Episode Two: Handling a Confirmed Case
You voiced your questions and concerns about the ASD School Start 2020 plan, and the District heard. Starting this week, ASD will air a twice weekly, pre-recorded Q&A session with a variety of ASD and community member hosts and guests who will take a deep dive into the details of what school will look like this fall. Videos will post by the end of day every Tuesday and Thursday leading up to the start of the school year. Topics will dig into everything from teacher tricks to encourage social distancing among young students (airplane arms!)? to how will my senior be best prepared for post-graduation life during a pandemic?
Send us your questions here! The District wants to hear your thoughts and comments to be considered for inclusion in the interview.
Lisa Miller: Thanks for tuning in to this ASD video series we're calling "Airplane Arms: Navigating Back to School." We chose that name because teachers with young students have been using that analogy of airplane arms to better understand social distancing, and we're hoping this video series will help you better navigate what the start of the school year will look like and answer all of your most asked questions. My name's Lisa Miller. I'm a communication specialist with the Anchorage School District. I'm also a mom. I've got a kiddo starting kindergarten in the fall. Hey, Jack! And I have just as many questions that you have about what the start of school will look like. So, today I'm joined with Chief Operations Officer Tom Roth, and our Health Services Director Jenn Patronas, and we're gonna take a deep dive into one of our most asked questions, which is what will the district do if there is a confirmed case in the school? So Tom, if you can kind of just, Tom and Jenn, before we dive into that, if you can describe the preparations the district is taking to really mitigate that risk as far as transmission in buildings and schools, and how we're prepping teachers and nurses.
Tom Roth: Great, no, thanks, thanks Lisa, that's a great question. So we, at the end of the school year, last school year, we recognized a need to anticipate the start of the new school year, in August. Specifically, we understood that based on understanding of COVID-19 that the risk of transmission was going to be there, that there were measures available, equipment available to reduce the potential for transmission, one, through protective equipment, and two, through sanitation. So we also understood that we were in a really kind of a global competition for these resources. So we have been very aggressive in procuring a number of items to reduce the transmission in our schools. We know that's very important for our staff and for our community. So we have procured literally hundreds of thousands of dollars worth of disposable masks, cloth masks, nitrile gloves. We're providing that, that PPE. We're also providing a number of barriers, PB, or protective barriers, plexiglass, in all of our school buildings to reduce the transmission. We've also invested a significant amount in hand sanitizer, which our intent, our plan is, and I'll, I'll use the prototype school and the prototype classroom. So the intent with the start of the school year, assuming based on, you know, what the COVID situation is that when they
Lisa Miller: You mean the risk level?
- The risk level, when a teacher goes into his or her school, in her classroom or his classroom, that there will be a standard kit in each classroom containing gloves, masks, sanitizer, that there will be a spray bottle with a disinfectant, that there'll be paper towels, that this will be in the classroom, and that we will continue to resource those. Likewise, we understand that there is a school, more for common areas, a school need. So we have a similar school-based kit, which is also inclusive of signage and floor marking, again, to try to create this distancing in our building. So we've been working this very hard. A lot of very dedicated people have been putting in long hours to anticipate, plan, and prepare, and here in the near future, we're gonna start actual distribution of these items in our schools.
Lisa Miller: What are the, you mentioned nitrile gloves, is that what you called them?
Tom Roth: Yeah, those rubberized gloves, the nitrile gloves there.
Lisa Miller: They're just rubber gloves?
Tom Roth: Rubber gloves.
Lisa Miller: Okay. And then as far as hand sanitizers and masks, you mentioned that the school will be procuring some of those. Is that gonna be on the back-to-school list? Do we want families to send their kids with the mask and hand sanitizers? Do we want them to have their own hand sanitizer, or is it, what can parents expect?
Tom Roth: The district is planning to provide hand sanitizer and masks. Now, I am not going to discourage any parent to take measures that they believe they need to, to provide an extra level of protection to their students. So if they want to send their kids to school with hand sanitizer, absolutely. But we're gonna provide it.
Lisa Miller: Okay, thank you, and then Jenn, as far as preparations for nurses, and I guess teachers too, what will that look like to prepare for, you know, if we're in that medium-high or medium-low or low risk category to return to schools in person?
Jennifer Patronas: Similar to what Tom just talked about with the prototype classroom kit, the nurses will also be receiving a kit that's more specific to their medical equipment that they may need. It includes things like gowns, N95 mask, surgical-grade mask, and gloves, and all of those supplies that they were unable to purchase at the end of last year, due to the shortage of medical supplies. So all of the nurses will have that kit. I have a team of nurses that I've been working with all summer that have made some informational training videos on how to properly sanitize your hands, how to properly wash your hands, how to don and doff your mask and properly store it-
Lisa Miller: What does that mean, don and doff?
Jennifer Patronas: Don and doff means to remove and to put back on-
Lisa Miller: Oh, okay.
Jennifer Patronas: Your mask, so that the teachers and students and all staff can watch those and see, you know, see how to do it because we had children, some of our students prepared those videos with us.
Lisa Miller: Oh, cool.
Jennifer Patronas: So, we're kind of excited about that. We have other videos coming out as well that include what it looks like for a child with asthma wearing a mask and how it may or may not affect their oxygen saturation. So we have training videos like that, as well as the nurses are gonna be receiving training directly from Dr. Zink, our state Chief Medical Officer, as well as Dr. Olson, who's our state School Health Advisor, and then Dr. Chandler, who's our Anchorage Chief Medical Officer. So they'll receive training directly from those individuals on COVID considerations, specifically for school, and nurses will be able to ask their specific questions. Additionally, the American Academy of Pediatrics has agreed to do a panel discussion with the nurses to talk about asthma considerations and how to take care of those medically fragile students in relation to COVID.
Lisa Miller: So lots of preparation and lots of different expert opinions, it sounds like.
Jennifer Patronas: Yes.
Lisa Miller: I'd like to, thank you for that, Jenn, I'd like to move on to this response matrix. We have this up now on our website. It's on asdk12.org, and it's under the School Start plan page, and this is breaking down scenarios in which the district would respond to a confirmed case. So can you just kind of walk us through this? There's a lot here. It's, you know, a lot to digest. So can you walk us through each scenario and what that would look like?
Tom Roth: And it's, I appreciate the opportunity, and I think the important thing for folks to understand is that the district has a system in the event that we are informed that we have a confirmed case, or multiple confirmed COVID-19 cases involving either staff or students in the district. I wanna say that, again, this is, it's a tool that we will use to facilitate decision making and the staff to make recommendations to the superintendent on actions if we do have a confirmed case or cases. So we have a number of situations. The first would be if we had a single confirmed case in the district. Again, it's just a case. It's, we don't know if it's a staff member or a student. Every case, every confirmed case will be investigated, and from that, from that investigation, we will have information that can help us, you know, either confirm or eliminate possibilities.
Lisa Miller: Mmm-hmm, and that's that's in that step here, the evaluated probability of transmissions in schools.
Tom Roth: Right, so our assumption on any case, any confirmed case is that there has been, at least that individual has been exposed to other ASD staff or students, that they have been in the school, unless we have confirmed that that's not the case, and that that would be the case where if you look at the chart, a low or no risk possibility of transmission. It would only be if we knew that that person had not had any exposure to staff or students in the school. In that example, I think we would simply not recommend any closure, but that, you know, we would take precautionary steps, that we would disinfect the school, that we would focus on the school building, again, just in the, err on the side of caution, but also that we have a responsibility to notify staff and students and stakeholders in that school that we had a confirmed case.
Lisa Miller: Can I ask, who's doing that? So that's contract tracing, right?
Tom Roth: Yes.
Lisa Miller: Essentially, and who's doing that, is that school nurses?
Tom Roth: Well, there's contact tracing that'll happen within the Anchorage Health Department. Generally, we'll get notification from the Health Department, but from that notification we'll do internally, we will internally confirm with us and it'll be a collaborative process. If we discover that there are more people potentially exposed that, you know, we would have the interaction with the Health Department, so they're also cognizant. So if we can't establish that there is no risk, then we're just gonna assume that transmission could have occurred, that from that we can make recommendations to the superintendent and the issue here, a lot of folks think that the reason you would close school is to allow for the disinfection. That's only part of it. The reason that you would close schools is you need to go through that investigation process, and then if we do have that potential exposure that we would want to remove that risk from the school before you would allow staff and students back into it. So if we can't confirm that nobody had any contact, that we have a reason to suspect, based on what our investigation reveals, that we could just recommend closure to allow that process to occur, and then we would do the disinfection and notification. So, that's one case in one school. So the other, another situation is maybe we would have multiple confirmed cases in one school. At that point, we have a much stronger reason to believe that transmission has and is continuing to occur in that school. So it kind of starts to amp up the district response in that we, given that circumstance, we think there is a likelihood that more people would have been exposed, that they could be infected, that we would recommend most likely in this situation, closure of the school for a longer period of time to allow for a more expanded investigation to potentially, you know, remove more people from the school to reduce risk.
Lisa Miller: One last question. So I think that kind of walks us through, you know, how things would expand, like you said, if there were one case or more than one case. You mentioned, or it says on this chart in the highest case scenario that schools would be closed up to 96 hours. So basically that's to do the contact tracing and to remove those individuals-
Tom Roth: That's right.
Lisa Miller: 'Cause it takes, you know, sometimes up to, what, a week to get tests back. So there-
Tom Roth: Well, yes, and there's no, and there's no real magic. So you see in that matrix 24 to 96 hours. It could take longer. It may take less time. It's a window. Again, what we're talking about here are a range of response options. The important thing is to mitigate risk. So until we feel like we have achieved that mitigation of risk, that our recommendation would be to continue to keep the school closed until we felt confident that everybody who could have been exposed to the confirmed case, you know, has been addressed. So that's, again, this is a single school, multiple cases in a compressed time period. And then the third category is if you have a much more broad number of cases across the district, so multiple confirmed cases in multiple schools. Now, what you're looking for is a pattern. Is it geographic? Is there an area, you know, say South Anchorage, where a number of schools have confirmed cases? 'Cause that will drive different types of responses. Is it one person in a number of schools without any geographic or any connection? If that's the case, then each one of those schools would be treated like a separate case in a separate school. But if you have a more regional matter where you have reason to believe you have a hot spot, then you're looking at a larger, potentially, a larger closure of a number of schools, transitioning into the e-learning. Or if you have a case where this is happening throughout the district that it would indicate a much broader issue for the municipality, potentially, that we could just recommend, in a fairly rapid way, recommend a transition to a high risk education delivery model until such time that the risk of broad transmission has subsided. So that's kind of the matrix, if you will. It's a tool to help the staff understand what's going on, and then to make recommendations to take action.
Lisa Miller: Okay, all right, well, thank you so much, Tom and Jenn, for walking us through the matrix and answering questions about what the district doing, is doing to prepare for the potential of a start in school. I think that helps, answers a lot of my questions, and I'm sure others' questions as well. So thank you so much for being here, and thank you for tuning in. If you have additional questions you'd like to ask, we will link to the Google Form where you can submit those questions. We're reviewing those. We'll enter those to our FAQs, or consider for another show topic. So, thank you.