chi st. gabriel’s health...2020/08/08 · symptomatic people in any setting. if pcr testing for...
TRANSCRIPT
CHI St. Gabriel’s Health Denise Herrmann, DNP RN CPNP
8 / 8 / 2 0 2 0
1
COVID 19 Basics
• Infectious Disease
• Novel virus not found before in humans
• Respiratory virus • Spread by nose/mouth droplets vs airborne
• Person to Person primary method
• Surfaces contaminated by droplets and then touched and introduced into nose, mouth or eyes is secondary method
• A lot is unknown and changes as we have more experience
https://www.health.state.mn.us/diseases/coronavirus/basics.html
r
45%
"' 40% .c -m a, Q 35% on c:: 0
iii 30% N
J! 25% a. "' 0 ;;c on 20% a,
"' a 15%
"' -~ - 10% 0 -C
el ... 5% a, ~
0%
All cases
HO$pitillned cases
HospitaUzed In IOU
Deaths
No n-hoop'italized ,cases
Hospitahed cases
case5 hoopitaHzed in, ICU
Deaths
'#. ';:j
I. ' ~ I ~
10·S 6-191 2,0-29 years years years
1,304 ,S,939 3,8 4
59 137 417
12 33 57
1 0 4 .......
Median Age (Range)
36 (<1. month - 109)
34 (<.1 month• 109),
59 (<1 mon h-105),
61 (<1 month - 99)
83 (<1 · 109)
it!
i I 30-39 4,0.49 SO-S9 60·69 vears years years years
10,783 8,458 7,533 4,455
565 637 983 982
110 191 333 378
14 22 l
82 2.00 i
I 70-79 vears
2,387
793
,258
315
II &0-89 yea:rs
1,922:
632
174
547
978
2.05
35
419,
partment of Health weekly COVID-19 Report: Updated 8/6/2020 with data current as of 4 p.m. the prev1011.1s day.
56
9
0
32 +-
U~II{/ m issin
1
2:
2
0
• MDH Coronavirus Disease 2019 (COVID-19)
• https://www.health. state.mn.us/diseases /coronavirus/index.h tml
3
0 0000
0 0000
0
Swiss Cheese
Layer mitigating efforts to reduce
the risk of transmitting
COVID 19
Planning Guide for 2020-21
• COVID-19 program coordinator
• Social distancing and minimizing exposure
• Cloth face coverings
• Protecting vulnerable populations
• Hygiene practices
• Cleaning and materials handling
• Monitoring and excluding for illness
• Handling suspected or confirmed positive cases of COVID-19
• Water and ventilation systems
• Transportation
• Support mental health and wellness
5
Planning for 3 Scenarios
Look at all the various aspects of your program or school.
Beginning to end of school day
Characteristics of student and adult population (high risk, role, place, etc.)
6
Safe Learning Plan for the 2020-21 School Year
Making a Decision
1. Prioritize the safety of students and staff.
2. Prioritize in-person learning, especially for younger learners and those with most need.
3. Recognize differences in potential spread among different ages.
4. Support planning, while permitting flexibility for districts.
5. Take into account disease prevalence at a local level.
8
To,tal number ,of cas,es for 1,ast 14 days. --
14-day County
Level Case rate
per 10,000
Weekly Report Data: 14-day County Level Case Rate
9
N
Data f:o r K:-12 'Schools: ·1 -dlay· 1C OV II D-1'9 1Case R'ate• by Cou mty
14-ill-, n 10!010 0 petli ~~ Ly : · Jl!i ,.,F iffl!lffl cl .Iii
"'"'"""'- 11{.tl · il:,'ll ilfl' · il{.illo il:r'lll•',m' iii']! . Jj",i ',!lii·'P,111 :lj'S-~Ui - """ .... , .... '1.11) LU [II.al ...... IUll :1"'.!D ,..., I.Lill ·- LUO ...... Uf! .,,., = ui., L>I LUii --- 1:.11.:1 i1D .... 11W' um 1MI ....... ,U::[ """ Im ,UJI ... '"" --- LUii 11:.B ,..., 111.U '"" llWI ._,..__ .an ...... ...., .ll ilil - ILD .... .... .... . 1 1:1 wn - .... <.al ""'" IIW:I """ LOI]
Ciniiii .... ... I= ,,... um :IC.l!I .... ""' i:;z, .... ·:i.-. .... [IUIJ -- l&U ..... ..... - .... UIJ
.uo !LU 1!11 •:;m LC' ID]
llnl'lr ll5ai>clrl4 ~~'- c.:u.. "-'·
Weekly Report Example
Data for K-12 Schools (PDF): https://www.health.state.mn.us/disea ses/coronavirus/stats/wschool.pdf
This data is posted to MDH Schools and Child Care website and updated every Thursday at 11 a.m.
10
Selecting a Learning Model
Number of cases per
10,000 over 14 days, by county of residence
Learning model
0-9 In-person learning for all students
10-19 In person learning for elementary students; hybrid learning for secondary students
20-29 Hybrid learning for all students
30-49 Hybrid learning for elementary students; distance learning for secondary students
50+ Distance learning for all students 11
Regional Support Teams
• Created in partnership with MDE, MDH, Minnesota’s regional servicecooperatives and local public health.
• Regional support teams are structured in a way that allows efficientcommunication from the school and district level to the state level in theevent of a confirmed case of COVID-19 in a school building.
• The regional support teams are made up of rapid response staff, healthconsultants and testing event planners.
12
Testing Educators and School Staff
• Home test available for every educator and school staff this fall at no cost.
• MDH guidance prioritizing testing for educators and school staff by health providers.
• Coordination and support for events due to any school exposure, including state implementation of larger events.
13
lose contacts tested
Testing with loca l proviider
Testing events
Consider Universa l Testing
Testing Strategies & State Supports
• Local provider testing when possible to ensure continuity of care for students and staff, with state assistance and coordination as needed
• State supplements local resources with staffing, lab capacity, logistics, resulting and other assistance
• Educators and students prioritized in state testing events in communities with increased COVID-19 circulation
14
MINN E SO T A DE PARTMENT OF HEALTH
Decision Tree for People with COVI D-19 Symptoms in Youth, Student, and Child Care Programs
For people (e.e.., children, care providers, or staff) who have symptoms consistent with COVID-19, send home or deny entry and reference the exclusion criteria in th is document to determine when they may return.
Symptoms of COV ID-19 include: new o nset cough or shortness of breath by themselves OR at least 2 of the following: fever (100.4°F or higher) , chills , muscle pain, sore throat , loss of sense of smell or taste, and gastrointestina l symptoms o f diarrhea, vom iting, or nausea .
If a person has a new symptom (for example, new loss of smell only) with no other diagnosis to expla in it, they should stay home and ta lk to thei r hea lth care provider abo ut testing for COVID- 19 , even if it is the only symptom they are experiencing.
For people who received a laboratory
test for COVID -19
What to do if you're waiting for
COV!D 19 test resu lts CPDEJ (www.health.state.mn.us/d iseases/coro navirus/wa it ine.gdf)
Positive test result : Stay home at least 10 days since symptoms fi rst appeared A N D until no fever for at least 3 days wit hout medication AND improvement of other symptoms.
Sibl ings and household members also st ay home fo r 14 days.
Negat ive test result but symptoms with no other diagnosis: Stay home at least 10 days since symptoms fi rst appeared AND until no fever for at least 3 days wit hout medication AND improvement of other symptoms.
Sibl ings and household members also stay home fo r 14 days.
For people with a COVID-19 diagnosis without a lab test OR people with symptoms consistent with COVID-19 without a medical evaluation (e.g ., monitoring symptoms at home)
Stay home at least 10 days s ince sym ptoms first appeared A ND unti l no fever fo r at least 3 days without medicat ion AND improvement o f othe r symptoms.
Siblings and household mem bers also stay home fo r 14 days.
•
m, MINNeSOTA
For people with other diae,noses (e.g., norovirus, strep throat) that explain the symptoms, or when a health care provider says symptoms are connected to a pre- existing condition
Stay home unti l sym ptoms have improved. Fol low specific return gu idance from the hea lth ca re provider or follow the Infectious. Pis.eases in Childcare Settines and Schools Manual (www.henne~.jn.us/da:ycaremanual).
If symptoms related to a pre-ex isting condit ion change o r wo rsen, talk to a hea lth care provider t o determin e next st eps.
Siblings and household members do not need to stay home.
Minnesota Department of Health J health.mn.gov J 651-201- 54 14 J 1-877-676-5414 J 625 Robert Street North PO Box 64975, St. Paul, MN 55164-0975 Contact health .com m unicat ions(@state.m n.us to request an alte rnate format.
0 6/02/2020
Exclusion Guidance
• Identify who: Ongoing daily work
• Will work closely with local public health / MDH
• Communicator to parents and staff
• Guidance is under review for future updates
• https://www.cdc.gov/coro navirus/2019-ncov/if-you-are-sick/quarantine.html
15
, DEPARTMENT OF HEALTH
Health Advisory: New Testing Priorities for SARS-COV-2 Minnesota Department of Health, Thurs, July 30 10:00 CDT 2020
Action Steps
Loco/ and tribal health deportment: Please forward to hospita ls, cl inics, urgent care centers, emergency departments, and convenience clinics in your jurisdiction. Hospitals, clinics and other facilities: Please forward to infection preventionists, infectious disease physicians, emergency department staff, hospitalists, primary care cl inicians, and all other health care providers who might see patients with acute respiratory symptoms. Health core providers: In addition to symptomatic persons, consider test ing:
• Continue to test symptomatic people. • Test asymptomatic people requi ring medical care, linked to ongoing investigations, or with
known exposure, including individuals working or attending K-12 schools or child care. • Report COVID-19/ SARS-CoV-2 Infections with in one working day by phone to 651-201-5414
or 877-676-5414 or using the COVID-19 case Report Form.
Background
In consideration of the test ing priorities outlined below, evaluate how your staff resources and laboratory capacity can be used to ensure test ing access for these priority groups. Individuals
being tested for surveillance purposes (e.g., those tested prior to employment, for sports team or camp participat ion, enrollment in an academic institution) should not be priorit ized for testing given nationwide reagent shortages and a lack of evidence to support the usefulness of a broad test ing approach.
Testing Priorities
This guidance is intended as a rank prioritization of SARS-CoV-2 testing. The fo llowing groups and order are priorit ized for SARS-CoV-2 testing:
1. Symptomatic People Symptomatic people in any setting. If PCR testing for SARS-CoV-2 is negative, symptomatic people should continue to self-isolate and follow setting-specific public health recommendations.
2. Asymptomatic People with Either a Known Exposure or Requiring Medical Care
7/30/20 HAN: Testing Priorities
• Health Advisory: New Testing Priorities for SARS-CoV-2: https://www.health.state.mn.us/communities/ep/han/2020/july30testi ng.pdf
• Asymptomatic People with a Known COVID-19 Exposure Individuals working or attending K-12 schools or child care Hospitalized patients Health care personnel First responders (e.g., EMS, law enforcement, firefighters) Individuals living, working or visiting congregate settings Individuals with medical conditions including pregnancy Individuals 65 years of age and older Individuals who live in households with a higher risk individual or who
provide care in a household with a higher risk individual Member of a large household living in close quarters
16
Interpreting a COVID-19 Test Result
Interpreting a COVID-19 test result: https://www.bmj.com/content/369/bmj.m1808
What you need to know:
• Interpreting the result of a test for COVID-19 depends on two things: 1. The accuracy of the test, and the pre-test probability.
2. Estimated risk of disease before testing.
• A positive RT-PCR test for COVID-19 test has more weight than a negative test because of thetest’s high specificity but moderate sensitivity.
• A single negative COVID-19 test should not be used as a rule-out in patients with stronglysuggestive symptoms.
• Clinicians should share information with patients about the accuracy of COVID-19 tests.
17
CDC Isolation Guidance Update
When You Can be Around Others After You Had or Likely Had COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/end-home-isolation.html.
Symptom-based Return:
• You can be with others after at least 10 days since symptoms first appeared AND at least 24 hours with no fever without fever-reducing medication AND symptoms have improved.
• Follow the updated CDC guidance until MDH updates the exclusion guidance to reflect the change.
Testing-based Return (not recommended):
• Depending on your healthcare provider’s advice and availability of testing, you might get tested to see if you still have COVID-19.
• If you are tested, you can be around others when you have no fever, respiratory symptoms have improved, and you receive two negative test results in a row, at least 24 hours apart.
18
Quarantine if You Might Be Sick
Quarantine if you Might be Sick: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html
1. I had close contact with someone who has COVID-19 and will not have further contact or interactions with the person while they are sick (e.g., co-worker, neighbor, or friend).
2. I live with someone who has COVID-19 (e.g., roommate, partner, family member), and that person has isolated by staying in a separate bedroom. I have had no close contact with the person since they isolated.
3. I live with someone who has COVID-19 and started my 14-day quarantine period because we had close contact. What if I ended up having close contact with the person who is sick during my quarantine? What if another household member gets sick with COVID-19? Do I need to restart my quarantine?
4. I live in a household where I cannot avoid close contact with the person who has COVID-19. I am providing direct care to the person who is sick, don’t have a separate bedroom to isolate the person who is sick, or live in close quarters where I am unable to keep a physical distance of 6 feet
19
Scenario 1: Close contact with someone who has COVID-19-will not have further close contact I had close contact w it h som eone who has COVID- 19 and will not have further contact or interact ions with the person w hile
t hey are sick (e.g., co-worker, neighbor, or friend).
Your last day of quarant ine is 14 days from the date you had close contact .
Date of last close contact w ith person w ho has COVID-19 + 14 days= end of quarant ine
mon tue e thu fri sat sun Last close G
contact with person who .•• ■■■ • ■■■ •••••••••••► 1
has COVID-19 2 3 4 5
6 7 8 9 10 1 1 12
13 14 c~---}§. ..... .l 7.. ...... J -~-...... J. ~-.... ,.,, day ol ~ quarantine
20 21 22 23 24 25 26
27 28 29 30 31 14 DAY QUARANTINE
Please note if your quaranrine sram a moon on day 1, then it would end at noon on the last day.
Quarantine if You Might Be Sick
Quarantine if you Might be Sick: https://www.cdc.gov/coronavirus/201 9-ncov/if-you-are-sick/quarantine.html
Calendar visualizations for 4 different case scenarios.
20
Wha1t to do if you're waiting for COVID-19 test results
COVJI>B' is cau~d b',1 -?1 'Wm t:t1 11t ca r.1 si,;iread easft,t rrom :;ier~ 11 to person. Fallo-.- tr..ee in7.ructl:on:S to he :;no ten yo~ elf. vu.Jr iramiJr, 11r.d your COffL"Tl!,:l'l ity •ti· 'fC".J 11re w eitir: ... :Or t est resi£:s.. There
s,e instnJctions;tar peop:1e wt10 11\'e ~ rru a p,eopk •111;hci,ao not 11 11 \le Sljmptorru.
If you have symptoms of COVID-19
sy::np,:o·::ns; an ioouc:.e o:rJ~ sbortnez 01' re e1t11, re.er, chills, lt~~acbe. m:udle ain. sore tt.10st:, or
1oz 01' :iam o,- SL'llell. Less on.e r... ~pto!Tls;c:11n inclUde vo:!Tlitin&, n ~a •. and d·i 11u h ea. Follow ttee
1inmuct:iorz wll ile you 1ue w 11· • .5 01' ycr.u :t6t rBUIU.
Separate yourself from other-s Staybiome. Conot. 50-to-wcct. ~o:J l;. ,or 1u:iy,o~r 2..z:e on.rtside tl"~home. lt p.J need ed iCII
a re, rouow the inffl\Xtiom •belo-•.
smy •war :from Dtlle1t people m y 011r hom.e.. .M m mi:b 11s r:i z ~ le, stsy m 11 :se te rDO!n 111Y.I u2 '!i
:separate •b11tJ-.100m., 1ir 11\.' II ·:i~ .
Wea1t a hlca·nas k iryou r~ ed to- ~ ~ur.)j othu p,eopk. ~d o:rver your rn.out 1n·~ nme witti ,11 tizue wl".ai you 0: 11.~ 1 ,:11· me,eze_ W~ h11r~s t:h01'C11.1;6'1>f ,11f't9w11 rd..
ATOid S:hllr.iDg per:Klnal homeMld itans.. DI> r.ot sh•~ toad, dist-.ie:s_. ,dri r:al.i r-15 f;)ll.52:5;, e11t rl5
atensils.. :tow~l!.., ,or bed di~ wit:h other eo le ill your borne. A.."ter usir-5 t tiee ~ 'TI~ WWI tllem wiih :sa11p ar..:I Yo' lbe;r_ C~an 11 ll tre<1u~r;Df to~ slldD~ ill y:,ur ho m~ dn'i¥, irou 5door blobs, '&,:it. aitt:M ~ Ii lt :ice,ts.
wam }'Dm tnnwl s- ofl:.en wit:tt ~ 11.r ,11nd ~ · fllr 11'1: .acst 2:0 ~ conds., ,or 112 ,111n 11·1mt11d·ba~ ha~
:s11nrt: iz.e r cant11inir--£; eo'li, :tD -;:, li, ,11lcx:il10I. Avoid t:cr.Jctiin,5 your ~--::e w rt:h Un--A",!i:i;h ~ 11nds.
Monitor your symptoms
M~ eop h 11"¥e: ild~pto:n~U1 .s.t :5et ~ tter in 11 W1·e ek or t'•"D . ·Sorn~ ea le •do not have ,11 ny sym:;toms. Pe,:,Jl le as~ s, arJ:l ,olC~ o r eo le who t: ·n other ur~er · 5 medical ,cancfl:i011s rn. sr 5,e,t
very ~CIC tro:n •COVJD-13.
What to do if Waiting for Test Results
• If you (or a household contact) are waiting for test results whether you are symptomatic or not, you need to remain home from school or child care.
• What to do if you’re waiting for COVID-19 test results: https://www.health.state.mn.us/dis eases/coronavirus/waiting.pdf
21
What To Do if You Have Had Close Contact With a Person
With COVID-19 To protect yourself, your family, and your community, you must separate yourself from ot hers, get tested and
watch yourself for symptoms such as fever, cough, shortness of brea th, chills, headache, muscle pain, sore throat,
or loss of taste or smell. Fo llow t hese instructions for at least 14 days after t he last day you were in close contact
w ith t he person who has COVID-19.
Separate yourself from others Stay home. If you need medical care, it
is important t hat you fo llow t he
instructions below. Do not go to work,
school, or any other place outside t he
home.
ii
Stay away from people who may be at
high-risk for getting very sick from
COVID-19, including older adults, t hose
living in long-term care facil it ies, and
people w rth health condrtions like
asthma, diabetes, heart disease, liver
d isease, severe obesity, and those who
have weakened immune systems.
If you become sick, separate yourself
from other people in your home. As
much as possible, stay in a specific room
and away from other people in your
home. Use a separate bathroom, if
available.
Do not use public tra portat ion, ride-
sharing (such as Uber or Lyft), or taxis.
W ear a facemask if you need to be
around other people, and cover your
mouth and nose with a tissue when you
cough or sneeze. Wash hands
thoroughly.
Avoid sharing personal household
items. Do not share food, dishes,
17 lllJ drinking glasses, cups, eating utensils,
a:i r towels, or bedding w ith other people in
your home. After using these items,
wash t hem t horoughly wit h soap and
water.
""
• Wash your hands often with soap and I. ~ wat er for at least 20 seconds, or use an
• alcohol-based hand sanitizer contain ing
at least 6()0..0 alcohol. Avoid touching
your face with unwashed hands.
Guidance for Close Contacts
• Guidance for anyone who is a close contact.
• Provided upon exclusion with the MDH template letter.
• Follow these instructions for at least 14 days after the last day you were in close contact with the person who has COVID-19.
• What To Do if You Have Had Close Contact With a Person With COVID-19 (PDF): https://www.health.state.mn.us/diseases/coron avirus/contact.pdf
• Use in conjunction with the Exclusion Guidance.
22
WihatTo Do Wh.en Notliffi:ed air a La1b--{!onfirmedl case of COVID-19 in
a Sdmoll o:r dhild Care Setting
1c::au.,a:hx4.-a-,u.l""lp~.ri !Wtl "i,a.J IM'-HJ:l rt l'm' , ·Mnta..""t:11
O:M)b c ft.Pala thllir'a.. l · pm,K.i::1 11:C P-..1:mt-u
........... .....
WJ:ets•,m r,:r;m 19tttirMrWfR:D~m ,sJ-el1 'FPF:! ("6'.'!'tYal:eat"'h:Aili10-Whllt:a'F:MUi?f'Vll'{vhratr-ts::11
lnfurmation ,ga1heriag .and :sha·lin:g
11liblri:h1,l\:iltaq
PETl!: K«I ~
fl'Ul~ l:-1'1.dl:a:.f.,
i:h1 M:IMl~1P anrwhln,=,u 1=nb:t·i:
.... _...,._,..,. "" ..... ,,.....,,, ---·Jll•
Waiting for Follow-up
• If you are alerted to a lab-confirmed case of COVID-19 in your school or child care setting please reach out toour new case follow-up inbox immediately.
• Appoint ONE point person to communicate with theMDH Follow-up Team per case.
• Please try to gather as much information pertaining tothe case prior to reaching out.
• What To Do When Notified of a Lab-Confirmed Case of COVID-19 in a School or Child Care Setting (PDF):https://www.health.state.mn.us/diseases/coronavirus/schools/casenotify.pdf
23
~
Contact Tracing: Do your part to keep your family, friends, and community safe.
WHAT YOU CAN liXPliCT TO HAPPl&N DUIIING CONTACT TRACING IF YOU HAVli IHliN DIAGNOSliD WITH COVID-19.
n.,w111 .... ,. ..... ,w .. 11tean.•<11111act _,._...._n,rH lfNIM111rawhil11 you Wll'lil sick.and 1111:, hoe sprnd COYID-19 to othl,s,
bnoiNohobo..._...,...,n.,._...i ......... ,,... .. -daing10 .. ...i,. w-...,.,_,,...,... ........ ..-___ ,_,.. ...... ,rd .... .... --·---
Contim.-ta 111onilmr,-.rh•lth.H,-. .,..,.... ...... IINtcaM ........ ,..
·---... ·--•'Jfflplllff'II includetn,uble lnlllhing, p11r1ist11nt p■in DI'
l'"UUAI in tha chmt. mnfusiDI\ in1ltii1J1D -• Drstayan ... Dr bhash lips Drfaca
cdc.gov/COVID19
CDC: Contact Tracing Communications Toolkit
• Contact Tracing Communications Toolkit: https://www.cdc.gov/coronavirus/2 019-ncov/php/contact-tracing-comms.html?
24
S1'e na nio 1: M DH is first notified o'f case
MD H is notified of I ab-confirmed case
MDH/lPH investigates case, and evaluates contacts
Seen a nio 2 You a ire first notified of case
You a re notified of la bconfirmed case
Gather as much information as you can pertaining to the case
and email MDHI followup t eam
M DH follow-up tean1 notifies you rr the re
is a case at your scho-ol/ch iM care
M DH i nvestigaites caise and ev-a I uail:es cointa,cts
MDH Action
Colla borate on further co:nta ct
i nv,esUgation and what notifications
and messagT11g needs to be done
Collaborate on further contact investigations and what notificatfons and messaging· needs
to be done
Joint Action
Lab Confirmed Positive Case Investigation Process
25
CDC Re-infection Update
• Duration of Isolation and Precautions for Adults with COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html
• Reinfection with SARS-CoV-2 has not yet been definitively confirmed in any recovered persons to date.
Question:
• Once you have had the disease and isolated the required time from apositive test or first symptom, thenanother family member gets ill, do youneed to quarantine again?
• For persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery, retesting is not recommended within 3 months after the date of symptom onset for the initial COVID-19 infection.
• Quarantine is not recommended in the event of close contact with an infected person.
26
of COVID-19
Strop Camnoan F .. Allhra S..MIIIIII lh,_ Cold Alorgla
0 0 0 0 0 0
0 0 0 0 0 0 0
0 S,,rrpom ofillness
Ill cdc.gov/coronavlrus ■HU,lllil'll, ,A;t ■
CDC: Limitations of Symptom Screening
Limitations of Symptom Screenings as Part of a School Reopening Strategy:
• Symptom screenings will fail to identifysome students who have SARS-CoV-2 infection.
• Symptom screenings will identify only thata person may have an illness, not that theillness is COVID-19.
• Symptoms of COVID-19: https://www.cdc.gov/coronavirus/2019-ncov/downloads/community/schools-childcare/COVID19-symptoms-tablegraphic-v1.pdf
27
Asthma Care in Schools During Pandemic
• Due to limited data, it is unknown whether aerosols generated by nebulizer treatments are infectious, therefore nebulizer treatments should be reserved for those children who cannot use or do not have access to an inhaler.
• Use of a peak-flow meter is not considered an aerosol-generating procedure, based on limited data. However, use of a peak-flow meter can trigger a cough.
• Requires
• Surgical mask
• Gowns, gloves, eye protection
• Separate space that must be cleaned and disinfected after use
• Performed with social distancing or leaving the room
Recommended
• HEPPA room air filter
•
28
Action Steps
• During COVID-19, asthma treatment withan inhaler and spacer are preferred overnebulizer treatments whenever possible.
• Asthma inhalers are not considered an aerosol-generating procedure.
• K-12 Schools and Child Care Programs: FAQs for Administrators,Teachers,and Parents(www.cdc.gov/cronavirus/2019-ncov/community/schools-childcare/schools-faq.html)
• Managing Asthma in Minnesota Schools(www.health.state.mn.us/diseases/asthma/schools/managing.html)
• MDH is encouraging prescribing providers to evaluate the opportunity to transition children from a nebulizer to an inhaler with spacer for use in schools and community settings during the COVID-19 pandemic
29
Minn1esota Chapter
Am 1can - , ad m of Pediatric DEDICATt:D TO 1" 1-H. HULT 0 , ALL tlllDU
·. P SUpports Mask date
mfll<il• "'Sat,mla_,,, 1Jl_1• • , Mi1me.mlans w;ill be requrin,d ta""""' a r.,.,., CD\-et"iLJ,S ill .o'II puJilk iJndom- sp-,; .011.d inrl,ooe- bu:si11ess 1mll!S11 llhey """.olooe, m>innfiLJ,S ID El<:ec.nt&-..,e On)!.,.. - 8i, annna1,a,d h,y ,...,._ 'l'i lll, lz cm , redur.sdn. _
·11 NAi\1? '19desship llmd.si,g1imnn 1.a.o le1ia-afr.1~pn11t li:Jrtlus llliSllu:re, .ol rmg 'l<ilm llhie Mirrrni,i;all> ·11 lllU!Sll As,mcimlkm and lllm~• a l rue.-111,al llh .. ., ari;.nnixalioos, ill ad. ' "'"" aflhe ' 1·enoor'r. .. ,...,muilCOmr.fll.
Ad.dili<l n-'" 11)', all .sllw:le11L~, .s'la6r, and nllhieo- J>l'l>JI I" p=nl ill sehonl bu.ild i, • andl disLri.eL nf:ri=s a r roorng ir,: o<il LrmA>pm1al ii:m nbicl"' """ l'llf1_1J ired la we.ar n fi 1>11.\'elinB, IJIOO!l Ibey .01'1! «'.l:e lllpl! bec.1u:se ni cr.11!ni11 1J110drie.ol 11nr~Llll health coodlilioos llnal 11L11 ke ill dj flii,u:11 In IJ:ilernle ""'"riLJS a r,..,,, oo,·erinG,
Snon.e: p.are i,b< ru,;,., been nr. kini; pt,diatrilliau,s; fn r .,.,,111pllim• lelten fa r ,JJ"j ms lffl2W:ffir.. Hnwe-.-es-, tlhe i:e. are iclllibed ;o)llll!pl!in rL~ li:ir 00111plinnor_
·11 NAi\l? reoo1muen,:I,; cn1rnideriu,,s w'h.iellhier llhie eluldl ii,; e.opa.blie m 11hyskally r,e1unnt'hema11·k in 1hee.1"ellt nfa n elllerg_e1K')'. lly · !hey shnu:ld 'l'iTTOar mue.. at,adtt;n '.tin sr. re. ooi;.nilin iMllies; r.ie llllllfJI diall:eriS"s, sii;.niJ!iem, L respiralll<T}' i111[>i11irmr.nts; (e.g. llraeheas!om.y err ni, axy en), a r r>:rlilm,ped:ic a r 1Je11rnlr,siic u,;ua (e.g.c,,rd:,rnl palsy) iflmey lilJ'ie 1111nbJe 11n H!loo--.·e ii lil'lilll i1J .a111 ~ -~cy. 1u ny n.al be .a~ 11n ,,~ar a. m.uk.. a r l10SJ!tr.1Lary im111air 11:ie11b =~• no'l be ble. Ln wear n mask
MNAAP Supports Mask Mandate
• Some parents have been asking pediatricians for exemption letters for various reasons. However, there are limited exceptions for compliance. MNAAP recommends considering whether the child is capable of physically remove the mask in the event of an emergency.
• If yes, they should wear one. Children with severe cognitive issues, sensory challenges, significant respiratory impairments, or orthopedic or neurologic issues if they are unable to remove a mask in an emergency, may not be able to wear a mask. or respiratory impairments may not be able to wear a mask.
• Under the mandate, children between the ages of 2 and 5 years old are not required to wear face coverings, but are encouraged to wear a face covering when in public if they can do so reliably. Children under age 2 years should not wear face coverings, in keeping with guidance from the AAP.
• MNAAP Supports Mask Mandate: http://www.mnaap.org/mnaap-supports-mask-mandate/
30
Face Shields
• For optimal protection, the face shield should extend below the chin anteriorly, to the ears laterally, and there should be noexposed gap between the forehead and the shield’s headpiece.
31
Masks with Vents
Any masks that incorporate a valve that is designed to facilitate easy exhaling, mesh masks, or masks with openings, holes, visible gaps in the design or material, or vents are not sufficient face coverings because they allow droplets to be released from the mask.
32
Multi-System Inflammatory Syndrome In Children (MIS-C)
MIS-C Home
MIS-C Statistics
Related Topics
Coronavirus Disease 2019 (COVIO-19)
Multisystem Inflammatory Syndrome In Children (MIS-C) Updated 7 / 1 7 /2020
MIS-C stands for multisystem inflammatory syndrome in child ren, a ra re and
serious inflammatory syndrome that affects chi ldren and young adults. It is a
new disease that appears to be linked to SARS-CoV-2, the virus which causes
COVID-19.
It causes fever and inflammation and can affect different body parts, such as
the heart, lungs, kidneys, liver, skin, eyes, brain, and gastrointestinal organs.
MIS-C is very rare. It can be very serious and children usually need to be
treated in the hospital.
Share This
~ Subscribe: COVID-19 updates
~ Facemasks & Personal T Protective E9uipment
~~ Surgeries & Procedures rlflft During COVID-19
Minnesota Helpline: For questions related to the COVID-19 pandemic, ca ll 65 1-
297-1304 or 1-800-657-3504
Mon.-Fri.: 9 a.m. to 4 p.m.
Multisystem Inflammatory Syndrome In Children (MIS-C)
Multisystem Inflammatory Syndrome In Children (MIS-C): https://www.health.state.mn.us/diseases/misc/index .html • We do not know yet exactly what causes MIS-C. • We know that many children with it have been
infected with SARS-CoV-2, the virus that causes COVID-19, or have been in contact with someone with COVID-19.
• One possibility is that MIS-C is caused by an abnormal immune response to a virus, such as SARS-CoV-2, but this has not yet been confirmed.
• We do not know yet why some children have developed MIS-C while others have not or whether there are certain health conditions that increase the risk of MIS-C.
33
Current and Up-to-Date Travel Information
• Refer to travel guidance from the CDC related to domestic and international travel:
• Travel: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html
• MDH Considerations: • Traveling:
https://www.health.state.mn.us/diseases/coronavir us/prevention.html#travel
• Current Executive Order does not ban travel in and out of MN, nor does it require a 14 day quarantine.
34
MDH Inboxes
• Public (parents, staff, non-nurse orchild care provider) Inquiry Inbox: [email protected]
• Question/Positive Case in Institutes of Higher Education(IHEs)/Colleges/Universities: [email protected]. us
• Question/Positive Case in Youthand Adult Sports: [email protected]
• Positive Case in Child Care, School, Day Camp: [email protected]. us
• Question from School Nurse, Administration or Child Care Provider: [email protected]
35
Thank You! MDE COVID-19 Inbox: [email protected]
(IEPs/504 plans, attendance requirements and drops, distance learning)
MDH Schools Inbox: [email protected]
(Exclusion guidance, health concerns, potential exposures, interpreting CDC/MDH guidance)