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Coronavirus

CDC Update: Recommendations for Schools

Screening, testing, and contact tracing are all mentioned as ways to slow COVID-19 spread.
6 min read
• 
Published
July 1, 2020
Dr. Robert Darzynkiewicz
Board-Certified Emergency Medicine Physician
Dr. Rob has over 13 years of ER experience, the last two as the Pediatric Emergency Director. He believes technology can improve healthcare access and quality for students and their families.

CDC update June 30th

The CDC updated their “Interim Considerations for K-12 School Administrators for SARS-CoV-2 Testing” June 30th.

The recommendations come with the CDC disclaimer that they are a nonregulatory agency so they “assist K-12 schools in making decisions rather than establishing regulatory requirements.” It seems that most of their updates continue to stress that these recommendations are not to replace “any federal, state, local, territorial, or tribal health and safety laws, rules, and regulations with which schools must comply.”

In addition, as with any recommendations the CDC understands each school is different. They state that “Implementation should be guided by what is feasible, practical, and acceptable and be tailored to the needs of each community.”

So what do they recommend? Screening, testing, and contact tracing are all mentioned as ways to slow COVID-19 spread.

Screening

Screening is mentioned at the bottom of this document. They mention symptom checkers and/or temperature checks. Of course, either should be conducted safely with the privacy of the student in mind. It is mentioned that students infected with COVID-19 are asymptomatic so some cases will not be detected by either temp screen or symptoms. I was hoping for more information here on the types of screens but there was nothing new. Not surprising as we know children are the least to be affected by COVID-19. If you still go to their symptom checker link and if your child is under 18 they don’t give you an answer on what to do but send you to a general link to “keep children healthy”. If you really want to see symptoms of children with COVID-19 here is another CDC link of the symptoms of 291 pediatric patients. I believe symptom checkers may be different (based on what the school can accomplish) and look forward to guidance from other national leaders (ex AAP, NASN).

Contact Tracing

There are definitions and links to contact tracing but again, how can that be implemented in school? Contact tracing is something that happens after a case is discovered and people have to be trained to be a contact tracer. School staff are not required to be tracers.

Testing

The first thing they state is that “school staff are not expected to directly administer SARS-CoV-2 tests.” Make sense. However, those (school-based health centers, nurses, physicians) that can do tests “in their capacity” may do so. They understand not all centers can do these tests nor “should they be compelled to do so.”

Nasopharyngeal swabs are the best test for active disease. Antibody tests are not reliable to detect if a student has an active disease (they can spread). And the jury is still out to determine, even if you have antibodies, could you catch (and spread COVID-19) again.

Why not just test the entire school then? With everything mentioned above, it seems like a possible solution. As per this release, the CDC does not recommend testing of entire schools and staff at this time (it was in bold on their web site as well). According to the site, there has been not been any study that shows this helps and they state many issues may hinder the benefit such as “the lack of infrastructure to support routine testing and follow up in the school setting, unknown acceptability of this testing approach among students, parents, and staff, lack of dedicated resources, practical considerations related to testing minors and potential disruption in the educational environment.”

I hope all this helps and we wish you a safe return to schools.

–Dr. Robert Darzynkiewicz, Hazel Health’s Chief Medical Officer.


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Parent Story
A father was concerned when his son was showing COVID-19 symptoms. His school uses Hazel, so he was able to contact a Hazel doctor from home.

The Hazel provider recommended he get a COVID-19 test and shared resources to help find a testing center in their area. The father was eager to help his son feel better and appreciated being able to quickly get answers and advice.
Nurse Story
A student came into the nurse's office with a sprained ankle. After icing her foot, she still was in pain, so the nurse called Hazel. Thankfully, her family had provided consent for over-the-counter pain relief because she was able to take some medicine and return to class feeling better.

After the visit, the Hazel provider reached out to the school nurse to check on the student’s injury. The nurse shared that the student’s ankle was improving, and she appreciated the follow-up.
Parent Story
A mother noticed her son was getting low on his asthma medication. She tried to schedule a visit with his doctor to refill his prescription, but no appointments were available. She didn’t want her son to run out of medicine, so she reached out to Hazel.

The provider was able to send the refill to a local pharmacy within one day. The mother was happy that her son would have the medicine he needed. She was also amazed at how easy and fast the entire process was.
Student Story
A student was coughing and sneezing a lot, but her family wasn’t sure if she was sick or had allergies. Thankfully, her school used Hazel, and they could get an answer.

After talking with the school nurse and the Hazel provider about her symptoms and medical history, the student was happy to find out it was likely allergies. She got some medicine and returned to class feeling better.
Student Story
During the pandemic, a high school student was having a hard time coping. She was sad about COVID-19 impacting her senior year, and she was worried about the state of the world. The student was also struggling with some personal conflicts, and she felt she didn't have the right support at home. After discussing her feelings, a Hazel doctor connected her with resources that she described as “life-changing.” She was very grateful and shared that she didn't know where to go for help before Hazel.
Parent Story
Shortly after COVID-19 began, a student began to develop tics. Her parents took her to a neurologist, but they wanted to get her into counseling as well. The student’s mother was having a hard time finding answers to her questions and didn’t know where to start the process, so she turned to Hazel.

The Hazel doctor listened as the mother shared her concerns and frustrations. Hazel reassured her that they would find the right services for her child. After the initial visit, the Hazel doctor partnered with the school counselor and the student’s mother to identify resources and counseling services that are a good fit.
Student Story
A student came into the nurse’s office because his vision went blurry. The Hazel doctor looked at his eyes, but he did not see any injury. As he asked him questions about his symptoms, he started to sense that he was down about something. After a few minutes, the student shared that he was really sad because his mom was recently diagnosed with cancer. He explained that he feels worried, and it’s hard for him to focus.

Hazel called home, and the student’s mother confirmed her diagnosis. They discussed how to help manage the child’s stress, and Hazel offered to connect the child with counseling resources through the school. The mother was very grateful for the guidance and was eager to get her child help during a stressful time.
Counselor Story
Hazel Health has been integral this year in getting our students the mental health services needed to help them live healthy lives.  The staff has been attentive, prompt, and resourceful. There is an evident sense of caring for the work they do and the students they serve. It has been a pleasure partnering with Hazel Health in providing mental wellness for our Garland ISD families.