involved in all of our COVID response efforts, including testing and other health management efforts, along with the research activities and so partnering across the university. We've done a number of things to try to be of assistance to our community, which is what consistent with what ASU tries to do, which includes we have closed about 15,000 case investigations. So we've been assisting the county with contact tracing and case investigations. Our Luminosity Lab created a website where we were able to connect hospitals and providers of PPE, as well as manufacture some of the critical supplies during the beginning of the pandemic. We have, I believe, about 150 different research teams that are working on things from, you know, vaccine candidates to, you know, treatment options to new testing technologies. And so we have a large group of people at work on those items. And then as many of you may not already know, we did stand up drive-through testing sites around the entire state in both rural and our major metropolitan areas. And we've done nearly 600,000 tests to date for the community. And then most recently, in the last two weeks, we have been providing logistic support and operating the state farm mass vaccination site with our various nursing students and other employees out there and plan to set up another mass vaccination site. So we've been hard at work trying to help the community in addition to the K-12 pilot that we'll talk more about today. So there's still a whole bunch of work to do. So we've all been hard at work and we're not out of the woods yet. So we're hoping that today we'll be helpful to the group in continuing to navigate the situation that we're in. I'm a parent, so I very much appreciate all of the work that you all are doing to try to bring our kids to school safely. So we're going to do what we can to be of assistance to you and that and we'll continue to do so as we move forward. We have been, as Amanda mentioned, working with 14 school districts on a number of things associated with the safe return to school. And just anything else that we can think of that we could be of assistance and we're incredibly grateful for all of your efforts. So while, like you, we don't have all of the answers, we've at least gathered together subject matter experts that can hopefully answer some of the questions that you have. Talk about what we've been doing at ASU and what's worked and what we've learned and provide you with some reliable and trusted information so that you can help the community you serve. So really appreciate everyone's time and participation and I'm going to turn it over to Michelle, who's one of the organizers of the event with Amanda. And thanks for everybody's participation and I hope it's a beneficial morning for you. Thank you so much, Tamara. Okay, so I'm going to just take a moment here and go over the agenda for the day. So over the next two hours, we will hear from subject matter experts and leadership from K through 12 districts across our state who will share best practices and address the challenges and questions you've voiced during registration. First, Dr. Joshua Baer will discuss what we currently know about how the novel SARS-2 virus that causes COVID-19 spreads in congregate settings such as schools and the different types and uses of available tests for asymptomatic and symptomatic individuals. Next, Dr. David Sklar will review different COVID-19 vaccines, address common questions about their capabilities and limitations and provide strategies for raising vaccine awareness and acceptance among students, staff, and parents. Then we will take a quick break during which time you will have the opportunity to ask Dr. Sklar a practicing ER doctor and professor of medicine questions about COVID-19. After the break, leadership from four diverse school districts across the state will discuss major successes, challenges, and lessons learned. Lastly, a panel of experts from Arizona State University, the University of Arizona and Arizona Department of Health Services will do their best to address your most pressing questions and concerns. Just a quick note before we start, during the symposium the Q&A box will be live and we will encourage you to enter any additional questions you may have as we go along and we will be monitoring this. So at this point, it is my privilege to introduce our first speaker, Dr. Joshua Baer. Dr. LaBear is the executive director of ASU's Biodesign Institute and one of the nation's foremost investigators in the field of personalized diagnostics. In response to the coronavirus pandemic, Dr. LaBear quickly repurposed expertise, equipment, and personnel to accelerate testing. The new ASU Biodesign Clinical Testing Laboratory developed a federally authorized diagnostic test known commercially as a QPCR to detect coronavirus for individuals who may have been exposed to the virus. This new lab gained CLIA certification for testing nasal swab samples and then became the first in the country to run saliva tests for coronavirus for the public. Dr. LaBear earned his medical degree and a PhD in biochemistry and biophysics from the University of California, San Francisco. He completed his medical residency at the Brigham and Women's Hospital and a clinical fellowship in oncology at the Dana-Farber Cancer Institute where he also founded the Harvard Institute of Proteomics. So, Dr. LaBear, I will turn it over to you. Hi. Well, good morning, everybody. This is a small enough group, so please don't hesitate if you need to interrupt me at some point because I'm not clear or you have a question. I think it looks like you're going to run the slides then. Okay. When are you going to advance the slide? All right. So, the first thing I'm going to say, and I know probably many of you have heard all this before, but just to remind you, what has made the SARS-CoV-2 virus, that's the name of the virus, so virulent and so problematic is that it has three characteristics. We say that it's sort of one the trifecta here. The first is severity, and it's kind of a maddening aspect of its severity because while it clearly kills people, I mean, we are losing countless people every single day, two people a minute, something to that effect. It also is very mild in other people, and I think that has been a challenge for this virus. If this virus made everybody sick, if it made everybody get a bad flu, you'd see a lot better behavior from everyone because they would know they don't want to get it, but unfortunately, better than 80% of people don't feel anything or fortunately, I suppose, and so they're less worried about it, but it is 10 times worse than the flu in terms of mortality. It is a severe virus for many people. The second is it spreads incredibly fast. We'll come back to this, but it spreads by airborne transmission, which makes it one of the worst ways of spreading because it's one of the hardest ways to control, and it is stealthy. By stealthy, I mean that the virus spreads from people who don't know they're sick, and that's what's been one of the biggest challenges. There are two other viruses in this family of viruses that are also deadly. You've heard of the SARS virus and you've heard of the MERS virus. Those are both deadly, but they've really all told, killed less than maybe tens of thousands of people total, not like the near million that we've seen now. That's because when people get those viruses, they're sick when they're spreading it, so they know they're ill. This one is challenging because people spread it and they don't know they're ill, and I think this comes back to the reason why some testing in the schools is going to be so important. The only way to find out if somebody is ill is to test them. So let's go to the next slide. This is just to remind us that this virus spreads exponentially. Each node here can give the virus to two or three people roughly. That's what the numbers suggest in the context of this virus. Now, it's not always true that one person gives it to three other people and that person gets to three other people. Sometimes one person gives it to 10 people and another person doesn't give it to anybody, but it's also important to remember that this spread doesn't happen in an instant. So if you click forward here, you're going to see that this first person will spread it to one person to two people and then go ahead, click again, and then it spreads over time. I emphasize this part because if we can interrupt this whole chain, then we limit the number of people that get the virus. That's the goal here. Limiting the number of people that get the virus does a lot of things for us. First of all, it reduces the chance that somebody will get severely ill and die from it. We don't want that at all, but it also limits the overall burden of virus in the community. The more virus that's around in our community, the more opportunities the virus has to mutate and form strains that are more difficult to manage. We really don't want to become a culture container for this virus and let it grow to huge numbers. We want to stop it before it has a chance to spread. If you go to the next slide. This just reminds us that this virus spreads by an airborne root. The virus surfs along the droplets of saliva that come out of our mouths when we speak and breathe. I know we don't always think about that, but when we speak and this has been documented, we produce about 2,600 droplets per second. That's a lot of droplets that are coming out of our mouths as we're talking. That means that as we converse with somebody, we're surrounded by a cloud of our own moisture. It becomes air that the other person breathes. It's the opportunity for the virus to ride along those droplets and infect the other person. There's been a lot of talk about six-foot spacing. I think we're all familiar with that. It is important, but keep in mind that that number is arbitrary. It came from studies done in the 1930s, so almost a century ago, when they couldn't even measure the size of the droplets that this virus is traveling on. Those larger droplets they could measure back then fall to the floor in three to six feet. But the droplets that the virus we know now travels on can linger in the air for a while, minutes even, and in some cases, even longer than that. It's around. The virus is out. It's in the air. It floats around. All of this, I think you can see where I'm heading here, is that mask wearing is really crucial. We have clearly documented that masks prevent these things from getting into our respiratory systems and infecting us. The key, of course, is that you want to mask on both ends. You want to mask on the person speaking and mask on the person listening. That adds two layers of filter that prevent the virus from ever making it from person A to person B. Many, many documented cases of people where there's been an infected person in the room, but both people are wearing masks and the other person doesn't get infected. Masks clearly work. We can go to the next slide. ASU has taken what we call an offensive strategy against the virus. It's great to do physical distancing. We talked about that. We talked about the importance of mask wearing. That's not enough. The virus is still spreading despite that. Part of our strategy has been testing. We think that testing is important, not only because it helps us identify those people who are ill and then allows us to get them out of circulation until they get better so that they don't have an opportunity to spread the virus, but it also actually alters behavior. It actually helps encourage people, believe it or not, to avoid spread. I think ASU is a good example of that. We randomly test the students in our school and every week a number of them get an email telling them it's their turn to get tested. We have seen transmission rates among our students at a very low level, far lower than in the community at large. We've had much less spread within the ASU community because we do this random testing. I think that testing is itself an intervention. It prevents the spread of the virus and it helps us identify quickly people who need to get separated until they get better. That's part of the reason we're using the strategy. Let's go to the next slide. Our lab set up a clinical testing scheme. We use technology that we already had for another purpose. We pivoted it to do what's called this QPCR test. I'm going to come back to testing in a minute. Our first tests were at the beginning of April last year and it has only grown since then. Today, typically in a day, we will do anywhere between five and 7,000 tests often. As Tamara mentioned earlier, we're doing them all over the state of Arizona. Thanks to the state of Arizona, those are underwritten by the Arizona Department of Health so they are free to the public. We have used saliva for a variety of reasons in large part because it is the medium by which this virus spreads. It's the most relevant source of sample to look at. It is as accurate as the nasal testing and it's a lot easier to get the sample. It's less traumatic. I think all you do is spit through a straw into a tube. We were able to collect a lot more samples that way. Let's go to the next slide. I'm going to briefly remind you of the different kinds of tests that there are out there. I'm going to start on the right-hand side here with the antibody test just so that we can dismiss it. The antibody test is a test that's used to determine if you had the virus in the past. Your antibodies won't be apparent until about 10 days or 14 days after you get infected. Antibody tests are not in any way helpful in determining if someone is currently infected with the virus. Really, what they tell you is that sometime in the past, that person had the virus. There are three other tests listed here for testing whether someone is currently infected. The LAMP rapid home test is a very specific test. It's one that you need to get a prescription for. I'm not going to really talk about that. It is an amplification test. The rapid test, the antigen test, you've probably heard about that one. It's advantage is that you can actually run the assay very quickly. The assay that we do in our lab takes a couple hours to run. This particular assay takes only 15 minutes to run. However, if you want to do a lot, a lot of samples, you have to line them up 15 minutes after each 15 minutes. It's not always as fast as it sounds. The bigger problem with the antigen test is while it's useful in people who are sick and who feel ill, it is not useful in people who are not. If you don't have symptoms, there's a very good chance that this test will not detect the virus in you. That's a huge problem because one of the main reasons for testing is to determine those people who are ill and who don't know they're ill. That's what we're after here. That's why we focus on this RT-PCR test, the one that we use for the saliva testing. It is the most accurate test out there for detecting the virus. It measures the RNA in the virus. That's the genetic material in the virus. We have a machine that amplifies that RNA. The test we use can detect down to around 200 virus particles per sample. Keep in mind that most people when they're ill have around 10,000 virus particles per sample. It's quite sensitive test. The test we use, test for three viral genes. There is virtually zero chance of a false positive. When we get a result, it's very clearly that there was virus in that sample. It is also important to remember that when you collect your sample is important in terms of when the test will be accurate. If you got infected today, let's say you got exposed today with the virus and we tested you on Monday, your test would likely be negative because it takes about four to five days for the virus in your body to amplify enough to be detectable by a test. You may have to get tested again. If we tested you by Wednesday or Thursday, your test would be positive. We've seen this in people already. Even though the test is quite accurate, it does depend on when you collect the sample from the person and where they are relative to when they got exposed to the virus. Let's go to the next thing. I'm not going to spend a lot of time on this. The ASU team has done a spectacular job in setting up a whole pathway for how to collect samples, how to run the samples, and how to get information back to people. We've got an integrated database that handles all of this. It is what's called HIPAA compliant database. For those of you who don't know what that means, it means that it respects the privacy of the individual. It's very secure database where nobody else can see anyone's medical result. Basically, every person creates his or her own portal. You log into your own portal and you get your result that way. It is true, and I will tell you that by law, all the results that we get get reported to the state. That is true for a pandemic like this. When we get results, they do get reported to the state, but the results are private and nobody else can look at it. This database can be accessed by your cell phone or by your computer. People log in through that. They set up their time for their test. They run the test, and then they get their result back from their own portal. Next slide. I'm briefly going to mention some variants because they are on everybody's mind right now. I will first mention that the reason there are so many variants is because there's so much virus. The more virus that's around, the more variants that are going to occur. Biology is like that. Whenever you make a copy of a genome or when any organism replicates, errors occur in the DNA copying, and new variations will appear. There are several that are appearing now that have functionally different characteristics. The strain from the UK, commonly called B117, appears to be a variant that is much more transmissible than the virus that we've been dealing with here. The last data I have heard is that it's no more severe. It is just more transmissible. We do know that the UK strain, the B117 strain, does respond to the vaccine. It is still targetable by the vaccine that we're using in the US. Nonetheless, if it were to take hold here in Arizona, for example, it would mean that we would need to reach a higher number of vaccination to achieve herd immunity because the more transmissible the virus is, the higher you have to go for herd immunity. The South African strain, which is called the B1351, a bit more troublesome. That particular strain looks like it does affect the vaccine efficacy. And so we really have to keep an eye out on that one. So far, it has not been reported in the US. But we really would prefer not to get it here. Obviously, we want to deal with strains that are resistant. And the Brazilian strain is yet another strain. I'm not aware that it evades the immune system yet. I need to look more into that. But again, all of these strains, the more transmissible they are, the more virus we're going to have in our community. We really don't want that. We want to reduce the burden of virus in the community so that we can get to herd immunity quicker and we can get back to our normal lives. Keep in mind that the emergence of strains is a reason to get vaccinated. The more vaccine we do, the fewer cases of virus we have, the less we have to worry about these other strains. And so all of these points to the need to get vaccination done. Next slide. So Tamara alluded to this already. The ASU does a lot of mass testing at statewide sites. Cardinal stadium is one of them. I think the Muni Stadium is another. I think we may have other places in Mesa and Chandler and others where we're now doing offering testing. The team there is just phenomenal. We've only heard great things from people who've used them. Typically, from the time you pull up to the time you're out, it'll be 15 minutes at most. Most people find that it goes very quickly, especially if you've scheduled it at a reasonable time. You'll see it goes very quickly. The team is very quick. You just collect the sample with the straw in your car, and then you're out. So I think these are the sites where the teachers would be able to go to get their tests done. All right. The next one. Right. And then we've really said this already. I'm not going to belabor this. I think I've covered all these points. We were the first to run saliva testing. I think we're still the only ones running. So maybe that's not true anymore. I don't know. But for a long time, we were the only ones doing saliva testing in Arizona and certainly the first in the country to do public testing using saliva. So it's gone very well. Overall, we've been very happy with outcomes there. I think this is most of what I have. Is there anything else on the next slide? This is just the instructions to collect the saliva. We use the drinking straw primarily to ensure that we get saliva. What we don't want is phlegm. We don't want snot. We don't want any other secretions up there. We're really just the spit in your mouth is what we're looking for. And the straw does a good job of ensuring we get that. That's crucial for our instruments to work. If they get the wrong substance, our instruments can't run the test. And it won't be valid anyway. But that's all it is. You just spit into tube. We actually have a video available on our website that shows pictures of sour food to help you produce saliva in your mouth if you have trouble doing that. So if you ever need that, we have that available. Next slide. And this just summarizes kind of where we're at. As Tamara mentioned, we're close to 600,000 tests now, well over a half a million. Our turnaround time is quick. Typically people will get their answer within 30 hours of when they do the test. So sometime on the day after you get the test, you'll get your answer back. We run tests all over the state of Arizona, including for the Department of Health Services. So it's a well-oiled instrument machine. All right, next. Don't need to tell you that right now things are not great in Arizona. We have a really high count number in the state. We are leading the country in terms of transmission. There's a bit of a hint that it's leveling off. I wouldn't start celebrating right now. I tell people that if you're in a car that's out of control at 140 miles an hour and you managed to wrestle it back to 130 miles an hour, you're still going way faster than you want to be going. And at 7,000 new cases a day, we're going way faster than we want to be going in Arizona. We don't want that many new cases a day. So right now the number of deaths due to COVID in a 12-month window outpaces cancer. It is the number two slot. Yeah, here you go. These are all deaths of COVID-19. And it is now the number two killer in the state and probably in several days, it will become the number one killer in the state. It will be the leading cause of death in Arizona over all other causes of death in a 12-month window. So it's a serious illness. Next slide. I'm not going to go into this. This is if you're welcome to come to our website which tracks trends. We post data every day in a variety of different charts and even some tables about what's happening currently in Arizona. So we track the different counties. We track how we compare to the nation and so on. And happy to help anybody here who wants to follow that information. It's kind of a useful way to know what's going on in the state. I think that's mostly what I have. Yeah, so I'll stop there. And if there are any questions, I can, I think I can answer them unless we're short of time. You know, Dr. LaBear, one of the questions that people have been asking and we're going to have people covering this, but maybe you can speak to this as well as why is it important to continue testing as people are becoming vaccinated, particularly in schools? Right, right. Well, lots, a couple reasons there. So first of all, the number of people who've been vaccinated right now is tiny compared to the total population. So the amount of vaccination we've got so far is really not significant in terms of overall statistics in the state. That's really important to remember. It's great that we're hitting people who are at risk of going to the hospital because we can ease up the burden in our hospitals, but there's still widespread virus in the community. Secondly, we don't yet know if vaccines prevent people from getting in and spreading infection. We do know the vaccines do prevent people from getting seriously ill. And of course, that's the most important thing. But they still might be able to spread virus. And so the best way to find out if people are carrying virus, and especially if they don't know it, is to do testing. It's the only way we know of finding out where the virus is. Great. Thank you so much, Dr. LaBear. We appreciate you and we hope you have a wonderful rest of your day. Okay, great. So at this point, I would like to introduce Dr. Sklar. So Dr. Sklar is a professor in the College of Health Solutions and advisor to the provost at ASU. He is distinguished professor and associate dean emeritus at the University of New Mexico, where he was a chair of emergency medicine, associate dean MDIO for graduate medical education, and the associate dean for clinical affairs. Dr. Sklar received his medical degree at Stanford and did an internal medicine residency at the University of New Mexico, and an emergency medicine fellowship at the University of California, San Francisco. He has authored or co-authored over 200 articles in medical literature and written two books, La Cuinica and Memoir, about his time working in a rural Mexican clinic and Atlas of Men, a prize-winning coming-of-age novel. He also happens to be lucky enough to be married to a colleague of ours here at ASU, Dr. Deborah Helitzer, who's the dean of the College of Health Solutions and has four children. Dr. Sklar has also kindly agreed to stay during the break and answer any questions you may have about COVID or vaccines. So please put any questions you have for him in the Q&A box, and then he will stay on after and answer them for you. All right, Dr. Sklar, I'll turn it over to you. Well, thank you very much, Michelle. And so, as you just heard, I'm a emergency physician, and I actually take care of people who get COVID. I also have, unfortunately, the bad luck of several family members who have had COVID, so I've had some personal experience, and I've also been vaccinated, so I can certainly talk about what that experience is all about. But before I begin, I do want to give some kudos to Dr. LaBear, who you just heard. I think what he has accomplished in a very short period of time is truly remarkable. He has developed a team. He's sort of the quarterback and the coach of our team. I'm part of that team and has developed a resource for the whole state that has been incredibly valuable. So, kudos to Dr. LaBear. I think we're so fortunate to have him, and I'm fortunate to be part of that team. So, I'm going to talk a little bit about vaccines now, because I think that's what we're going to really be mostly focusing on. So, vaccines, first thing about it is vaccines work, and as you can see here, when you have a vaccine, the disease really pretty much disappears. I actually have taken care of people who weren't vaccinated, who had some of these terrible diseases, such as tetanus, diphtheria, pertussis, measles. So, I'm old enough to have taken care of patients with these diseases, and in several cases they died of them. Fortunately, now, the worst of them, smallpox, tetanus, diphtheria, pertussis, have pretty much disappeared. Measles is very little and polio has pretty much disappeared. Influenza we still have, but the vaccines do work. Next slide. And because of vaccines, we're all living longer. So, around the turn of the century of 1900, the average lifespan was about 50 years in the U.S., and now it's about 80, and a large part of that is because of vaccination. Children are no longer dying of these terrible diseases, and they're living to adulthood and being able to live a long and hopefully healthy life. Next slide. Now, we've heard a little bit about COVID, and unfortunately COVID is a new disease, and so what that means is we have not developed as a population any immunity to it, because it is new. So, when we get exposed to a disease, we develop antibodies, and in some cases babies are born and they get the antibodies from their mother, or they get exposed at an early stage, and that helps us fight off the worst effects of the disease. But COVID is new, and we don't have any antibodies to it now. Next slide. And I think you've already seen from Dr. LaBear's slides that we've been developing several spikes or surges of disease over the last year. Each surge, I think, has been bad, but we I think hope that that would be the worst of it. Unfortunately, now we are in the throes of the worst surge, and I'll come back to that in a moment, because what I don't want us to do is think, okay, if we get the vaccine, now we can stop doing a lot of the things that really need to be done to reduce this current surge, I think we're going to need to have the vaccine and continue some of the public health activities that will reduce our risk. Next slide. So, what's a vaccine? Well, a vaccine is a substance that we give that it can be injected, or it can be given orally or into the nose, and it stimulates our immune system by bringing into the body either a part of a virus or a bacteria that is similar to what the actual virus or bacteria that causes the disease would create or would introduce into the body. And so we then develop antibodies that will attack the actual virus or bacteria when presented to us. So, if we get the vaccine, and in the best of cases, we will develop antibodies, and then if we get exposed to the actual virus or bacteria, we now have those antibodies that will attack the virus or bacteria before it causes problems for us. And so, therefore, we then don't have the severe symptoms or get very sick or die or anything like that. So, vaccines can prevent and or reduce the severity of a disease and then reduce the spread of that disease because we don't have, we're not coughing or sneezing. All right, next slide. So, there are four types of vaccines being developed right now, and I'll go through these just very briefly, mostly focusing on the last, which is the one that we're mostly, that's what people are getting now in this country. And so, the four types of vaccines are, first of all, the inactivated vaccine, where we actually take the virus and kill it, and then it will not be able to proliferate, but by then injecting it, we are able to then develop antibodies to the actual virus or bacteria or parts of the bacteria. But that's an inactivated vaccine. Then there's protein-based vaccines where some of the surface proteins from a virus or bacteria are injected. In this case, it would be the COVID spike protein. And then that is used to stimulate our antibodies. Then there's the viral vector vaccine. So, what happens is some of the viral DNA is actually put into another virus that is not a dangerous virus, and then that virus is injected into the body, and then the DNA creates RNA, and then the proteins are produced that our antibodies then respond to. And then the one that we now have is the gene-based vaccines. That's the Pfizer and Moderna vaccine that we're giving out right now in Arizona and all over the U.S. And in that case, we're giving some of the messenger RNA. It's actually injected into the body, and I'll show you how that works. But as it gets into, and here's a picture of it, where the RNA is encased in a little fat nanoparticle. It's a little tiny molecule that carries the RNA into the body and protects the RNA from being destroyed before it actually gets into the cells. And then that RNA produces the spike proteins, which then cause antibodies to respond to those proteins just as if we had an infection from the virus itself. So, it's really quite a unique type of vaccine, and because of the way it was developed, it was actually done very quickly. So, those are the four kinds of vaccines, and this is the one that we're currently using. Next slide. Now, unfortunately, there are some complications and some side effects from the vaccines. The most serious complication is anaphylaxis. It's very rare, but anaphylaxis may have heard of people who have really severe reactions from bee stings or they may be allergic to peanuts or something like that. And that's a reaction that the body has where you develop a rash and difficulty breathing and sometimes the blood pressure will go down and you feel very sick. Fortunately, it's very rare. I think there have been out of a million doses, about 10 cases, and the people who have had those really severe allergic reactions are usually people who have had other kinds of bad allergic reactions to other kinds of either food or get bee stings or something like that. Many of them already have the EpiPen, which is the way we counteract those allergic reactions, but it's also the reason why if you get vaccinated, we'll ask you to stay for at least 15 minutes to make sure you don't become one of those people that have the anaphylactic reaction. And then, if that were to happen, they have the medication right there at the site that they can administer so that you'll be fine. In any case, that's the most severe reaction. The more common types of reactions are not so severe, usually just soreness in your arm that develops about 12 hours after the injection. The injection itself is pretty painless, but people will develop pain in your arm, sometimes a little fever, weakness, achiness, things like that. And most people have had those reactions for the second vaccination. The first one usually goes pretty well. The second one, some people, maybe five or 10%, will have more of these side effects, but they last maybe a day or so. And if you take Tylenol, you're usually fine. So not a really bad reaction. Next slide. Now, I want to talk a little bit about what we call vaccine acceptance. It's really important that we get people to take the vaccine because that'll be our way of getting rid of this pandemic, is to get everybody vaccinated. And there's a real variability and acceptability of vaccination based on countries. The U.S., about 60% of us are willing to be vaccinated, but another 30% or so are sort of on the fence. And hopefully, as they watch others get vaccinated and not have any bad effects, they'll be willing. And then there's about 10% that are just really against getting vaccinated. And so our plan is really to try to get the 60% who want to get vaccinated to be able to get vaccinated to make it easy so that there aren't really impediments. And I'll talk a little bit about those in a minute. But so that, again, they get vaccinated. And then for the 30% who are on the fence to also be able to provide the information and hopefully support from families and friends to get them vaccinated. And the 10% who don't want to get vaccinated, that may be an uphill battle to convince them. But hopefully, they'll eventually come around and do that. Next slide. So how do we raise vaccine acceptance? And again, as many of you who are involved in education, I think you'll have a very important role with that. You'll be developing trust among your colleagues and eventually with students when they start to get vaccinated. We can't do that yet. But eventually, we will, I think, just being able to educate people about the vaccine. So developing trust is very important. And over the last few years, I think trust in our whole system has been sort of challenged by problems related to science and truth and so on. So we need to rebuild that and do it through education. Also, social media leadership, I think, with the Biden administration coming in and requiring everyone to wear masks and providing leadership by showing that that's important. Hopefully, that will be helpful. And then, as I mentioned earlier, reducing the barriers so that when people actually get onto websites, they can actually get their appointment and feel confident that they'll get the vaccine and making sure the logistics are really very, very efficient so that when folks go to get the vaccine, there aren't long waits and that we're able to do it well. So those are ways of, I think, improving vaccine acceptance. Next slide. Now, I did mention children and the tests that were done on the vaccines did not include children. So at this point, the Pfizer vaccine has been approved for children 16 and over, and Modana is 18 and over. So unfortunately, younger children, although there are tests now going on to show that it's effective and safe in children, we don't yet have approval to vaccinate children. But I think that'll probably come in the next few months. Next slide. So what do we need to do now? Well, as I mentioned, because the vaccine is surging in our community, we do need to continue to limit the current spread. And we are having five, six, eight, 10,000 new cases in Arizona every day. So we need to do the things that we know will reduce that spread, such as wearing masks, staying home as much as possible, social distancing, quarantine of people who are exposed or who have the illness, then making sure that we do vaccinate everyone possible, trying to get to 80 or 90% immunity, and doing that through education, social support and logistics. We also do need to provide good medical care for the people who do get sick. And that's sort of what I do. So I take care of people who get very sick in the emergency department. And I think we are doing better with that. But sadly, we are still losing people, some people who get really bad cases of COVID and it's heartbreaking. Whenever I go into the emergency department and see people who were healthy previously come in and are really suffering, and then I can tell that they're probably not going to make it. And it is really heartbreaking to see that. And it is real. That's why when people say, well, is this a hoax? Absolutely not a hoax. It's real. Also providing financial support to people who get COVID. And I have a family member who works in the restaurant community and he got ill. He's a server and didn't really have any financial support from the restaurant where he worked. And so he had to take off two weeks from work, didn't get paid. And you can see that that's really a disincentive for people to either be tested or to report or to quarantine because there's no financial support for them. And we need to do better on that. Hopefully we will. And then we have to have health policies that really are more effective than what we've done so far. So I'm going to end there and hopefully we'll have a little bit of time for questions. I'm really open to any questions you have. Personal, clinical, vaccine, although this is about vaccine, this is really also your chance to talk about any questions you might have. So Dr. Sklar, we do have a question here. So between the first and second doses of vaccine, if someone is displaying COVID-like symptoms, do they need to quarantine? Also once vaccinated, if exposed, will they still need to quarantine? Yes. So the answer so far at this point is yes. And there's a few reasons for that. First of all, after the first vaccine, you are somewhat protected, but you're not totally protected. So you could get COVID after the first vaccine and could then be spreading it. So if you do have, if you have symptoms of COVID, you should get quarantine and be tested. Now, the challenge is that some of the side effects of the vaccination are similar to COVID. So for example, fever, achiness, those are all very similar to the actual disease. And so that can be a bit of a challenge. And so we do ask people who are having those symptoms after they've been vaccinated to monitor themselves. And if they continue to have those symptoms, that they should actually get tested and quarantine until their test is then found to be negative. But the answer is yes, you can. And you can also get the virus, get the disease even after you've been fully vaccinated. It's not 100%. It's about 95%. So there are going to be 5% of people who will still get COVID even with vaccination. Great. Thank you so much. So someone else asked after having COVID, how long should someone wait to receive the vaccine? Yes, well, that's a great question. And as it turns out, probably about 20% of our population in Arizona probably have had COVID. And what the recommendation is, is that you wait about 90 days or so, I would say, because we know that there is a fair amount of protection after you've actually had the disease, because you essentially created antibodies for most people who have it, they do create antibodies, although it's probably less so if you had a asymptomatic case. So if you had COVID, but had no symptoms, your antibody production is a little bit less. But still, you are somewhat protected after you've had COVID. And so we recommend about a 90-day period before you get the vaccination. And that also allows us to prioritize people who haven't had COVID to get the vaccine who have no protection. So that's the recommendation at this point. Great. Thank you. And one last question for you before we move on. Where is the science with getting vaccines for adolescents and teenagers? Yeah. So for adolescents and teenagers, if you're 16 and over, you can get the Pfizer vaccine. And so it was tested on groups like that, 18 for the Moderna. There are studies right now going on in younger children. I think probably it will have it down to about age 12 soon once that data is reviewed and analyzed. So I would anticipate in the next month or two that we'll be able to include children under, well, down to the age of about 12. But that hasn't yet been validated. That's what it looks like. And then hopefully younger children after that. Wonderful. Well, thank you so much, Dr. Slarvi. Really appreciate you taking the time to be here with us today. And I know I certainly learned a lot from your presentation. So thank you so much. Yeah. Well, good luck, everybody. And hope you learn a lot today. During the lightning round session, leaders from K through 12 schools and districts across the state will share major successes, lessons learned and current challenges they are facing. Each of these schools and districts are currently participating in a pilot project with the Arizona Department of Health Services and Arizona State University to help schools safely operate this spring. And it has been truly amazing getting to know these leaders and hearing about the extraordinary and honestly heroic efforts they have spearheaded to address this unprecedented pandemic. With that said, I would like to introduce Dr. Sherry Dorothy, superintendent at Myanmar School District and Mr. Glenn Lineberry, principal at Myanmar Junior Senior High School. Good morning. Dr. Dorothy is going to lead off on our end. Yes, it would help if I unmuted. Thank you for having us and good morning. Some of the successes that we've experienced is that we were able to build a consultative decision making process based on data, collaboration with our health authorities and our knowledge of the community. And we use this process consistently. So there were no surprises to our population. We also had a steady and very transparent communication with students, family, governing board members, and our community, which was also very consistent. This is by no means painless. We have one of the challenges, one of the difficulties we've had is that we have never really received effective guidance as to what we ought to do. Lots of great information has come from all sorts of government agencies, but it usually doesn't tell us how to do it in a school. So for instance, we knew when we started hybrid instruction that we needed to scan the temperatures of students coming in. And we figured out on our own that that meant we needed to scan temps of kids getting on school buses when they got on the bus so they didn't carry anything to other students. But what do you do with a kid who presents at the school bus stop with a temperature? If they're one of my high school kids, you tell them to walk home. It's not that big a deal. But what do you do with a kindergarten or a first grader? And we've never really received guidance on these things. The second thing that we discovered is that in many of our families, the computer we sent home was the very first computer in the house. And so these kids lacked the kind of technology supported home that most of us can unthinkingly provide to our kids. Just little things like when the computer's not working, turn it off and turn it back on again or use this for copy and paste. That those sorts of that knowledge and those skills just doesn't exist in a lot of our homes. Dr. Dorothy. Do we have any questions? There's some other things that I could bring forth if you'd like me to. And some of our challenges were that we maintain student engagement until we have. What do we do to do that? That's been very difficult. And I'd like to ask Mr. Lineberry, one of the things that he did with a solution for that. Well, yeah, the first thing is that, and mind you, we haven't done this very well. But the first thing we did last spring, when we learned how different distance instruction is from in-person instruction is we worked with a group at Mary Lou Fulton, the Office of Scholarship and Innovation and developed a training for our teachers on how to use Canvas, on how to use Zoom, and on general distance instruction techniques. And that, I think, saved us in that it made, it equipped our teachers with some basic skills and built their confidence that they could do this. But this has largely been a very difficult process. We started the school year off on a distance basis and had real engagement problems. We were able to come back for nine weeks of hybrid instruction in the fall. And that gave us a chance to finally teach our kids how to use the devices that we'd issued. So that was a huge help. Some of the other things that we've identified, too, and I know districts across the state, nation, and probably world are identified these as well, is how do we make up for the lost instructional time? Do we put that at the forefront? Do we put forth a social and, you know, our well-being for both our students and our staff? So it's very critical that we meet our social and emotional needs for all of our staff, our students, and even some of our parents are very needy with that. So those are a couple of the challenges that we've also identified. And there's one more thing, and that's that we will, now that we've made these investments in technology, we'll be continuing to use this going forward. And a lot of our families can't afford effective internet connections. We were able to purchase some T-Mobile hotspots for about 300 of our families, but those will run out at the end of the school year. And we have some locations. We cover about 1,100 square miles in our district and the town of Roosevelt, for instance, up at Roosevelt Lake. There is no cell coverage up there. We were able to strike a deal with Tri-City Fire Department where our kids can go and sit on the picnic tables outside the fire station and use their wireless, but we need longer-term solutions for remote areas and for families that can't afford internet access at home. I think that's most of what we have. Yes. Wonderful. Thank you so much. I appreciate both of you being here today and sharing these insights with us. So at this point, we will go on to Vista College Prep. So I'd like to introduce our next presenter, Julian Meyerson, the founder and executive director of Vista College Prep. Thanks so much. Thank you for having me. So would love to share just a few of the successes, definitely some of the challenges, and then Michelle, happy to go from there. But for our first sort of success that I can share, I think really around the communication and clarity around metrics at Vista College Prep. So Vista College Prep were K-8 public charter schools serving just over 1,000 students in the central city south and Maryville communities. And so a big focus for our team has been to clearly and transparently communicate our decision-making process to all of our key constituents, just as you heard from the other district that had just shared, our families, our students and our staff. And so as a public charter school, we opted to use the Maricopa County School Reopening Dashboard and Guidance to really create an awaited average of zip code level data for our students and families. And so we didn't feel like just looking at the city of Phoenix or just the zip code of our school locations really represented our school communities. And so we were then able to use that data and monitor our cases on a weekly basis and share that with our team and families. And so concurrently, we were also studying how Arizona and other states across the country were using metrics to guide reopening planning. And so we created a phase reentry plan based on our regional zip code data and in a weekly email to all staff and families communicated where we were currently at with our data and how that aligned with the metrics we set. And so our phases way back in the early fall really called first for teachers coming back and then our youngest and most vulnerable students. And so we went back in the middle of October and while we were only in the building for two weeks until cases started to spike again, we ultimately didn't have any pushback from our families or our staff about the decision to both open at that point or close. And I believe that that's because we were so clear and transparent about how we were making decisions at that time. I'd say the second thing that I think is going well or that we feel like we've done well over the course of the last 10 months or so is how we prepared for that return to the building. And so in preparing to launch our phased return to the building in October, we met with local and national experts connected with countless other schools nationally. And again, as you heard from the other district, really sort of finding that information ourselves and created a mitigation plan that I believe allowed our buildings to run successfully. And so we created a document that detailed nearly every scenario we could think of created the corresponding action plan, including draft emails, draft parent emails, contact tracing protocols, and all of the various operational steps in the building to, you know, where kids would exit and where teachers would enter to ensure that health and safety was our number one priority. And so in preparation for that, we had countless all staff zoom calls where we walked through all the protocols, brought teachers who were turning to the building to practice and do walkthroughs of all of those new protocols and redid the schedule to account for that extra time outside, hand washing breaks for just all the PPE, HEPA filters, masks. And while we communicated to staff and families that we knew it could be just one week that we were in the building, two weeks or more or less, you know, the fact that we were able to actually be back into the building and our entire team was really committed to making that effort to both test our systems in that smaller setting, push for in-person learning whenever possible, and really ensure that we were ready once we decided to bring all students back. And again, I think as a result of our team's preparation and the leadership of our principals and our entire network, that research and communication not only do we not have any cases, but I think our team and our families felt that while we were prioritizing getting back into the building as soon as possible, we never compromised on ensuring health and safety, which was our number one focus. And then to move into what we learned, which were, you know, many things over the course of these last 10 months, I think the first one that we learned, which is also why we're excited to be part of this pilot program, is that there was a real reticence to get tested. And so when we were in-person and doing all of the protocols related to contact tracing, again, we first brought back our kindergarten and first graders and our most vulnerable students across second and eighth grade. And as you can imagine, with that age range, we had a lot of coughs, a lot of runny noses, symptoms that are unfortunately also symptoms of COVID-19. But as a mom and as a school administrator, also just typical of young children. And so at that time, with even just one symptom, it was recommended that a child stays home until they're symptom free. However, occasionally, obviously, students would have two symptoms. Parents would also have symptoms. And in that scenario, we would recommend getting tested so that a student did not have to be out for at that time that full 10-day exclusion. And so we found that our families in our school community didn't feel comfortable going to get tested and so would instead opt for that full 10-day exclusion. And we think, and after a variety of different focus groups following that time period, that it was really as a result of a lot of misinformation in our community about the risks of getting tested. And most importantly, a question of access to getting tests in our school community. And so as a result, we had so many kids at home with that 10-day exclusion, popping in and out of virtual and in-person learning. It made the return to in-person learning just operationally and academically very difficult. So very eager to get our testing systems up and running so that access is really no longer a barrier. And then our second kind of final lesson learned is kind of tied to that first challenge in many ways, that reticence to get tested was a need for an education campaign. And so we quickly realized that as a school, we needed to increase the opportunities to educate our families and staff about COVID. We're hearing a lot of misinformation about the virus, how you get it, how you can protect yourself and in the absence of any sort of national directive and unified campaign, it was really on us to fill that void. And so we started adding COVID facts and information about the virus in our weekly emails, working on other partnerships to start a speaker series and ensure we're ready to provide science-backed information from the CDC and other sources to our parents and staff who need it, especially as we now embark on supporting our staff to get the vaccine. And then finally, I'll just share our kind of current challenge, which is the, you know, how we are evaluating metrics as we now think about how to get back into the building. What metrics do we use and how do we with clear science-backed evidence evaluate them? So we continue to hear and read that schools themselves are not the super spreaders we once thought. However, that statement's always caveated by as long as community spread is not under control. And so I, and I think our network team is in full agreement that with the right mitigation strategies, schools can be safe places for students and teachers. However, our mitigation plan controls for what's happening just inside our building. We all want to be back in person. And so our current challenge is what does as long as community spread is under control mean? And we've really not been able to get a solid answer on that. And so we're in agreement that our past set of metrics where, you know, 6% positivity, we would do X and 7% positivity, we would do Y doesn't work now. But our, in our community with our regional set of zip code data, our percent positivity is now 26% with cases per 100,000 at 950. And so that's clearly different than where we were back in October at 6%. And so we're trying to assess now, when does it become operationally impossible to open? When is it truly unsafe? And how can we create some guideposts to evaluate returning to the building? And that's it. Thanks, Michelle. Yes, absolutely. Thank you. So I just have one question for you, if you don't mind. What have you done to help students overcome learning loss and academic regression during this time? Sure. So, you know, I think first and foremost, like you heard from the other district, I think we really tried to prioritize access. We also provide transport when we're back in the building, we provide transportation, which we think, you know, it's not choice unless you have access to that choice. And that's exactly how we feel in terms of the technology access as well. So we went fully one to one, we were not a one to one school before. We ran a first time ever summer school program over the summer. We also partnered with Boys and Girls Clubs and a few other NAU and others to increase impact over the summer to our kids, ensured all of our students had hotspots that needed them. And I'd say our big academic focus for the, you know, over the course of the last really five to six months has been a full dive into synchronous learning. So in the spring, we were far more asynchronous where, you know, we'd have reported lessons, things like that. We really fully switched to being fully live or synchronous in all of our classes across kindergarten through eighth grade, a really strong focus on small groups for guided reading. So we sort of divided up our early elementary where, you know, kids are in groups of five or six, getting that sort of one on one, quote unquote, five to six kids to one teacher, individualized attention, we use something called the step assessment. And so kids are kind of in their step groups, receiving that guided reading instruction, and we increased the amount of intervention opportunities. So we were originally running more sort of, you know, still sort of the full groups Monday through Thursday, we've added additional intervention blocks on our Friday schedule. And then just a huge focus on attendance, you know, really thinking about incentives, how are we ensuring that all of our kids are showing up every day so that we then can focus on the engagement on the backend. So I'd say that those are some of the ways we've tried to prioritize ensuring that, you know, really pushing back against every notion that this is going to be a loss to your farm kids. Great. Thank you so much, Julia. We really appreciate your time today. Thank you. So next we have Tucson Unified School District. And I'd like to introduce Leslie Lenhardt, because the Director of Communications and Media Relations at Tucson Unified School District. Great. Thank you, Michelle. Good morning, everyone. So I'm Leslie Lenhardt. I'm the Director of Communications and Media Relations for Tucson Unified. And for those of you who aren't aware, Tucson Unified is the largest district in Southern Arizona with over 40,000 students and 88 schools, K through 12. And as our district, we are one of the only districts in the Pima County area that has remained remote, because we have decided, as a district, to always follow the science and the metrics to make sure that our transmission rates are in a minimal to moderate level, which in Pima County has not happened since the start of the pandemic. So some of our successes, just to start off, is we created as a district a cross-functional team that really worked closely together to develop web policies and actions and access for our families. It included everything from curriculum instruction options, online learning resources and platforms that we were using, additional professional development for our teachers, as well as district policy changes and resources for our parents. So as far as how to use the various platforms that we were engaging in and making sure that all of our students had technology. As a district, we had to deploy almost 20,000 computers. So many of our students are from lower income families. So computers like some of the other districts are not something that is common in their homes. So keep getting those into the hands of everyone, as well as Wi-Fi access. The second thing that we felt went really well is the partnership that we had with the Pima County Health Department liaison team. They really have been a great part for us, helping us understand where the metrics are, explaining what they felt were the interpretations of some of the safety options that we made should make sure our priority for our district. As far as lessons learned, a couple of the things that we really felt were challenges for us was the lack of partnership between the state and county entities. We felt that there was lots of varying opinions and vague input for schools. So we really had to ourselves dig in, filter through the facts, and really find our own best practices between what we were hearing and what we ourselves or other communications with other districts in the area of how they were mitigating and making sure everyone was safe. The second thing that was challenging for us as far as lessons learned is the many changing and different metrics between CDC, the state, the county, everyone had a different interpretation and what was an important metric. So for us, that made it a little bit more challenging. What we were really hoping for is that at least on the state level, there would be a universal message of what we should do, especially in the school districts, because there was little input or very vague in general input there. So for us, getting the state leaders and county leaders all on the same page would have been great. So we had to manage through those speed bumps on our own and develop what we were going to do and what we felt was best for reentry plans for our district. Currently, we have three big challenges that we've identified amongst our team. One is every school that per state order has to have a learning space. And so being able to keep staff, healthy staff in those learning spaces for our students that need to be on campus has been challenging. So due to the isolation and quarantine requirements, we totally understand why we have to have those. But because we are a remote district, having to have those in-person spaces has made it a little more challenging. The second challenge for our district has been vaccine distribution across Pima County. We have tried to manage and understand the varying processes and methods that it is being distributed in Pima County has been very difficult. We have the state doing one thing. We have Banner Health doing another. We have Pima County doing a third. And as a district, it almost is like a free-for-all. Wherever you can find an appointment, you know, instead of having a universal, here's the process we'd like your district to go to and your locations. Really, people have been just trying to jump with the chance of getting a vaccine if they're in the appropriate group. Because, like most schools, we want to get back on campus. Our teachers want to be back in person with their kids. And so the vaccine distribution is super important to where we are going. And then our third challenge, and we hear it from both our staff and our students, is the concern of mental health challenges that people are having through the amount of stress, the varying things that they're dealing with in either within their own family or within watching their students, some of the challenges they're having, and how they manage and support them. And so getting enough mental health support out there for our district, for all of our leaders, our teachers, our students, has been really important. Our counselors and social workers have done a really great job. But I believe as throughout the pandemic, most people have been challenged in some way for, from the mental health side. And so when as we look forward, we're really hoping that our leaders can begin to work together, so that as a district, we can figure out how to make up for some of these learning losses that all of our students are participating in. You know, we've set up additional tutoring sessions and summer school or boot camps that will be happening in our schools over the next, you know, as we go into the summer break. But it really is challenging to not have a universal message and really leaving it up to every district to figure it out on their own, which we're happy to do, but a little more support would be very appreciated. That's it. Thank you so much, Leslie. I do have one question for you. What has your district been doing to help students with special needs? Sure. So on our campus or in our district, we have over 7000 students that have different types of special needs. And so those students are among what we call our high-risk students. And so we actually have brought and developed on campus in-person learning for them. We have what we call our hubs. So there's, I believe, eight hubs across our district where these students go during the normal school hours and are able to get all of their regular in-person learning as well as occupational or physical therapy, different things, support systems that they might need that we would normally give them within when we're in a quote-unquote normal year and not all remote. Great. Thank you so much. I really appreciate you being here today, Leslie. Thank you. Next, we have Dr. Quinton Boyce, who is the superintendent at Roosevelt School District. Awesome. Good morning. Thank you for having me. Super excited to be able to share a little bit about our community down here in South Phoenix Roosevelt School District. I appreciate the opportunity just to talk about some of the work that we're doing and things that we're working through. A couple just really quickly out the gate, things that have been going really well, successes for our community as we navigate pandemic. I'm really excited and proud of our technology deployment plan. Fortunately, prior to pandemic, we invested heavily in brand new devices for our community. Every student has an Apple device and every teacher has two. From that perspective, prior to the pandemic really hitting home and shifting from a traditional in-person experience to a virtual experience, we had devices which was a huge benefit for our community to move in that direction of virtual learning. That was one huge success. The other one was we've been very intentional about standing in the gaps for our families beyond teaching and learning. Teaching and learning is what we're charged to do. Additional context about our community, nearly 100% of our families qualify for free reduced lunch that gives some context to our demographics. We do teaching and learning as our main jam, but we also stand in the gaps for any other need that our students or families may have. That's included over a six-month period during 2020, providing roughly a half a million meals to our students and families. In addition to that, while we had amazing and beautiful devices, we needed to help close the digital divide. We worked with community partners and solicited ownership. We were able to get our students connected at a pretty alarming rate. Right now, proud to share that every student that needed help with high-speed reliable internet, we've been able to intervene and help provide that resource so that virtual learning can indeed look different and be more meaningful. That is another big success for our community. Some of the things that we've learned, virtual learning is hard. Nothing about our system outside of having those beautiful devices prepared us for shipping everything to a virtual format. Our teachers, administrators, support staff, also like they're back in year one of their profession, no matter how long they've been doing the job. We doubled down on professional learning during the summer of 2020 just to try to equip our community. We created a whole suite of professional learning experiences to make sure that our teachers felt equipped to start the 2021 academic year. It was pretty ambitious. We created a lot. What we realized was that there is a such thing as too much professional learning considering context and anxiety of it all just still feels so different and new. In hindsight, we listened to our community. We were more intentional about differentiating that learning. Some professionals, they were all in. They were super comfortable and excited to take in more learning. Others needed additional help. Another lesson learned, number two I would share, is there's no such thing as enough communication. We've been navigating impossible decision after impossible decision. One may think that we've done ample communication for both our internal and external stakeholders, but what we quickly realized is we need more. Even if the update is there is no update. We've been a little bit more intentional about thinking through what our communication protocol is going forward. A couple of challenges that we currently face, we're still navigating through. One is pandemic fatigue and I'm sure that's a reality for everyone. Whether we're talking about students, parents, or staff, everyone is fatigued. Teaching and learning is looking incredibly difficult or different rather than it has in the past and that difference is palpable. And so reminding everyone that this too shall pass is definitely key to keeping people encouraged. I worry about the social and emotional needs of our students and the sanity of our staff. And because we're human, we're carrying things outside of work as well. We get countless emails about loved ones passing away and financial hardship. And so just keeping people encouraged while everything around continues to look difficult is something that we work through. And another challenge that I'll share as I wrap up is that in our South Phoenix community, there's a real challenge when it comes to COVID resources. And so large-scale routine testing we haven't had access to which is why I'm super excited about upcoming partnerships. While our numbers in South Phoenix have been high compared to county average, just having access to resources to help our community navigate and persevere in the face of a pandemic is a challenge that we're currently navigating and we're reaching out to all stakeholders looking for additional support. So that wanted to share just a little context about our community down here in South Phoenix at Roosevelt and happy to be a part of this experience. Wonderful. Thank you so much, Dr. Boyce. If you wouldn't mind just answering one question for us before you have to sign off. So it seems like right now there's a tension between people who are experiencing COVID fatigue and are loosening up on mitigation strategies. And then there's also a lot of simultaneous fears and anxieties about going back to school in person. Can you talk about some of the ways that your district has been addressing some of the fears that parents may have and anxieties that your population may be experiencing? Awesome. Great question. Thank you. So one of the things that kind of goes back to the communication point. Figuring out a way and we've been working on partnering with healthcare professionals and creating virtual sessions that parents and students can engage in and ask questions really is getting information out. Getting correct and clear information out is a big strategy in helping to disarm. What is real anxiety and understandable anxiety in our community? So many of our students live in multi-generational homes and so it's not just it's not just child and parent, but it's grandparent as well. And we know that in this pandemic there are certain demographics that have been hit harder. So our job, our strategy one is to create space for as much real and appropriate and accurate information which is partnering with healthcare officials. And the other thing I would say is we just continue to share the mitigation strategies that we're implementing so that people know that schools are doing a lot to create as safe of an environment as possible. But big answers communication. Well thank you so much. We really appreciate you taking the time to be here today and I know you're on two webinars this morning so we really really appreciate you being here. Thank you so much. Thank you. You have a good one. You too. So at this point we are going to move into our Q&A session with subject matter experts and so I would like to introduce you to our panelists this morning. So we have experts from Arizona State University, the University of Arizona and the Arizona Department of Health Services who are going to be doing their best to answer some of the questions that you posed during the registration period. So I'm going to pose the first question which is going to be for Dr. Jean which is what metrics are important for schools to consider when making informed choices about safely operating, opening, and closing? Good morning. Thanks for having me. So as of December 2020, children and adolescents less than 18 years have accounted for approximately 15% of all COVID cases reported in the US. Efforts to reduce COVID-19 in families and communities in addition to mitigation strategies in schools and child care programs are important for preventing transmission to kids and adolescents and so you know we know that what we see in schools is a reflection of the transmission in the larger community and that's the reason for the three main school benchmarks that characterize the different levels of community transmission and these three benchmarks that have been put into place include case rates so the number of people infected with COVID-19 per 100,000 population in the area that the school serves, percent positivity or the percentage of PCR diagnostic tests that are confirmed positive out of all tests performed in a select area, and COVID-like illness percentage of hospital visits. So this comes from a hospital surveillance system and it monitors the percentage of people who visit emergency rooms and hospitals with COVID symptoms and this is one of our first signals that a decrease or increase in community spread is occurring. So you know all three of these are important metrics and taken together they give a summary picture of community transmission but it's also important to note that these are general guidelines and the state has said that they will support jurisdictions who are able to maintain a safe learning environment regardless of the levels of community transmission. You know here in Maricopa County they've really emphasized that the recent publications that have shown benefits of in-person learning particularly in elementary schools and emerging data indicating that in-person school attendance is not a risk factor for youth testing positive. So the guidance here has been to preferentially keep elementary and middle schools open for in-person learning whenever possible. Great thank you so much. The next question is for Dr. Aaron Krasnow who unfortunately was unable to make it today but he sent the following response for me to read on his behalf. Dr. Krasnow said there are little things we can do every day for example mitigation efforts like mask wearing, hand washing, social distancing and big things like policy, education and ensuring access to basic needs that all mitigate the spread. All of us can do the little things and together they add up to major impact but only some of us can tackle the big things even through their impact even though their impact affects all people. If you are one of the people who can influence policy provide essential supports such as financial aid food and emotional support then your impact is magnified and you have a special role to play but no matter what if everyone also takes the little steps the spread of this virus is harder and fewer people will get sick and die. Dr. Jean do you have anything that you would like to add to Dr. Krasnow's response? No I think you really hit the nail on the head you know usually when we try to illustrate this point we show a figure with lots of layers of swiss cheese and essentially you think about all of these interventions being imperfect they all have little holes in them but if you layer enough of them together you can really reduce the opportunity for the virus to spread. Great thank you so much and I have another question for you. A lot of school employees have been asking how and if protocols around mitigation strategies such as mask clearing and social distancing testing and quarantining can change once most of the teachers and staff have been vaccinated. Do you have any advice for schools or thoughts about how policies may vary depending on the availability and roll out of vaccines? Well so that's a great question and right now as of today there is no change to the CDC to state or the county guidance about mitigation efforts as a result of a vaccination and this is primarily because the vaccines are not 100 effective 95 percent is still incredible but it means that one in 20 still could potentially get sick. We also don't know whether you can spread the virus even if you're vaccinated and we don't know how how long the immunity lasts and so you know I think these answers are coming and we do expect the guidance to change pretty soon as the science is evolving but you know right now the no changes to the guidance so you know I think more broadly this question is also speaking to our collective desire to get back to normal right and I heard many of the panelists say that we see people relaxing their efforts everyone is fatigued you know we want something or anything to allow us to ease up on these restrictions. The vaccine is the best hope for this someday but the mitigation efforts are truly you know as of this moment still our best chance to stop the spread of the virus so you know when we reach more of the population vaccinated we'll have sort of a combination of the mitigation efforts plus the vaccine and then hopefully one day being vaccinated alone will be sufficient to control the virus but again that time is not now and not in the near future unfortunately. Great thank you so much. We had an earlier question that was specifically related to quarantine in terms of what what guidelines are folks following for for staff CDC is recommending anyone should quarantine for the full 14 days now 10 if you're exposed to reduce the spread so I think just some questions around best quarantine guidance. How Dr. Jean do you want to answer that? Sure I can't speak to what everyone is doing I know in Maricopa County that recommendation to the schools is is the 10 days following the CDC change from 14 to 10 and so they have put out that recommendation to the schools and you know there is in that CDC guidance there is the opportunity to leave quarantine at seven days with a negative test. Great thank you so much. Okay so this next question I'm going to direct to Philip. Many schools have expressed concerns around how to encourage and enforce social distancing on campus. Can you please give some examples of what ASU has done to address this on our campuses such as in classrooms and common areas like dining halls? Absolutely thank you so much Michelle and so some of some of my answers will be advantageous for university setting in comparison to a K-12 setting and then some of them are actually more challenging for us but we initially started by having every student faculty and staff at the institution go through a training and actually declare a commitment to our community and acknowledge that they were going to participate in all of the mitigation efforts so basically by having them sign quasi contractual language around mitigation strategies allowed us to really implement a strategy of mask wearing social distancing hand washing etc that we knew that they would more or less abide by somewhat under fear of penalty but moreover we really just guised it all under a commitment to what we call the sun double way and the sun double way of life and so on campus we've taken in all of our common area spaces and made them reservable so we still allow individuals to use those spaces but they need to reserve it and they have to stay within CDC guidelines for congregation. In terms of our classrooms we have really cut our in-person attendance which I know is a luxury we have at the university in half so any classroom that was normally 24 individuals would now be at 12 individuals with 12 individuals attending via zoom or other technologies. In our lunchroom spaces and our dining hall spaces we've been able to go to grab and go only again a luxury I know we have at the university and then what we did is we increased and created new outside and outdoor space for people to be able to congregate and we actually went ahead and built on our campuses some permanent structures with fans and those types of things for people to be able to still congregate outside while observing social distancing and then additionally throughout all of our space we have an ongoing campaign and communication campaign in every single entryway and every single elevator all throughout campus to renew and re-emphasize the need to continue to wear masks etc. Our biggest challenges as you can imagine are within our residential halls where people are expected to live and so we've really asked our students to not have a lot of outside guests come into our residential hall spaces it really is just for residents only and we've been able to keep our on-campus student infection rate under four percent the entire fall semester with a little blip around week two but once we got that under control our students have really taken a lot of pride in keeping our rates low so it's really a commitment that we ask our students to make we ask our faculty and staff to make and then we just continue to emphasize that through communication that we're happy to share with everyone. Thank you so much I have one more question for you right now Philip how do you think school administrators can address and dispel misconceptions about COVID-19 including the safety and effectiveness of vaccines among students staff and parents? Yeah so again one of the key things we've been able to utilize and I'm sure if I'm speaking to people that are only at the elementary school level it might be slightly more difficult is really letting our students drive the messaging and drive the information and so instead of taking a top-down approach we really engage with our student government with clubs and organizations with student leaders and ask them to make sure that they were leading the forefront of our social media campaigns making sure that they were the individuals walking around campuses setting good examples and so as an example this spring we're creating a speaker series where we're looking to do a bi-weekly conversation with our students on really general use language around vaccines around mRNA around giving our student body an understanding of what goes on in a vaccine and why it's really important for our overall ability to stay at ASU and stay in person and that's all being driven by our Programming Activities Board an organization called the Student Health Advisory Board and our and our student government so one thing that I would really encourage especially those that have high schools is the availability and ability to have your students make these commitments but then also be the individuals that step up and so we have many different campaigns even in our vaccines right now that we call mask up sleeve up and so again it's we want you to wear a mask and we want you to raise your sleeve and get that vaccine and so we promote those by giving out stickers by creating social media stickers by creating ways for individuals to show off that they've made this commitment and so we have so much pride in our student body to be Sun Devils that they really want to engage in this space and who doesn't like a sticker right so just trying to find fun little ways to engage our students and really leading us in making sure other individuals are aware of the importance to make these commitments great thank you I know everybody likes stickers and free stuff that's for sure um so Stephanie this next question is for you um several schools have reported confusion around where to have their staff vaccinated can you please explain how the vaccine distribution is being handled by the state cows and other entities such as hospitals and schools and provide leadership on this call with recommendations for how they can most efficiently vaccinate their staff thanks Michelle so the vaccine rollout um has been very complicated and continues to be very complicated the supplies in Arizona remain limited and we just we cannot meet the current demand and and uh that's actually a good problem to have because we know we'll get more supplies um in the future we do expect this limitation to continue for at least a few more weeks on top of the supply issues we have multiple partners that are simultaneously implementing vaccination plans and they are all just a little bit different so we have our primary partners which are the county health departments we have the state run vaccination sites which are currently at the state farm stadium in the phoenix municipal stadium um and then we have public private partnerships that are beginning to roll out as well the state and federal guidance provides just a basic framework for freight for phased rollout and this is where it was decided that school and child care staff would be included in phase one b but because of the limited vaccine supplies and then the fact that each county has unique population groups the rollout is very inconsistent between counties counties also in some cases have um sub prioritized the prioritized list uh due to these population groups and the limited supplies as an organization your lea should communicate with your county health department and in some instances we've been able to coordinate vaccination either on site or within a community site uh with district teachers and staff as the primary audience as an individual you should visit azhealth.gov slash find vaccine this has the most up-to-date information about vaccine availability and can help you find a vaccination site near you so as i said we have all these partners helping to roll out this vaccination and this has also led to confusion with the registration process there's multiple platforms you can use to register for your vaccination and so again that azhealth.gov slash find vaccine that site's going to be the best place and the easiest place to access all vaccine appointments all at one time great thank you so much Stephanie I just have a quick follow-up question for you um I know that some people have been wondering um you know do they need to get their second shot at the same place or through the same entity that they got their first dose of the vaccine um is that something you can speak to yes that that's a great question and you can receive your first dose and your second dose at alternate sites you just have to make sure that it's the same vaccine um so I can speak to maricopa county we have some sites giving Pfizer and some are giving Moderna so if you get Pfizer the first time you have to make sure your second is also Pfizer that find vaccine website will also include which vaccine is being administered at each location wonderful thank you so much Stephanie we really appreciate it um so okay the next question is for Jennifer who is on faculty at our edson college of nursing and health innovation but she also used to be a school nurse and so Jennifer we've received a lot of questions um from school nurses about how the binax now antigen tests that are um offered by the states of the counties are administered and analyzed so can you briefly explain how this test is administered and maybe the difference between how the antigen test is administered versus an mp swab um and uh how it can be used on school campuses so in other words how in under what circumstances would you use this test at schools um michelle thank you for having me here this morning um as she says i practiced school nursing for over 20 years um and uh more recently i'm teaching at the college of nursing trying to spark uh nurses interest in my love with just community and public health um our goal is the school nurses to keep students in school so i know someone was speaking earlier to the kina gardener who would come in and have a running nose which they often do and you know how do you determine whether it's covet or just a running nose so i think um a lot of the schools have uh policies in place to determine who needs tests who doesn't need testing but having something in the school would be wonderful to do that way you wouldn't have to unnecessarily send students or staff home and have the day the long quarantine period um this vinax now antigen card seems to be something relatively simple and from what i know is relatively inexpensive it'd be nice if this if it was in school district budgets to have these you have school nurses most hopefully most of you do on your campuses they're the experts in public and community health first of all i would recommend that you you know you seek their guidance they know how it runs um what's best for your school but this vinax now antigen card is as i said it's pretty simple it doesn't have to be refrigerated so that's kind of nice because you can keep them in your locked cabinet um you would use them for students or staff who have active symptoms of COVID not just you know you're not going to use it to determine if they can come into school events or you know they can return to school after having COVID but you could use them for the symptomatic people that are on your campuses um it's like a credit card uh size little kit that you would be able to um you know write their name with a sharpie on it open it up you would do a um you know you have a little reagent um a little bottle to put some drops in this card and then you would collect a sample a respiratory or a nasal swab specimen the nice thing about this is that it's not the nasal pharyngeal it's not the one where we go all the way up we did a lot of that testing with uh some people in back in April and uh you know it's not that comfortable but to do this one it's only like an inch into the nasal uh each nasal uh each nostril and you would maybe go an inch into you get a little resistance twist it a few times gently take it out put it in the other nostril twist it around and then put it into this card um there's a little hole that you could put it right into shut the card and time it for 15 minutes so it's really nice that you could have a um a test with it or a result within 15 minutes even for kids you know as I mean a little kid it's going to tickle but you know it's not going to hurt anybody um you use the same swab for each nostril putting it in there um so to me I think uh it's something that you know would be very feasible to have in any school health office as long as you had the you know the area to do the testing getting the results back have enough little timers so if you were for some reason testing five kids at a time you could have five little timers set for 15 minutes so you don't get confused on the time um so yeah that's that's what I I know about that and as a school nurse I would have loved to have something like that in my office great thank you so much Jennifer we really appreciate it um this next question is for Brianna who has been overseeing our site operations for our testing sites in state one uh Brianna how can schools help their community members such as students parents and staff locate and access nearby testing sites statewide hi yeah good morning thanks for having me um it's actually really easy so azdhs.gov they're uh right when you type in that website and go there they have a whole map right on their front page that allows you to type in a zip code um you can zoom in or in and out on the map um to see locations uh nearby and it lists the times and hours of operations and days of operations um and it includes all of the ASU saliva tests and lots of different other organizations that are providing um testing as well great thank you so much Brianna um okay so our next question um is for Dr. Levis Munoz can you please describe what your research has shown about the impact of COVID-19 on child and adolescent mental health and what advice would you give to all the school leaders on this webinar who are looking for ways to provide students and parents with social and emotional support during this time good morning thank you for having me first i'll start by telling you that we have a cohort study underway we're we're designing it currently there's nine investigators from ASU and U of A that are looking at the mental health impacts of COVID-19 among other aspects of COVID-19 so that study is underway but to do that study i've been spending a lot of time looking at the literature and so here i'll give you a brief synopsis of what i found so since November 1 to January 20th in the state of Arizona we have seen the cases of COVID-19 triple in that time pediatric hospitalizations have increased by four four thousand percent in the state of Arizona so we're looking at not only the direct impact of COVID-19 so the physical effects of symptoms but we're also looking at indirect effects such as job loss of somebody in the family learning online loss of socialization the emotional costs that come with isolation and so studies outside of Arizona have shown us that suicidal thoughts and attempts among 11 to 20 year olds who present in emergency room departments have shown an increase there's been an increase in 2020 that's compared to 2019 and another study found children in quarantine were more likely to report stressors than children that were not in quarantine all of this is no surprise to you all because you are seeing the social and emotional impact of the virus so let me shift gears to ways to be supportive first and foremost i want to stress taking care of yourself is not a luxury it is a necessity and if you're like me you're thinking how in the world am i going to find time to take care of myself i barely i'm barely able to get through what i need to so here are some examples taking a few minutes to eat a meal catching a power nap allowing yourself to cry giving yourself permission to feel your feelings whatever they are without judgment taking a walk or if you're into working out doing that taking five deep breaths notice yourself talk if it's critical then find positive thoughts to replace those critical thoughts and recognize the fact that you're here or the fact that you showed up to teach or to show up show up at your job in light of the pandemic the racism and the political unrest deserves recognition and then enjoy moments where you are in the moment so practice staying right at what you're doing if you are teaching that's what you're doing in the moment if you are writing a manuscript that's what you're doing if you're washing the dishes you're focused on washing the dishes as far as students my recommendation and what my reading shows is flexibility flexibility flexibility this looks like creating opportunities to meet the students where they're at giving them chances to socialize in small group activities switching them up from being with their friends to being with people they don't know maybe groups of about three some successes i've seen is creativity in teachers who have assigned stuff like creating a netflix series or using storyboard comic strips things to keep in mind when children and adolescents are depressed is hard to concentrate so expect some disorganization and forgetfulness i also recommend reducing stress by rethinking activities that produce anxiety like time tests or competitions and my last recommendation would be to find the good honor it and recognize it so it's important to think about what is not going wrong at this moment and those pieces sometimes get unrecognized so thank you for having me thank you so much Megan do we have any questions for dr. leves new y'all we don't have any posted but if other folks have follow-up i know this is a topic of great interest please feel free to pose in the q&a okay great so i'm going to go on to one other question and then we might return to you if that's okay um so philip this last question is for you there's a lot of parents who are struggling to support students while learning at home right now and many students are feeling disengaged and falling behind what resources are out there that can help yeah so we have an entire program at asu called asu for you which is um our continuing education adult education and um just general public access to educational site and on that site we have an entire virtual um teacher virtual educator um component that we really encourage all of you to take a look at and i know uh i believe michelle you'll be following up with an email to everyone and we have that link included in there and there's a myriad of resources right there for helping at home educators including parents um that are now turned into educators due to the pandemic that helps people um to create new and fun ways to think about engaging via zoom how do you create an engaging environment in your home how do you help to educate and separate space in yours in your place to help educate um and so there's a myriad of resources right on that website that are all available for free and then we are also offering some of our trainings through our prep digital space which is a k-12 digital educational space for any district that wants them so um any way in which asu can be helpful to you as a district um to help your not only educators in the classroom but also your educators at home um help your students prosper during this time we're we're availing that to you so it's asu for you it's a completely free resource dedicated to justice topic great thank you so much philla um so at this point we are actually going to um go into our closing remarks and next step so i just want to say thank you so much to all of our panelists and subject matter experts who were helping and volunteered their time on a saturday to be here um i know most of us at asu are working mornings nights weekends and we have been since march like many of you on this call so um i really appreciate all of you so much um i would like to close today by um letting you know that as a very small token of our gratitude for your participation the center for the future of arizona will be providing everyone who attended with a professional development certificate and you will be receiving that by email around february fifth uh we will also be reaching out to email you a list of resources so philip has put together a really excellent toolkit of free resources that are available to you that you can use as educators that you can share with your communities with parents and with students um we're also going we're recording this and we're going to make this recording available to you so that you can share it with your communities um we'll break up the videos so that if you would like to increase awareness around testing or vaccines with your communities you can send out or post little snippets of this video um and we'll also be sharing the full video as well um we'll also be reaching out with a survey because we'd really like to gauge your interest in convening among your similar types of schools um to build learning communities across districts so we know that this emergency will not be the last unfortunately and we want to make sure that you have a community of your peers that you can turn to and support each other share best practices problem solved and come up with solutions together so that you don't feel like you are in this alone and I just want to um at this point then turn it over to Dr. Amanda Burke with the Center for the Future of Arizona who has a quick announcement before we end. Thanks Michelle. I just wanted to share with you all as we talk about the vaccine um certainly now there's an issue relative to supply and demand but once we're able to meet the demand of those who want to be vaccinated we know we're going to have to turn our attention to figuring out how to support those who may be less sure and I wanted to make you aware of a resource and we'll include this in the follow-up set but the Center for the Future of Arizona recently conducted the statewide Gallup Arizona decennial survey and we asked in that survey um to how Arizonans think about the vaccine what are some of the factors that will influence them and deciding to take it and we've actually published because of the timing and how important this issue is an early look at the results through the Gallup organization that includes what information do Arizonans trust and I can share that medical experts are at the top but the data is by demographics as well as by regional data and so I think that could be helpful for many of you as you're working within your communities on those information campaigns and then I just want to add my thanks on behalf of the Center for the Future of Arizona for your time for your interest and for all the incredible work that you're doing every day on behalf of kids students or kids students who are students teachers faculty in the larger community so thank you so much yes absolutely on behalf of ASU as well we appreciate everything that you're doing for our children our communities during these really unimaginably difficult times so we just really want to let you know that we appreciate you and we see everything that you're doing and we value you so thank you so much I hope today was useful and helpful and we will be in touch soon be well