Dr. Bob advocates for clear science/data to drive school board’s masking decision

Dr Bob Lorinser

MARQUETTE, Mich. — Dr. Bob Lorinser offered his recommendations to the Marquette Area Public Schools Board of Education (BoE) Monday regarding masking in school. The community has been concerned about whether to highly recommend or to require masks in school. Dr. Lorinser also offered insight on how the BoE’s decision could impact the school’s in-person attendance. 


Dr. Lorinser spoke as a physician, a community member, a father, and a grandparent with grandchildren in schools who are not eligible for a vaccine. His recommendations are different from the CDC and the Michigan Department of Health and Human Services.


“Defining the level of risk to escalate or deescalate mitigation strategies such as masking in schools is the key to your decision-making,” said Dr. Lorinser. “A key component is who establishes the risk— the CDC, the State of Michigan, your local public health departments, board of education, vocal community members, or the vote of the simple majority. What information the decision-makers gather to defend their position is also vital.”


Dr. Lorinser emphasized he must make recommendations to safeguard the community. Still, with that, it is the BoE’s choice to accept the advice, modify the direction, or not take the advice given.


He says the State of Michigan and most local health departments are not planning to issue COVID-related orders or mandates for various reasons but are issuing guidance and recommendations. Therefore, the decision regarding masks in school will be Marquette BoE’s, in partnership with the community.


“I would hope that any decision made is with the utmost consideration to keeping the children in our care safe,” said Dr. Lorinser. “I want to review some facts to make sure everyone knows they are recognized. Some facts and data defend masks, and others support alternative solutions. I hope you will use these facts to help your decision-making.”


The facts Dr. Bob presented to the Board include:


COVID will be with us for years to come, and we need to learn how to live with it. Even though COVID will be present for years, its negative consequences will vastly diminish, and so will our required mitigation to address them.


Vaccination continues to be the best strategy we have to address COVID. Vaccines for 5–11-year olds will not be available until November or December from the most recent estimate. Vaccines are remarkably effective in preventing hospitalization and death for all age groups for whom it is approved. The vaccine is safe, with over 4 billion doses given worldwide. “I strongly recommend it.” 


The pandemic has multiple components separate from the public health and medical consequences — social, emotional, economic, psychological, political, and educational, to mention a few.


According to CDC data:

  • The risk of COVID to a child aged 5-17 is similar to influenza regarding hospitalizations and death.

  • Less than 1% are hospitalized

  • Around 1/100,000 will die.

  • 1 in 4 infections is reported.

  • An estimated 120 million Americans have already been infected

  • According to multiple data sources, the current Delta variant is around 3-4 times more contagious than the flu.

Delta surge is present in the UP and Marquette, with our rates in Marquette increasing 15-20-fold over the last three weeks and more than fourfold over the previous week.


Natural immunity is real and protective; vaccinating those previously infected reduces their risk around twofold from the baseline risk, which varies widely depending on community transmission.


Masking reduces transmission of COVID by around 70% from your baseline risk. The absolute benefit varies with local community transmission rates.


COVID is an airborne and droplet transmitted disease. Other countries have different strategies, and we should watch with interest their results. Specifically, England recommends no masking in schools and does not quarantine close contacts but recommends COVID testing, an approach that started Aug 16.


Early in the pandemic, data from the United Kingdom suggested that with extremely low community transmission (less than 10 cases/100,000 people/week), secondary transmission within schools where masking was not required or recommended was minimal. But our rates are currently increased eight-fold.


The opposite was seen in Tel Aviv, where uncontrolled spread among unmasked students was observed in schools when community spread was believed to be controlled. 


School districts in Ohio, Wisconsin, and Missouri have successfully implemented modified quarantine, which permits asymptomatic, exposed student and staff classroom contacts to remain in the in-person instruction setting if index case and exposed contacts were masked. 


School-based transmission during universal mask results in less than 1% secondary transmission, unlike household transmission with rates as high as 50%.


Under most quarantine policies used in K–12 schools throughout the 2020–2021 school year, the impact of quarantine on school operations and attendance was substantial. For every primary case within schools, 4–10 students/staff are identified as close contacts and required to quarantine. This practice resulted in hundreds of thousands of missed days of school and work despite a secondary transmission rate of less than 1% when both parties were masked.


Dr. Lorinser said local health agencies are considering modified quarantines for asymptomatic students who are appropriately masked. Those schools/classrooms with universal masking with only school-based COVID contacts — regardless of the distance — will be allowed to continue in-person education while asymptomatic.


He says exposed individuals should continue to quarantine for all other extracurricular activities at school and activities within the community setting. In those schools without universal masking, close contact definition and resulting quarantine will continue and could extend beyond six feet to include the entire room if Delta variant COVID transmission warrants such.


“Based on the current known COVID facts, I offer the following two recommendations for your consideration,” said Dr. Lorinser. 


“1st Recommendation: Our local schools should determine the level of risk to escalate or deescalate mitigation strategies such as masking in schools after discussing the facts and in consultation with students, parents, school staff and teachers, public health experts, and others.


“2nd recommendation: Marquette BoE should consider universal masking of 3K-6th grade — as a COVID vaccine is not currently available for those under age 12— and highly recommend masks for other grade levels. The duration of the required or recommended masking depends on multiple factors. I recommend this be reviewed monthly or when significant changes occur.”


Dr. Lorinser says the community and the BoE’s decision to start the year should not determine the entirety of the school year and argued these sacrifices are for the betterment of the community “at this time, under these circumstances.”

“We must move forward together out of this pandemic,” said Dr. Lorinser.