1 9 S C H O O L N U R S E R E S P O N S E COVID-19 Illness caused - - PowerPoint PPT Presentation

C O V I D - 1 9

S C H O O L N U R S E R E S P O N S E

COVID-19

• Illness caused by infection with a new

coronavirus (called SARS-CoV-2)

• Virus is related to other coronaviruses that

cause mild illnesses such as colds, but more closely related to those that cause more severe illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS)

• First discovered in Wuhan, China in 2019
• Declared by World Health Organization as

a Public Health Event of International Concern on January 30, 2020

• Currently globally distributed

COVID-19

• Highly infectious
• Transmission is person-to-person by

respiratory droplets, in air and through contaminated surfaces

• Transmission does not appear to be

seasonal

• People can be infected and able to infect
• thers without showing any symptoms
• Symptoms when shown can be very mild

to fatally severe

• Fatality is most often associated with

health-compromising, underlying health conditions

COVID-19 Risk

Risk for transmission is high when in close proximity with

• Infected person
• Recently contaminated

surfaces Risk for severe illness with

• Increasing age (beginning

around 40, and significant for those 65 and older)

• Pre-existing medical

conditions such as obesity, high blood pressure, heart disease, diabetes, and asthma

COVID-19 Symptoms

• Feeling feverish or a measured

temperature greater than or equal to 100.0 degrees Fahrenheit

• Loss of taste or smell
• Cough
• Difficulty breathing
• Shortness of breath
• Headache
• Fatigue
• Chills
• Sore throat
• Congestion or runny nose
• Shaking or exaggerated

shivering/Rigors

• Significant muscle pain or ache
• Diarrhea
• Nausea or vomiting

COVID-19 Severe Complications

• Pneumonia
• Respiratory failure
• Acute respiratory distress syndrome
• Sepsis
• Cardiac injury
• Multi-organ failure (kidney failure, shock)
• Blood clots in lungs, heart, legs, or brain
• Multi-Inflammatory Syndrome in Children
• Inflammation of the heart, brain or muscle

tissue

• Secondary bacterial infections
• Worsening of pre-existing chronic medical

conditions

COVID-19 Prevention

Masks Social/Physic al distancing Handwashing Disinfection of high-touch surfaces

Masks – Non- medical/cloth

• Serve to contain respiratory

droplets of wearer rather than protect wearer from droplets expelled by unmasked others

• Should cover nose, mouth and

chin, fitting snugly to the cheeks

• Most effective when all wear

and combined with physical distancing of 6 feet or more between persons

Social/Physic al Distancing

• Based on premise that respiratory

droplets (from breathing, coughing, sneezing, etc.) do not suspend in air, but fall to ground over a limited distance

• Six (6) feet kept between people

decreases opportunity for droplets from

• ne person to reach the other
• The more persons present in a given

space increases concentration of droplets in air, so maintaining lower numbers of people gathered together additionally decreases opportunity for droplets from one person to reach another

Disinfection

• Important to clean and disinfect

surfaces that are touched in common throughout the day

• Clean commonly-touched surfaces in

classrooms between different class groups, if the same room will be used by multiple class groups

• Ensure cleaning products are stored

safely, including storing harmful products where children cannot access them, and ensure that harmful cleaning products are not used near children

• CDC has guidance on cleaning

community buildings

Handwashin g

• COVID-19 enters the body through the

mucus membranes of the eyes, nose and mouth

• Hands can transfer the virus from

contaminated surfaces to the body by touching the eyes, nose and mouth

• Frequent washing of hands for 20

seconds with soap and running water is simple and effective way to reduce contamination

• Alcohol-based hand sanitizers also

effective, but not preferred way to maintain hand hygiene

All together now: The “swiss cheese” model

Imposed Social/Physic al Distancing

Isolation: The separation of individuals infected with the virus (even if they are not showing symptoms) from people who are not infected Quarantine: The separation of individuals who might have been exposed to COVID-19 from others

Isolation and Quarantine in the School Setting

• Daily screening of students,

staff and visitors for COVID-19 lab test results, symptoms and/or exposure to known COVID-19- infected persons

Daily Screen Symptoms? Yes Isolation Exposed Quarantine No Yes OK for school No Lab Positive? No Isolation Yes

Exposure at School: Identification of Contacts

• Notification that lab-confirmed case of COVID-19 at school
• Exposure = within 6 feet for 15 minutes or more during

infectious period, irrespective of mask-use status

You are a Close Contact if you (were)….

• Within 6 ft for at least 15 minutes during the 2

days before the person got sick up until when they began isolation

• Sneezed or coughed on or somehow got the

infected person’s respiratory droplets on you

• Cared for a COVID-19 infected person at

home

• Shared eating or drinking utensils with the

person

• Had direct contact (touched, hugged, or

kissed) with the person

• Rode on a bus with the person for at least 15

minutes during the 2 days before the person got sick up until when they began isolation

• In a classroom with the person for least 15

minutes during the 2 days before the person got sick up until when they began isolation

Person with COVID- 19

Symptomatic Infectious Period Calculation

Begins two (2) days before symptoms start Ends one (1) day after symptoms stop as long as it has been at least ten (10) days after symptoms began

Asymptomatic Infectious Period Calculation

Begins two (2) days before date

• f lab test

Ends ten (10) days after date of lab test as long as no symptoms develop*

*If symptoms develop, timeline restarts to that of Symptomatic Infectious Period Calculation

Quarantine Period Calculation

Begins on date

• f last exposure

to lab-confirmed case Ends fourteen (14) days later as long as no symptoms develop*

*If symptoms develop, timeline restarts to that of Symptomatic Infectious Period Calculation

School Mitigation Responsibilities

Daily Screen Lab, symptom

• r

exposure ? Enter school Lab- confirmed? N Y Notification Letter as required by TEA Deep clean Exclude case 1+10 days; exclude contacts 14d Identify close contacts Notify close contacts of exclusion Notify WCCHD immediately Y Exclude exposed 14d N Exposed to known case? Y Exclude symptomatic person 1+10d N Notify WCCHD with line list of excluded individuals

WCCHD Mitigation Responsibilities

• Receive reports of COVID-19 laboratory test-positive cases and

their contacts at the school from schools

• Report cases and contacts to state public health investigators

for case investigation and contact tracing and monitoring

• Assist schools with guidance for infection control, disinfection,

notifications, and decisions regarding potential closures

• Provide a Call Center to answer general questions about

COVID-19 from the public

• Coordinate and communicate with schools on a regular basis

Mitigation Best Practices beyond TEA

• Close contacts should be identified by time and proximity,

irrespective of mask usage*

• Nurses should utilize PPE inclusive of N95 respirators, gloves,

gowns, and eye protection

• Individuals excluded from campus for COVID-19-related symptoms

who obtain an alternative diagnosis from a medical professional can return to campus when deemed non-infectious by that medical

• professional. Negative COVID-19 laboratory results alone should not

be used for return to campus before the individual meets the 1-day without fever, and 10 days past symptom onset requirement.

• Probable cases of COVID-19 should be responded to with the same

mitigation strategies as confirmed cases

*N95 respirators are not masks and will be considered separately if used as part of full PPE

On-going Surveillance

• In addition to well-established

weekly surveillance in schools for influenza-like illness (ILI), schools will be asked to provide aggregate numbers of COVID-19-like illness (CLI) and total absences via a combined ILI-CLI online report form

For Additional Information and Guidance

• Email epi@wilco.org
• Call (512) 943-3600
• Visit www.wcchd.org