Parents advised: Prepare kids for first day of school
As the first day of school approaches Monday, health professionals encourage parents to have their child up-to-date with their immunizations, practice wearing masks and proper hand washing hygiene to encourage a safe reopening of schools.
On Monday, the Lee County School District held a live Partners in Student and Staff Health panel, which was broadcasted on its Facebook and YouTube channels for the community to watch as they prepare for Aug. 31.
School Superintendent Dr. Greg Adkins said what they have learned through this COVID-19 pandemic is that every day brings a new challenge, so it is important to tune in and adapt to protocols to make sure there is a very safe reopening.
“I sincerely appreciate, as we move forward in this effort that we have had partnerships like these folks up here on this panel,” he said. “We could not have done it without them.”
Adkins said he is an expert in education, but not in health and medicine.
“When you are facing a health crisis like we are in right now, it is very comforting to know you face it as part of a team,” he said. “We have literally been working on reopening our schools since we closed in March, so if you think about it we have been working on this reopening for quite some time.”
Adkins said the district will continue to work on getting rapid testing for COVID and has been in contact with Lee Health, as late as Monday morning. He hopes that is something they can bring to fruition in the near future.
“We do have a safe schools reopening guide and a closure matrix that helps guide our decision making and also I think will guide our students and staff in terms of what they need to do to stay safe,” Adkins said.
District spokesperson Rob Spicker asked many questions from the community during the Partners in Student and Staff Health panel, which included health professionals from Lee Health, Physicians Primary Care, Island Coast Pediatrics and the Florida Department of Health – Lee County.
Steps to get ready for school
Angela Smith, administrator of the Florida Department of Health, Lee County, said it is important for children to get the influenza vaccine, as well as making sure their child is up to date on all pediatric immunizations. It is also important to teach their child to communicate when they are not feeling well, practice hand hygiene and the proper wearing of a face mask.
Dr. Nicole Bruno, a pediatrician with Island Coast Pediatrics, said it is important to have the child practice taking their masks on and off, as well as wearing them for long periods of time.
“When they take their masks off (it is important) to put it face down and not touch their face,” she said, adding that germs are on the outside of the masks. “Make sure it fits, so it doesn’t fall down when they talk and tight behind the ears.”
Dr. Dana Crater, a pediatrician with Physicians Primary Care, said extra hand sanitizer to keep on the child’s desk is an extra measure she is taking for her children. She said also to keep extra masks in the child’s backpack, so they have an extra supply.
Dr. Mary Beth Saunders, infectious disease specialist with Lee Health, said cloth masks should be washed daily after use.
School District of Lee County Health Services Coordinator Beth Wipf stressed that students should physically distance themselves from their friends and not to gather in large groups. Students should also limit touching surfaces and continuously wash their hands throughout the school day.
“Everyone needs to do their part to socially distance, wear a mask and make sure to wash their hands,” Adkins said.
Bruno said additionally students should eat the healthiest foods possible to keep their nutrients up, as well as take multi vitamins, including zinc and vitamin C. She said it is also important to drink plenty of water and exercise.
Families need to be careful outside of the school hours as well, Crater said.
“This is going to be a really big change for our community of having thousands upon thousands of children going back to school,” she said. “Let’s be very careful. Don’t let your child come home from school and get together with a large group of kids at someone’s house. Please try to be careful the first couple of weeks and months, so we can have the most successful opening that we can.”
Sick, stay home
The most important message is if your child is sick, a teacher is sick — stay home, so they can heal.
“Your child wakes up with a runny nose, or sore throat, I would keep them home and watch them. It is not a ‘Oh, the school will call me if there is a fever and send them home kind of day,'” Bruno said. “Right now it is ‘If my child has any symptoms abnormal to their normal functioning they need to stay home.’ If they have allergies we should not miss a day of our allergy medicine because that clear runny nose counts as a symptom right now.”
How to differentiate sickness and COVID
Bruno said she is working on getting rapid testing at her office so they can determine if it is cold symptoms or COVID.
“Ten days from the start of your respiratory symptoms is when you should return to school and that is COVID or not COVID,” she said. “That is presumed COVID until proven otherwise. Any symptom keeps you home, any symptom.”
Crater agreed that any symptoms, a child should stay home. If they get the child tested and they can rule out illnesses, including COVID, the child may return sooner.
Saunders said you can have other infections at the same time as COVID.
“It doesn’t always detect people that may actually have COVID, depending on where they are in the disease. If your child has symptoms of COVID and they are sick, they are going to be isolated away from other children and maybe their family for that 10-day period,” she said.
Masks
Saunders said they know that wearing masks to protect others from the spread of COVID-19 is critical.
“The amazing part to this is children are so adaptive. In the beginning we thought they will never keep a mask on and they won’t know what to do. It will be all over the place, but we have seen it in our day cares. They put their masks on. They wear them all day long. They are doing great and in some instances I think they do even better than some adults,” she said.
Crater said that science does prove time and time again that wearing a mask dramatically decreases the transmission of COVID-19.
“It’s absolutely the right decision for the school district to require masks. I know that there is a lot of misinformation out there and a lot of parents worry, is this safe for my child. I can tell you from a scientific standpoint, it is absolutely 100 percent safe. There is no risk to the wearer. Science proves that it is very, very safe,” she said. “Also in areas and states where masks have been made mandatory, we have consistently seen a dramatic decrease in the number of cases.”
As masks requirements have been instituted, many areas have seen numbers decline, Bruno said.
“We know that it works. We also know from evidence from other states having gone back to school without masks, those schools very quickly closed,” she said. “So this is the only way that we can safely send our kids to school that has been proven already. Our probability numbers can safely tell us there is no doubt that that is how we need to do this moving forward.”
Bruno said she takes care of students in all schools, some of which are private schools not wearing masks, which has already resulted in positive COVID tests.
In July, the Florida state surgeon general issued a public health advisory urging residents of Florida to use masks whenever social distancing was unattainable.
“The school environment is a very good example of that. I commend you in taking the step forward in making it a mandate. I think it will make a big difference,” Smith said.
Spicker then asked what qualifies as an exemption for parents that may be having a difficulty obtaining medical exemptions for a child to qualify for not wearing a mask.
Wipf said they are requiring that parents submit documentation from their health care providers if they have a medical condition that would prohibit a child from wearing a mask. The documentation will be submitted to the school.
“There will be a committee that will review the documentation and make a decision on best next steps for that student,” Wipf said.
Another question from the community, concerned those students whose speech is still not clear through the mask — does that student get left behind if they are not able to clearly communicate to the teacher.
“Of course we will never leave a child behind,” Wipf said. “We will continue to work with all students in the adjustment of wearing a masks. There may be different issues with every student related to the mask. It’s part of how we are going to educate the student. We are going to reiterate and make sure that every student is successful.”
Adkins said a good thing that has come out of this pandemic is the district is learning how to educate children in different ways.
“We have had to learn how to become agile and flexible and I think at the end of the day we are actually going to be better off overall when we are able to get back to somewhat of a traditional setting,” he said. “All of these lessons that we have learned during this period of time, I think is going to improve how we deliver instructionally in a multitude of different ways.”
How families are to be notified of positive COVID-19 cases
Smith said the core of public health is contact tracing, which the Department of Health does 365 days of the year for other reportable diseases.
“The nuts and bolts of what will happen as far as if a student tests positive (is) the parent or caregiver will receive a phone call from the health department. We will do an in-depth interview about the child’s symptomology, who they were around, where they have been. Then we will take all that information and then we will determine when the child’s infectious period is and deem the individual’s contacts of that case, and not the contacts of case,” she said. “Part of that includes working with Beth and the school district to provide complete classroom lists if the child was on campus during the infectious period, bus lists, those types of things. The biggest thing that I can say for parents is make sure you answer the phone. If you don’t recognize the number and we leave a voice mail please, please, please call us back. It is very important to do this as timely as possible.”
It is the law in the state of Florida for labs and physicians to report to the Department of Health any positive case — positives and negatives for COVID-19.
“I may get a call from a physician, as well as the laboratory that processes those specimens. Then we have a communications plan with the district, so if the family calls Beth, the school nurse, or the principals we are communicating and appropriately getting our arms around that as quickly as possible,” Smith said.
Wipf said they have a process in place, so they can contact the Department of Health as soon as they are notified, so contact tracing can begin.
Hours are the ultimate goal, so that students or faculty are not returning to school if they were exposed or ill. To do that, the Health Department has a team of about 10 that is dedicated to solely COVID. An additional 85 to 90 people can supplement that number.
Individuals will be notified that they were exposed to a case, but not specifically who that case is for privacy reasons.
The school district is providing a helping hand to the Department of Health by requiring that every single classroom have a seating chart, as well as on the buses and cafeteria in order to help with contact tracing.
Bruno said as a physician in the community, when she is counseling parents on positive testing for their kids, she asks that they be completely transparent with everything they have been in touch with.
“You don’t have to go around screaming it, but inform everyone this is what it is. If they don’t know they can’t take the adequate safety measures,” she said.
Quarantine
Quarantine happens when someone has been exposed to someone known to be COVID-19 positive. Isolation is when you, yourself, are positive and you have been asked to isolate because you do not want to expose anyone else.
“When we quarantine someone as a contact it is for 14 days from their last date of exposure to that lab confirmed positive case,” Smith said. “We are looking at the person’s symptomology. If they were asystematic it is two days prior to the test result that are considered infectious and then isolated for 10 days after that positive test result. If systematic, we wait 24 hours of resolution of fever without the use of a fever reducing medications and improvement of overall symptoms and then 10 days after that positive test result. There is a lot that goes into who fits what category and what is being applied.”
Saunders said if the child is on quarantine for 14 days, it does not mean the mom and dad have to be as well. She said they will need to be quarantined if the child is sick and requires isolation.
“You still need to watch your child for any symptoms that develop that suggest that they do have COVID,” she said.
Bruno said if the child is positive, the parent has to stay home for 14 days, too.
“The mom is positive, the kid also has to stay home. They are in a quarantine bubble together. The household contacts are the highest risk for sharing it unless you can clearly keep them in their own side of the house,” she said.
Children COVID hospitalizations
Bruno said as far as her patients, she has not had to send any children to the hospital for COVID, but the numbers of the kids being hospitalized has increased since June.
“So, yes we are seeing an increase in hospitalizations for our children,” Bruno said. “They are not critically ill, not many of them, but there have been children deaths, about eight now in the state of Florida.”
Crater believes the real take home is that children, when compared to adults, are at far less at risk of hospitalization and death from COVID. Her experience since the beginning of the pandemic is that in the positive cases that they have seen, the child’s fever never rose above 100.8 to 101.
“Most of them have either got a case from someone else in their house or were asystematic or had very, very mild symptoms, but that is true if you look across the country of hospitalization rate of children under 20 years old COVID positive,” she said.
Success stories in preventative measures
Crater said she likes to quiz all of her patients coming in, even if they are not coming in because they are ill. Many of her patients have been in camp settings, both indoors and outdoors.
“I have asked has there been any cases in your daycare, day camps. The majority of the time the answer is no, there hasn’t been any cases, or I have heard there was on case, so they closed for a week, but now they are back open. I have been really pleasantly surprised by that and it gave me a lot of hope for the upcoming school year,” she said.
The few positive cases that they have seen from daycare and sports camps have been scattered, Bruno added.
“The kids that had not gotten sick, I believe are in the safer daycares with the masks on,” she said. “The sports camps are outside and they are taking the safety cautions of grouping in separate pods. Those are all the positive things I have seen that facilities are doing.”