The latest installment of the #PWChat series was Part 2 of our discussion centering around the reopening of schools during the COVID-19 pandemic.
Below are the highlights from the chat. You can read the full transcript here, by scrolling down to the corresponding questions and responses. The recap of Part 1 can be found here.
Welcome to PART 2 of the #PWChat on opening #school during #COVID19, with co-hosts @MVP_Pediatric & @DrLindaMD. Our plan is to go until 3pm EST, officially, but let’s keep the convo going well after! pic.twitter.com/1gCZBxTW7j
— Physician’s Weekly (@physicianswkly) August 20, 2020
since you’re tweeting about it, please come join our #PWChat on this very topic, happening RIGHT NOW
— Physician’s Weekly (@physicianswkly) August 20, 2020
Q1: What can we learn from schools in Georgia, Tennessee, Indiana & other states where schools reopened despite growing #COVID case counts, & students have tested positive at a number of schools, causing closings & thousands to be quarantined?#PWChat pic.twitter.com/VgJwJyqBr3
— Physician’s Weekly (@physicianswkly) August 20, 2020
Agreed.
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Good point! We do not know what the long-term complications will be. #PWchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
Common per AAP pic.twitter.com/A1oFR5na1k
— His Holiness (@thelama_himself) August 20, 2020
Yes, definitely agree with this. In areas where the numbers are still climbing, it is probably not wise to reopen schools.#Pwchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
Or work with children with special needs who require one-on-one, hand-over-hand assistance for ADLs, those who require PT and/or OT, or most kids younger than 8 in my experience#PWChat
— Physician’s Weekly (@physicianswkly) August 20, 2020
Agree…children are almost as likely to contract the virus as adults….schools should not have re opened or at least offer virtual as an option..
— Keith (#MaskUp) Pereira MD, #IRad (@keithppereira) August 20, 2020
Q2: What can we learn from this photo from North Paulding HS in GA after schools reopened in early Aug, where students say they’ve been suspended or threatened w/ “consequences” for such pics & where #COVID19 cases had already been reported?#PWChat pic.twitter.com/v7xdsVVYUc
— Physician’s Weekly (@physicianswkly) August 20, 2020
A2 – This photo is concerning & should be displayed. This school is putting its community at risk. #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Absolutely…or they just felt like #COVID19 was not overly concerning and chose to just go “back to normal”.
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
A2 That I wish it was ONLY about science and medicine. The fact that outside, vested interests, are driving this discussion shows that it was never about the kids and their wellbeing #pwchathttps://t.co/HSJlz3G5RR
— Kerim (@UCLAKerim) August 20, 2020
Q3: How should the 90% growth in #coronavirus cases among children in the U.S. in the 4 weeks prior to Aug 12—according to an analysis by the American Academy of Pediatrics and the Children’s Hospital Association—be factored into #reopeningschools?#PWChat pic.twitter.com/qLlNxqrzL4
— Physician’s Weekly (@physicianswkly) August 20, 2020
A3. I think we need to look at the areas where the growth has been happening to see which schools shouldn’t reopen. #pwchat https://t.co/frXT0P1ihM
— Linda Girgis MD (@DrLindaMD) August 20, 2020
A3 – We have to ask ourselves: What prevalence threshold of #COVID19 is safe to open schools to reduce the risk of spread? What safety measures for prevention of spread work best in my school? #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
A3 – We need to do this… #PWChat pic.twitter.com/DnsUL3SaLv
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Yes! It is a process to to imagine beyond constraints, but incorporate practical constraints to develop reasonable solutions.
— Alisa Niksch, M.D. (@alisadoc1) August 20, 2020
I agree that we should err on the side of safety. #Pwchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
Here too. Everyone has their own space. And they have to wipe down everything after using it. And no phone sharing. #pwchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
Yes, I think this is a good alternative in some areas, However, our public high school has thousands of students and limited outdoor space. It would be physically impossible to conduct multiple classes for all students in the limited space. #PWchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
And also, once we’ve quelled parents’ fear, then we need to counsel the teachers. #PWChat
— Art Fougner (@sonodoc99) August 20, 2020
oh, it most certainly is. Just saying that’s adding another layer for staff, parents, etc to have to play it by ear based on the weather forecast, which around me, is wrong more than it is right
— Physician’s Weekly (@physicianswkly) August 20, 2020
Q4: How do you feel about the hybrid approach to #reopeningschools, in which students attend either part of the week & the rest is virtual or they attend for 1 week then virtual for 1 week? Win-win? Lose-lose?#PWChat pic.twitter.com/0Qmo5hsfjJ
— Physician’s Weekly (@physicianswkly) August 20, 2020
I agree. However, if the large school systems have the resources, they may be able to implement it. It is all about resources at this point…and that it part of the problem. Not all districts have the resources to make schools as safe as they want to…or should. #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
A4 – It also provides in-person student interaction. If it can be done safely, I think that it is a “win-win”. #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
That is a challenge. The hope is that there will be some flexibility with employers. #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Been working on a model for this, but agree, way too many variables. It’s super messy.
— Karyn “It should feel like over-reacting” Baum MD (@karynbaum) August 20, 2020
a number that I realized likely meant nothing and shouldn’t be used for real interpretation.
— Brian Still, MD (@brianrstill) August 20, 2020
i would like to read it if you have a copy.
— Brian Still, MD (@brianrstill) August 20, 2020
There is a study from the 50’s where PEG was vaporized into a controlled “ward” where the other “ward” had oxygen pumped into the ward. The PEG kids got better faster. The peg molecule I speculate is large enough to attach to the virus and drop it to the ground. Very simple!
— James Kralicky (@JamesK0611) August 20, 2020
Q5: Many school districts are using/planning to use temperature checks as a screening measure for #COVID19, either as kids arrive or asking parents to do it, but Dr. Fauci has advised that these checks are unreliable (https://t.co/Llv8bkJRrB). Now what?#PWChat pic.twitter.com/CsN66TAfm1
— Physician’s Weekly (@physicianswkly) August 20, 2020
A5 – There will be people who are completely asymptomatic & be missed by any screening method, but that is all that we have to offer at this point. We really need rapid, cheap & frequent #COVID19 testing as the “screening” method. #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Mix that with false negatives & false positives for testing, plus slow results and low availability in some places, and seems like we’re not in great shape#PWChat
— Physician’s Weekly (@physicianswkly) August 20, 2020
I’ve seen many patients with many other symptoms and no fever. And then there are those who are asymptomatic. You can always check your antibodies. #PWchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
Q6: Many school districts desire #COVID19 testing of students prior to reopening. What are your thoughts on doing this, and is it feasible from a staff & resource availability and time perspective?#PWChat pic.twitter.com/Yw5vdTUDa7
— Physician’s Weekly (@physicianswkly) August 20, 2020
A6 – Also, the timing of the testing is crucial, if you don’t have a test that you can give frequently & cheaply with a rapid turnaround time. #PWChat pic.twitter.com/yRkSLuEHcD
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Yes…supplies and resources are the limiting factor. In an ideal world widespread, frequent testing would be the key to controlling this…in addition to PPE. #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Suddenly struck by the parallel with quality inspection vs engineering. Foundational approach is that you can’t “test quality into a product”, came with safety – engineering out the risk is taken to be the best approach
Maybe same holds with infection?#pwchat
— Matthew Loxton (@mloxton) August 20, 2020
Seems to be mixed bag depending on the district, in my experience. Some are providing it (whether they have enough and the right kinds isn’t clear), some aren’t.#PWChat
— Physician’s Weekly (@physicianswkly) August 20, 2020
Agreed. I think in some places the teachers can say “no, I’m not teaching in-person w/out proper PPE. I’ll stay virtual”. But not sure that’s the case everywhere#PWChat
— Physician’s Weekly (@physicianswkly) August 20, 2020
Read an article in which a teacher described what she was given – 2x masks, 1 small bottle of handcleaner, 1 larger bottle of disinfectant.
This is the total of PPE and supplies FOR THE ENTIRE TERM#pwchat
— Matthew Loxton (@mloxton) August 20, 2020
The assumption seems to be that the teacher provides own PPE, materials, and supplies.
This doesn’t sound even close to sub-optimal#pwchat
— Matthew Loxton (@mloxton) August 20, 2020
They should have everything provided to them to maintain their safety and the safety of the children who they are teaching… #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
If you have the spare testing capacity, sure. I would like to see them rather focus on changing the environment to suit having large numbers of infectious people in the school. Engineer risk out wherever possible rather than trying to screen it out#pwchat https://t.co/Ln0u86RXWa
— Matthew Loxton (@mloxton) August 20, 2020
If you have the spare testing capacity, sure. I would like to see them rather focus on changing the environment to suit having large numbers of infectious people in the school. Engineer risk out wherever possible rather than trying to screen it out#pwchat https://t.co/Ln0u86RXWa
— Matthew Loxton (@mloxton) August 20, 2020
received letter from kids’ district saying they know younger kids & those w/ special needs will struggle w/ masks, so start getting them used to wearing them now if you plan to send them (we’re doing hybrid or 100% virtual starting 9/16) b/c they’re NOT optional#PWChat
— Physician’s Weekly (@physicianswkly) August 20, 2020
A7. If you want your child to go to school, they have to wear a mask. That’s it. It’s about protecting others. #pwchat https://t.co/KK2r9uxBa1
— Linda Girgis MD (@DrLindaMD) August 20, 2020
I agree. In NJ, they have a virtual option. If you don’t want your child to wear a mask, they are not allowed in the school building. They can still learn from home. #PWchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
That is good. You can make the best decision for your family…without affecting others at their school. If you won’t wear a mask, virtual school is an excellent option… #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
Q8: For those schools that are going to reopen, what advice can you give to parents, students, and all school staff (teachers, admin, related services, bus drivers, cafeteria workers)?#PWChat pic.twitter.com/PcmhIlC9Mw
— Physician’s Weekly (@physicianswkly) August 20, 2020
I agree. I read somewhere that 40% of teachers have an underlying chronic medical condition. They should be given medical leave if they don’t feel comfortable returning. #PWchat
— Linda Girgis MD (@DrLindaMD) August 20, 2020
I couldn’t agree more! #PWChat
— David Epstein, MD, MS, FAAP (@MVP_Pediatric) August 20, 2020
This.
Act and engineer as if everyone is infectious but also susceptible.
Also test processes continually and continually improve using PDSA#pwchat https://t.co/IDKC0oeRAK— Matthew Loxton (@mloxton) August 20, 2020
A reasonably accurate saliva-based point of care test with results in no more than an hour would be a game changer here. #PWChat
— Art Fougner (@sonodoc99) August 20, 2020
This.
Act and engineer as if everyone is infectious but also susceptible.
Also test processes continually and continually improve using PDSA#pwchat https://t.co/IDKC0oeRAK— Matthew Loxton (@mloxton) August 20, 2020
We’re officially out of time, but PLEASE, let’s keep this very important discussion going!
In the meantime, we give special thanks to @MVP_Pediatric &
