Tag: masks

Going Back to School During the Omicron Surge

How do we get kids back in school safely during the Omicron surge?

How do we get kids back in school and prevent them from getting COVID during the Omicron surge?

“Students benefit from in-person learning, and safely returning to in-person instruction continues to be a priority.”

Guidance for COVID-19 Prevention in K-12 Schools

After all, that’s what everyone wants, right?

Is anyone surprised that Texas leads the US in childhood COVID deaths?
Is anyone surprised that Texas leads the US in childhood COVID deaths?

It’s hard to see how we can do that safely without a lot more people getting vaccinated and boosted, masking, practicing social distancing, more testing, and following through on quarantines for those who are exposed, and isolation for those who are sick.

“CDC recommends universal indoor masking by all* students (ages 2 years and older), staff, teachers, and visitors to K-12 schools, regardless of vaccination status.”

Guidance for COVID-19 Prevention in K-12 Schools

Still, in most cases, folks don’t want to go back to on-line schooling, especially for long periods of time.

So to get kids back in school during the Omicron surge, parents, students, and staff should all work together to keep their kids safe and healthy by:

  • going into home quarantine if they have been exposed to someone with COVID and they are not vaccinated (including a booster dose if they are at least 18 years old and are eligible) or have not had COVID in the past 3 months, remaining in quarantine for at least 5 days. After 5 days, if they have not developed symptoms of COVID, they can get a COVID test and if it is negative, they can return to school, wearing a well-fitting mask for an additional 5 days. And of course, they should get tested if you develop symptoms at any time during these 10 days. If they can’t get tested after 5 days, they can still leave quarantine early if they don’t have symptoms and will wear a mask for another 5 days.
  • going into home isolation if they have COVID, remaining in isolation for at least 5 days, with the ability to end isolation after 5 days if they are fever free for 24 hours, have either had no symptoms or improving symptoms, and will wear a mask for an additional 5 days whenever they are around other people.
  • keeping away from anyone who is at high risk for severe COVID disease until the full 10 days of quarantine or isolation ends.
  • maintaining adequate distance from others during times when they have to take off their mask at school and they are still within the last 5 days of your quarantine or isolation, like when they are eating lunch.

And what if they can’t or won’t wear a mask consistently and correctly and are in quarantine or isolation?

Since they aren't allowed to tell anyone to wear a mask, the Texas Education Agency is trying to implement just half of the CDC guidance to end quarantine and isolation early. Unfortunately, it really doesn't work if you don't wear a mask!
Since they aren’t allowed to tell anyone to wear a mask, the Texas Education Agency is trying to implement just half of the CDC guidance to end quarantine and isolation early. Unfortunately, these plans don’t really work safely if you don’t wear a mask!

Then they should finish out their full 10 day quarantine or isolation at home!

“Staying home when sick with COVID-19 is essential to keep COVID-19 infections out of schools and prevent spread to others.”

Guidance for COVID-19 Prevention in K-12 Schools

What else does the CDC recommend to help keep kids in school safely?

“Vaccination is the leading public health prevention strategy to end the COVID-19 pandemic. A growing body of evidence suggests that people who have completed the primary series (and a booster when eligible) are at substantially reduced risk of severe illness and death from COVID-19 compared with unvaccinated people.”

Guidance for COVID-19 Prevention in K-12 Schools

In addition to vaccination, quarantine and isolation strategies, the CDC recommends consistent and correct mask use, physical distancing, screening testing, improving ventilation, handwashing and respiratory etiquette, contact tracing, and cleaning and disinfection, etc.

“Recommend screening testing for high-risk sports and extracurricular activities at least once per week.”

Guidance for COVID-19 Prevention in K-12 Schools

For example, in areas of low to moderate COVID transmission, doing screening tests of kids in high risk sports and extracurricular activities might help prevent outbreaks. On the other hand, when transmission rates are high, schools should probably just cancel or hold high-risk sports and extracurricular activities virtually to protect in-person learning.

Will this work?

Many big city school districts aren’t convinced and are already delaying the start of the second half of the school year…

“With the above principles in mind, the AAP strongly advocates that all local, state, and federal policy considerations for school COVID-19 plans should start with a goal of keeping students safe, physically present, and emotionally supported in school.“

COVID-19 Guidance for Safe Schools and Promotion of In-Person Learning

Let’s hope the COVID surge ends quickly, states and school districts do more to protect our kids, more people get vaccinated and boosted, and we can get all of our kids back in school!

More on COVID School Guidance

The Latest on Masks to Keep Kids From Getting COVID

Face masks work to prevent the transmission of COVID and can help keep kids, many of whom are too young to be vaccinated, from getting COVID.

That kids wearing face masks to keep them from getting COVID is controversial is amazing to many people, especially pediatricians.

Why wouldn’t you want your kids to wear a mask if it could protect them?

The Latest on Masks to Keep Kids From Getting COVID

And yes, the data does show that wearing a mask is safe and protects kids from getting COVID…

Need some proof?

Let’s take a look at what’s happening in Texas.

A few weeks ago, there were 86 active staff and 708 active student cases in GISD.
A few weeks ago, there were 86 active staff and 708 active student cases in GISD.

In one north Texas school district that opened early, on August 2, they now have 67 active staff cases and 564 active student cases.

While that’s a lot, it is important to keep in mind that as cases are continuing to rise in most other school districts, leading to more than a few temporary school closures, they are actually dropping in GISD!

Why?

Staff and students in GISD are wearing masks and their active case counts are dropping!
Staff and students in GISD are wearing masks and their active case counts are dropping! They also limit the capacity for indoor and outdoor events once positivity rates get too high.

It is almost certainly because their staff and students are wearing masks!

Masks Save Lives

Wearing a mask can protect the person wearing the mask and the people around them.

Need more proof that masks work?

Wearing a mask is especially important to protect those who are too young to get vaccinated and those who have a true medical contraindication to getting vaccinated against COVID.

“When used in conjunction with widespread testing, contact tracing, quarantining of anyone that may be infected, hand washing, and physical distancing, face masks are a valuable tool to reduce community transmission.”

An evidence review of face masks against COVID-19

Wearing a mask is also important as COVID variants surge, some of which are more infectious, even to those who are fully vaccinated.

Masks save lives.

“Without interventions in place, the vast majority of susceptible students will become infected through the semester.”

COVID-19 Projections for K12 Schools in Fall 2021: Significant Transmission without Interventions

Parents should ignore the misinformation and disinformation about facemasks and COVID-19.

“To maximize protection from the Delta variant and prevent possibly spreading it to others, fully vaccinated people should wear a mask indoors in public if you are in an area of substantial or high transmission.”

Use Masks to Slow the Spread of COVID-19

In addition to social distancing, they should wear a mask and should encourage their kids who are at least two years old to wear masks in school and when in public around a lot of other people.

More on Masks Save Lives

Are We Going to See a Summer Surge of RSV This Year?

Folks need to understand that RSV might still be coming. If not in the next few months, then maybe this summer. And if there is no summer surge of RSV, then it will likely be back even worse next year.

A summer surge of RSV?

I know, it sounds ridiculous, right?

After all, in a typical year, RSV season begins in September or October and peaks in December or January.

Of course, this hasn’t been a typical year…

Are We Going to See a Summer Surge of RSV This Year?

Except for COVID-19, rhinovirus, enterovirus, and some adenovirus, we haven’t seen most of the seasonal viral outbreaks that we typically see each year.

There hasn't been any RSV in Texas this year.
There hasn’t been any RSV in Texas this year.

There was no RSV, flu, or seasonal coronavirus, etc.

Not that anyone has been complaining…

It was one of the bright spots that came out of all of the social distancing, mask wearing, and travel restrictions to control the COVID-19 pandemic!

So why would anyone think that we might see a summer surge of RSV?!?

The news that folks in Australia started getting hit with RSV a few months ago, when it was still summertime!

Remember, Australia is in the Southern Hemisphere and their summer runs from December to February and their autumn from March to May.
Remember, Australia is in the Southern Hemisphere and their summer runs from December to February and their autumn from March to May.

What caused the summer surge of RSV in Australia?

An unexpected surge that is also being reported in South Africa…

“Recent reports from Australia described an inter-seasonal RSV epidemic in Australian children following the reduction of COVID-19–related public health measures from September 2020 to January 2021.”

Delayed Start of the Respiratory Syncytial Virus Epidemic at the End of the 20/21 Northern Hemisphere Winter Season, Lyon, France

Is it because they got their COVID-19 cases under good control early and relaxed many of their COVID-19 related public health measures, including eliminating mandates to wear masks and most restrictions on public gathering, and allowed kids to go back to school?

Whatever the reason for the surge, what is most troubling is that we may not have to wait until this summer for our own surge!

“In 2020, the first RSV cases of the 20/21 season were detected in Lyon at week 46 and 47 (Figure 1) at the same time of the southern hemisphere outbreak. A sustained detection of cases was observed from week 51, which is the expected time of the epidemic peak, to week 5. On week 6, the RSV epidemic was declared in the first French region (Ile de France) while the number of RSV cases has continued to increase in the Lyon population.”

Delayed Start of the Respiratory Syncytial Virus Epidemic at the End of the 20/21 Northern Hemisphere Winter Season, Lyon, France

France is seeing RSV too – with a 4 month delay to the start of their season. And they haven’t relaxed their physical distancing recommendations as much as Australia, as they were still seeing cases of COVID-19.

And as if all of that wasn’t enough, the summer surge of RSV in Australia is at rates that are much higher than is seen in a typical RSV season!

Wasn’t that expected?

“Our results suggest that a buildup of susceptibility during these control periods may result in large outbreaks in the coming years.”

The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections

While larger future outbreaks have been expected, most people likely thought they would start with next year’s season.

“Our findings raise concerns for RSV control in the Northern Hemisphere, where a shortened season was experienced last winter. The eventual reduction of COVID-19–related public health measures may herald a significant rise in RSV. Depending on the timing, the accompanying morbidity and mortality, especially in older adults, may overburden already strained healthcare systems.”

The Interseasonal Resurgence of Respiratory Syncytial Virus in Australian Children Following the Reduction of Coronavirus Disease 2019–Related Public Health Measures

I’m not sure anyone is ready for RSV and COVID-19 at the same time. That’s not the Twindemic folks were warning us about!

But maybe we should get ready to start seeing some RSV.

March is typically close to the end of RSV season, not the beginning.
March is typically close to the end of RSV season, not the beginning.

After all, rates of RSV are starting to increase in Florida and the South Atlantic division of the United States.

While there is no way to know if we will see this trend in other states and we may just be delaying when RSV season starts anyway, parents should know that we can always protect those who are most at risk from severe RSV disease.

“Ideally, people with cold-like symptoms should not interact with children at high risk for severe RSV disease, including premature infants, children younger than 2 years of age with chronic lung or heart conditions, and children with weakened immune systems.”

RSV Prevention

At some point, we might even have to consider changing when Synagis, the monthly shot that can help prevent RSV, is given. Should we continue giving Synagis to high risk infants this Spring and Summer, for example, instead of stopping in March?

Mostly, folks need to understand that RSV might be coming. If not in the next few months, then maybe this summer. And if not this summer, then it will likely be back with an even worse next year.

More on RSV

Mask Exemptions for Kids During the COVID-19 Pandemic

If your child doesn’t want to wear a face mask, your pediatric provider might be able to offer more help than just an exemption.

Some parents who don’t want their kids to wear a mask at school might think about asking their pediatrician to write a mask exemption for their kids.

You can easily spread what you don't know you have... Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren't a good idea unless they are medically necessary. #BeInformed
You can easily spread what you don’t know you have… Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren’t a good idea unless they are medically necessary. #BeInformed

Before they do, they might understand that there are very few real medical reasons for these types of exemptions for wearing a mask.

Masks Control the Spread of SARS-CoV-2

More and more, we are learning that masks can help prevent the spread of SARS-CoV-2, the virus that causes COVID-19, protecting both the person wearing the mask and the people around them.

“The prevention benefit of masking is derived from the combination of source control and personal protection for the mask wearer. The relationship between source control and personal protection is likely complementary and possibly synergistic, so that individual benefit increases with increasing community mask use.”

Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2

Still, that doesn’t mean that everyone has gotten used to wearing them…

Hopefully, most folks do now understand why they are important though.

Wait, why are they important, especially if you are healthy and the people around you don’t have COVID-19?

Mostly it is because people with COVID-19 can be contagious:

  • up to two days before they start to show symptoms
  • up to two days before they test positive, even if they don’t have any symptoms

So if you are waiting to put on a mask until people around you have symptoms, then you will eventually get exposed, probably without even knowing it, and you might get sick, ending up in isolation, not being able to go to school or work.

And if you wait to put on a mask until you start to show symptoms, then you will likely eventually expose other people to the SARS-CoV-2 virus.

The alternative, if you want to reduce your risk of getting sick, is to just wear a mask any time that you can’t social distance (stay at least six feet apart) from other people.

Mask Exemptions for Kids During the COVID-19 Pandemic

So what are the medical reasons that kids, like adults, can’t wear a mask all day while they are at school?

“The Department supports actions by the airline industry to have procedures in place requiring passengers to wear masks in accordance with the CDC Order, CDC guidance, and TSA SD. At the same time, the ACAA and Part 382, which are enforced by OACP, require airlines to make reasonable accommodations, based on individualized assessments, for passengers with disabilities who are unable to wear or safely wear a mask due to their disability.”

Notice of Enforcement Policy: Accommodation by Carriers of Persons With Disabilities Who Are Unable to Wear Or Safely Wear Masks While On Commercial Aircraft

In general, a child over age two years should wear a face mask unless:

  • they have a physical or intellectual condition that would keep them from being able to remove their face mask by themselves
  • they can’t tolerate wearing a face mask because they have a condition such as autism spectrum disorder, intellectual disability, or a mental health disorder
  • they have a physical or intellectual condition and wearing a cloth face mask gets in the way of their ability to communicate

But shouldn’t these kids just do virtual school if they can’t wear a mask, instead of getting an exemption?

While that might be an option for some kids, others need the extra services that they get at school, which they can’t get with at home schooling.

In addition to a face mask exemption, some things that might work in some situations when a child won’t wear a mask include:

  • a face shield
  • a transparent face mask
  • using different fabrics for the mask
  • trying a bandana or gaiter
  • try to desensitize your child to wearing a mask

What about asthma?

In general, most kids with well controlled asthma should be able to wear a face mask. If your child’s asthma is so severe that it is made worse by wearing a face mask, then they likely need an evaluation by a pulmonologist and it might be best to avoid being around others during the pandemic.

If your child can wear a face mask, but just doesn’t want to, then it might help to allow them to pick their own mask, with a comfortable fabric and fit, maybe even getting a mask with a favorite character on it.

“Model it! Make it familiar by wearing a mask too.”

Getting Your Child to Wear a Mask

And don’t expect your child to want to wear a mask at school if you don’t wear a mask when you go out or if you don’t believe that wearing a mask is necessary.

More on Mask Exemptions

7 Things to Know About COVID-19

Everything you need to know to reduce your risk of getting and exposing others to COVID-19.

We are far enough into this pandemic that there really is no excuse that folks still don’t know about the importance of going into quarantine after being exposed or why you should practice social distancing and wear a face mask.

As usual, Del Bigtree gets this one wrong. Hedrich wasn't the first to talk about herd immunity.
As usual, Del Bigtree gets this one wrong. Hedrich wasn’t the first to talk about herd immunity.

And yet, cases are once again surging all over the country…

7 Things to Know About COVID-19

In addition to knowing that the pandemic isn’t over and won’t be over for some time, you should know that:

  1. you could have been exposed to SARS-CoV-2 if you had close contact (less than 6 feet apart) to someone with COVID-19 (has symptoms or tested positive) for at least 15 minutes, even if you were both wearing masks (sure, there is much less risk if you were wearing masks, but to be safe, it still counts as an exposure). And with the latest guidelines, the exposure doesn’t have to for a continual 15 minutes, but rather “a cumulative total of 15 minutes or more over a 24-hour period.” So if you were close to someone with COVID-19 for 5 minutes each hour for three hours, then that counts as close contact. Fortunately, if you are fully vaccinated, including a booster dose, this kind of close contact does not mean that you have to go into quarantine, unless you develop symptoms of COVID.
  2. you can develop symptoms of COVID-19 from one to 14 days after you are exposed to someone with COVID-19. This is the incubation period for the SARS-CoV-2 virus and the time you should be in quarantine after your exposure (although there are some new options to end quarantine early).
  3. testing negative soon after you are exposed to someone with COVID-19 doesn’t mean that you can’t develop symptoms later in your incubation period! Although testing is a very important part of containing this pandemic, you don’t necessarily need to rush to get tested right after you are exposed. You can, but understand that an early negative test doesn’t get you out of your quarantine. A positive test will shift you into a period of isolation, but know that some COVID-19 tests, especially the rapid antigen tests, are more likely to give a false positive result if you don’t have symptoms. If you are going to get tested after being exposed and don’t have symptoms, the optimal time is probably about 5 to 7 days after your exposure and remember to continue your quarantine if it is negative, or at the very least, wear a mask (part of the guidelines to end quarantine early).
  4. you can be contagious for at least two days before you develop any symptoms of COVID-19 or test positive and will continue to be contagious for at least ten days, the time you should be in isolation (a stricter form of quarantine). If you had severe symptoms or have a severely weakened immune system, then you might be contagious for a much longer period of time though, up to 20 days. And remember that you can continue to test positive for weeks or months, long after you are no longer contagious, which is why repeat testing is no longer routinely recommended. As with quarantine, there are options to end isolation early, after 5 days if your symptoms are getting better (or no symptoms), as long as you wear a mask for another 5 days.
  5. you can be contagious even though you don’t have symptoms, which is why, if you are unvaccinated or high risk, you should try to always wear a mask and practice social distancing when you are around other people. You don’t know who has COVID-19!
  6. if you continue to be exposed to someone with COVID-19 in your home, your 14 day quarantine period doesn’t start until they are no longer contagious, as you will continue to be exposed that whole time. That’s why some folks end up in extended quarantine for 24 days- the 10 days that the COVID-19 positive person was contagious + 14 days of quarantine, which started once the person was no longer contagious. You may be able to shorten this period with the new guidelines though.
  7. we can’t count on natural herd immunity to end the pandemic, as that would mean millions and millions of people dying. But understand that there is a middle ground between the extremes of total lockdowns and doing nothing. Wear a mask, keep six feet apart from other people (social distancing),and avoid crowds until you can get vaccinated and protected!

Most importantly, know that the more people you are around, the higher the risk that you will be exposed to and get sick with COVID-19.

Avoid crowded spaces, wear a mask, and practice social distancing to decrease your risk of getting COVID-19.
Get vaccinated and boosted, avoid crowded spaces, wear a mask, and practice social distancing to decrease your risk of getting COVID-19.

Is it really essential that you have a family gathering with 25 or 50 people right now, as cases once again begin to surge in your area because of the Delta Omicron variant? Will you be able to keep everyone six feet apart? Will they be wearing masks the whole time?

Do you want to keep schools and businesses open?

Then get vaccinated and protected!

And if you can’t get a vaccine, wear a mask, practice social distancing, wash your hands, avoid crowds, and stop acting like the pandemic is already over or never existed in the first place!

More on COVID-19

Why There is Still So Much COVID-19 Confusion

Cognitive biases, heuristics, and logical fallacies are likely affecting how you are viewing information and advice about COVID-19.

Early on, it was easy to understand why there was so much confusion about COVID-19, after all, it took some time before we even got a real name for the new or novel virus that is causing this pandemic.

And now?

While there is still a lot more research to do, we have already learned a lot about the best ways to help prevent and treat COVID-19 infections.

Do you know who to turn to for trusted information and advice about COVID-19?

Too many people don’t seem to understand that though…

Why There is Still So Much COVID-19 Confusion

Many people also don’t understand that advice and recommendations often shift and change as we get new information.

“It is irrational to hold any view so tightly that you aren’t willing to admit the possibility that you might be wrong.”

What would it take to convince you that you were wrong?

And of course, you have to expect that to happen when you are dealing with a brand new disease!

So what are people confused about?

Everything from the effectiveness of face masks to prevent the spread of the SARS-CoV-2 virus (they do) to whether our COVID-19 death counts have been inflated (we are probably seeing under-counts).

Surprisingly, some people are still confused about just how deadly COVID-19 infections really are.

If you think made-up news and information is true, you might want to rethink where you regularly get your news and information from...
If you think made-up news and information is true, you might want to rethink where you regularly get your news and information from…

Why are so many people still confused?

“Compared with other Americans, adults who “often” use social media to get news about COVID-19 report higher levels of exposure to the conspiracy theory that the pandemic was intentionally planned.”

Three Months In, Many Americans See Exaggeration, Conspiracy Theories and Partisanship in COVID-19 News

Where are they getting their information???

Who do you trust for information and advice about COVID-19?

I’m guessing it isn’t from experts…

Who to Trust About COVID-19

Adding to a lot of the confusion we are dealing with are folks pushing misinformation.

As you learn who to trust for information about COVID-19, you will hopefully develop the skills you need to be more skeptical about all of the things you see and read.

“Although my main message is that awareness of cognitive biases can lead to more effective messages and measures to mitigate the effects of the pandemic, where cognitive bias is regarded as harmful, it may be helpful to take steps to reduce such bias. Education and awareness of cognitive biases are key, so that individuals and organisations question flawed or traditional thinking habits and try to promote evidence based thinking. At an individual level, the additional advice is to slow down in your thinking, pause and reflect, and seek external views.”

Covid-19 and cognitive bias

And you will hopefully turn to sources that many of us use, including:

Still confused?

Check your biases.

Don’t let them get in your way of following the advice from the experts that could protect you and your family from getting and spreading the SARS-CoV-2 virus.

What does that mean?

Well, if you don’t think anyone should tell you to wear a mask, then you will likely look for information and advice that says masks don’t work and aren’t necessary (confirmation bias).

You will also likely not believe any information and advice that says COVID-19 is deadly.

Why?

Well, if you believed it was deadly, then you would work to avoid it and try to keep those around you safe, including doing things like wearing a mask. Instead, cognitive dissonance, the anxiety you get from believing in two things that contradict each other, will push you towards believing things that reinforce your idea that you don’t have to wear a mask.

What to Know About COVID-19 Confusion

Tired of being confused about COVID-19 and other things?

“It’s sobering to note all the ways in which human brains distort decision processes; perhaps it’s a wonder that any good decision is ever made.”

How to Make Better Decisions About Coronavirus

Be more skeptical and look for new sources of information and advice and understand how cognitive biases, heuristics, and logical fallacies affect our decision making.

More on COVID-19 Confusion

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