To: The Editors of the New York Times
The article "Why Virus Testing at One Elite School Ran Afoul of Regulators" by Apoorva Mandavilli published online in the New York Times on 3/30/2021 was misleading, inaccurate, and omitted critical information that Ms. Mandavilli was given both by New Trier High School and by SafeGuard Surveillance that countered her main thesis - that New Trier may have inadvertently violated federal regulations on testing. I recognize Ms. Mandavilli is an admired and award winning science journalist, but I am asking for a full retraction of the article based on the grossly unprofessional standards used as evidenced by the narrative below and the harm done to our school district and community by the baseless allegations made by the author that were knowingly incorrect.
The statement that "New Trier may have inadvertently violated federal regulations" is weak to begin with and acknowledges that it is unsubstantiated. Most importantly, Ms. Mandavilli received both verbal and written information from the District and others while writing the article showing this statement to be false.
1) Ms. Mandavilli quotes one sentence in the article from the December 28th letter from CMS (Centers for Medicare & Medicaid Services, the agency that oversees C.L.I.A. certification) to SafeGuard Screening ( attached) , but omits a very important sentence that establishes the authority for the process SafeGuard and New Trier have implemented: "CMS is temporarily exercising enforcement discretion under CLIA for SARS-CoV-2 surveillance testing, specifically, neither CMS nor the State survey agencies on its behalf will cite non-CLIA certified facilities, provided that the facility does not report actual test results, but only refers an individual to a CLIA-certified laboratory for further testing."
In our February 8, 2021 and February 9, 2021 email follow-up correspondence with Ms. Mandavilli ( attached ), we explicitly point her to this critical sentence, which she summarily dismissed in her response citing "folks" she is speaking with and "what she is hearing." Responsible reporting would have at minimum quoted this sentence in the article. However, the article's thesis would fall apart if she included it, because it is the exact statement that allows for the process she is trying to discredit.
If she had included it, she would not be able to explain why that sentence does not apply, as evidenced by the fact that the Illinois Department of Public Health and CMS have restated, after the appearance of your article, that the process being used by New Trier and SafeGuard does not violate regulations. It is reasonable to assume she read the sentence we highlighted for her, understood that sentence, and choose to not include it because there would be no possible explanation to hold her thesis together and thus no story to write. This seemingly deliberate omission in support of her incorrect thesis has besmirched the reputation of a well-respected school district by implying we are violating federal law, when we provided evidence that in fact regulators time and again had affirmed our program is lawful.
2) In the February 8 follow-up to our interview with Ms. Mandavilli, we noted "As we stated in the interview, our use of this specific screening tool has been discussed with the Illinois Department of Health and the Cook County Department of Public Health, which determine health guidelines related to schools, and neither of them raised any objections to the use of this screening or the manner in which we use it as a mitigation factor."
The quotes she uses from IDPH are irrelevant and misleading. In her article, Ms. Mandavilli writes, "But Melaney Arnold, a spokeswoman for the department, said state regulators "did not approve the use of SafeGuard Screening to provide test results to individuals." and "SafeGuard has been warned to cease providing diagnostic results to schools," Ms. Arnold added. "The investigation and follow-up continue."
The quote is irrelevant. Neither SafeGuard nor New Trier provide test results or diagnostic results to individuals, nor did we ever state that IDPH approved of a practice that is outside the regulations. We repeatedly provided this information to Ms. Mandavilli.
3) That being said, the one change that was made based on the December 28th letter was Safeguard stopped using the phrase "finding of potential clinical significance" and simply referred individuals to a CLIA lab for a diagnostic test. As we stated in our February 8 email, the original phrasing was used by SafeGuard based on a recommendation from a Wisconsin CMS division to David O'Connor, whose lab was running the same type of surveillance in Wisconsin, and our language was adjusted after that letter was sent to conform with the Illinois recommendation.
4) As for the investigation referenced in the quote, a local reporter spoke with IDPH and reported on April 1 "Then in March, IDPH received two anonymous complaints to our Clinical Laboratory Improvement Amendments (CLIA) program. CMS reviewed the complaints and did not recommend an investigation," the IDPH spokesperson told Patch. The full article is attached . It seems while finalizing her article for publication, Ms. Mandavilli failed to fully vet the claims in her article which was researched well over a month ago.
The fact that the article was published at all came as quite a surprise to me. I had assumed Ms. Mandavilli had decided not to pursue the article once we provided information showing that her thesis was inaccurate. We had no contact with her and no article was published for almost two months during a quickly changing pandemic environment. Admittedly, Ms. Mandavilli reached out to a New Trier administrator the day before the article was published, while the school was closed for break, to ask if there were any "material changes." Before the school district could respond and even after receiving an Out of Office message, the article was published. Even so, we understand SafeGuard did respond to her, and she failed to include any new information in her article that disputed her original thesis. The lack of contact and the rush to publish after a long delay highlights Ms. Mandavilli's negligence in missing the critical point that there was no investigation.
5) The lack of balance in the article was noted by parents, students and others who contacted the school district, starting with Ms. Mandavilli's opening phrase "It was supposed to be a pandemic triumph…" Besides being a pejorative characterization, she never reported on the immense amounts of information she was given that showed how the program has helped our school and community. That information included the very important fact that the same test she was trying to paint as unregulated and unproven has successfully identified more than 100 cases of COVID-19 in our community alone, many of them asymptomatic, and that total does not include the numerous cases identified by the other schools that use the same test. I understand that reporters are given wide berth to choose what information to include in stories they report, and I am not attempting to dispute that. However, I would like you to thoughtfully consider the reporting of this story in totality, including all the information your reporter was provided. I hope that my concern is not dismissed out of hand and you investigate what I believe are willful omissions of multiple facts that put her premise in dispute and are unbefitting of the New York Times' ethical and journalistic standards.
6) Toward the end of the article, Ms. Mandavilli states "SafeGuard should have obtained C.L.I.A. certification for its tests, or New Trier should have applied for a waiver to implement its program, according to testing experts." Again, the same line of thinking applies here - she ignored critical information and did not ask her testing experts why the exception from CMS does not apply to our process, given the conclusion that New Trier should have applied for a waiver. Or, if she did ask, she did not report on it. No explanation would have been forthcoming, so it was perhaps easier to ignore the issue to ensure the thesis held together. Vague terms like "testing experts" indicate an off the record arrangement with someone who does not directly oversee the program. Again, we provided evidence that those at CMS who directly oversee these programs said that CLIA certification is not needed if diagnostic results are not provided - which they are not.
7) In the next paragraph, she quotes Mr. Scott J. Becker, CEO of the APHL, an expert she had relied on in past stories who had no direct knowledge of this specific situation "It's not hard for a school system to get a C.L.I.A. waiver." Yes, many schools in our area have CLIA waivers to administer the BinaxNOW antigen test. I think it was either disingenuous or showed a lack of understanding of the complexity of PCR and RT-LAMP tests as compared to the BinaxNOW test to suggest any school could get a waiver to implement a PCR or RT-LAMP process. Again, the entire point is irrelevant since a waiver was not needed by SafeGuard to conduct the type of surveillance being implemented as directly stated in the CMS language she willfully chose to omit.
8) In Ms. Mandavilli's quote "Although SafeGuard technically did not deliver a diagnosis, the implication was clear - after rapid testing, some students were presumed to be infected, and they and their siblings were sent home." it is unclear to whom the implication was clear other than herself. Importantly, we stated in our February 8 correspondence "The surveillance screening referral to PCR testing is no different than requiring the same of a student with a temperature or a stomachache. As we discussed during the interview, the screening is one mitigation measure among many we are employing during a pandemic to keep our buildings safe." If she had talked with any parents or more students, she would undoubtedly hear that from their point of view the school was not presuming infection in any of these cases, but rather being cautious with the safety of our in-person environment, and referring all of these students for a PCR test.
As we also stated in that correspondence, "Our remote learning environment is robust and offers students the opportunity to continue their learning while either quarantining or seeking a PCR test or alternative diagnosis. Remote learning students participate in the same classes via Zoom as their in-person peers…"
9) Ms. Mandavilli conflates two important and distinct issues when she reports on the tension at our Board meetings claiming that "the introduction of the test did not go well." New Trier experienced the same in-person/remote debates playing out in communities across the country which have been extensively reported in your paper. While we were implementing an additional mitigation measure with our saliva program, the debates she speaks of were centered on how many students we could safely have in school and how often, not whether testing was a good idea or a bad idea. In fact, when we made the saliva program mandatory, we only had a handful of discussions with families about their discomfort with participating in the program out of approximately 4,000 students. The mischaracterization and the conflating of two issues is below New York Times and Ms. Mandavilli's standards.
10) Ms. Mandavilli continued her inaccurate framing of the issue, posting what I view as a sensationalist and false caption on her professional Twitter promoting the article: "NEW: Late last year, New Trier High School, which serves Chicago's most affluent suburbs, rolled out a $1.3M million testing campaign to keep the school open, regardless of rising infection rates in the community. What could go wrong?" ( see attached )
Nothing has gone wrong. We have helped identify asymptomatic cases of COVID-19 before the individuals could inadvertently infect others. We have held safe, sustained in-person learning since November, even during a local surge of cases. We have had no documented cases of transmission in our school. And, we have done so within the regulations set by the appropriate governing bodies.
The remainder of my concerns are either less important to me or could be deemed "stylistic". However, I want to make sure I bring them to your attention.
1) In Ms. Mandavilli's paragraph on our surge of cases in February, her point is unclear. She explains the circumstances, then starts the next paragraph with "New Trier has remained open" followed by a comment on the policies in New York City public schools. I was confused as to whether our staying open was a good thing and a "triumph" of our mitigation efforts or whether she was suggesting the saliva program did not work or whether she was implying we should have closed in the manner New York City schools would have. I certainly expect more clarity from the New York Times. Perhaps the Tweet from her mentioned above explains what her real purpose was to criticize the school for opening to students, in spite of the multitude of mitigation measures we employed, including the surveillance process, and in spite of the fact that we have had no cases of in-school transmission.
2) She also states that the Rand corporation reported that schools have found testing programs difficult to implement. Yet, we have been successful in implementing our program. Again, Ms. Mandavilli lacks clarity as to the points she is trying to make.
3) Language such as "Still, the school pushed ahead with testing" and "planning ways to keep the school open and keep it that way" are extremely disrespectful to the thoughtfulness and hours my team has put into successfully opening school and sustaining in-person learning safely for our students.
4) Ms. Mandavilli describes the program as a $1.3M testing campaign, inaccurately describing the cost. "Late last year, New Trier, which serves families from some of Chicago's most affluent suburbs, rolled out a $1.3 million testing campaign." The testing program was presented to our Board in publicly available information as a $600,000 to $1.3M program, depending on the number of students in school participating each week and other factors. By deliberately picking the higher number rather than listing a range or an average and framing it around the affluence of our community, it misrepresents the cost range that our Board of Education approved. The actual cost of the program will likely be less than $1M.
5) Ms. Mandavilli repeatedly refers to the program as a "testing" program, rather than a surveillance program. Although the District may have used the term screening or testing occasionally in the fall as the processes of regular surveillance was still developing, we were very clear to Ms. Mandavilli that the school was conducting surveillance, not testing. By deliberately and prominently using an incorrect term to describe the process, it helped lend credence to her false thesis, that C.L.I.A. licensure was needed for the process, as "testing" implies licensed diagnostic testing. This inaccurate term was used 31 times in the article, starting with the headline and subsequently in the second sentence "Instead, the coronavirus testing program…" It cannot simply be explained as the use of a layperson's term to explain a complex process and appears to be a deliberate choice of terminology to promote a false narrative.
In summary, I ask that the New York Times publish a retraction of the article stating that New Trier did not violate federal regulations, inadvertently or otherwise. The evidence presented shows a lack of responsible journalism. I am aware of the quality of many of Ms. Mandavilli's pieces and the compelling stories which led to her being awarded the Victor Cohn prize for Medical Science writing. This article was not one of those pieces. Ms. Mandavilli ignored important information for your readers and in at least one instance failed to follow-up on her findings before publishing in the way a local reporter did. A retraction by Ms. Mandavilli and the New York Times is in order.
Paul J. Sally, Ed.D.
New Trier Township High School District 203