In a new directive, the Shelby County Health Department strengthened communication requirements of schools to families and staff, but stopped short of requiring schools to notify all families or the public about all cases of COVID-19 at a school.
Schools and child care facilities must coordinate with the Shelby County Health Department when there is a “confirmed” case of COVID-19, according to the directive issued Monday.
The health department and school or facility will then determine and identify parents, students and staff “at risk” and notify them of the case within 12 hours, per the directive.
The directive states that the individuals deemed “at risk” should receive weekly updates from the school, and also include actions taken to mitigate and reduce transmission risks and any changes to building operations.
The meaning of “at risk” in the directive is someone who is exposed or potentially exposed, Joan Carr, spokesperson for the department, said Monday.
Someone “at risk” of exposure is often considered a close contact. Close contacts of a COVID-19 case are generally described as people who have come within six feet of an individual for 10 or 15 minutes or more.
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In July, the health department recommended that schools implement six feet of social distancing among individuals on its campus.
The directive stops short of instructing schools to notify the entire campus community of a case. In Shelby County, communication protocols among districts in the area differ from one another.
Thursday, Alisa Haushalter, director of the county health department, defended Shelby County’s decision to follow state guidelines and not report COVID-19 cases publicly by school. Gov. Bill Lee has announced changing protocols related to school reporting at least three times this month. Last week, Lee said he was seeking federal guidance on the matter.
Alisa Haushalter, director of the Shelby County Health Department, speaks to reporters about the COVID-19 case at the the Shelby County Emergency Management and Homeland Security Office on Wednesday, March 11, 2020. (Photo: Ariel Cobbert/The Commercial Appeal)
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Locally, guidance from Le Bonheur Children’s Hospital instructs schools and school facilities to communicate new cases to all families within the school, as well as to communicate with individuals who are close contacts.
That guidance states that names should not be disclosed in these communications.
“That’s the fairly standard way that the schools notify for any infectious disease outbreak,” Dr. Jon McCullers, pediatrician-in-chief at Le Bonheur Children’s Hospital, said in a recent interview.
McCullers, also a department chair and professor at University of Tennessee Health Science Center, has advised Memphis and Shelby County leaders throughout the COVID-19 pandemic.
“So if they’re going to have an outbreak of flu or rotavirus, there’s usually a note that goes home that says, ‘Somebody in the school or several kids in the school have this. We just wanted to keep the parents informed,'” he said.
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In lieu of reporting COVID-19 cases by school, the state has started reporting cases among school-age children, from 5 to 18, by county. The data, updated daily, shows reported cases among the age group in total and over the last 14 days.
Monday, Dr. Steve Threlkeld, co-chair of the infection control program at Baptist Memorial Hospital-Memphis, described a constant battle between the need for public health officials to know about the prevalence of infectious diseases and the privacy of those who have been infected.
“It is nothing new out there to report diseases, we do it all the time,” he said, noting there are dozens of reportable diseases in addition to COVID-19, ranging from measles and HIV to chlamydia and tetanus.
“As a physician, certainly, more information is good,” Threlkeld said. “Information, after all, is what science is based on. You have to have information to make informed choices.”
He said schools needed to identify new cases, but ultimately, it’s impossible to know how many kids walked in the door with the virus on the first day. And since school-age children are less likely to become severely ill, it’s almost impossible to know if they contract the virus without testing, he said.
Testing capacity is limited, Threlkeld said, and though it has been increasing recently, that hasn’t come with much federal guidance on how schools should plan for testing students and staff. He said the issue of cases in schools was a microcosm of the problems seen in the community at large and around the country.
“We need to have a plan to test the kids when they are exposed,” he said. “But it’s difficult to say with certainty what number is most important.”
Right now, he said knowing the number of cases was a good place to start.
The new information in the directive is in full below:
“When there is the occurrence of a single confirmed COVID-19 infection at elementary and secondary schools, childcare facilities, or other in-person learning facilities, the leadership of the learning facility shall coordinate with the Shelby County Health Department to identify parents, students, and staff who are risk. Once identified, schools should notify parents, students, and staff who are at risk within 12 hours. Further, updates to parents, students, and staff at risk should be provided by schools, at a minimum, on a weekly basis. In the updates, schools and other in-person learning facilities shall include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations in the buildings or facility will be altered.”
Commercial Appeal reporter Corinne Kennedy contributed.
Laura Testino covers education and children’s issues for the Commercial Appeal. Reach her at email@example.com or 901-512-3763. Find her on Twitter: @LDTestino
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