Reader opinions: In-person graduation ceremonies pose risk to Hoover community

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As medical, nursing, public health, and other allied health professionals who are alumni of Hoover City Schools, we are appalled at the decision to hold in-person graduation ceremonies.

We feel extremely fortunate to have attended Hoover City Schools, where we learned to think critically, evaluate evidence and make informed decisions. It is in light of current evidence regarding the COVID-19 pandemic that we strongly urge the Hoover city school board to cancel these mass in-person gatherings.

This decision would protect all involved, from the students, families, teachers, staff, and venue employees, to others in the community who would come in contact with graduation attendees.

It does not require health care experience to understand that we are living through a once-in-a-lifetime event: a global pandemic. We are in a time of great uncertainty and risk; what we currently know about COVID-19 is alarming.

Nearly 100,000 people have died in the United States, including many in Birmingham. Although Alabama has had 10,000 confirmed cases, estimates of true infections are 75,000,[1] with daily infections continuing to rise,[2] and the state is only completing half as many daily tests as recommended.[3]

Viral transmission occurs readily between people in close contact, and transmission can occur even when a person does not feel sick. While certain groups are at greater risk for complications and death, anyone, including the young and healthy, can become critically ill and die from this infection. Equally alarming are the unknowns: we do not have a vaccine, and there are not yet any scientifically reliable treatments.[4]

Simply put, a large-scale graduation ceremony cannot occur safely at this time. Every piece of public health guidance advises against them, including Alabama’s.[5] There are numerous examples globally of super-spreader events that rapidly increase cases, overburden health care systems, and force us to reinstate stringent social distancing measures.

We understand that graduates are being given KN95 masks, but without training on proper use, such masks only create a false sense of protection. Graduates will be allowed to take off masks while on stage when interacting directly with others. Guests are neither required to wear masks nor supplied any, and the thousands of attendees will have to enter through the same three gates.

Although mask wearing can help mitigate harm, there is no reassurance that large gatherings can be adequately protected during an active outbreak with such an infectious contagion. Additionally, using these health care-grade masks consumes scarce personal protective equipment (PPE) needed for health care workers.

Graduation should be a time for celebration, not a time that puts lives and health at unreasonable risk. As Hoover High School alumni, we understand the 2020 seniors’ excitement for an in-person graduation. We cannot imagine the disappointment of missing out on this final high school moment, especially after having to forego senior prom and other cherished events. But as health providers, we are on the front lines, bearing witness to the human tragedies from COVID-19 every day. The aftermath of the event will come later. Will we allow new graduates to suffer the grief of knowing that their graduation ceremony may have caused their parent, grandparent or friend to get sick and possibly die? Or to leave one of their classmates with respiratory damage requiring years of rehabilitation? Will Hoover City Schools be seen as responsible if a student becomes ill and dies?

Of course, the damage is not only to mental and physical health. Outbreaks harm the economy, which can only recover when people are confident that they are safe. A large resurgence of cases could lead to a return to stringent stay-at-home measures, further harming Alabama’s economy.

Let us be clear: the decision to hold in-person graduations is the sole responsibility of Hoover City Schools. Administrators may try to communicate that the decision to attend is a personal choice; however, Hoover City Schools remains the primary decision-maker to host such events.

School administrators hold a position of leadership, one that affects the most privileged and vulnerable alike, and they therefore have a duty to make decisions in the best interest of all students, their families and the broader Hoover community. By holding graduations in-person, the district sends a misleading and irresponsible signal that it is safe, when we know it is anything but.

Attendance at an in-person event may have far-reaching unintended consequences. Attendees will disperse from the large gathering into the community, some returning to their work as essential employees, to grocery shopping, and to their families, some of whom are elderly and immune-compromised.

It is the nature of infectious disease that no behavior is solely about weighing risks and consequences only for oneself; each action has an impact on others’ well-being and ultimately society as a whole. The administrators who have been charged with these students’ education must also take responsibility for their safety, health and well-being. We urge them to make the right choice for the sake of public health.

  1. Bonnie Kaiser, PhD, MPH, HHS Class of 2004
  2. Sharon Tsay, MD, HHS Class of 2003
  3. Irving Ye, MD, MBA, HHS Class of 2003
  4. Libby Mims, MD, HHS Class of 2005
  5. Nathan Welty, MD, PhD, HHS Class of 2004
  6. Joi L. Johnson, BS, MAABS, HHS Class of 2004
  7. Amy Boggs, MSN, RN, RNC-NIC, HHS Class of 2004
  8. Michelle Fullard, MD, MSCE, HHS Class of 2002
  9. Cain Anne Beachum, PharmD, BCGP, HHS Class of 2005
  10. Kathryn Bussey Filipiak, RDN, HHS Class of 2002
  11. Drew White, PharmD, HHS Class of 2005
  12. Corey Self Johns, PT, DPT, HHS Class of 2003
  13. Claire Schroeder RN, BSN, MABC, HHS Class of 2005
  14. Brittany Rogers, MSN, FNP-C, HHS Class of 2007
  15. Wasef Muzaffar, MD, HHS Class of 2004
  16. Russell Fung, MD, HHS Class of 2008
  17. Allison Diop-Frimpong, MSW, JD, HHS Class of 2001
  18. Meagan Cochran, MS, CGC, HHS Class of 2006
  19. Nick Cochran, PhD, HHS Class of 2005
  20. Emilie O’Brien White Hallford, MD, HHS Class of 2003
  21. Emiliya Adelson, PhD, HHS Class of 2008
  22. Kellye Sutherland, PharmD, BS, HHS Class of 2003
  23. Stacey Jenkins, RN, BSN, MS-Emergency Management, HHS Class of 1996
  24. Jessica Lander Schnell, MD, MPH, BSN, RN, HHS Class of 2006
  25. Leanne (Clark) Rupp, MSW, LCSW, HHS Class of 2001
  26. Lucy (Zhou) Hoyle, MSHA, MBA, HHS Class of 2010
  27. Michelle Price, MSN, ACNP, HHS Class of 2005
  28. Pavan Kapadia, MD, FACC, HHS Class of 2004
  29. Megan Hennigan, MD, FAAP, HHS Class of 2001
  30. Whitney McKenzie, PT, DPT, HHS Class of 2004
  31. Alesia Pruitt, BS, HHS Class of 2004
  32. Britt Marett, RN, BSM, HHS Class of 2003

[1] https://covid19-projections.com/us-al

[2] https://epiforecasts.io/covid/posts/national/united-states/

[3] https://www.npr.org/sections/health-shots/2020/05/07/851610771/u-s-coronavirus-testing-still-falls-short-hows-your-state-doing

[4] https://www.covid19treatmentguidelines.nih.gov/overview/

[5] https://www.alabamapublichealth.gov/legal/assets/order-adph-cov-gatherings-050820.pdf