As is standard practice in COVID cases occurring in the schools, the district immediately consulted with Vashon’s Medical Reserve Corps (MRC) about the details of the case. But in this instance, Superintendent Slade McSheehy chose not to accept the MRC’s recommendations for wider quarantine and contact tracing measures in response to the incident.
On Monday — one week after possible exposures to students — McSheehy, School Nurse Sarah Day and others will meet with a Public Health Seattle King County official and members of its investigation team to receive further guidance.
The first official news about the cases came on Friday, March 24 in an email from McSheehy to district parents that did not specify that the cases involved students. (The email was sent prior to the confirmation of the fourth case, on Saturday.)
In that email, McSheehy said all of the “positive cases did not result from any school program or activity” and that all of the individuals who tested positive were exposed at the “original incident.” Three of the quarantined individuals were exposed later, as a result of what McSheehy called “an outdoor school activity.”
McSheehy’s email noted that Public Health authorities and the MRC had been informed of the cases and that due to the complex nature of the incident, the district would continue to monitor the situation and had not closed their investigation.
Prior to the time that McSheehy sent out his email, multiple islanders, some of whom requested anonymity, spoke to The Beachcomber. These islanders said that some of the infected individuals were students who had traveled first by ferry and then a district school bus to sports practices at the school earlier in the week — potentially exposing a wide number of other students.
When contacted by phone, McSheehy confirmed that the positive cases included two students who had taken ferry and school bus transportation to attend sports practices. He added that the person with the fourth confirmed infection had not attended sports practice and also been exposed at the originating incident, which did not take place at school.
He also said that he had been told that Vashon’s MRC had recommended to School Nurse Sarah Day a much broader quarantine of potentially exposed students, including commuter students who had ridden the school bus with the infected students, and that an entire team playing one sport at the school should be quarantined.
Dr. Jim Bristow, a member of the Medical Reserve Corps, characterized the MRC’s recommendations differently, saying that the MRC had recommended quarantining and testing students who had ridden the bus with the infected students, and also that contact tracing should be undertaken to understand whether or not athletes who were not on the bus should also be quarantined. Because activities had occurred outdoors, he said, the MRC believes those exposures were lower risk.
In any case, McSheehy said he had not spoken personally to any MRC members about the case but had chosen not to accept their recommendations for two reasons.
The first, he said, came from his reading of Department of Health guidelines online. He said he did not find specific guidance regarding exposures on school buses, and so had focused on the definition of a “close contact” as a person who had spent a cumulative total of 15 minutes within six feet of an infected person. The bus ride from the North End ferry dock to VHS, he said, takes 11 minutes.
He said he determined, after consulting with team coaches and students and reviewing camera footage from the school bus, that only three additional students had been exposed to the infected students for more than 15 minutes, including time spent on two bus rides both to and from school.
Moreover, he said that his primary reason for not quarantining more students was based on his concern for the mental health and social well-being of students, and the positive impact of participating in sports in terms of these concerns.
“I’m student-centered, and thought that the MRC’s recommendation put students’ mental health and social well-being at risk,” he said.
Additional communication about the incident has been given to students currently involved in sports activities in the school, providing information the district thought was important, as well as resources and information on testing, he said.
Sports practices paused for one afternoon at the school last week due to the case, but have resumed since that time.
McSheehy’s response to the incident differed from the standard practice of the MRC, which has consulted with the district throughout the pandemic and informed the response of Day in her contact tracing role in previous district cases.
In a phone interview, Dr. Zach Miller, who is an infectious disease specialist who has overseen many of the MRC’s contact tracing efforts, spoke broadly about the necessity of sometimes casting a wide net in the early stages of a contact tracing effort, with the understanding that some of those initially quarantined might well be released early as further details emerge.
He also said that the success of contact tracing efforts is determined by the speed at which they are initiated, thus limiting further transmission.
The highly effective contact tracing efforts of the MRC in other cases on Vashon, Miller said, have often involved multiple interviews with people that have taken place over a period of time, yielding more information along the way — including at times, new information about the origin and timeline of cases. Frequently, he added, people’s recollections about their close contacts evolve over time.
Reached by phone, Day, the school nurse, declined to comment, saying decisions regarding this case were made by the school administration and that she referred any questions back to the administration.
In another phone interview, Dr. Bristow, of the MRC, explained why the MRC made its recommendation, which he said the group of doctors relayed to Day on Wednesday.
“Our concern was the activity bus that took them to school for practice,” Bristow said. “Buses are enclosed and not very well-ventilated places where super-spreader events are well-documented to occur.”
He also said that it was not possible to know if the bus ride, including loading and off-loading, took 11 minutes or longer. Additionally, he said that students had not only taken a bus to the school but presumably a second bus back to the ferry after practice.
“That would double the cumulative exposure time, which is what matters,” he said.
Current CDC guidance defines a close contact as someone who has been within six feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period — for example, three individual five-minute exposures for a total of 15 minutes in one day.
Bristow said the MRC doctors had found McSheehy’s decision not to follow their recommendation odd, given the timing of the incident — before spring break next week, and following that, a return to limited in-person learning at McMurray Middle School and Vashon High School the week of April 12.
With a conservative quarantine strategy in place before those two important calendared events, he said, the district could have put this case behind them by the time secondary students returned to the classroom.
Placing McSheehy’s decision in context, Bristow said that the business community on the island had done extraordinarily well in terms of taking a cautious and highly transparent approach when cases had cropped up in local workplaces.
“We started by reminding local businesses that they were going to have cases — but the goal is to conduct your business in such a way that when you have a case, you prevent [further] transmission,” he said. “The same thing applies to the school district.”
In the end, Bristow said that in the MRC’s opinion, McSheehy did not choose the strategy that has kept Vashon safe throughout the pandemic.
“What’s kept Vashon safe is a conservative approach,” he said.
The new cases in the schools, he said, could potentially have real public health consequences.
“The MRC leadership is all on the same page about this,” he said. “We feel strongly about this issue.”
The most recent cases mark the first time students have been potentially exposed to COVID at school-sanctioned events, but Bristow said it probably would not be the last.
“We need to do what we can to minimize transmission,” he said. “VISD seems not to be doing that since potentially exposed students are continuing to come to athletic practices.”
McSheehy called the district’s response to the case “a good learning moment for everyone” which would lead to reviewing and refining COVID-response policies and procedures in the district.
Ultimately, though, he said he was the person responsible for making final decisions regarding VISD’s response to COVID cases, and that he is engaged more in “harder, more complex cases.”
“I am the decision-maker and with that responsibility comes tough questions,” he said.
He declined to comment on whether Nurse Day had recommended following the MRC’s advice in this case.
Including the most recent infections, 12 cases of COVID-19 linked to VISD have been announced by VISD. The district’s last case, announced on March 18, involved a positive case in a staff member in the District Office.
Team sports practices and workouts are in full swing at the school district for some time, with 188 students currently registered for Nisqually League competitive sports, said Andy Sears, athletic director for the district.
A six-week season for cross-country, football, girls’ soccer, volleyball and boys’ tennis recently concluded; a seven-week season for baseball, softball, golf, boys’ soccer, girls’ tennis, and track and field is taking place through May 3. VISD’s final season for basketball and wrestling will take place indoors from May 10 to June 14.
According to the Governor’s Phase 3 reopening rules, 400 people can now attend these indoor sporting events.