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School Nurses Will Be Calling The Shots When Kansas City Students Go Back To Class

School nurses will have to manage coronavirus symptoms in their buildings this fall. That's tough because many kids have mild symptoms, and COVID-19 can look like cold, flu and allergies.
CC -- U.S. Army
School nurses will have to manage coronavirus symptoms in their buildings this fall. That's tough because many kids have mild symptoms, and COVID-19 can look like cold, flu and allergies.

School nurses will have to check temperatures, triage symptoms and even do some contract tracing on behalf of local health departments when in-person learning resumes.

School nurses will be on the front lines of the pandemic when districts bring back students this fall.

They’ll be making judgment calls about whether those symptoms are allergies – and who needs to quarantine at home for 14 days.

“So if we have two siblings in a school in different grades and different classrooms, and one has siblings and the other does not, I would allow the other sibling to stay in school,” said Angela Myers, a pediatric infectious disease doctor at Children’s Mercy Hospital. “Obviously continue all the precautions that school is doing with distancing, masking and frequent hand washing.”

But Shelby Rebeck, the director of health services for the Shawnee Mission School District, said that she might make a different call, depending on what symptoms a child presents with.

“If we have a kiddo who presents at 1 p.m. with a fever, cough and a loss of taste or smell, it is likely that at that point we’d exclude the household contacts, the siblings,” she said. “However, if we had a student with a headache, body aches and a sore throat, it’s probably unlikely (to be COVID-19).”

In the United States, only about 2% of all coronavirus cases are in children younger than 18, and 94% of them have non-severe disease, according to Children’s Mercy. It’s one of the reasons pediatricians have said that students are better off learning in school than online this fall.

But identifying coronavirus in kids is difficult because they’re less likely than adults to develop fever, cough, shortness of breath and diarrhea.

Rebeck said she’s often asked whether parents should even be sending their kids back to school right now.

“Your gut feeling as a parent and making that decision in conjunction with your child, that’s the right answer,” Rebeck said Friday during a Children’s Mercy webinar for school nurses.

The Johnson County Health Department released guide rails for reopening schools this week, with a final recommendation for the first day of school expected Aug. 17. But right now, the outlook for in-person school for all students isn’t great. Too many Johnson County residents are testing positive, said Sanmi Areola, director of health and environment.

“We cannot open schools at a 9% infection rate,” Areola said at a town hall about reopening schools on Thursday. “We cannot open schools at 100 cases a day.”

One of the challenges for school districts is that about 80% of parents want their kids in school this fall whereas teachers are more cautious. In a survey of Shawnee Mission teachers, less than half said they were comfortable returning to their classrooms to teach. In fact, 42% of certified staff and 58% of unlicensed personnel – paraprofessionals, cafeteria workers and bus drivers – said they have conditions that put them at a higher risk of contracting COVID-19.

Megan Foreman works for the Johnson County Health Department. She said at the town hall that if schools take precautions like social distancing, mask wearing and hand washing, the risk to educators is no greater than it is for other adults who’ve gone back to work.

She’s most concerned about families not respecting school-imposed quarantines. She hopes the possibility of not being able to participate in sports or activities will encourage families to do the right thing.

“When we say a group is quarantined, that can also be your sports team, your art club or your bus route or anytime we can show we have transmission within the group, we need to quarantine the entire group,” Foreman said. “It’s just one more shot in the arm for following the rules.”

Rebeck, the director of health services for the Shawnee Mission, said parents need to prepare for disruptions to the services schools normally provide, as it’s likely at least part of the coming semester will be virtual.

“School districts cannot be expected to do it all,” Rebeck said. “Schools serve a day care need. We feed students breakfast and lunch five days a week. We have social workers and counselors and school nurses on staff to address and physical health needs.

“But perhaps our communities should start addressing these issues outside of the educational setting.”

Elle Moxley covered education for KCUR.
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