I am going to mute all once we get started and hand this over to Ben and Beth.
Angela, you may not be aware that your sound is on
Its Kathryn Bonyai, not Angela
it's hard to hear
Yes, very difficult to hear
hard to hear
I thought this started at 10?
Who is talking? Yes, hard to hear.
It hasn't started yet, that's a nurse's mic that's open
Mary Ann Skersey
Yes, I thought this started at 10 and hard to hear.
I thought it started at 10am?
Is it moving to a different location?
It isn't the presentation just someone who is talking but didn't mute
ok thank you!
I see that we are recording. Will there be a copy of this posted somewhere to reference later?
With a high percentage of school aged kids being asymptomatic with Covid, does it make sense to screen all for temps before entering the school?
If we understand the wearing of masks to be our proven primary prevention against the spread of coronavirus and understanding schools will manage individual circumstances why are masks not a mandate for the re-entry plan.
Should OT/PT services wear gowns? For routine work with students?
Should students and staff be tested for COVID prior to school reentry? And then follow up with daily screenings?
Please, describe how big a cohort should be and how many cohorts a student could be in. Our school is proposing 4, if I understand it correctly.
thank you for doing this webinar
I am also on with Beth's login info so she should be able to get on
is the state looking at pooled testing for buildings and will there be municipal sewage testing to monitor for outbreaks
Will we be able to get a copy of this presentation?
Now more than ever we need a nurse at the DOE. Are there plans to hire one soon?
can we expect the state to provide us with a decision tree to follow when a student/ staff tests positive (or shows signs)?
Infra-re thermometers have proven themselves to be inaccurate
Who will set the guidelines for when a student can return to school who show any type of symptoms? Do they require a negative test if they want to come back before the 10-14 day time period that is recommended by the CDC?
As we work on our protocols for sick students, could you please confirm my understanding of the following: If a student is sick with ANY of the symptoms of COVID-19, they should be tested, and remain out of school (and isolated if they live on campus) until the test results come back. If they are positive, they go by the 10/3 rule to come back to school/out of isolation. If it’s negative, we could let them come back as long as they follow our regular exclusion of ill students/staff policy? (i.e., fever free for 24 hours, no vomiting/diarrhea, etc). This is incredibly important for us to understand, as a large percentage of our school is made up of boarding students. If this is the case, it is highly likely we will be putting students in isolation often (cough/sore throat/runny nose), and administration needs to be very clear with this for their own understanding and for parents.
Are you touching base with nurses who are running summer programs now for insights for the fall? We are in session now and all sorts of tweaking will be needed..
Will the questions we submitted via email be addressed?
Will there be testing readily available for kids and staff that have suspected symptoms?
If we have to send home students (ultimately staff as well) due to cough/cold/runny nose, etc…they will need to be tested for COVID19 or see out a healthcare provider for dx or return to School note. In the NHPR Exchange program you did not answer the question about testing taking 3+ days. So we are expecting students/staff out for that long? How do we account for the lack of transportation? Are Health Care providers prepared for the influx of all of these students being excluded due to symptoms?
Any suggestions on placing portable HEPA filters in the health office and any classroom where there is low air flow/circulation? thank you
What is the increased risk for a classroom if a teacher were to use a face shield while physically distanced with all students masked vs. all being masked? In this scenario, if the teacher came within 6 feet of a student (i.e., to help them with a math problem) they would put on a mask. If this is not idea/acceptable, have you seen any efficacy studies on the masks that have a clear “window” in the mouth area?
my staff getting tested are out for 9 days on average
Dr. Chan — Your thoughts on the large recently published South Korea study finding that children 10 and older can spread the virus at least as well as adults? What implications does this have with partial to full reopening of schools and the current relatively low NH infection, hospitalization, and death rates?
accessible and rapid testing will be key if children are not to miss school unnecessarily. What will be our statewide system?
How many symptoms do/does a person have to present with to be "sent home"? Are we to differentiate for a person's "normal" daily symptoms ~ i.e. seasonal allergies vs. possible COVID symptoms?
We have low-to-no community transmission in our town & surrounding towns. What should our threshold be for closing school in response to community transmission? (working at a small, independent school (K-8) in Lyme, NH. We are planning for 6’ desk spacing, masks for all)
We are recording this presentation so that you will be able to access it later.
We have eliminated all team sports except for our soccer program for the fall season, as that is a large reason why students come to our school. It is not quite clear to me from the “Safer at Home Amateur and Youth Sports Guidance” what happens during game play. It seems unsafe for athletes to be masked. Would regular soccer playing be considered “close contact” if the player was in a game from another New England school? We are having our players be in their own “pod” at school, for safety’s sake. If a team pod remained masked and 6’ away from everyone out of their pod while not actively playing, could we consider this relatively “safe”?
Hepa filter pro or con? Funding available for PPE?
What kind of information/data can we bring to our administrators to advocate for masks for all (K-8), so our teacher-cohort feel comfortable returning to school? Some teachers or their family members are immunocompromised. We plan for mask break during nap time, recess, and PE.
Dr. Chan - will there be official changes to the guidance of out of school for 24 hours fever free to the 72 hours?
What about PPE?? Will we have enough to open? Will there be a stable supply chain for NH needs?
proper guidance for staff who are pregnant? PPE-wise?
Will you be posting the slides along with the recording?
Please guide us in the need and use of Face Shield for smaller children, hearing impaired and lip readers.
Dr Chan- how do you feel about hypochlorous acid fogger machines to clean classrooms?
So are we now going to need to send everyone home with any of those symptoms?
What is your comment on the testing data? How many of those tests are for people who are testing frequently for work requirements. Therefore more tests are being done but are we really testing more unique individuals? How does this impact the % positive?
if we are still going by the 6 feet rule why are we allowing desks to be 3 feet apart?
Should we not be doing neb treatments for asthma?
I hope 3ft will change to 6ft.
I saw that Pediatric Physician Association is saying 3-6 ft. Which is accurate
Does a sty still represent one of the symptoms?
Half our younger students have runny noses and coughs on any given day. Do I send them all home? How do I decide who stays and who needs to go home?
since the symptoms are so varied can you provide guidance for school nurses for when a student should be sent home
@ Teresa we have not done nebs in the LTC setting since March
Thank you Meg!
What about kids who vape? Does this increase spread of the virus?
There has been information that the respiratory droplets stay in the air for up to 4 hours
the list is symptoms is so broad, we see multiple students in a typical day with these symptoms. How do you recommend we as school nurses deal with these symptomatic students in this pandemic? Should I be isolating and sending home everyone of these students??
nebulizers & inhalers without a chamber cannotbe administered in school?
8 kids sharing one stall bathroom, one right after the other. all unmasked special needs kids. Concerns?
@Rebecca - my understanding is no nebs in school, MDI’s with chambers only.
For students in pre-k special ed and kindergarten, they will be moving around the room and not sitting in an assigned seat for the whole time at school. With this being said, would you recommend keeping the whole class home for self isolation if there is a student who is positive?
In the hospital setting nurses need to be fit tested to make sure N95 masks fit properly. Is that going to be provided for all school nurses? How often do we change the masks between symptomatic kids?
Orders have been cancelled. Where are we getting PPE?
is Homeland Security still going to provide PPE the second week of August?
fit testing for N95?
N95s require fit testing based on OSHA directives
all of our students are unmasked special needs kids. They cough, sing, scream etc spontaneously. Do all staff need eyewear when closer than 6 ft?
Our interactions with students are prolonged
Its not brief contact when you have a young child with a fever cough and other symptoms. Its prolonged close contact every visit to care properly for these students.
should nurses be wearing N95 when assessing symptomatic students? or while in isolation room
Boarding school nurses and staff will potentially be taking care of positive cases on campus
Do you have a surveillance plan for schools this fall?
Please define "surgical masks". Most masks available for purchase state that they are "non medical". Are these adequate for staff/students.
Washable masks - need to purchase filters(recommended to use filter for one week), made here in NH: envomask.com
procedure masks…surgical masks should be reserved for hospital
Will NH DHHS notify the schools in the district if a child under 18 tests positive?
Are there any true medical conditions that would preclude a student or staff member from wearing a mask in school?
How many square feet is needed per child if they are to stay 6ft apart. what about buses using the 6ft model?
If I dismiss a student home with symptoms of covid, do I need to dismiss siblings of that student if the sibling is symptom-free?
How are we supposed to screen students and staff when we have over 500?
temperature and questioning is recommended for the parent to do prior to coming to school or getting on the bus. How will we get this information daily.
Are there any studies on mass temp taking, reliability of non-touch thermometers?
Is there a digital means or an app possible that parents could enter the information to be retrieved by the SN.
Will there be any PSA’s for parents to keep home ANY ill student? Not sending ill students to school? We will have parents medicate a student and send to school..this won’t change!
we are in session now, our parents don't have thermometers, or send in temps of "146, or 85.6". We are not able to depend on this info in any manner.
Can we receive an extracted copy of the chat with the recording link? Will you be answering all the questions verbally or via email? This chat contains some fabulous questions and I would like to see all answers are shared
Has the BON been consulted regarding our scope of practice and what is being expected of us?
Are symptoms and temperature screening of students to be recorded in student records?
Is it one study that says 3 feet is oK?
how did thy come to 3ft? this whole time it has been 6ft
Kids sitting" in close proximity" is not enough criteria. Kids are moving all day long, especially the young ones.
Are there any studies available if effective distance for children? Was the Lancet study based on adults or children?
I would think you would only record temps over 100.
If we need to use 3 foot distancing shouldn’t masks be worn for kids greater than 2years old?
Will healthcare providers be encouraged by the State of NH NOT to right letters allowing a person to not have to wear a mask?
you mentioned distancing is not the only way to protect, why no face coverings in classrooms if they are only 3 feet apart?
Standards for restaurants and other businesses has been 6 feet. How can it be acceptable for schools to be 3 feet?
Leaving it to the schools about masks makes it very difficult to enforce
Agreed Teresa McCormack, must be mandated.
Teachers are not comfortable with the change from 6 feet to three feet
Our district is mandating face masks for staff as well as students
Does the NHSNA have a position or guidelines for our return to school?
Please elaborate on your statement regarding face covering use in younger children "risks outweigh the benefits". What are the risks?
What are recommendations for "mask breaks", storage of masks if off. (lanyards vs paperbag on desk?) Does it increase infection risk if student taking mask on and off (lunchtime etc)?
Consistent messaging for the public should be applied
My special needs kids are not able to wear masks at all, have significant difficulty with oral secretions, behavior, biting etc. Also will not stay in assigned seats. Cohort size given this?
Kathleen Rawley, what is the messaging to staff/parents/guardians/students if they choose to not wear a mask?
This is not within our scope of practice!
uncontrolled situation and face coverings- that would be the ES setting. kids are ,paving all the time
Can you please provide questions for the screenings so that it is the same across the state?
not clear why staff need to be screened at building, but relying on parents to screen students?
Our policy is still in draft yet to be approved by SB but I would imagine unless medically warranted they need to comply
If a student is sent home, evaluated by their HCP, and determined to not have COVID-19, can they return to school even with their mild runny nose?
Please send these slides to all principals and superintendents. I think that they will appreciate them.
mild symptoms. if a student has a runny nose are they to be sent home?
so any child with any of the symptoms
Many families have "Politicized" face masks. (Parents refuse to wear masks and practice the same with their children) What can be done in regard to asymptomatic/contagious students who refuse to wear masks? Should masks be mandated in order to enter school?
I assume we wait until results to have them come back?
Will proof be required before reentering school that they've been tested and are neg?
Can we please have this page of who to exclude examples? so that it can be printed?
please provide slides for this presentation- so we know when to exclude and test
I will get the slides and load them on the department web site under COVID resources.
May students remove masks at desks 6 feet apart but not at 3 feet apart?
After testing, should there be a second test? I've seen the first test come back negative and 3-5 days later, test positive. How long should they be excluded?
I've read that up to 30% of tests give false negatives. Is this still the case? If so, even if the child tests, they might be positive and receive a negative result.
is research still showing that tests will only test positive while virus is shedding?
Recommend testing? So it is not required?
along with my question regarding PPE availability, will NH have enough tests to administer?
Testing is taking 10-14 days and some parents that are just going back to work are excepted to keep children home with each occurance? Not to mention as ourselves and other staff members in the building. I called around to testing centers and the tests are taking a long time.
Are primary care providers being prepared for this mass influx of students for testing? This list of symptoms is going to result in almost every student visiting the health office being sent for testing, especially winter months.
why did the CDC change from 72hrs to 24hrs? hasn't all research shown 72
Our local pediatricians aren’t automatically testing people for covid. They are saying to stay home and then go to the ED if respiratory issues. So is that going to change?
Or just the opposite . . . I know of five staff members from a local LTC facility that were all asymptomatic and had "false" positive results during routine screening. When testing was done again the following day and labs were sent to a different lab they all tested negative.
Do school nurses need to quarantine? Who would take care of the health needs of the students?
How will we secure enough tests?
can you send us this PowerPoint?
If improved sx, but not completely resolved, they are ok if still continuing to cough as long as improved?
@shawna most require symptoms to test and Ive seen some say if you have symptoms, treat as positive and still given no test.
My town will test everyone. But the peds are not sending kids to be tested.
it seems we are moving from actual assessment (looking at throats, listening to lungs) to triage, checking temp, taking history and sending home
what about keeping window open to ventilate when in isolation
Does the DHHS have a decision tree for us to follow? It would be nice if we all practiced the same guidelines statewide.
Occ Health will be overwhelmed with calls and patients. How will they increase staff to manage this?
If we are exposed and have to be quarantined, can we collect unemployment?
I am concerned about the Teachers/staff if exposed to any students/staff with COVID 19. What is our recommendation? Do they quarantine?
Can we keep several students in one isolation room sitting six feet apart with a divider of some sort
If we are in a room with someone whose symptomatic without proper PPE and so as nurses would need to quarantine for 14 days, then doesn't that apply to all staff and students exposed in a classroom or hallways, instead of just those sitting at desks around the students?
This would be a great presentation for school administrators
Are curtains (plastic or cloth) adequate for separation?
Can this be shared to the superintendent and principal associations?
can we get a compilation of all these questions?
Please make this presentation shareable
where will we find or afford sub's for nurses when we are out
I will be saving the chat and also post that on our web site.
who is going to be responsible for contact tracing?
Debra, I think we are never without PPE
The sub question is a great one…I sub at schools and the pay can be appalling
I have 20 days worth of PPE. Where is everyone getting their PPE these days. School health cancelled my orders>
Is there extra staff on public health because the number of calls coming in to get guidance on this is going to be extraordinary
I would think public health would be responsible for contact tracking?
Sub pay needs to be $200./day during COVID
sUBS WILL BE TRAVELING THROUGHOUT A VARIETY OF DISTRITS. Will they need to quarantine for two weeks after each school they sub for
What should a school do if a student refuses to comply with safety measures such as wearing a mask?
Would the administrator of this presentation please send us the powerpoint slides?
I understand no singing like choir, but can younger kids sing through their masks - this is a big part of classroom learning in young grades
I agree with some. I would really like to share this presentation with my admin.
Cecile It should be that anyways!!
Where are all of the Medical Directors?
will this powerpoint presentation be available as a resource after this meeting
My district is $125/day…needs to be more
Since there are so many questions, could Dr. Chan review the questions and send the Q & A to the group in a written form? Many of the questions I am sure have been answered with the presentation.
For sub pay
we routinely have kids come back the day after we send them home with fever- parents don’t follow the policies even when reminded. the logistics of tracking all kids sent home, when they come back and keeping them out will need much more effort than we can do alone as school nurses
what if you do not have a window?
How do we conduct PE? Keeping students in classroom cohorts will require PPE indoors during bad weather? If sports are discouraged due to risks, how do we do this?
exhaust fans to bring air out of classrooms
can fans be used to exhaust outside
window units ac appropriate?
PE indoors, not PPE
Our schools do not have AC. The 5th floor is unbearably hot in September without masks. No fans? I don't know how any learning will take place.
a decision tree from DHHS for symptoms and dismissal to home for school nurses would be really needed heading into this school year. Can DHHS provide this
second Jean Picard
s request for a decision tree.
What is the current turn around time for testing?
When there is a mask break, where should students and staff put their masks. Many adults seem to wear them below their chins, rather than take them off.
I also agree with Jean- that would be very helpful.
Should districts review HVAC systems (both for cooling in the early fall and heating in the winter) to determine if air circulation will spread droplets?
did anyone else just lose audio?
@Stephanie - In the NHPR interview with the Commissioner - this question was not answered and skirted around. Testing is still 3+ days for results
if temps are taken at school how should they be done , before the first classroomentry, outside the school upon entry
Don’t apologize, it was very helpful!
Please Don’t Apologize Dr Chan. We all appreciate you!
This was fantastic Ben
Temps should be taken at home before they get on the bus!
@Anne - parents fib and/or medicate or will forget
I agree with Jean Picard as well. The list of "potential" symptoms noted at this point, basically tells me if a student comes in with any vague complaints, they should be dismissed. The potential of an exposure and the liability of keeping even a "mildly symptomatic" student in the building is so great.
Oh I know! They need to be held accountable!
Thank you for this session! Can we do another one for additional questions?
agreed temps need to be taken before bus or car drop offs
Test results are now taking up to 7 days to come back, according to a friend of mine who is an APRN and works at an urgent care.
DHHS could easily give us a decision tree. Many states have already produced and shared
This is a great presentation!
All this information is important and extremely helpful. Thank you Dr Chan.
please respond to infrared thermometers. They may be a risk to a nurses license due to some of the more expensive ones being more accurate and the inexpensive not
Is there discussion among government officials regarding supports for parents who will be displaced from work to care for sick children? Compliance rates for keeping sick children home would improve if employers were unable to take punitive actions against parents who need to call out sick to care for children, or who provide sufficient sick time for this reason (both must be mandates). Work is the number one reason I hear from parents who are not able to care for their sick child, and why dismissal times are often significantly delayed when children are sent home.
thank you Dr Chan. This was helpful!
will there be guidelines for high risk students/staff
Thank you DHHS and NHSNA!
Thank you Dr. Chan! You and the DHHS staff are so are appreciated!
Thank you Dr Chan and NHSNA
Helpful, thank you
Thank you so much!!
A doctor's office said that if the test is ordered by them, it only takes 24-48 hours. If from another test site- 4-7 days.
thank would be very helpful
Good idea Frank
That would be wonderful! Thank you
Thank you Dr. Chan and NHSNA!
Thank you Dr Chan, this was very helpful, and yes, a second session would be great!
Also please refer to NHSNA working draft
thank you this was great!
A decision tree would be helpful
Yes sooner than later
This has answered many question today
yes, that would be great
If a student is sent home with symptoms and asked to get tested--~do the siblings also have to go home while waiting for results?? or just after a positive test is reported??~is that classroom closed immediately? Or after a positive test is reported
Will the questions I emailed when I registered for this conference call be addressed in conjunction w/the chat questions?
Sooner than later!@
Thank you Dr Chan and all - especially to NHSNA for all your support!
Thank you for your time! It is critical that we have clear guidance prior to reopening our schools. Consider opening up additional questions.
YES ASAP PLEASE
we need guidance so we can be consistent when we speak with parents and staff
Sooner than later. Thank you Dr. Chan!
That is agreeable
Yes that will be helpful!
yes thank you!
It would be very helpful to have another ZOOM meeting addressing questions that school nurses have.
Yes! Thank you very much. This was very helpful.
Yes Frank and thank-you
yes! that sounds great!
DECISION TREE PLEASE
Can you tell us how to access today's recording/slides?
Concern re high risk medical need students and their safe return
That sounds like a good plan
screening questions for all schools
Yes please!! and sooner rather than later. A lot of our guidance is based on these answers
Decision tree please!
What about use of playground equipment?
Yes, specific answers to the questions will be helpful.
As soon as possible please, district administration is looking to set up policies asap
NHSNA cam help you with questions
I can't come off mute
Yes, as soon as possible please. Our districts are trying to finalize plans and waiting for our imput
Yes another call is great. Thank you for planning to post the powerpoint.
we have a task force that is meeting this afternnon
decision tree would be HUGE
YES PLEASE….but also invite school ADMINS
Will the state being supporting us with PPE?
Good idea to invite school admin
NHSNA guidance please
NHSNA would like to collaborate with DHHS
Paula you are wonderful
decision tree would be great!
Can this recorded presentation become sharable so we can share with our administrators?
thank you Paula
It would be helpful to see the questions and answers posted. This might save time as well.
yes to decision tree!!
Decision tree is imperative
Thank you for this opportunity. I know time is precious.
If we have parents checking temps at home do we only recheck if they show up with symptoms or do you recommend that everyone be tested again when arriving at school.
Please include nurse reccomendtions
exception for private car travel for parents who are staff transporting child to college out of NE do they have to isolate for 14 days
decision tree yes
thank you !
Do we need to notify admin with students names who presented with covid symptoms daily? Is so, how doesthis affect confidentiality?
There a lot of specific questions that need addressing. I also think the DOE needs to address sub nurses. There will be a great need for them. Most districts have one or two subs but many have none. The sub pay is terrible and with this added responsibility/exposure many subs will not be willing to work for the pay. Vast majority pays less than $ 125/day
are there specific face shields kids have to wear?
I believe many of us are looking for answers that we can report to our districts in the next day or two. The presentation has been very helpful, but as you can imagine we have specific scenarios that we need to speak to. Please do your best to turn this around quickly.
thaNK YOU SO MUCH
Thanks for your time.