Coronavirus Chronicles — Teachers As Health Gatekeepers

In regard to the communicability of COVID-19, the latest estimate says that about 40% of transmissions are initiated by people who display no symptoms of illness. Elevated body temperature is one of those symptoms, so, to put it another way, the average asymptomatic person has a window of about a week in which to pass the disease on to others before they themselves experience any signs of sickness, including fever. And, apparently, a very large percentage of coronavirus victims never develop fever.

Yet, this is the Number 1 test proposed as a diagnostic to determine whether or not there should be in-person school classes this fall. Meanwhile, the general, overall situation of America in relation to the virus is no better than it was in the spring, when schools were abruptly closed.

Who gets the job?

Childhood Obesity News looked at the possibilities of designating parents as the temperature monitors, or making school bus drivers assume the responsibility. Who is left? School nurses have become almost as obsolete as chimney sweeps, but even if a school is lucky enough to have one, how long does it take for one nurse to point a temperature-sensing device at 1,000 students?

If temperature-checking is delayed until the child reaches the school building, what happens if they don’t pass? If the teacher or staff member says, “You can’t be here,” is the school system responsible to get that child back home safely? What if they won’t leave? Who deals with these arrangements and complications? At any rate, teachers could be asked to divide up the task of temp-checking everybody.

As if they don’t have enough to do already

An article from the American Academy of Pediatrics (AAP) contains a long, scary passage about students who have asthma attacks at school and need on-site nebulizer treatment, which is described as an aerosol-generating procedure. So an asthmatic student who was unfortunate enough to pick up the virus would be a very dangerous individual, with the potential to become a superspreader, as the virus travels via aerosolized particles.

None of this sounds good, and in fact sounds far above and beyond what should be required of a teacher. The AAP also mentions that a child infected with the virus “may have only gastrointestinal tract symptoms.” This paints a picture of teachers being required to not only take temperatures, but to interrogate each child about the current state of his or her bowels.

Teachers and other school personnel will need training in how to recognize potential symptoms in both children and adults. Not just the routine ones, like a runny nose, which is widespread due to other causes, and is virtually meaningless as an indicator of COVID-19. Does any person in the building have diarrhea, difficulty breathing, persistent chest pain or pressure, or blue-tinted lips or face? Is anybody unable to stay awake, or acting more confused than usual?

A rash inside the mouth has recently been added to the symptom list. Could teachers be asked to conduct oral inspections? No mask, and so close? It would not seem like a wise move, but because the study of this disease is both new, and subject to many stressful influences, opinions differ on what constitutes a good idea.

But it gets worse

A whole separate and higher level of alertness will be demanded, to know when to summon immediate emergency medical care. In case a student shows up with the rare but very serious MIS-C (Multisystem Inflammatory Syndrome in Children), there are many additional signs to watch out for. Fever or diarrhea, of course, plus neck pain, rash, bloodshot or red-rimmed eyes, extreme fatigue, “pseudo-frostbite” or (pink or purple) “COVID toes,” diffused redness of the chest, hives, cracked lips, bumpy “strawberry” tongue, swollen hands and feet, irritability, and sluggishness.

Also, pediatrician Dr. Bo Stapler reminds us that educators and other school personnel need to be on the lookout for blood clots, swollen lymph nodes, abdominal pain, seizure, or stroke. Will children be asked to remove their shoes and socks? To show their chests and stick out their tongues? Will teachers be expected to feel around for swollen lymph nodes? Will they be required to gain certification as field medics?

And what about teacher safety?

Thanks to their Twitter accounts, we have the privilege of hearing from actual school employees, like librarian Abby Cornelius:

Saw my doc today for annual checkup. Her recommendations for me and my teacher friends:
1) have at least 5 n95 masks (no homemade masks) and label them mon-fri. Let them sit for a week between wearing.
2) with the n95, also wear a face shield.
3) wear mask in a high bun and cover hair because droplets can rest in hair and then spread if touched.
4) when getting home, clothes go straight to washer, don’t bring work stuff in house
5) buy life insurance and update will.

Here is a poignant message from teacher Heather Lynette:

I am from a district in WI and we have been told: 5 days a week, full days… Teacher MUST wear masks, but children don’t have to. At current, we will have full classes. (Pray for us)

Your responses and feedback are welcome!

Source: “COVID-19 Planning Considerations: Guidance for School Re-entry,” AAP.org, 06/25/20
Source: “Symptoms of Coronavirus,” CDC.gov, 05/13/20
Source: “For Parents: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19,” CDC.gov, 05/20/20
Source: “The Latest on the Mysterious Inflammatory Syndrome in Children,” Medium.com, 07/07/20
Image by muffinn/CC BY 2.0

 

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources