By Ashley McCarty-
Dr. William Hablitzel of the Adams County Health Department attended the special ACOVSD Board Meeting on Aug. 4 to discuss COVID-19, reopening, and board concerns.
“I think where we’re going to be for sometime is somewhere between controlled and uncontrolled chaos. There’s no rules for what you’re planning now to reopen schools, there were no rules for closing schools, and we had some concepts that we can use, some safety concepts,” said Hablitzel.
COVID-19 was unheard of just six months ago, a lot of knowledge has been generated since, said Hablitzel, “but what you hear in the media, what you read about, much of it’s not based in fact, it’s based in fear. So, sometimes it’s good to just sort of regroup and look at what we do know, and how it pertains to schools and kids. One thing we’ve heard is, what are you worrying about schools for? This virus does not affect kids, it really doesn’t have any consequences for long term consequences most people do find, and kids can’t transmit this virus,” said Hablitzel.
Hablitzel presented two COVID-19 studies to the board. The first was a prospective study that came from Germany, posted in The Journal of American Medical Association.
“They looked at 100 people that were diagnosed at a testing center with COVID-19, and then they tracked them forward along with 100 people that were not diagnosed with COVID-19,” said Hablitzel. Three months after diagnosis, MRI imaging was taken of the heart — 78 of the 100 individuals had evidence of structural damage; 60 had evidence of inflammation, which, when severe, can lead to cardiomyopathy.
“Another study, that really impacts schools, when we talk about reopening, that kids can’t transmit this, so what are we worried about? [The] CDC released a report on Friday of last week, about a summer camp — an overnight youth camp in Georgia during June — and this camp followed all of the CDC guidelines for summer camps — with two exceptions. They did not keep doors and windows open to promote ventilation in buildings, and they did not require that attendees wear masks,” said Hablitzel.
Early in the camp, a teenage staff member developed chills and was sent home; he tested positive for COVID-19.
“They sent everyone home, the camp was closed, and of 597 attendees and staff, the CDC was able to locate test results from 344 of them. Of those 344, 260 were positive for COVID-19. That’s a 76 percent positive rate. I don’t think there’s a whole lot of room for debate whether or not COVID-19 can be transmitted easily among children,” said Hablitzel.
When looking at the plans for school, Hablitzel said to adhere to the things that they can control; keeping distance, barrier protection, face masks, personal hygiene, and not touching the face. While they can’t really control the latter, Hablitzel suggests role-modeling and promoting hygiene during class — washing hands before and after.
“The other principle that’s extremely important, as we’re going to talk about with your staff member, is co-herding. Keeping the same group of kids together as much as you can throughout the day, and assigned seating for school buses, assigned seating classrooms [and] cafeteria, because you want to be able to — if someone gets sick — you want to be able to pull out and track who was around this individual,” said Hablitzel.
When looking at tracing individuals for their risk of infection, we’re looking at close contacts, said Hablitzel. Close contacts are defined as being within six feet of an individual, for 15 minutes or more.
“From the little snippets that I have heard about this staff member that attended a staff meeting, became ill or had started having symptoms on a Thursday evening — we look two days before then, [from] symptom start, looking for close contacts. So, if this teacher would have attended a meeting on Tuesday, early in the day, and developed symptoms later in the day on Thursday, then I would not be concerned about the people in that meeting, and then, if it was within that two day period of time, then I would look at who was close to this individual within six feet, were they wearing masks, in determining risks,” said Hablitzel.
The same process will be applied when children get sick at school, he said.
“I say when kids get sick, because you better be comfortable with the fact that we’re going to have kids testing positive. If you’re not comfortable with that fact, don’t open the schools. It will happen. What we don’t know is how many, and what you’re working through with these reopening plans is to reduce that risk and manage that risk as best we can, and again, managing risk of something that we don’t know all the facts about is hard. Except, I will offer that we will be in the boat with you, and we’ll all learn how to band together,” said Hablitzel.
Hablitzel also addressed the process to use when kids or staff get sick.
“The other thing I would ask the board to be thinking about, is what process do we use when kids get sick or a staff member gets sick? The principles there are, we remove that individual from that congregate setting, and we isolate them. Then we do contact tracing. Those are the three steps. So anyone with symptoms, or a fever, they go home, and they don’t come back until an appropriate period of time where they’ve been fever free. That has been traditionally 72 hours during the pandemic. That guidance has changed in the past two weeks to 24 hours fever free. I feel more comfortable with a stricter standard,” said Hablitzel.
Hablitzel said when those children come back, he would insist on a nursing evaluation before they return to the school environment.
“I would also ask that the expectation is that a parent brings them to school when they [return after being sick.] That keeps the kid off the school bus until we’re certain that it’s as safe as we can we can make it,” said Hablitzel.
Even then, there’s no guarantee, he said.
Hablitzel and the board discussed the parameters to determine when to close the school. Hablitzel advocates developing a closing plan that encompasses all potential possibilities of COVID-19, influenza, and norovirus.