CDC Has Changed the "Close Contact" Definition

[k1p1ssk, BSN, RN]

I saw this WaPo Article this AM (I hope you can all read it and that it isn't behind a paywall): CDC expands definition of who is a ‘close contact’ of an individual with covid-19

And yep, sure enough, the CDC has expanded who is considered a close contact (from https://www.CDC.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/appendix.html#contact?

"Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period* starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated."

Huge implications for our classrooms. We were hoping that a max of like, 4 kids would have to go out and quarantine if we had a positive case... now it looks like entire classrooms will have to shutter if we have a positive case as our teachers can't guarantee that the students weren't within 6ft of each other for less than 15minutes over the course of the school day.... especially with different eyes on them at recess/lunch, etc.... Though our district closed the entire HS/MS building for 1 positive case and wasn't planning on closing an elementary school because of the distinct cohorting happening in those pk-6 buildings... I think they'll have a hard time explaining why if they don't close the entire school. We shall see, I'm sure!

 

[SchoolNurseK, BSN, RN]

This has been our criteria for determining a contact for quite some time.  The question I keep getting is, what about masks?  Parents want to know why we are wearing the masks at all if this is how we are determining contacts.  I am not sure what to say, honestly.  The chances of their child being positive are significantly lower with the mask, but they argue that we should either not quarantine if the mask was being properly worn OR don't wear the masks.  Anyone else having this conversation?  What are you saying?

[Flare, ASN, BSN]

We closed earlier this week due to a spike in cases within the school.  I just saw this as well and was coming here to spread the word, but you guys are on it!  I love this group so much.  Honestly, us school nurses (as I toot my own horn) are amazing ?

I'll let the suits take it from here.  They made  the plan, they can change the plan.  

[BrisketRN, BSN, RN]

We've been following this definition since the beginning of our school year.  This basically means our staff has to be hypervigilant about keeping all students 6 ft apart and keeping themselves 6 ft apart from students as much as possible.  Even so, we have only had one active case in our school and we closed that whole classroom down for 14 calendar days.  You can't be too safe.  We're telling parents we're following the state and city department of health mandates.  It's out of our hands.  Masks are required.  6 ft distancing is required.  No sports is required.  Don't shoot the messenger!

[CanIcallmymom, BSN, RN]

36 minutes ago, SchoolNurseK said:

This has been our criteria for determining a contact for quite some time.  The question I keep getting is, what about masks?  Parents want to know why we are wearing the masks at all if this is how we are determining contacts.  I am not sure what to say, honestly.  The chances of their child being positive are significantly lower with the mask, but they argue that we should either not quarantine if the mask was being properly worn OR don't wear the masks.  Anyone else having this conversation?  What are you saying?

The CDC says this: 

"Because the general public has not received training on proper selection and use of respiratory PPE, such as an N95, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE.  At this time, differential determination of close contact for those using fabric face coverings is not recommended."

 

https://www.CDC.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/appendix.html#contact

[SchoolNurseK, BSN, RN]

6 minutes ago, CanIcallmymom said:

The CDC says this: 

"Because the general public has not received training on proper selection and use of respiratory PPE, such as an N95, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE.  At this time, differential determination of close contact for those using fabric face coverings is not recommended."

 

Thank you!!  This is exactly the backup that I needed.  You guys are THE BEST!

[Queen of Icepacks, RN]

35 minutes ago, SchoolNurseK said:

This has been our criteria for determining a contact for quite some time.  The question I keep getting is, what about masks?  Parents want to know why we are wearing the masks at all if this is how we are determining contacts.  I am not sure what to say, honestly.  The chances of their child being positive are significantly lower with the mask, but they argue that we should either not quarantine if the mask was being properly worn OR don't wear the masks.  Anyone else having this conversation?  What are you saying?

Our lead nurse keeps reminding us that masks reduce the chance of transmission they do not eliminate it.   I use this often with our parents.   

We have been going under the 15 minute with in six feet cumulative within 24 hours since the beginning.  

[ruby_jane, BSN, RN]

Huge implications is right. 

 

[Mavnurse17, BSN, RN]

My district is and has been going by 15 CONSECUTIVE minutes, not cumulative.  They decided that because it would be impossible to keep any school open if we were going by cumulative.  I heard in our weekly update meeting yesterday that we're continuing to go against this new CDC information until further notice ?

[AdobeRN]

2 hours ago, SchoolNurseK said:

This has been our criteria for determining a contact for quite some time.  The question I keep getting is, what about masks?  Parents want to know why we are wearing the masks at all if this is how we are determining contacts.  I am not sure what to say, honestly.  The chances of their child being positive are significantly lower with the mask, but they argue that we should either not quarantine if the mask was being properly worn OR don't wear the masks.  Anyone else having this conversation?  What are you saying?

This has been our criteria also.  Ours has changed a bit a few weeks ago - we no longer quarantine whole class from grade 3-5 if both positive person and close contact are wearing their masks. Grades 6-12 is case by case basis depending on the mask wearing.  K-2 classes are still all quarantined since they are not required to wear a mask in class. 

[JenTheSchoolRN, BSN, RN]

2 hours ago, Queen of Icepacks said:

Our lead nurse keeps reminding us that masks reduce the chance of transmission they do not eliminate it.   I use this often with our parents.   

We have been going under the 15 minute with in six feet cumulative within 24 hours since the beginning.  

Same. Though I did forward this change to my admins this morning with a note that said "and we have already been using this metric is conjunction with DPH." 

But I also noted to remind STAFF about this because I'm actually more worried about the staff to staff interactions vs students-student ones right now. 

[k1p1ssk, BSN, RN]

In our district, we had asked our PH nurses point blank if we, as a school, should use cumulative vs. consecutive and they told us consecutive, which is why that is what we had been doing. The documentation from our state's DPH is not clear. I did speak with a contact tracer nurse I know in our state yesterday and she said that from the beginning, they have been using cumulative, so she's a little unclear as to why our PH nurses said consecutive. Either way, Admin is on board to change this and we're thinking of running a mock COVID drill at a faculty meeting soon. Partially to spook faculty and staff into realizing how quickly their laxity with regards to physical distancing are going to cause us to close (Though, I thin a lot of them want that).