Health Management Plans During COVID-19 | Pandemic Guide for Families

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Aug. 27, 2020

Haverhill Public Schools has created this document to provide parents with an understanding of how COVID-19 will be managed in schools, and how other health needs will be met. As guidance from the federal and state level change, Haverhill Public Schools will update/amend protocols, in accordance with the local Board of Health.

As stated in the DESE Protocols for responding to COVID-19 scenarios in school, on the bus, or in community settings (revised date August 20, 2020), A safe return to in-person school environments will require a culture of health and safety every step of the way. 

It is not one mitigation strategy but a combination of all these strategies taken together that will substantially reduce the risk of transmission.

These mitigation strategies include, but are not limited to:

  • Students and staff staying home if feeling sick
  • Wearing face coverings
  • Frequent hand hygiene
  • Physical distancing

These strategies, and others, are discussed in the Haverhill Public Schools Opening Plan dated August 11, 2020. 

General Overview

Health services in each school building will continue to be managed by the school nurse(s). In some settings, additional support staff may be utilized to meet the needs of our students.

Each school will maintain dedicated space for well services such as medication management, first aid, and supportive services for students with chronic conditions. 

Additionally, each school will maintain a medical waiting room, separate from the nurses office, where students who present with symptoms which may be attributed to COVID-19, and are being dismissed for further evaluation and testing, will be supported and monitored. Students will be placed at least 6 feet apart at all times, and must wear a mask. Students will be provided mask and meal breaks, and have restroom access.

All students and staff will be required to wear a clean mask while in school per the Haverhill Public Schools mask policy (July 2020) and they will be given mask breaks throughout the day. Masks should cover the mouth and nose. If a student or staff member is unable to wear a mask due to a disability, an IEP or 504 accommodation must be in place. 

Handwashing with soap and water for at least 20 seconds will be done throughout the school day. These times include, but are not limited to, upon arrival at school, before eating, after using the restroom, after coughing/sneezing/blowing your nose, etc.  If handwashing with soap and water is not possible, then students will sanitize their hands with a hand sanitizer containing at least 60% alcohol. Per DESE and DPH Joint Memo dated 8/18/2020.

The Department of Elementary and Secondary Education, in conjunction with the Massachusetts Department of Public Health, has provided school departments and Boards of Health with school guidance and protocols related to COVID-19. From these documents, Haverhill Public Schools has adopted/amended or created protocols to guide school nurses and administration as students return to our buildings.

Decisions regarding closures of individual schools or the district will be made in conjunction with DESE and the local Department of Health. 

Management of Student who is Symptomatic

The CDC and MDPH guidance are the backbone for COVID-19 management. Health care providers have been given defined criteria to be utilized when evaluating an individual who is feeling unwell.

If your child arrives at school feeling unwell via bus, your child will be assessed by the school nurse prior to joining his or her class cohort.

If your child feels unwell during the day, he/she will be brought to the health office for assessment.

The school nurse will utilize the following guideline in assessing every student:

  1. Evaluate symptoms:
    • Fever (100.0 or higher), chills or shaking chills
    • Cough (not due to other cause, such as chronic cough)
    • Difficulty breathing or shortness of breath
    • New loss of taste or smell
    • Sore throat
    • Headache when in combination with other symptoms
    • Muscle aches or body aches
    • Nausea, vomiting or diarrhea
    • Fatigue when in combination with other symptoms
    • Nasal congestion or runny nose (not due to other causes, such as allergies) when in combination with other symptoms

If student presents with any one of the above listed symptoms (or two symptoms when considering headache, nasal congestion and fatigue), he/she will be considered as an individual who may be presenting with symptoms of COVID-19, and must be dismissed for further evaluation.

  1. Student will be settled into the medical waiting room (must wear mask/face covering), and parent or guardian will be contacted to pick up student. Students presenting with COVID-19 like symptoms may not ride bus home. 
  2. Parent will be provided written guideline which will recommend testing for COVID-19 at a local testing site. Contact with primary care provider is recommended.
  3. Once COVID-19 test is complete, student will stay at home while awaiting results (time to receive testing results varies by testing site and may take up to several days)
  • If test is positive:
    • Student must remain home for at least 10 days and until at least 24 hours have passed with no fever without the use of fever reducing medication, and improvement in other symptoms. – Per DESE and DPH Joint Memo dated 8/18/2020
  • If test is negative: Student may return to school once asymptomatic for 24 hours, without the aid of medication
  1. If student is not tested, they may return to school 10 days from start of symptoms, as long as their symptoms have improved and they have been without a fever for 24 hours without the use of fever reducing medication. – Per DESE and DPH Joint Memo dated 8/18/2020

Management of Close Contact to Someone who has Tested Positive

The Joint Memo Clarifying Key Health and Safety Requirements for Schools , published 8/18/2020 from DESE provides the following definition of a close contact:

  • If a student or staff member tests positive for COVID-19, their close contacts will be defined as only those who have been within 6 feet of distance of the individual for at least fifteen minutes consecutively, while the person was infectious whether they were masked or not. 
  • The infectious period begins 2 days prior to symptom onset. 
  • If someone is asymptomatic, the infectious period is considered to begin 2 days prior to the collection of their positive test. 
  • While previous guidance stated that all students in an elementary classroom would be defined as close contacts, this new guidance provides a narrower definition of a close contact which mirrors DPH guidance. 

When district is notified that one of its staff or students has tested positive for COVID-19, the following actions will occur:

  1. School nurse and building administration will determine who may have been in close contact with an individual who has tested positive within 48 hours prior to individual testing positive. This will be done based on attendance, classroom seating chart and transportation seating charts. 
    • This means if a student is sent home on a Tuesday with symptoms and test results are returned on Thursday, the district will investigate close contacts for Monday and Tuesday of that week.
  2. School nurse and building administration will work with COVID Tracking and Resource Nurse, and Haverhill Health Department Nurse to verify close contacts.
  3. District will provide initial contact with families to inform them that we have identified their student as a close contact. 
  4. Isolation guidance for the student will be provided by the Department of Health and/or Contact Tracing Collaborative. 
  5. Students will transition to fully remote learning for 14 day quarantine.

Individuals who are considered close contacts are encouraged to be tested for COVID-19 4-5 days after exposure.

  1. If the test is positive, individuals will receive guidance from the Health Department on isolation guidelines and must remain out of school for at least 10 days.
  2. If the test is negative, individuals  will remain in quarantine for a duration of 14 days as symptoms may occur anytime between the 2nd and 14th day after exposure.
  3. On day 15, individuals who are quarantined, and are not experiencing symptoms, may return to in-school learning.

 

Daily Health Assessment (Attestation)

Daily health assessment of students and staff is an integral part of Haverhill Public Schools strategies to prevent COVID-19. All students and staff must stay home if they are feeling sick.

Each day, please answer the following questions before sending your child to school:

  1. Has your child exhibited any of the following symptoms within the past 24 hours?:
  • Fever greater than 100 degrees Fahrenheit, chills, or shaking chills
  • Cough (not due to other known cause, such as chronic cough)
  • Difficulty of breathing or shortness of breath
  • New loss of taste or smell
  • Sore throat
  • Headache when in combination with other symptoms
  • Muscle aches or body aches
  • Nausea, vomiting, or diarrhea
  • Fatigue, when in combination with other symptoms
  • Nasal congestion or runny nose (not due to other know causes, such as allergies) when in combination with other symptoms
  1. Has your child  had “close contact” with an individual diagnosed with COVID-19 within the past 14 days? 
    • “Close contact” means:
      • Living in the same household as a person who has tested positive for COVID-19
      • Caring for a person who has tested positive for COVID-19
      • Being within 6 feet of a person who has tested positive for COVID-19 for about 15 minutes
      • Coming in direct contact with secretions (e.g., sharing utensils, being coughed on) from a person who has tested positive for COVID-19, while that person was symptomatic. 
  2. Has anyone in my household been asked to self-isolate or quarantine by their doctor or a local public health official in the past 14 days? 
  1. Has my child travelled outside of the following states: Massachusetts, New Hampshire, Vermont, Maine, Connecticut, New York, or New Jersey in the past 14 days? (Massachusetts travel guidelines as of August 22, 2020.) As these low risk states will change over time, please refer to the following link for updated States that you may visit without restriction? (https://www.mass.gov/info-details/covid-19-travel-order) 
  1. Is my child waiting for results from a COVID-19 test for any reason? 

If you answer yes to any of the above questions, please do not send/bring your child to school. Please contact your child’s school to discuss the reasons for keeping your child home, and to receive further guidance.

Special Concerns and Considerations

Asthma Management and Use of Nebulizers in Schools

Parents/guardians are asked to contact your child’s physician if school asthma management has included the use of a nebulizing device to deliver Albuterol or other broncho-dilating medications. Nebulizers pose additional risk of aerosolizing viral particles and it is the recommendation of the American Academy of Pediatrics, and DESE, that schools assist parents in the transitioning of students to Metered Dose Inhalers with spacers for medication delivery

Suctioning Procedures

If your child may require suctioning while at school based on a specific diagnosed condition, please contact your school nurse or Katie Vozeolas, BSN RN NCSN, Director of health and Nursing Services at: kvozeolas@haverhill-ps.org, or 978-478-8579 to discuss.

Like the use of nebulizing equipment, the act of suctioning increases risk of aerosolizing of viral particles.