Back to School and COVID-19 Lorrie Ramsey, MSM, BSN, RN Chief Nurse Consultant July 24, 2020
Welcome and Introductions Pam Pontones, MA Deputy State Health Commissioner State Epidemiologist Lindsay Weaver, MD, FACEP Chief Medical Officer Tara Morse Contact Tracing Project Manager
ISDH Back-to-School Guidance Resources: • Preparation for a COVID-19 Student/Staff: K-12 Schools • Back-to-school handouts, social media graphics and videos • Guidance for when a student, faculty or staff member can return to school (English) (Spanish) • COVID-19 Screening Decision Tree • Frequently asked questions • Excel tracking sheet for cases and contacts
ISDH Back-to-School Guidance Creating a school contact tracing toolkit: • Excel tracking sheet for cases and contacts (done) • Preparing for positive cases (adding higher education) • Checklist for identifying close contacts • Contact tracing responsibilities chart • Quarantine and isolation guidance (K-12 and higher education)
Mask and Face Coverings Guidance for K-12 School Administrators on the Use of Cloth Face Coverings in Schools: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/cloth- face-cover.html Encourage parents, caregivers, and guardians to practice wearing cloth face • coverings at home before the first day of school. If parents, caregivers, and guardians model appropriate use of face coverings and help students get used to wearing them, students may be more comfortable using them. • Use behavioral techniques such as positive reinforcement Let them choose their face covering • Display age appropriate posters and materials with visual cues that show the • proper way to wear a face covering in classrooms and hallways. • Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading if it is not possible to wear one.
Who is a close contact? CDC defines a close contact as: A person who spends greater than 15 minutes within 6 feet of a positive COVID-19 person from the 48 hours prior to the positive person’s symptom onset or positive test collection date if asymptomatic. While mask use decreases the risk of infection, at this time it does not change recommendations for quarantine. Close contacts need to quarantine at home for 14 days after the date of their last exposure.
Who is a close contact? Q. If two people are cloth masked with no physical contact and within 6 feet for more than 15 minutes is that still considered a close contact? Q. Two people are cloth masked with extensive physical contact (two soccer players guarding each other, a wide receiver and defensive back guarding each other for 10 plays in a row) is that considered a close contact? In the situations above, if the individuals were within 6 feet for 15 minutes or more, • while cloth masks reduce the rate of transmission, they are not proven to eliminate it completely and close contacts are still identified even when both the parties where wearing a mask at the time of exposure. CDC notes that identification of a close contact is irrespective of whether the person with COVID-19 or the contact was wearing a cloth face covering or whether the contact was wearing respiratory personal protective equipment (PPE). Additional guidance can be found https://www.cdc.gov/coronavirus/2019-ncov/php/public-health- recommendations.html
Who is a close contact? Q. If two people are cloth masked with brief physical contact, is that considered a “direct contact” and thus the person must quarantine? • We would not consider brief physical contact as described in that scenario as a close contact unless the proximity, without physical contact, extended beyond that 15-minute threshold. A key consideration is if the contact was face to face. • CDC Considerations for Youth Sports : https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/youth- sports.html#risk
Steps after notification of positive case • Parent notifies school • School notifies local health department • School identifies students and staff who are close contacts using class schedule, cohort groups, activities, bus, etc. • Create contact list with names, DOB and phone numbers • Report information to centralized contact tracing: 1-833-670-0067 • School and/or LHD notifies close contacts and ISDH follows up with messaging • If close contacts test positive, process starts over
Classroom Pod
Recess Pod
Bus Contacts • Siblings sit together • Assigned seats/seating chart – Label the seats – Even if kids are absent • Cracked windows or fans • Distancing as much as possible • Masks
Whom to Quarantine • Anyone the student was within 6 feet of for more than 15 minutes in the two days before she developed symptoms should quarantine for 14 days • Recommend contacts are tested 5 days after date of exposure and monitor for symptoms • If test is negative, still need to complete quarantine since symptoms can develop up to 14 days after exposure despite negative test
Whom to Quarantine • Siblings – They are also close contacts and also must quarantine at home for 14 days – Students around siblings are not close contacts UNLESS their tests come back positive, in which case the process starts for them
Contact tracing roles • Notification is key for early intervention • Answer the call: When an ISDH contact tracer calls, the number on the caller ID will show as 833-670-0067 or may display as “IN Health COVID” • Everyone has a role to play – Parents and family – Schools – Local health department – Indiana State Department of Health
Contact tracing roles: Parents and family • Monitor their children for signs and symptoms, screening before school and extra-curricular activities • Keep them home and quarantined or isolated if they’re suspected or confirmed to have COVID-19 • Keep student home while waiting for test results • Share positive results with kids and close contacts they know and can get tested • Call their school immediately if results are positive
Contact tracing roles: Schools • Identify close contacts in school • Call local health department • Provide contact information to LHD and ISDH centralized contact tracing program (ICCTP) • Share information with parents, notify close contacts • Determine date of last exposure for contacts • Keep seating charts (classrooms, busses) • Designate a point of contact
Contact tracing roles: LHDs • Work with schools to identify close contacts • Notify schools when a case is identified • Partner with schools on closure decisions • Provide guidance on closures
Contact tracing roles: ISDH Centralized case investigation and contact tracing • New cases receive the text message shown on the right. The text will come from 877-548-3444. • They will then receive a call from a contact tracer. • The number on the caller ID will show as 833-670-0067 or may display as “IN Health COVID” if the carrier allows it.
Contact tracing roles: ISDH Centralized case investigation and contact tracing • You’ll receive the text messages shown on the right. The first is initial contact asking to complete a survey. The second is daily monitoring. • The text will come from 877-548- 3444. You’ll then receive a call from a contact tracer. The number on the caller ID will show as 833-670-0067 or may display as “IN Health COVID” if your carrier allows it.
Contact tracing roles: ISDH • Resources, including social media, handouts and videos • Consultation on school re-entry plans • School report for all cases in Dynamics who report working in, attending or visiting a school
Contact tracing roles: ISDH • This includes preschools/daycares, K-12 schools, and colleges and universities • The report will be in the LHD App—Microsoft Dynamics. This will only be available for LHD staff who have a Dynamics account • ISDH will send out a daily reminder to LHDs with a link to access their report— please be on the lookout for that email starting next week • The report will detail the patient’s name, the school they are associated with, grade level, and what their link to the school was (student, faculty, visitor, etc.). • Please note that at this time, this report will NOT go directly to schools. It is the responsibility of LHDs to get this report to schools if they wish for the information to be available. • We are planning a WebEx to review this report with you, probably next week, so watch for more information.
Contact Information Lorrie Ramsey, MSM, BSN, RN Chief Nurse Consultant backtoschool.isdh.in.gov
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