In today's edition:

  • More mitigation measures mean safer schools
  • In focus: Gun policies that work
  • Supporting India is in all our best interests
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Schools: Mitigation Measures Whittle Down Risk
People living with a child who attends school in-person have an increased risk of reporting evidence of COVID-19—but with enough mitigation measures, that excess risk can be squashed, according to a large new study by Justin Lessler, Liz Stuart, and colleagues.
The context: The issue of in-person schooling has been hotly debated in the US throughout the pandemic, leading to a patchwork of policies and a “natural experiment” with schooling and COVID-19 risk. 
But the researchers suggest there are ways to slash that risk while keeping schools open. 
The results: When schools used seven or more mitigation measures—such as mask mandates for teachers and scaling back extracurricular activities—the excess risk associated with in-person schooling mostly disappeared.
When 10 or more mitigation measures were in place? That excess risk disappeared completely.
There’s no proof of a causal link, but the findings “definitely point in the direction of the risk from in-person schooling being controllable with common sense mitigation measures,” Lessler said in a Facebook Live yesterday where he and Stuart discussed the research.
For districts, school staff, and families, ensuring schools are safe is still a tricky calculus that involves mitigation measures, closely monitoring community transmission, and getting people vaccinated. 
When deciding whether to send kids back to school, it’s key to look at the “whole package”—namely the activities that are part of going to school. “Your school can have the best mitigation in the universe,” says Lessler, “but if your kid has to ride on a bus with no [mitigation measures] to get there, it probably doesn’t matter.”  
Stuart’s advice to schools: Have a plan, and be prepared to pivot.
Extreme Risk Protection Orders: A Policy that Reduces Gun Violence
When gun violence makes headlines in the US, the ensuing divisive debate can overshadow an important fact: There are policies that work to reduce gun violence. We’re running a series of articles highlighting some of these effective policies.
In the first of the series, Shannon Frattaroli, a core faculty member of the Johns Hopkins Center for Gun Violence Prevention, and Jeffrey Swanson, a professor in Psychiatry & Behavioral Sciences at Duke University School of Medicine, explain how extreme risk protection order laws work:
  • An ERPO is a temporary order from a judge restricting access to guns by a person who is behaving dangerously and poses a high risk of harming themselves or someone else. 
  • ERPOs are issued by civil courts and do not result in a criminal record. 
  • States differ in who can petition the court for an ERPO, but the vast majority are initiated by law enforcement.
  • In Connecticut and Indiana, early research shows that one life was saved through averted suicide for every 10–20 risk-based gun removal actions. 
  • ERPOs have been used in California and Washington state when people were planning mass shootings.
In states where these laws are in place (currently 19 plus Washington, DC), it is critical to ensure that this important policy is known and used so violence can be stopped before it happens, the experts note.
ICYMI on the podcast: “Red Flag” Laws: Extreme Risk Protection Orders and What Went Wrong in Indiana
The recent mass shooting in Indianapolis sparked a national conversation about “red flag” laws, or Extreme Risk Protection Orders. This episode delves into what went wrong in Indiana, and what needs to be done to implement laws effectively that keep firearms from people at high risk of harming themselves or others.
Grown-Ups Should Go First
ICYMI: In Wednesday’s edition, we focused on the ethical questions around US kids being vaccinated before adults elsewhere—such as India. By and large, our experts agree: Vaccinating adults—either domestically or abroad—should come before expanding access to adolescents and children.  
"While humanitarian assistance is a moral obligation, supporting India in this time of need is also in the best interest of the U.S. and the world," wrote Bloomberg School faculty Amita Gupta, David Peters, and Brian Wahl in The Hill this week.
To help spread the word about their nine-point proposal for aid, our social team adapted the piece for Instagram.
Patent Support for Waiving IP Protections
In a move that surprised many in the public health community, President Biden announced support for waiving intellectual property rights for COVID-19 vaccines.
For more on what a patent waiver could mean—and not mean—Jennifer Nuzzo suggests this thread from Tom Bollyky.
What Do We Need to Do to End the COVID-19 Pandemic, What Does an Ending Look Like, and How Close Are We?
Vaccinations are seen as the primary tool to prevent COVID-19 infections, but are there other things we should be doing to bring down transmission rates? Caitlin Rivers and Crystal Watson from the Center for Health Security return to the podcast to discuss where we are, what still needs to be done, and when they'll know that the pandemic is truly in the rear view mirror.
What Teen Vaccines Mean for School Reopenings (The New York Times)
Adolescents could soon be eligible for COVID-19 vaccines, making full, in-person school even more likely. But Jennifer Nuzzo says vaccinating kids is not the only path to a mask-free future: “I actually think we can make a lot of progress without having to do that,” she says.
CDC says coronavirus could be under control this summer in U.S. if people get vaccinated and are careful (The Washington Post)

Coronavirus infections could be driven to low levels and the pandemic at least temporarily throttled in the US by July if the vast majority of people get vaccinated and continue with precautions against viral transmission. Justin Lessler projects, under the most optimistic scenario, that COVID-19 deaths could drop into the low 100s per week in August and into the “tens” per week in September. 
Will Covid-19 vaccines protect you against variants? 9 questions about variants, answered. (Vox)
What’s complicating the COVID-19 situation is the rise of new variants of SARS-CoV-2, the virus that causes COVID-19. Several of these variants contain mutations that can make prior immunity less effective, allow the virus to spread more readily, and, in some cases, cause more deaths. Amesh Adalja says India’s reopening back in February after supposedly “defeating” the virus shows “complacency” in lifting many of the country’s restrictions. 

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