Coronavirus concern for incoming student

[NurseAlice]

Hey guys... I have a major concern that my administration just brought to my attention. We have a student who will be arriving from Hong Kong next Thursday. There have been 8 confirmed cases of the Corona virus in Hong Kong. The student themselves has not been confirmed to have the disease, but given the recent news, we are all very concerned about whether or not to accept this student. I have emailed my lead nurse as well as our health department leader and am awaiting their response. Can we even accept medical clearance from a doctor and allow them to come to our school? I'm so nervous because I have absolutely no experience in dealing with this sort of thing. Any advice would be appreciated. I am just very concerned about the safety of our students and staff.

[AdobeRN]

Check with your local health department. I am in Texas and our county health department stated there wasn't anything we needed to be doing right now - we are not to exclude kids.

[ihavealltheice]

On 1/29/2020 at 3:53 PM, AdobeRN said:

Check with your local health department. I am in Texas and our county health department stated there wasn't anything we needed to be doing right now - we are not to exclude kids.

Same here.

This what I received today:

Guidance for schools
K-12 schools may have exchange students or other students who attend their school and have traveled to various areas in Asia, including China. A student who has traveled overseas to Asia or specifically to areas designated by CDC as areas of risk for NCoV, and is well, is not
restricted from school or any public activities.

If a student who has traveled in the last 14 days to areas designated by CDC as areas of risk for NCoV develops fever and respiratory symptoms (cough or difficulty breathing), call your local health department and they can assist with determining what additional evaluation is needed and where it should take place. At this time of the year, there are many possible causes for respiratory illness, and it is likely a medical visit for further evaluation (including laboratory testing) will be necessary.

Hope this helps ?

[guest464345]

I agree with the above comments. As a former epidemiology nurse, I would explain it to administration this way.....there was an enormous outbreak of measles in New York, a city of 8 million people, within the past year. It was all over the headlines. During that outbreak, would you accept a student from New York in your school, if they had no history of measles symptoms, and no recent exposure to a specific person with confirmed measles? Same deal, there are like 7 million people in Hong Kong and 8 confirmed cases. There's no evidence to exclude a kid who's not sick, unless in some specific cases if they had direct exposure (i.e. as a hospital worker or household member, not just a community member) to a known case of the illness within the specific timeframe of the incubation period (~2 weeks).

Of course, in this hypothetical situation MY admin would probably say yes, exclude them, and exclude anyone who coughs once, and exclude anyone with itchy skin because they probably have scabies, and burn the building down if you see a bedbug.....but that's my own problem ?

[Flare, ASN, BSN]

I agree with the above. If the student is asymptomatic, then there is little reason not to accept this child. I would imagine that people coming through customs and immigration from get screened a bit closer these days. But... maybe not. I don't know their practices

Anyway, here's the NJ DOH stance on it as of right now:

January 28, 2020
Novel Coronavirus 2019 (2019-nCoV) Information for K-12 Schools

Many K-12 school administrators, teachers and parents within New Jersey are concerned about how the current outbreak of the 2019 Novel Coronavirus (2019-nCoV) in Asia will impact their communities and wish to take appropriate steps to mitigate any risks. The word “novel” means new. The Centers for Disease Control and Prevention (CDC) is working hard to learn as much as possible about this new virus so that they can better understand how it spreads and its associated illness. The New Jersey Department of Health is also working hard by developing guidance and education materials should this new virus impact our residents.

What is the difference between seasonal and novel coronavirus?

Coronaviruses are a family of viruses and there are different types of coronavirus within that family, much like there are different types of influenza viruses. Coronaviruses in general are not new, they are quite common and are a frequent cause of respiratory illnesses such as the common cold. Coronaviruses tend to circulate in the fall and winter months, similar to influenza. Most people get infected with these viruses at some point in their lives.

The type of coronavirus that has recently emerged in Wuhan, China is a new type of coronavirus and is infecting people for the first time (which means that people do not have any immunity to it).

What are common symptoms of 2019-nCoV?

Information to date suggests this virus is causing symptoms consistent with a respiratory illness such as cough, fever, and shortness of breath.

How is 2019-nCoV spread?

At this time, it’s unclear how easily or sustainably this virus is spreading between people. Chinese officials report that sustained person-to-person spread in the community is occurring in China. Personto-person spread in the United States has not yet been detected, but it’s likely to occur to some extent.

Cases in healthcare settings, like hospitals, may also occur.

How is 2019-nCoV treated?

Currently, there is no specific antiviral treatment recommended for the coronavirus. There is no vaccine to prevent this virus, and the CDC advises that the best way to prevent infection is to avoid being exposed to this virus.

What precautions should be taken for a person who traveled to China?

The CDC recommends that travelers avoid non-essential travel to Wuhan, China. Chinese officials have closed transport within and out of Wuhan.

If a person travelled to China in the last 14 days and is sick with fever, cough or difficulty breathing they should:

• Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.
• Avoid contact with others.
• Not travel while sick.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Wash hands often with soap and water for at least 20 seconds. Use an alcohol-based hand
• sanitizer if soap and water are not available.

If a traveler who returns from China is not ill, they may continue to attend school.

What preventive measures should a school take to help reduce the spread of respiratory illness?

NJDOH recommends that schools and childcare settings increase education on respiratory hygiene. Staff and children (as developmentally appropriate) should all be taught and asked to follow these steps that prevent the transmission of respiratory infections:

• Cover your coughs and sneezes with a tissue or into your sleeve, not your hands.
• Avoid touching your eyes, nose and mouth.
• Wash hands often for at least 20 seconds, especially after coughing or sneezing. Use alcohol based hand sanitizer if soap and water are not available.
• Stay home if you’re sick, especially with a fever.
• Avoid people who are sick.
• Clean and disinfect frequently touched surfaces and objects.
• Additional preventive measures include:
  • Adhere to exclusion recommendations from public health. For acute respiratory illness; fever free for 24 hours without fever reducing medication. Doctors notes for return do not supersede public health recommendation.
  • Separate sick students and staff from others until they can be picked up to go home.
  • Provide adequate supplies, including clean and functional handwashing stations, soap, paper towels, and alcohol-based hand sanitizer.
  • Encourage routine surface cleaning through education, policy, and the provision of supplies.
  • Get a flu shot – it’s not too late to be protected!

School Cleaning Procedures

Special sanitizing processes beyond routine cleaning, including closing schools to clean every surface in the building are not necessary or recommended to slow the spread of respiratory illness. Schools should follow standard procedures for routine cleaning and disinfecting with an EPA-registered product.

Typically, this means daily sanitizing surfaces and objects that are touched often, such as desks, countertops, doorknobs, computer keyboards, hands-on learning items, faucet handles, phones and toys.
Outbreaks involving novel coronaviruses evolve quickly and recommendations from public health officials may change frequently as new information becomes available. Please check the following
websites often for updated information.

[tining, BSN, RN]

Airport screening while it might work and have the appearance of doing something only works if the person being screened has not taken fever reducing meds or has not recently been exposed.

[NutmeggeRN, BSN]

Agree with all, I think having your local public health folks in the loop will provide another layer of expertise, and hopefully prevent a full blown panic attack on social media once parents get any wind of this....

[NurseAlice]

Thank you so much for the great info! I feel much better about it now. My DOH leader just called and said that all flights from China arriving in Florida are being routed to Atlanta where they will be screened by the CDC. She said that no clearance letters are needed and as long as they are not ill, they are able to return to school. I know this probably might seem obvious, but I didn't want to assume anything. The epidemiology department is also giving me a form to use to assess the student if they begin to exhibit symptoms of illness. Thank you for all your help guys. I really appreciate it ?

[NurseAlice]

4 hours ago, NutmeggeRN said:

Agree with all, I think having your local public health folks in the loop will provide another layer of expertise, and hopefully prevent a full blown panic attack on social media once parents get any wind of this....

It may be a bit too late since the student's family actually ended up telling a few parents themselves

[ruby_jane, BSN, RN]

Remember back to Ebola? We were instructed to take the temperature of any student coming from the affected area and ask a few health questions that were blessed by the CDC. We may start doing this again. But I haven't been told to...

[NutmeggeRN, BSN]

17 hours ago, NurseAlice said:

It may be a bit too late since the student's family actually ended up telling a few parents themselves

No way???!!!! LOLOL!!!

[tnbutterfly - Mary, BSN]

The WHO declared a Global Health Emergency yesterday afternoon.

There has been a confirmed case in the US of human-to-human transmission of the novel coronavirus.

There have also been confirmed cases of asymptomatic human-to-human transmission in Germany.

Please take a look at the latest allnurses article posted yesterday with the latest updates.

Coronavirus Update - World Health Organization Declares Global Health Emergency