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COVID-19 Back to School FAQs

Dr. David Rottinghaus, Chief Medical Officer/Vice President of Medical Affairs at Butler Health System prepared the attached COVID-19 School FAQs sheet to give some insite.

What is the difference between Influenza (Flu) and COVID-19? COVID-19 has no established immunity in humans since it is new to the human race.  Therefore, everyone can get it.  Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a new coronavirus (called SARS-CoV-2) and flu is caused by infection with influenza viruses. Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, and testing may be needed to help confirm a diagnosis. Flu and COVID-19 share many characteristics, but there are some key differences between the two. While more is learned every day, there is still a lot that is unknown about COVID-19 and the virus that causes it. 

Why is Self-Monitoring Important? This will be vital to containing the spread of COVID-19. Reporting symptoms is important and reporting positive results is equally important. There needs to be openness to reporting and this information treated in a non-judgmental fashion. Complicating self-monitoring is the belief that up to 40% of people that get the virus may not have symptoms and can still spread the virus. 

When Should Students/Staff Stay Home? When they feel sick or have close contact with an individual that is ill or tests positive.

Clarification of quarantine needs: 

• If tested positive, who stays home?  The person that tested positive and any close contacts.

• Who returns and when?  Per guidelines, a person testing positive may return after 10 days of quarantine IF not having any symptoms for 24 hours and reaching 10 days.

• If tested negative, when can one return?  If they had a close contact, guidelines are to remain at home for total of 14 days despite a negative test. 

• If related to someone who has tested positive for COVID-19, what are recommended quarantine guidelines/restrictions? Same as a close contact - 14 days. 

There are some exceptions:  Essential workers can return if they follow the proper precautions for masking, distancing, hand hygiene and they are without symptoms. If symptoms develop, they must quarantine immediately.

Will the whole classroom have to quarantine if a student tests positive or a member of a student’s immediate family tests positive?  Follow the close contact guidelines.  See below:

At what point do you recommend the entire school quarantine?  This will probably be evident when a large number of staff/students need to quarantine and attendance is so low that remaining open is not justified.  Any options to remotely learn/attend class should be considered. 

If there is a positive case in one of my children’s classrooms, will all of my other children need to be at home, or just that one child? If the child in the classroom is a close contact, they will need to stay home.  The other children would be secondary contacts by definition and would not have to stay home. 

Definition of Close Contact and Secondary Contact (for both school and home situations): Close contact is a person that spends 15 minutes or more within 6 feet of another person with COVID-19.  A secondary contact would be a friend or family member or that close contact.  In general, guidance for secondary contacts is to monitor for symptoms, but not self-quarantine.

If traveling to Ohio or similar nearby state to visit a parent on a regular basis (divorced family type of situation with one parent being out of state, and student goes there every other weekend or once a month), does my child need to quarantine before returning to school each time? There are hot-spots and areas with higher community spread and high rates of positive cases. This should be considered on a case by case basis.  What people do and how they behave both at home and away determines their risk. For example, frequenting restaurants and gathering with large groups of people anywhere is high-risk behavior.

If families go on vacation during the school year, do you recommend quarantine? If so, how long?  See chart above-depends on the location and situation.

If my child has just a sinus or ear infection, when can they return to school? This is going to prove very difficult as the year progresses and other seasonal viruses and illnesses begin to circulate. Assessment by a pediatrician or family physician will be valuable.  Hopefully testing for COVID and other viruses will be more widely available in the fall and winter. 

Are there longer recommended stay-at-home times for children that have illnesses that are not COVID than there may have been in previous years?  If the illness can be determined to not be COVID and, instead, another diagnosis, then the stay at home times will be the same as those illnesses were in the past, such as seasonal influenza. 

If all students and staff are required to mask but someone has a medical exemption, does this violate HIPAA regulations or protections? Keeping the diagnosis or reason for not being able to wear a mask confidential should protect any school against HIPAA.  Very few, if any, individuals cannot wear a mask.  An alternative to mask should be face shields.  They do not restrict breathing and are highly protective if the shield comes down over the person’s mouth.    

What information are we allowed and/or required to release to families and staff about persons who are exempted from masks?  HIPAA would not allow you to release the specific reason why a mask cannot be worn.  A general statement saying that those individuals must wear a face shield is probably good.  Face shields may be a very attractive alternative to masks for staff and students. 

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