School Reopening: : Some Public Health Context Chesterfield County - - PowerPoint PPT Presentation

School Reopening: : Some Public Health Context

Chesterfield County School Board July 20, 2020

Alexander P Samuel MD MPH Health Director Chesterfield Health District

Outline

• Assessing Community Transmission
• Metrics
• Modeling
• Public Health Considerations related to Reopening

General Perspective

https://preventepidemics.org/covid19/science/insights/adaptive-response/

Assessing Community Transmission

Synthesis of Several Metrics Number of New Cases Percent Hospital Beds Occupied Hospitals Reporting Difficulty Obtaining PPE Number of Current Hospitalizations Test Percent Positivity Percent of New Cases Reported in Healthcare workers Number of New Confirmed Outbreaks (last 2 weeks) COVID-like illness & Influenza-like illness visits and hospitalizations Number of deaths by date of death or date of report

Central Region Transmission Status (7/18/20)

Current Level of Transmission: Low Transmission Trend: Steady

Some Key Indicators (Metrics)

• Number of Cases – increased over the past 12 days
• Compared to 28 days for Virginia as a whole
• Generally declining over the month of June
• Case Incidence = 9.0 new cases/100,000 people
• Compared to 11.1 for Virginia as a whole

Central Region

Central Region Transmission Status (7/18/20)

Some Key Indicators/Metrics (CONTINUED)

• Percent Positive PCR Tests in the Central Region
• Decreased Steadily in June
• Plateaued, but was still at good level, 6.3% (Goal < 10%), Virginia is at 7.9%
• The rate of outbreaks was Low at 0.03 per 100,000
• Had been decreasing for 8 days
• Virginia was at 0.05 per 100,000
• The rate of current COVID hospitalizations was 9.7 per 100,000
• Steady Decline in June, increased over past 10 days
• Rate was 8.2 for Virginia, with increase over past 14 days

Interlude: Brief Focus on Percent Positivity

• Not a measure of level of virus in a

population

• Intended to be a measure of adequacy
• f testing resources
• People get tested multiple times
• Labile indicator – changes

depending on number of people who get tested

July 20, 2020 Chesterfield County Percent Positive test results = 7.8%

Modeling (UVA COVID-19)

• Projections based on current case numbers and
• trends. Impossible to be 100% precise.
• Sensitive to mitigation efforts currently in place
• Observes influence of policy and behavior
• Chesterfield County currently fits the scenario:

Light Rebound – Better Detection - Surge

Mar Apr May Jun Jul Aug Sep 2020

Chesterfield: LR-BD-S

100 - 50 - 0 -

• No single good Indicator of Transmission
• Synthesis of key indicators can help with understanding level of

current transmission and direction of trends

• Modeling projections (though not absolutely precise) can speak

to future situation based on current context and trends

• Public awareness and behavior change is key driver to reducing

transmission

Takeaways – Assessing Community Transmission

Other Considerations - Children & COVID-19

What we Know

• Children don’t contract the virus at the same rate adults do
• Children are more likely to have mild symptoms or be asymptomatic
• Hospitalization and more severe outcomes are linked to underlying

chronic disease

What we Don’t Know

• The Role of Children in Transmitting the Virus is Unclear

Other Considerations – COVID-19 and Adults

• Most adults have mild symptoms or are asymptomatic
• Those at Higher Risk of Hospitalization & Severe Outcomes
• Older age: > 65 Years Old
• Chronic Medical Conditions:
• High Blood Pressure, Obesity, Cardiovascular disease, Asthma,

COPD, Chronic Kidney or Liver Disease

Considerations – Mitigation Approaches

• STAY HOME WHEN ILL
• Symptom Screening
• Distancing
• Aim for 6 ft, but if not possible: 3 ft minimum AND face covering
• Face Covering – Encourage for Everyone
• Use when minimum of 6 ft of physical distancing cannot be maintained
• As is medically and developmentally appropriate
• Hand Hygiene – need to teach it & establish routines!
• Environmental Cleaning
• Regular wiping down of high-contact surfaces

Interlude: Face Coverings

Considerations - Preparation

• Training for Parents, Students, Teachers, and Staff
• Ensure Mitigation Practices and other Controls are in Place
• Internal Protocols for what to Do when someone becomes sick
• Isolation
• Communication Plans
• Plans for Closure (if necessary) and cleaning
• Coordinate with Public Health – case/outbreak investigation

Thank You