With the start of the academic year less than a month away, school district officials in Arkansas are preparing response plans for when a student presents symptoms that could mean he has been infected with the coronavirus.
It's still unclear whether kindergarten-through-12th grade schools will be able to quickly, safely and effectively segregate students suspected of having covid-19 from students suffering from common colds, allergies, strep throat or the flu.
School officials will have to ensure that parents or guardians of a student who shows symptoms will have the child tested for covid-19. It's a critical step in determining if other people have been exposed to the virus, so officials can respond accordingly.
One or more confirmed covid-19 infections in a school will likely begin discussions among district officials and the Arkansas Department of Health about moving classes online to prevent its spread.
Janice Warren, the assistant superintendent for equity and pupil services in the Pulaski County Special School District, supervises about 28 school nurses and acknowledged that the logistics will be "challenging."
When students arrive at school, their temperatures will be taken, and if a student is running a fever, he will be sent home. It will be up to the parent to get the child tested for covid-19, Warren said.
"We're not going to be able to say or determine that, 'Oh, Janice has the temperature, she has covid, and we need to isolate everyone in her classroom,'" Warren said Thursday. "That's not going to happen until we know that there is definitely ... a covid diagnosis, and that would be from a medical professional."
Younger students, in particular, run temperatures "all the time," Warren said. She referred to colds or the flu, plus allergies from August through October.
There is at least one nurse at every Pulaski County Special School District campus, she said. Nurses will be provided with personal protective equipment like face shields, according to Warren, and the district has bought hospital-style curtains for designated isolation areas.
In the Little Rock School District, the latest version of the district's "Ready for Learning Plan" was released Thursday and says in the event of a suspected covid-19 case, the potentially infected student or staff member will report to the nurse's isolation room and then leave campus.
"Employees and students' parents/guardians will be advised to contact their primary care provider for health guidance," the plan states.
Nurses will study seating charts and interview colleagues to track potential exposure before getting the results of the individual's covid-19 test. Students and staff members who have been exposed to a confirmed covid-19 case will have to quarantine at home for 14 days, according to the plan.
Pamela Smith, a spokeswoman for the Little Rock School District, said the district's supervisor of nurses Margo Bushmiaer was unavailable for an interview.
In any given year in the Little Rock district, health services personnel field hundreds of students who arrive with symptoms, indicating the flu or strep throat, that might point toward covid-19.
According to the district's Health Services Annual Report, during the 2019-20 academic year nurses reported 1,744 occurrences of students with influenza symptoms, of which 1,185 were confirmed by a physician.
Strep throat, another illness with symptoms not unlike covid-19, was reported 662 times in the district during the past academic year, with 414 of those occurrences confirmed by a physician, according to the report.
According to the Centers for Disease Control and Prevention, relatively few children with covid-19 exhibit symptoms like fever, cough or shortness of breath when compared with adult patients, and they don't require hospitalization at the same rate.
Nevertheless, recent studies on the coronavirus suggest that although students may be less vulnerable to the virus and generally do not seem to develop serious complications, they may carry at least as much viral material as infected adults, The New York Times reported Thursday.
Given that possibility, the findings raise questions about whether reopening schools will be safe for older or immuno-compromised adults in schools or at home.
Teresa Knapp Gordon, president of the Little Rock Education Association, called the district's stated protocol for reopening schools "unrealistic." She said the plan is not going to protect the staff.
"Our educators are very concerned, and our nurses are very concerned," she said in an interview Thursday. "I think our nurses are going to be quickly overwhelmed."
The teacher's union is advocating for the Little Rock district to hold classes solely online at the start of the school year because of rising covid-19 case numbers and deaths in Arkansas.
Currently, the district plans to allow parents to select between in-person and virtual instruction for their students, with the exception of pre-kindergarten, which will be taught in-person per a state directive, Little Rock School District Superintendent Mike Poore said in a video message Thursday.
Families must choose between virtual or in-person instruction by Friday.
Knapp Gordon said that although the protocol says a nurse will evaluate a student with symptoms, "there's no way to test that child and confirm that they have covid at the school."
"So it won't be until the parent takes the child to the doctor and the doctor does the test and gets the results back, and by then, a number of people could be infected, because, as we have read recently, children don't necessarily present with fever," Knapp Gordon said. "And as a matter of fact, they could be asymptomatic carriers and expose people without ever knowing that they have had covid."
Gov. Asa Hutchinson said during at a news briefing Wednesday that plans for covid-19 testing in high schools are "still developing."
Later, during the same news conference, when asked about testing and contact tracing capability, the governor said the opening of school is more than three weeks away, so "you probably should ask me that question maybe a week out."
He added that "our answer will be hopefully much different than what it might be today."