INDIANAPOLIS – A child returning to school this fall might go through the following morning routine: Their parent checks them for COVID-19 symptoms, they take a socially distanced bus ride, and a faculty member, like a school nurse, conducts a final screening at the school entrance before letting them through the door.
As students return to class, many school districts have introduced routine symptom screenings into their reopening plans. But their effectiveness and feasibility in stopping the spread of COVID-19 in schools remain unclear.
Adam Karcz, director of infection prevention at Indiana University’s Riley Hospital for Children, said screenings are limited for a variety of reasons, including that the novel coronavirus shares many symptoms with common illnesses like the flu, and not everyone with COVID-19 will have symptoms.
“COVID-19 is unique with the challenge that you can spread that without being or showing signs that you’re actually sick,” Karcz said.
Third-grader Hadley Steckler enters a school bus with other students on the way to Sycamore Elementary School in Avon, Ind.
Though screenings might help in preventing the spread of the coronavirus, the Centers for Disease Control and Prevention doesn’t recommend universal health screenings or COVID-19 testing at schools because of such limitations.
That’s why Karcz says school districts should pair symptom screenings with other mitigation tactics.
“Screenings are one part of the puzzle,” Karcz said. “The other parts of that puzzle that you can see that schools are putting in place are the universal masking, the social distancing, the hand hygiene and the additional disinfection.”
But symptom screening shouldn’t all be on the schools. Karcz said parents should partner with districts to stop community spread.
“We all have a public and social responsibility as part of helping reduce COVID-19 and the community,” Karcz said. “If a child is sick or showing signs or symptoms, parents are going to know best.”
Quite an undertaking
Varying circumstances for schools might make this image unrealistic, said Linda Mendonca, president-elect of the National Association of School Nurses.
“With screenings to enter the building on a daily basis,” Mendonca said, “logistically, it’s a lot.”
Harper Williams waves from the bus as she prepares for her first day of first grade at Sycamore Elementary School in Avon, Ind., on Wednesday, July 29, 2020.
Parents taking part in screening their child for symptoms also helps take some of the burdens of contact tracing off school nurses, who Mendonca says will be spread thin as schools reopen.
About three in 10 schools in the Midwest don’t have a nurse, and about one in three have a nurse working full-time in 2017, according to data from the Journal of School Nursing.
Though the Indiana Department of Education reported about 70% of school nurses working full-time at one building in 2018, it tallied only about half of the state’s schools in its survey.
“How do you open a school without a school nurse?” Mendonca said. “That’s a challenge.”
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A lack of funding for school nursing programs won’t only make school nurses susceptible to COVID-19 infections, Mendonca said. It’ll also leave students vulnerable.
“The safety of students and staff is the priority here,” Mendonca said. “That’s what needs to be taken into consideration when any decision-making is made.”
That’s why Mendonca believes schools should do whatever it takes to mitigate community spread, no matter what it takes.
“Things are changing every day,” Mendoca said. “Scientists are learning more about COVID-19 every day, so it’s very hard to know how it’s gonna play out in schools.”
This article originally appeared on Indianapolis Star: Back to school, COVID testing: Why screenings not enough to stop virus