I hope this finds you all
well! It’s been awhile since I last checked in. For those of you who closed in
the spring, I hear your concerns about safely reopening in the fall. Others who
stayed open (or closed only temporarily) have ongoing concerns about common
childhood illnesses in the context of the pandemic, especially given that people
with COVID-19 have had a wide range of symptoms reported, ranging from mild
symptoms to severe illness. Symptoms may appear 2-14 days after exposure
to the virus. According to the CDC, people with these symptoms may have
COVID-19:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
Guidelines suggest that centers
should continue to follow their usual inclusion/exclusion criteria for managing
fever (temp greater than 100.4 F) and other symptoms. Some centers have
modified their policy to require a child to remain fever-free without
fever-reducing medication and be symptom-free for up to 72 hours before return
to the center. Symptomatic staff should be held to the same standards as the
children. Some are also requiring provider documentation before the child can
return. The CDC Decision Tree can help with decisions about exclusion and
school closure: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-schools.html#schools-prepare.
School closure is indicated only if an infected person has been in the
building (not someone who may have been in contact with an infected person),
and then only for 2-5 days to allow for deep cleaning and disinfecting.
This site provides additional
guidance: https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/guidance-for-childcare.html
Decisions regarding COVID-19 testing are guided by the
CDC, contact tracing, and family discussions with providers about whether
testing is warranted, based on symptoms and likelihood of exposure. There are
no recommendations for testing as a screening/preventive approach. This is the
Keep Maine Healthy web page that addresses testing: https://www.maine.gov/covid19/restartingmaine/keepmainehealthy/testing.
The Maine standing order can be found at https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/documents/MEDHHS_StandingOrder_COVID19testing_06-08-2020.pdf. Eligibility requirements for testing need to be met. Testing facilities can be
found at https://get-tested-covid19.org/
- type in your zip code, and you will get a list of testing sites within
a 40-mile radius. As I understand it, insurance companies are waiving fees for
COVID testing and it is free for uninsured persons.
The CDC website states the
following regarding quarantine at home for positive COVID-19:
Persons
with COVID-19 who have symptoms and were directed to care for themselves at
home may discontinue isolation under the following conditions:
- At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
- At least 10 days have passed since symptoms first appeared.
This guidance is just that –
guidelines, not mandates – as each center has unique environments and
situations. Any decisions made about modification of health policies need to be
clearly communicated to families in writing and consistently implemented.
Please share any newly
developed or modified practices and guidelines that you’ve found to be
effective in maintaining a safe environment during this pandemic – you can
comment directly to this post. I continue to marvel at your courage, resilience,
and flexibility to ensure the wellbeing of the children you serve as well as
your own staff.
Stay safe and be well!
Deb
