On Epidemics

Topics related to COVID-19 and other pan/epidemics. Some serious. Some historical. Others just for fun.

Whew, we made it! End of the (Pandemic) School Year

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Left: 1st day of school
Middle & Right: Last day of 6th and 4th grade

Tuesday, May 25th was the last day of school for us, not counting the weird 2-hour optional day on Thursday. The kiddos finished 6th and 4th grade. I was absolutely elated for them to be done, much more than in a “regular” May. In my role as an educator, I found this year to be tough. That said, I found that parenting school-age children was even more difficult.

Our school district provided two options for each quarter of the 2020-2021 school year: attend in-person with masks and distancing or participate virtually. Having experienced the struggle of working/parenting/monitoring the children during last March-May, we decided to send them in-person, stocked with a backpack of reusable and disposable face coverings.

August through October went fairly smoothly. Both of my kids were happy to be back. The new norm did consist of pockets of classmates out for quarantine due to a single-case exposure, but no secondary outbreaks. Tennis — the perfect pandemic sport — became a hit for my tween, and both adapted to the additional COVID measures surprisingly well. My kids never made a single negative remark about wearing masks. This was surprising, given that they typically complain about everything.

In November, the learning interruptions began. Since that point, we rarely had a full week without at least one child at home. First, a surge of cases prompted the elementary school to close as a precaution for two weeks. Then the superintendent called off Thanksgiving. Asynchronous days were added to the calendar. Less than two weeks after Thanksgiving, we were notified (on day 7 after exposure!!!) that tween was in quarantine. Four days after she went back to school, the district abruptly and understandably shut down in-person learning until mid-January.

Once the kids returned in person, the remainder of the year was choppy. We were grateful for the DL mode when tween’s health issues kept her out of school from mid-February through spring break. She returned to school only to have five scheduled asynchronous days for standardized testing from April 23rd to May 3rd. With one week left, the middle school called us on May 17th about a possible COVID exposure. Tween finished the year on quarantine, joining Zooms to watch her peers celebrate the end of school, but thankfully, never got sick. It certainly was a pandemic ending to a pandemic year. Meanwhile, little sis finished in-person and was thrilled to go to a nearby park for the year’s only field trip.

Completing school this year felt monumental. I’m sure the teachers and staff agree. I fully understand the challenge of quickly learning new technology and teaching hybrid courses, while worrying about the risk of transmission — the difficulty magnified because of the pandemic context. I applaud the teachers for having to create their multi-modal forms of instruction.

As a parent, this year has been a struggle. In-person, then online on Zoom, then online, but asynchronous, then one in-person, one online: repeat, repeat, repeat. The mix of asynchronous and synchronous days brought confusion, as I tried to help my kids navigate the numerous made-up-sounding platforms, programs, and forms of communication (7 teachers for 6th grade, 4 for 4th grade). The gamification of education only made everything more tricky to decipher.

Of course, we were among the lucky households. In the last year, the pandemic-induced approaches to schooling nationally and internationally have magnified inequalities. Success in the virtual/hybrid model wasn’t about student responsibility for “buckling down” and focusing. Instead, what was often lost was the foundation that enables learning in such an environment. Even if a device was provided, not every student has access to consistent WiFi and functioning printer.

And (this is a big one), not every kid has an adult available who can monitor and assist with distance-learning. Some might argue that “kids have to be responsible for keeping track of their schoolwork.” I would somewhat agree with this statement in a regular, in-person environment, in which assignments are distributed, completed, and then returned. However, virtual learning during a pandemic is a far-cry from the conventional setting. When students and teachers are not physically at school, it is so much more difficult to identify deadlines, find assignments, know how to turn them in, have the technology to turn them in, and ask questions. Plus, virtual learning strips away the support of classmates. My kids are pretty motivated learners who love technology, yet they often needed my help to decipher the system.

We’ve all had to make-do, push through, try our best, etc. and can hopefully look forward to better times (hopefully, soon) in which all kids can get vaccinated. But I do worry about overly optimistic articles that claim that this year’s educational approaches were somehow superior to an in-person experience. Yes, there are a few positive takeaways. It is fantastic to have so many amazing online talks, seminars, and tours. Online classes also have a place in education (I’m teaching one now). As is, a hybrid model doesn’t work in general, though, especially without resolving the many additional obstacles that block or hinder learning. This experience has hopefully made me a better instructor. At the very least, I am more mindful of students’ access and outside challenges that impact their achievements.

Pandemic education has shown us the value of regular school. It is so much more than acquiring repositories of facts, memorizing equations, or producing worksheets. School isn’t just a building or a set of objectives. What we are celebrating isn’t simply an end to a challenging year, but an optimistic return to a predictable learning community. For now, we’ll enjoy summer.

Returning to Normal: Lessons from the “Spanish Flu”

katiefoss On Epidemics
Published on December 14, 1918 in The Lima Times-Democrat

With the eased CDC guidelines on mask-wearing for those vaccinated, the lifting of mandates and safety restrictions have varied significantly. Public health authorities and individuals have speculated on the timeline for a “return to normal” and what that entails: how to reopen, the adjustment to social situations, and overall experiences for this transition. Much like this moment, people in 1918-19 faced similar questions as the influenza/pneumonia crisis subsided.

From 1918 through 1919, influenza infected at least one-third of the world, causing more than fifty million deaths, with over 675,000 in the U.S. Despite its name, “Spanish Flu” likely emerged in Haskell County, Kansas in March 1918. This deadly influenza and pneumonia combination first appeared at Camp Funston and the nearby Haskell Institute – a boarding high school for indigenous students. As war raged on in Europe, domestic outbreaks of the virus continued throughout April and May, receiving very little media coverage. To most Americans, the “Spanish Flu” seemed to begin in the summer, as newspapers told of rising cases in Asia, Germany, Spain, England, and other countries. When the flu returned to U.S. soil in September, notably at Fort Devens, Massachusetts, it was perceived as the first American wave. As outbreaks spread across cities and states, its news coverage competed with and sometimes paralleled the overseas battles.

Surgeon General Rupert Blue and the U.S. Public Health Service periodically put out information and guidelines on influenza – distributed through local and national newspapers. Similar to the COVID-19 pandemic, approaches and restrictions varied geographically.With only print media, content was limited to the broad scope of the national papers or nearby outbreaks in local newspapers. In other words, people knew little about what was going on outside of their own communities.

As cases rose, most towns and cities closed theaters, pool halls, and other businesses, banned dances, concerts and gatherings, and discouraged crowding in public spaces. But even this was inconsistent. Minneapolis, Minnesota closed down. Across the river, the city of St. Paul stayed open. Responses across schools also diverged, as school boards held special meetings, debating the best way to proceed. According to Alexandra Stern, Martin Cetron, and Howard Markel, most schools closed for periods up to fifteen weeks. However, Chicago, New York, and New Haven were among the cities that remained open, using medical inspection and individual quarantine to reduce transmission. Businesses that remained open marketed their adherence to safety protocol. At the end of October in 1918, Seattle’s Bon Marché department store took out full-page ads to lay out precautions taken against influenza, which included masks on the salon employees, the removal of chairs in restrooms, and a trained nurse on staff in the infants’ department “advising mothers how to protect their families from influenza.”

An ad from Seattle’s Bon Marché department store, laying out precautions taken against influenza, which included masks on the salon employees, the removal of chairs in restrooms, and a trained nurse on staff in the infants’ department. Published on October 26, 1918 in The Seattle Star.

After the Surgeon General recommended mask-wearing in September 1918, Red Cross volunteers across the country produced identical gauze face coverings. Mask requirements were inconsistent by town. Boulder Springs, Colorado fined $100 to “any one caught not wearing a facial adornment in the form of a mask” as reported in The Anaconda Standard local newspaper. Yet in an Indiana town, children at school were exempt from mask-wearing. Private businesses also mandated masks. For example, Lima, Ohio’s Hotel Norval Domino Room advertised music and dancing in the local paper, stating, “Flu masks required.” While most hospitals required masks, Brooklyn’s Kings County Hospital banned employees from wearing them, even when cases rose among its nurses and doctors. 

Published on October 10, 1918 in the Des Moines Tribune

Concerns about transmission for mass transportation prompted epidemic rules for streetcars. Seattle staggered business hours to prevent overcrowding on streetcars required one-third of the windows to be open, enforced by police surveillance. In Portland, all streetcar windows had to be removed for additional ventilation. Children were altogether prohibited from riding on streetcars in Topeka, Kansas until the ban was lifted in February 1919. At Camp Gordon, Georgia, roads were sprayed with “a special antiseptic oil” to reduce the spread of germs through dust. Other rules addressed the sick and dying. New York City passed a law requiring landlords to provide heat of at least 68 degrees. Upstate, influenza victims had to be buried within twenty-four hours of death.

The reopening of society and lifting of restrictions was just as varied and confusing as it is now, if not more so. No effective vaccine existed to slow the spread, cases were inconsistently tracked, and the influx of soldiers from overseas complicated quarantine orders. “Returning to normal” in 1919 meant the reopening of society: schools, businesses, gathering places, taking part in dances and other activities that had been postponed, and gradual dissipation of fear. At the same time, for life to truly feel “normal,” soldiers had to return home and adjust to post-war life. It didn’t happen overnight.

While May 2021 does not directly parallel early 1919, the transition out of the influenza pandemic can provide insight and reassurance as to this moment. Reopening occurred over months. Just as most cities were beginning to close, Boston and others that had been hit earlier, started reopening as the end of October, with modified Halloween activities to acknowledge the somber post-epidemic tone. Across the United States, though, restrictions were temporarily halted on November, 11, 1918, as parades erupted to celebrate Armistice.

“Impromptu Allentown Armistice Day Parade,” November 11, 1918
Allentown Morning Call Newspapers, Public domain, via Wikimedia Commons

Many towns then resumed restrictions, relaxing them toward the end of December or in early January, taking different approaches. News coverage on the pandemic turned optimistic before the crisis subsided. On New Year’s Day, a writer for the Lexington Herald-Leader observed, “Life is getting back into normal again, the influenza ban is about to be entirely lifted and school work to be resumed.” There’s never been uniform agreement about what to do during a pandemic or how to reopen. Public health authorities and regular people disagreed in the past and continue to do so now, with questions that resonate now: Are masks still necessary? When can sporting events resume? Will spectators be permitted? Are children safe at school? Town leaders took different approaches to relaxing quarantine and mask rules – some opening everything at once, with others easing up gradually.

In the first months of 1919, stories of enjoying the first dance after restrictions were lifted appeared next to announcements of illness and deaths. Likewise, news and social media in 2021 have juxtaposed vaccinated reunions with COVID tragedies, especially for countries that have struggled with the vaccine rollout. As society reopens, there needs to be public physical and digital spaces for remembering and mourning, and preparation for the inevitable outbreaks that will continue. Months after Seattle lifted its restrictions, the 1919 Stanley Cup Final had to be canceled on April 1st after multiple players and a team manager developed influenza, ending the series in a 2-2 tie. Assuming the Tokyo Olympics go forward, similar disruptions are likely for unvaccinated athletes and teams. Until global vaccination rates consistently high and cases decrease significantly, we too will continue to experience outbreaksand deaths.

The biggest takeaway from the “Spanish Flu” is the light at the end of the tunnel. While we need to grieve lives lost, the world has pushed through before and will do so again. Disease outbreaks have and can produce some positive changes, from improved waterways and sanitation to emergency preparedness plans. Remote learning and working, access to technology, and innovation in education are among the significant improvements that will hopefully continue forward. Lastly, the last fifteen months have sparked new interest in the history of epidemics and pandemics. The experiences and moments of COVID need to be preserved and disseminated for future generations to remember this crisis.

Free Beer or Campus Mandate: Addressing the Reluctant

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Others’ vaccination status affects all of us.
Me after my first dose.

As of April 27, 2021, 141 million Americans have received at least one dose of a COVID vaccine and 95.9 million are fully vaccinated, according to The Washington Post. These rates differ greatly by state and demographic.

We are witnessing a growing number of people who fit in a gray space of immunization, in which they aren’t against getting vaccinated for COVID-19 and yet, they haven’t received their first shots. Clumped into this group are also those who did get the first dose, but have lagged for the second.

The largest two clusters of unvaccinated people: conservative, rural white people that believe that any COVID precautions (including the vaccine) infringe on their freedom and people of color, whose hesitancy stems from a history of medical betrayal. While these groups (especially the latter) certainly warrant attention, I’d like to focus on a different population: those who are not opposed, but aren’t very motivated to get vaccinated. College students, twentysomethings, and additional folks that fit this description feel that they don’t have enough of a reason to make a vaccine appointment and then take time from work/school/life to go to an immunization site and get the shot. I say “shot” and not “shots” because these people need the one-dose. If it’s hard to prompt someone to get a first dose, the second dose is unlikely (helping to explain the drop-off of 2nd-dose recipients).

With the current widespread availability of vaccines in the U.S. for ages 16 and over, most people who were eager and willing have already been immunized. The vaccine-reluctant, then, need to be targeted, with their carrots identified. History is repeating itself on this one. In the late 1950s, this same age group held out on getting the polio vaccine, believing they weren’t susceptible enough to the virus to make it worth the shots. As I wrote about in my article for The Washington Post, the Ad Council initiated a mass public health campaign addressing this hole in the herd immunity.

How do we motivate the vaccine-reluctant during our current pandemic? We need a combination of targeted campaigns with messages that appeal to this age group, combined with incentives. Creative motivators have already sprung up: free donuts from Krispy Kreme, beer from Sam Adams and a number of breweries in New Jersey, on-campus vaccine site raffles, and employer-specific bonuses of vacation time or cash, to name a few. West Virginia Governor Jim Justice has promised savings bonds of $100 for those 18-35 who get the vaccine. In D.C., the organization Marijuana Justice gave out free joints at vaccination centers on April 20th, much like the Michigan-based “Pots for Shots” campaign. Such incentives have and will help close the gap of the vaccine-reluctant.

However, it’s not enough. What we need are vaccine requirements for various activities and places. To be pandemic-responsible, concerts, music festivals, and other large-gathering attendees should have to provide proof of vaccination — a notion that is being considered for Burning Man and other events scheduled for later this year. Additionally, college campuses need to mandate COVID vaccines for students, faculty, and staff. According to The Chronicle of Higher Education, 209 colleges will mandate vaccines. Most of these institutions are private and located in blue states. Mandatory COVID vaccination fits with existing immunization requirements (MMR, varicella, meningitis) and still allows for religious exemptions. Widespread college and university COVID vaccine mandates will (obviously) incentivize the difficult-to-reach population, normalizing this immunization for young adults. This approach also reinforces the necessity of mass vaccination as vital to public health — not as a person choice.

We need drastic action to even begin to dream of herd immunity, if that is a possibility. Motivating the super-spreader group to get vaccinated should be a top priority. Since emotional appeals may not reach the vaccine-reluctant, it’s time to create incentives and requirements that push them to get vaccinated. A free beer and the return to campus life?

On Our Need for People

katiefoss On Epidemics
I got a taste of Maslow’s third stage and now I can’t get enough.
(https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons)

I’ve been dreaming about the world of people since March 2020. As an extrovert, I crave social interaction. I’m not talking about big parties or dance clubs (never my deal). Rather, I’ve missed the conversations that make up everyday life — with employees at a store, colleagues in the copy room, students in the hallway, parents at kids’ activities — casual, unplanned encounters, along with scheduled coffee and lunches with friends.

My second dose of Moderna gave me the freedom to start planning again. To clarify, I am far from ready to whip off my mask and attend an indoor wedding or stroll into a casino. I’m talking about outdoor exchanges with fellow vaccinated friends.

These little tastes of socialization have reminded me of what makes life really good. Yes, Zoom has worked for the last year. But video chats are not the same. The virtual platform just cannot naturally convey the ease of small talk.

We have been disconnected from each other, our community, and the world. My few recent encounters over the last couple of weeks (two coffee meetings outside, some hallway chitchat, and speaking with three fellow parents on separate occasions), have reminded me of just how much we need to socialize. Even if we just speak of the mundane — no innovation, nothing is moved forward or seemingly “accomplished” — value exists in the interaction itself. Our current collective awkwardness at doing so demonstrates the necessity of connecting with other people.

While I regularly consume social media platforms, they are not a substitute for in-person conversation. Facebook and Twitter are great for sharing personal news, observations of the mundane, and pics of cute things. These virtual spaces do not allow for elaboration of that news or in-depth discussions. Our reliance on these platforms as socialization substitutes has been inevitable, yet faulty, as we are reduced to “likes,” hearts, celebratory phrases, and emotional abbreviations. Or even worse, social media sometimes reveals the raw hatred of humanity, with posts voicing thoughts so nasty that you would never say them in public (prompting me to click “Unfollow”).

Connection only through technology is a distant second to in-person interaction. Nothing can replace a smile, a laugh, or a sympathetic head nod (or a hug — once we get there). We need other people. The last few weeks have reminded me that life is so much more enjoyable when you can share your thoughts and experiences, while listening to those of a fellow human. And now that I’ve had a little interaction, I WANT MORE. (Friends, I promise to dial it back if we get together so I don’t scare you away).

From Inoculation to COVID Vaccination: The Wonder of It All

katiefoss On Epidemics
Me after dose #1 of the Moderna vaccine, outside of my car.


Skip this post if you detest emotionally-charged posts because that’s what it’s going to be.

From March 4th: I got my first shot of the Moderna vaccine today, jumpstarting my immune system to protect me against COVID-19. How, you might ask? I volunteered at our campus vaccine clinic. At the end of the shift, they had extra doses to distribute to the volunteers. I got lucky. Of course, we (as in the faculty) should have been included anyway. But that is (and was) another post.

Instead, I want to revel in what a true miracle this is. My use of this word should not convey surprise or lack of scientific rigor. Rather, it refers to, as I say above in the title, my absolute amazement that we have come to this point. For the world to have multiple effective vaccines against a strain of coronavirus that is little more than a year old, is almost inconceivable to me, a layperson who has never worked in a lab.

This happened because of the ability to build upon what others have done to move up a few steps. To capture knowledge, distribute it, and then preserve the content for future innovators. Our moment now occurred because of thousands of experiments that produced nothing, failed to support the hypothesis, or protect the test subjects from becoming infected.

Salk’s vaccine emerged decades after the first scientist prematurely promised a vaccine (40 years, to be exact). But we also need to consider what was not known when that initial declaration was made in 1912.

I am so incredulously grateful that we can be at this moment. We have never had a point in time in which an outbreak grew into a pandemic and while it was still ravaging society, scientists successfully developed a vaccine. In 1918, some scientists claimed to have a vaccine and injected soldiers with vials of something. However, since they didn’t even know that influenza was a virus, it did little to protect anyone.

How can anyone doubt such innovation? Why would a person question such an amazing gift? Even stranger are the conspiracy theories about the vaccine. How would a microchip fit inside the syringe? Wouldn’t you see it floating around? How would it fit through the needle?

What had to come together for this moment? It’s not just about what’s in the syringe. We had to have the technology to create the vials that contain the vaccine, the syringes themselves, and the needles. Take a step back and add the freezers that can store the vaccine, gloves and an understanding to protect those administering the vaccine. Lister and the process of antisepsis to prevent infection from dirty needles. I could go on and on.
Instead I am going to eat some cheesecake and watch TV. Because I can.

Written on April 3rd: I received my 2nd dose on the morning of April 1st. I’ve waited until the side effects have subsided to write out my thoughts.

Once again, I felt equally amazed as the needle went into my arm. It only lasted a second and it barely hurt. I felt like king of the world as I strutted out of there, beaming under my mask. Ten hours later, I started to feel the effects — first tired and then achy all over. Around 2:30 a.m., I woke up with chills, more aches, a headache, and some nausea. Fortunately, the latter two subsided by morning. Friday was a Netflix day, referring to the only thing I felt like doing, especially when fever set in during the early afternoon. By evening, though, I felt much better. And today (Saturday), I am 100% myself. Totally worth it for protection against COVID-19.

For this round, I’ve been thinking more about inoculation than 20th century vaccinations. It is unclear exactly when inoculation first started in Turkey, India, and China. We only know when it was brought to Europe and Colonial America. An enslaved person, Onesimus, first conveyed to Reverend Cotton Mather that intentionally infecting oneself with smallpox could ward off a deadlier version of the disease. Inoculation, also known as variolation, had already been practiced in India, Turkey and China. When smallpox broke out in Boston in 1721, Mather encouraged local physicians to try inoculation. Dr. Zabdiel Boylston was the only doctor willing to attempt the dangerous practice and did so with success. Even with early 18th century record-keeping, it was clear that those who were inoculated with smallpox were significantly less likely to die of the disease. (For more on this story, read my book).

Unlike vaccination, inoculation produces an infection of smallpox. Therefore, it wasn’t practiced unless there was an outbreak of the disease. Following 1721, inoculation became more common and refined with each epidemic, playing a crucial role in protecting soldiers during the Revolutionary War against the disease. At the turn of the 19th century, Dr. Edward Jenner’s work led to vaccination as a replacement for inoculation, sparking immunity without having to suffer from an infection of the disease itself.

So many brilliant people have come together to make the COVID-19 vaccines happen. But we can’t forget where the ideas originated. Like I said on March 4th, this feels like a miracle, NOT because the process was rushed (it wasn’t), but because of all of the components that had to come together over hundreds of years for us to have this moment. It is truly amazing.

Me after dose 2 in the 15-minute waiting period

Lessons from the past: Radio in the Chicago 1937 polio epidemic

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This literacy activity is based off of my article for The Conversation, found here.

Until the last half of the 20th century, it was not unusual for schools used to briefly shut down for weeks or even months. I’m not just talking about holiday or summer breaks. Hunting season, the fall harvest, and inclement weather kept students at home. Times of crisis also impacted education, as coal shortages in the 1930s and 40s forced schools in cold regions to temporarily close, as illustrated in this newspaper article from 1936.

Herman Schools Close During Week. Herman Record (Nebraska). Feb. 20, 1936 -
From the Herman Record, Feb. 20, 1936

Before the advent of vaccines and treatments for scarlet fever, measles, diphtheria, and polio, outbreaks of these common childhood illnesses also prompted officials to close schools.

School closings typically halted formal learning, granting kids extra time for play or work on the farm. Schools sometimes compensated for the additional closings by shifting the academic calendar or by mandating Saturday attendance once school was back in session.

The concept of distance-learning did exist, mostly through correspondence courses (classes taught by mail), but wasn’t commonly used during school closures. That is until Fall 1937, when school officials in Chicago decided to teach children at home using a relatively new technology: the radio.

It might seem weird to us now, but people in the 1930s were very used to just sitting and listening to the radio. By this time, over 90% of urban American homes had at least one radio — and they tuned in often, spending more than 4 hours a day listening to news and entertainment. (For an overview, watch this video). Individuals and families gathered around the radio much like we would a TV.

Radio had been used as an educational tool periodically since Penn State first offered broadcasted college courses in 1922. On a small-scale, radio programming occasionally served as a substitute for in-person instruction, as in 1932, when radio provided summer school curriculum in Chicago after budget cuts eliminated the regular session. Yet, no one had tried using radio to teach large groups of children.

Polio was a feared disease back then. While most people only had mild cases, the disease sometimes led to either temporary or permanent paralysis. Photos of children in iron lungs (machines to help them breathe) or using crutches frequently appeared in newspapers and magazines, making people more afraid of polio.

Pictures like this contributed to the fear of polio.
The U.S. Food and Drug Administration, Public domain, via Wikimedia Commons

In the summer of 1937, a polio epidemic erupted. On August 31, 1937, the Board of Health in Chicago ordered the start of school to be postponed due to the record number of polio cases (109, just for August). Instead of just keeping kids at home, a “radio school experiment” was launched, led by Assistant Superintendent Minnie Fallon. She worked with 14 principals to design the curriculum for 317,000 children in grades 3-8. (It was decided that those in lower grades might not do as well with radio learning).

On Monday, September 13th, students tuned in for their first day of radio school. Three radio stations broadcasted the lessons, with local newspapers printing daily schedules, like this:

The schedule for Sept. 14, 1937, printed in The Chicago Tribune

Over a week, students were taught math, English, social studies, physical education, and science, with each lesson lasting 15 minutes.

Unlike our video technology now, the radio was a one-way form of communication. Teachers couldn’t talk with their students directly, however, a telephone helpline was set up for questions. Similar to today, parents had to oversee the radio learning, captured in this photo of a mom helping her kids:

Printed in The Rock Island Argus on Sept. 14, 1937.

The experiment only lasted three weeks. Declining polio rates meant that children got to go back to school in person. Even with this brief time, the radio school was a success, demonstrating that the technology could be used to teach people. Radio stations began to partner with local educators and found more ways to make radio educational. By February 1938, radios had been placed in many classrooms and opportunities for kids to do their own news shows had begun.

Discussion Questions

  1. Why did the children of 1937 have to stay home? How is that similar to our need to have distance learning in the past year?
  2. What would it be like to learn through the radio? What do you think were some of the obstacles to this approach? How would that be different from lessons through Zoom or other video platforms?
  3. Not everyone had a radio then, just like not everyone has a computer now. What does it mean for the children who are left out in remote learning? What can be done to help families who don’t have internet access or computers?
  4. Radio learning led to the use of more technology in the classrooms. How will distance-learning now lead to new kinds of learning in the future?
  5. Media content from the past give us a glimpse into different cultural moments, like the radio school. After the COVID pandemic is over, what will people know about this time period from the news, social media posts, and other content produced in this time? If you only watched TikTok or Youtube videos from 2020-2021, what would you think that living through this pandemic was like?

Why aren’t higher ed instructors considered teachers? (And where they stand in different parts of the country)

katiefoss On Epidemics, On Teaching
Not everyone has been teaching online.

On December 30th, The Tennessean announced that K-12 teachers and child care workers would receive the COVID-19 vaccine in phase 1B, after health care workers and senior citizens. Many states have similarly modified their COVID immunization hierarchies, some of which include higher ed in phase 1B.

Note: I recognize that all states are lagging behind in the vaccine rollout and that most places aren’t even to close to phase 1B. The lack of a clear, consistent, unified, plan contributes to the implementation struggles.

My quest to learn more about higher ed’s status prompted me to ask questions in a private Facebook group. The more than 580 posts abundantly demonstrated the lack of information communicated about the rollout, inconsistencies with who can receive the vaccine in 1B, and what constitutes an educator. Aided by the (very helpful) vaccine tracker in The Washington Post, I studied individual state plans and the recommendations of the Centers for Disease Control and Prevention (CDC) to ascertain if higher ed instructors were addressed at all.

My vaccine distribution scavenger hunt was more difficult than it should have been. A few state health departments provide clear graphics on their vaccine homepages to guide users through (like Arkansas). But most states barely convey any distribution information. Instead, I had to dig through lengthy PDFs to find the info. Adding to this, different states opted to name and number their plans differently. Most states use “phases,” but differ on how many phases (1A, 1B, 1C for some, but Massachusetts, New York, and Rhode Island use whole numbers. MA has 3 phases. The other two have four). Alaska has tiers. At least three states don’t explicitly list phases (Florida, Georgia, and Indiana), but somewhat describe the order.

No wonder people are confused.

At the state level, 44 include teachers in an early phase of the rollout. A few more states appear to do so, but aren’t clear in their plans. Arkansas, Mississippi, South Dakota, and West Virginia specifically include higher ed instructors in the same classification as K-12 teachers. Massachusetts, Nebraska, Nevada, Oklahoma, Virginia, and Wisconsin list higher ed instructors in the phase after teachers. The remaining states directly exclude higher ed and/or are vague in their plans. Furthermore, in some locations, counties decide the distribution and have elected to vaccinate specific groups of local college or university instructors, as exemplified with the immunization of Arizona State University instructors teaching in-person. I will note that vaccine plans do continue to change, especially at the local level.

In the midst of my research, Elizabeth Redden’s Inside Higher Ed article gave me hope about the possibility of instructors receiving the COVID-19 vaccine in the teacher phase of the rollout. In it, she quotes CDC spokesperson Kristen Nordlund, who clarified that the CDC recommendations did indeed include “college, university and professional school teachers, support staff, and daycare workers” (as quoted in the article). Redden went on to outline the positions on vaccine priority from different organizations and then highlighted counties and states that plan to vaccinate higher ed instructors. I appreciated this well-researched article and felt optimistic overall about our possible inclusion in the rollout.

However, this clarification is not part of the CDC’s official recommendations. This is a big “however,” given that the written CDC guidelines served as the foundation for the state and county vaccine plans. In other words, unless your state already listed higher ed. instructors in the rollout, Redden’s article and Nordlund’s CDC endorsement means little for the implementation. My communication with my own local and state health departments unfortunately confirmed this statement.

The omission of higher ed. instructors from COVID vaccine plans draws from the false assumption that all colleges and universities continue to only offer classes online, thereby eliminating contact. In reality, modality has depended on the program, school, and state COVID responses. I won’t go into the economic, technological, and pedagogical reasons that colleges and universities have decided to offer forms of in-person learning, but instead acknowledge that it has and is happening. According to “The College Crisis Initiative”, approximately 48% of the 2,958 colleges and universities studied included some form of face-to-face contact between instructors and students for Fall 2020. Nearly 27% of schools were primarily or fully in-person. Even in some COVID hotspots, in-person returns are underway for Spring 2021. Staff also have interactions with students and other people, putting them at higher risk for transmission.

Why is this an issue? The age range of traditional college students aligns with those most likely to transmit COVID-19.

The CDC COVID Data Tracker Cases by Age Group. Found here.

Masks and social distancing have helped to protect instructors thus far, but may not be enough for the far more contagious COVID-19 variant spreading throughout the world. Thus, given the extent to which instructors must interact with a highly-transmissible sect of the general public, they should be clearly included in vaccination distribution plans. And aside from public health rationale for this inclusion, isn’t it also problematic to suggest that higher ed. instructors are not teachers?

Farewell, 2020: Reflecting on This Cultural Moment

katiefoss On Epidemics
Picture of people in line, January 2020.
January 2020. In a line to pick up crates of Florida oranges.

One year ago, we were preparing to leave for Florida on a family vacation on New Year’s Day. By the time we were at Universal Studios on January 6th, I had heard a little bit about the new strain of coronavirus, but wasn’t too concerned at that point. When the semester began, my teaching assistant mentioned trying to buy masks to send home to her family in China. I casually remarked that I just couldn’t imagine that Americans would ever be willing to wear masks — that individualism would prohibit such collective action. I had no idea that we were on the cusp of a global pandemic.

By the beginning of February, the epidemic was raging in China and cases had started to appear in other countries. Stories of the quarantined cruise ships signified the virus’s potential spread. Locally, some people were, as I perceived then, irrationally worried about catching coronavirus, prompting me to write this op-ed. (Oddly enough, I’ve observed the same folks disregard the threat of COVID now). As cases spread throughout the world, I became addicted to the Johns Hopkins COVID-19 Dashboard, an invaluable resource that has visually depicted the rise of the pandemic in-real time. Watching the numbers increase, first in Seattle, then in a scattering of other places, I wondered what was to come. I got an email from a New York Times reporter, asking about the politicization of the pandemic (even in February). This inquiry and subsequent article prompted me to really delve into what was being done and the skewed messages conveyed to the public.

COVID-19 entered my county in March. On Wednesday the 11th, MTSU President Sidney McPhee announced that all classes would resume remotely after an extended Spring Break. With this news, I advised my kids to bring home everything that they needed on that Friday, suspecting that they would be out for a bit. March 13th marked the last day of regular school, although we didn’t know it at the time.

With the shutdown, my blog became my outlet to the world. I wrote and shared so many blog posts that Facebook banned my website as spam. For me, writing these usually brief reflections has been cathartic. As our reality quickly morphed into a sweatpants existence, I needed a way to connect. At the same time, having just written a book on epidemics, I felt so many paralleled experiences to those of the past. Despite the blog format, I extensively researched all my historical entries — probably spending more time than one should for something with such little reach.

My explosion of media literacy activities stemmed from both my desire to give my kids something to do and to contribute to the wealth of materials that others were sharing last spring. Like many, my children had weeks with no school assignments and plenty of time to fill. I tried to give them something even remotely educational to help structure our day and attempt to teach them. (Note: they were often not thrilled with the theme days, essays, and other activities). Even though we were definitely privileged in our position, March and April were extremely stressful months for me. I was mostly failing at both teaching my own classes online and educating my children.

Picture of author dressed as Maria von Trapp
My kids were not amused when I woke them up dressed like Maria von Trapp on Sound of Music day.

Blogging provided me a way to express myself without the hassles of formal gatekeeping and to immediately respond to the moment, be it Trump’s outrageously dangerous claims about injecting bleach or the expectations of extending remote learning. Still, I periodically published pieces that went beyond this site, with articles on how past epidemics changed society, why the nickname “Typhoid Mary” shouldn’t be used, and on the shutdown’s disproportionate burden on mothers.

Summer brought more of a return to normalcy. I expect kids to be home then and we no longer faced the arduous list of online videos and assignments. Nice weather and the reopening of some businesses expanded our possible activities and made it feel more like vacation. I slowed down in blogging and writing to teach a class online and spend time outside with the kids. We focused on our Foss world, while keeping abreast of the turmoil of injustice.

With August came more mask mandate questions and school debates. Feeling like it was a lose-lose decision, we opted to send the kids back under the adopted protocol of required masks and distancing. I taught hybrid courses for the first time, lecturing under a mask in a ballroom-turned-classroom that seemed more appropriate for a time-share demo, rather than a college class. But, for what it was, it worked. We pushed through. The kids pushed through. Life seemed semi-normal for August through October as we anticipated that things would fall apart. And then they didn’t.

Masked up and ready for the mock trial of Mary Mallon
Picture of nearly empty ballroom lined with chairs
Last day of class in the ballroom.

November became the up-and-down month. The election and vaccine news delivered hope of a different reality, as did making it through the end of my semester. And yet, rising cases and school closings near locked us down again. Our family of four canceled plans and activities to return to just being us. No Friendsgiving or Christmas trip.

Picture of kids with four dogs in front of a Christmas tree
Fostering puppies to make Christmas at home a little more exciting.

What’s differed from the spring, however, has been this fractured picture of the true reality. News stories and charts have conveyed that Tennessee skyrocketed into a dire state for December, topping the list for new infections. And yet, a dissonance exists here. Everything is open. There’s no statewide mask mandate, just a county one with little enforcement. Aside from school, not much has been canceled. On local social media sites, people are asking about in-person church services, promoting “maskless Santa” before Christmas, and using the word pandemic in quotation marks. Obviously, the lack of public health observance is why were in this situation, but there’s not a lot of acknowledgement of this cause-and-effect.

We have such a split in what we know and what we’re seeing. Adding to this disconnect has been the near-absence of a unified recognition that things are bad. Aside from the numbers and the occasional story, very little media coverage has personalized the dire impact of the pandemic locally. Where are the lists of names and photos memorializing those deceased from COVID? Why don’t we have images of the COVID wards in our hospitals? And, more importantly, how is it that the leaders who endorsed and embraced the March shutdown are ignoring the actual crisis now?

I haven’t been blogging as regularly as I did in the spring, partly due to time, but also frustration. Some posts I never published because they were too heated or too intensely called out those around us. My popular articles focused on pandemic creative writing in 1918 and radio remote learning during a 1937 polio epidemic in Chicago.

Living through a pandemic is a fluid, diverse experience that shapes each person differently and at different moments. What we specifically knew in March has changed and expanded dramatically. As such, my reflective essays are very much a product of a particular moment and set of feelings, which all share uncertainty in the future and a serious concern about the pandemic. Even with the research I conducted for my book, I never could have imagined just what this would be like. I was unprepared for the large-scale denial of a disease that has killed so many people. These months have revealed both the worst in humanity and the best. I sincerely hope that 2021 brings the quick distribution of vaccines and overall, a more unifying time. Even more so, I want life to not just “return to normal,” but to become a better, more equitable version of a reality in which we can be together again, without the social distancing.

Here’s to 2021!

Where are we in the pandemic timeline? (It’s not good).

katiefoss On Epidemics
The interactive COVID-19 map, updated and published by The New York Times.

COVID cases continue to escalate and the death toll for the U.S. has exceeded a quarter of a million. Yet, as this FiveThirtyEight poll shows, over 30% of Americans are “not very” or “not at all” concerned about infection. Obviously, as we head into the holiday season, this is incredibly problematic.

The division between those who believe in science and the anti-maskers can be attributed in particular to one’s political affiliation and primary source of information. These factors are mitigated by geography, as local and state authorities set the tone for the regional public response early in the pandemic, often paralleled in local news coverage. Moreover, experience with COVID’s effects, either personally or through friends and family, also shapes the extent to which people view the disease as a threat.

We also can’t dismiss the toll of “pandemic fatigue” on public behavior, as individuals stop caring about precautions that they would have taken months ago because it feels like we’ve been doing this forever. Why are we in this spot? Unlike past outbreaks, our global access to information enabled countries around the world to learn about COVID early on and (to different extents) take action. In short, we feel like we should be past this pandemic because we’ve been in it so long. Except we haven’t.

Last spring, we pretended that the first wave had a conclusion, a denouement. It did — if you live in New York City or other places that experienced the surge and the dwindling of cases. The rest of the U.S. was really in a waiting period. In this calm before the storm, many people took the precautions needed to carry us through the pandemic. However, collectively, we acted like that was it, that we had made it through the wave. In reality, most of the U.S. has only just begun its red zone.

Let’s compare where we are to this moment in past outbreaks/epidemics/pandemics. From my study of 200 years of epidemic history, I can tell you that both small and large-scale outbreaks follow specific patterns in their construction in media messages and in public perception. For this comparison, ignore the amount of time we’ve known about COVID., focusing instead on the severity of the crisis itself.

Placed in the midst of other epidemics, we are approximately at the same timeline point as . . .

  • August 1721, Boston smallpox epidemic
  • October 1793, Philadelphia yellow fever epidemic
  • October 1918, “Spanish Flu” across U.S., “Spanish Flu”
  • Late January 1925, diphtheria in Nome, Alaska
  • September/October 1952, polio in the Midwest
  • December 1968, “Hong Kong” flu in New York and many other places

These critical points not only mark escalating cases within different outbreaks/epidemics/pandemics, they also share collective public emotions: sadness, scarcity, panic, and loss. While there are certainly variations in responses, shared characteristics define the severity of the situation. Listed above are the peaks of despair, when hospital ran short of staff, beds, and equipment. Gravediggers and coffins became in demand. Images of this moment captured rows of the ill in makeshift hospitals, stacks of wrapped bodies, and quarantine signs. Towns and local media became solely focused on the sick, dying, and deceased, seeking supplies and care providers, while banning public gatherings and funeral bell tolling. Ministers ceased holding services for fear that they were spreading disease among parishioners.

This is where we are in our COVID-19 pandemic. If you are not feeling this moment yet, it is not due to the case numbers. Rather, it is the cultural climate that is imaging a reality that is not this one. Many local news outlets have opted not to publish cause of death as COVID-19 or showcase the experiences of survivors, blocking communities from the devastation from this disease. We have convinced ourselves that we did the work last summer so we must be fine now. NOPE. Even if you are not personally seeing it, the U.S. (and most of the world) is in crisis mode.

We are at a crossroads for what will happen next. Changing the course of the pandemic needs to occur at all levels, including our individual choices. It might feel like we’ve been in this pandemic state forever. Unfortunately, though, we are deeply in the midst of the crisis — a reason to stay home, not to give up.

What Polio Can Teach Us About This Pandemic

katiefoss On Epidemics , , , ,

Most historical comparisons to our current crisis have been to the “Spanish Flu.” And while several of my essays challenge some of the parallels put forth, I understand why people have been so quick to return to 1918 for answers. Its global reach and profound impact on the U.S. and most of the world feel somewhat similar.

Yet in focusing on this comparison, we miss the series of epidemics that might in fact paint a closer image to our current reality. Throughout the 1940s and 1950s, poliomyelitis emerged periodically in epidemic form, reaching its peak in the summer of 1952. Less than a year later, Jonas Salk’s vaccine was approved for a mass trial, which would prove effective.

What can these polio epidemics teach us about COVID-19? The diseases themselves are not similar. Polio is caused by a three types of a human enterovirus that spreads through contact or contaminated food and water. COVID-19 is a a novel coronavirus, transmitted by respiratory droplets.

What we can relate to is the mystery surrounding the disease. As with COVID-19, with polio, you never knew who would become ill or how bad it would be. Approximately 72% of polio cases were asymptomatic. Those who felt sick usually had mild symptoms. Only a small percentage developed the paralytic form, experiencing either temporary or permanent paralysis of a limb, limbs, the diaphragm, or multiple affected sites–its course unknown. And although it was characterized as a disease of children, adults also contracted polio, particularly in the later epidemics. [Note: I’m speaking in past tense here to refer to the mid-century outbreaks. Polio cases are still emerging in Afghanistan, Nigeria, and Pakistan).

What we can take from the periodic polio epidemics in the first half of the century are ways of living that are accustomed to interruption, the importance of a unified public response, and a healthy respect for disease itself. No one knew when polio would come to town. But when it did, local spots quickly closed down to reduce the spread of disease. People were quarantined and isolated as needed, sometimes even at camps. Movie theaters, public pools, and other gathering places shut down, as parents were advised to avoid having children mingle in new groups. Polio also led to local school closings for short periods, which were opened back up when it was believed that the threat had passed.

No one proposed that polio was a hoax or questioned the severity of the threat. The National Foundation for Infantile Paralysis (NFIP), founded by President Franklin D. Roosevelt and his business partner, Basil O’Connor, united the nation in the fight against poliomyelitis. NFIP campaigns provided education and raised money for rehabilitation and research toward a vaccine. During outbreaks, the NFIP provided additional health professionals and resources, including rocking beds, iron lungs, and other equipment, through coordinated efforts between the local and national levels.

We know the work of the NFIP was successful, demonstrated in the number of people helped and the production of two effective vaccines. At the same time, the NFIP also modeled what can be accomplished in terms of care and research when a nonprofit organization receives long-term public and governmental support.

Polio reminds us of the enigma that is disease. Privilege has shielded developed countries from experience with contagion, causing people to forget its power. In the early to mid-20th century, most people wouldn’t openly resist public health efforts to curb outbreaks. Rather, they were grateful for scientific progress against disease and celebrated the diphtheria antitoxin, each new vaccine, and the introduction to antibiotics.

It is problematic to only look to the 1918 influenza pandemic for lessons. Its first wave was largely unknown, meaning that the experiences of the Spanish Flu were limited to just a few months. As I outlined in earlier essays, we can’t even compare today’s mask mandates to restrictions of that pandemic (and yes, I’ve heard of the Anti-Mask League of San Francisco). Since World War I very much dominated public agenda and therefore, the pandemic seemed to both appear and conclude quickly. Instead, we should learn from the polio experiences. We can remember that we have done this before and can do it again. But, as in the past, we need to support health professionals, public health experts, and those working to develop a vaccine.

Appeared in Vogue and other media outlets