Wednesday, July 15, 2020

Midsummer check-in

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: 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.

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: The Maine standing order can be found at Eligibility requirements for testing need to be met. Testing facilities can be found at - 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!

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