A Message From The School Nurse: November 22, 2020

11/18/2020

Dear Harding Academy Parents,

In the past few months I have, understandably, fielded many COVID-19 related questions from parents, and while I am more than happy to do this on an individual basis, and will continue to do so, I thought that especially with the rise in cases of COVID-19 in Nashville that it would be a good idea to address many of these in this format. You will see that some of this information has been shared in my semi-weekly Messages From the Nurse, while some of it has not yet been. This may be a good document to keep handy as some of these questions may not pertain to you now, but may in the future and this could be a good resource to look over at that time. After you read this, if you have additional questions, feel free to email me at clarkm@hardingacademy.us. I will continue to add to this list as questions arise and will keep it available on the COVID-19 Resource tab in CompassNet.

Frequently asked questions:

What symptoms warrant my child staying home from school:

Since most any symptom can be a sign of COVID-19, if your child develops any symptom they will need to stay home from school. How long they stay home, and whether or not they need to see a doctor or get tested for COVID-19 depends on the symptoms they are experiencing. Please refer to the TN Dept of Health's Return to School Algorithm here to determine if your child should attend school, or contact our nurse, Moira Clark, if you are unsure. We base our decisions on this algorithm and so if they are experiencing any of the symptoms listed there they will need to stay home. As a reminder, if your child falls into the category of the second blue bubble, then siblings need to stay home as well. Please keep Moira Clark informed when your child is home due to illnesses so that she can determine when your child (and any siblings) can return to school.

Should my child get tested if they are sick or showing symptoms:

How do we know if an individuals’ symptoms are due to allergies, a common cold, or COVID-19? That is a difficult question to answer without a test. As stated earlier, the list of possible COVID-19 symptoms is long, and even with the typical, more common symptoms of COVID-19 it can look very much like a common cold, allergies, or another respiratory (or even stomach) virus. For that reason the TN Dept. of Health has advised that there are only a few acceptable diagnoses that will allow clearance for students with one high risk symptom, or two low risk symptoms to return to school (read on for more details and examples below).

As you may recall we sent out the TN Dept. of Health’s Return to School Algorithm in an email in September, which showed what we are basing our decision making on when we determine when we will send students home, and when they can return. I would like to point out the section in the bottom of the form where in small print there are details of what an acceptable diagnosis is for return to school, and what is not. Please note:

““Examples of acceptable diagnoses would include fever due to urinary tract infection, strep throat confirmed by a positive strep test, rash from poison ivy, etc. Diagnoses of respiratory and viral conditions such as allergic rhinitis, seasonal allergies, upper respiratory tract infection (URI), pneumonia, pharyngitis without positive strep test, viral illness, etc., DO NOT exclude the diagnosis of COVID-19 and DO NOT justify return to school.”

Although in the past we have accepted some of those diagnoses for return to school, from this point on we will no longer be accepting them, even if a doctor writes a note and gives clearance for the student to return to school. If your child has one high risk or two low risk symptoms and they are not diagnosed with one of the acceptable diagnoses listed then they must have a negative covid test in order to return to school or they must remain home for ten days with the assumption that they have COVID-19. We do realize that each case is different and we will continue to go case by case. For that reason it is important that you contact our school nurse, Moira Clark, if your child develops any symptoms. Then, based on your child’s current symptom(s) and past medical history she will work with you to determine what the proper next steps should be. Please click here to see the algorithm.

Is a rapid COVID-19 test acceptable:

PRC tests are the preferred test since they are more accurate, but at this time rapid tests will be accepted IF the student was symptomatic at the time of the test. In cases when an individual is asymptomatic (not showing any symptoms), rapid tests have been shown to have more false negative results. A false negative test result is when the test result comes back as negative, when in fact the individual is infected with COVID-19 and can spread it to others.

Can my child come to school if a household member (parent, sibling, etc) is a close contact of a positive case of COVID-19?

Yes, if a household member has been determined to be a close contact of someone who tested positive for COVID-19, and is quarantining, your child can come to school, but we strongly encourage that person to be tested ASAP for covid and for household members to get tested as well. (Please see next question for more info)

Can my child come to school if a household member is planning on getting tested that day for COVID-19, or has a pending test?

No, if a household member has a pending covid test, or is going that day to get tested for COVID-19, your child may not come to school until the test result comes back, and only if it is negative. Since they will be out of school anyway, it is a good idea to get the whole family tested because if the student is positive we would want to be able to contact trace if there was exposure on campus. There are many cases that are asymptomatic, and despite a lack of symptoms they are still able to spread it to those around them.

What happens if a household member tests positive for COVID-19?

If a household member tests positive for COVID-19, everyone in the household will need to be quarantined, and everyone should get tested right away, even if they are not showing symptoms, since many people can be asymptomatic and can spread COVID-19. Although you will be in quarantine and no longer spreading it, it would be helpful for the school if you test your child right away so that we can know if they were positive when they last attended school. Due to the many variables involved when there is a positive case in the household, it is best to speak with Moira Clark about when your child will be able to return to school. She will be basing her decisions on this document from the TN Dept of Health, which follows the same guidelines and protocols as the CDC. It is important that families be aware that when there is a household contact who tests positive, that it is likely that the household members will be home for longer than the 14 day quarantine period, unless they are able to truly isolate that individual from the rest of the family for their ten days of isolation, when they are still contagious. Please refer to the section in the document for household contacts.

If a child is determined to be a close contact and we have been told that they need to be quarantined what does that mean?

To be clear, as a school nurse I am able to tell parents that their child is quarantined from school and school related activities, but as a school we do not have the authority to tell you that your child must abstain from anything else. Those with that authority (The TN Dept. of Health) do not currently have the capacity to contact everyone to give them this guidance, so we are strongly encouraging those who have been quarantined from campus to follow the recommendations of the CDC and the TN Dept. of Health. According to the CDC “Quarantine is used to keep someone who might have been exposed to COVID-19 away from others. Quarantine helps prevent the spread of disease that can occur before a person knows they are sick or if they are infected with the virus without feeling symptoms. People in quarantine should stay home, separate themselves from others, and monitor their health.” The quarantine of an individual is for 14 days because it can take up to 14 days for the virus to present itself. Please keep others out of harm’s way by continuing to intentionally quarantine your child not only from in-person school, but by not allowing them to participate in extracurricular activities; such as dance, recreational league sports, trips to the store, or a restaurant, etc. until the quarantine is completed. This also includes not having other people over to your house. During the 14 days of quarantine it is important to keep an eye out for any symptoms that may present. If the TN Dept of Health had the capacity to do so, they would be calling to do symptom checks each day and to ask if your child has remained at home. While this may occur, as I said earlier, the likelihood is low.

Please see this link for what the TN Dept. of Health says about what to expect if you or someone you know has been possibly exposed to COVID-19. Please click this link to view the TN Dept. of Health’s Release of Cases and Contacts From Isolation and Quarantine.

Should my child get tested if they are quarantined:

The CDC recommends that all individuals who are considered a close contact, and therefore quarantined, get tested. The CDC states, “Testing is recommended for all close contacts of persons with SARS-CoV-2 infection. Because of the potential for asymptomatic and pre-symptomatic transmission, it is important that contacts of individuals with SARS-CoV-2 infection be quickly identified and tested.” This can help with the stop of the spread of the virus, and to help us assess if it has spread in our school community. If your child does get tested please let us know the result, regardless of whether it is positive or negative. As a reminder, a negative test result does not mean that the quarantine is lifted. That test was a reflection of the individual's status at the time of the test, so if it is negative the full 14 day quarantine still needs to be completed. If you want to read more about COVID-19 testing please click on this link.

If my child is a close contact and is in quarantine, if they get a negative COVID-19 test can they come back to school earlier?

No, a negative COVID-19 test result does not change the 14 day quarantine because it can take 14 days from an individuals’ last exposure to develop symptoms, so although your child may not have COVID-19 at that time of the test, they may develop it after that. During the 14 day quarantine you should keep an extra eye on your child for any developing symptoms, even if they seem minor, such as a runny nose. The only thing that can decrease the time in quarantine is a positive test result, and that is if it is done in the first few days of quarantine.

If someone living in a household (ex. a parent or sibling) has been an exposure to COVID-19, does the Harding Academy student need to stay home?

If a household member (parent, cibling, etc) has been exposed to someone who tested positive for COVID-19 and is considered a close contact, as long as the child is not considered a close contact they can come to school, since they would be considered a contact of a contact. If that household member decides to get tested, then the child would need to stay home until the (hopefully negative) test result comes back, or if that household member develops symptoms, then the child would need to stay home until the parent gets tested for COVID-19. This is where we do rely on parents to keep us informed.

Does the school require that parents, and siblings who do not attend Harding Academy, and who have been informed that they are close contact to get tested for COVID-19?

We do not require that a household member who has been exposed get tested, as we do not have the authority to make anyone get a test. The CDC does recommend that all close contacts get tested, but they and the TN Dept of Health do not require it either. This is a situation where if a parent informed me that they, or a sibling that does not attend Harding Academy, was determined to be a close contact, I would recommend that they get tested, based on the CDC recommendations. I have had many conversations like this with parents, and the parents that I have spoken to have been very receptive to doing this. The main variable here is whether or not parents are reaching out to me with this information. Many are, but I can not guarantee that I have been made aware of all the times that a parent or sibling has been determined to be a close contact.

What positive cases are parents notified of:

Positive cases of any students
Positive cases of any faculty or staff working at Harding Academy
We do not notify our community if parents or siblings who do not attend Harding Academy test positive, but our full time nurse, Moira Clark, does talk with the family about the proper timing of quarantine and return to school

What does Contact Tracing look like when a student tests positive for COVID-19? Does the school consider the activities that child does outside of school?

The first thing to know is that we have a COVID-19 response team. This team is made up of several different school personnel that can give input on the various different possible points of exposure on campus. This team is kept informed of any pending COVID-19 tests, and as soon as we are notified of a positive case in our community, our response team goes into action, whether it is during the week or weekend. We immediately start talking and divide up the tasks at hand.

For contact tracing, to determine who is considered a close contact of the positive case, we start looking back 48 hours prior to the start of symptoms, if the individual was symptomatic, or 48 hours prior to the date of the test, if the individual was asymptomatic. During that time period, anyone who had been 6 ft or closer for an accumulation of 10 minute or more, over a 24 hour period during that time will be considered a close contact. Since it is an accumulated 10 min we will need to quarantine more strictly than we may have prior to that change in protocol.

As we conduct our contact tracing, we are not only talking with the teachers, and other faculty and staff who work with the individual on campus, but we also talk with the parents to assess any other possible scenarios where other Harding Academy students may have been exposed off campus. This includes inquiries about things such as carpools, sleepovers, recreational sports, parties, dance classes, etc. We do rely on the parents to tell us any contact tracing that needs to be done outside of school that involves any students from Harding Academy.

Once the COVID-19 response team has confirmed with each other that thorough contact tracing has been complete, David Skeen sends out emails to inform our community. The first email is sent to the parents of any students who have been determined to be a close contact, with instructions to quarantine and our strong recommendation that their child be tested for COVID-19. Once those parents have been notified, an email is sent out to the faculty and staff and a separate email is sent out to all current parents at Harding Academy. At that point it is our hope that the contact tracing has been thorough and complete, but there may be instances where we learn of additional potential exposures that were somehow missed, and if that is the case we will contact those parents ASAP to inform them that their child needs to quarantine. This does not happen often, but it is a possibility.

Please note that while conducting our contact tracing, and as we communicate to the families, it is a high priority for us to keep the name of the individual private. We only tell those who need to know the name in order for contact tracing to be done. If you are informed that your child is considered a close contact, while we are happy to answer questions that you may have, we may not be able to tell you the exact time and place where they were potentially exposed since that would give up the identity of the student who tested positive. Thank you for your understanding on this matter.

Where would you recommend that we get tested?

There are several COVID-19 Testing Sites available. The following are the sites that I would recommend based on feedback from parents on ease of getting tested and turn around time for test results. As of 11/16/20 I am no longer able to accurately tell you how fast tests are coming back, since the testing sites and labs are currently overwhelmed with the amount of tests that are being administered.

TN Dept of Health COVID-19 testing sites: (these tests are completely free)

*Note: these are supposed to be for Nashville residents but they will test anyone. The Williamson county site often takes longer than the Nashville sites

M-F, 8:00am to 2:00pm
No symptoms required
PCR tests only
No appt needed
Drive up testing sites
Locations:

Meharry Medical, 918 21st Ave
Nissan Stadium, Lot N
(Williamson county testing site is at The Agricultural Center)

St Thomas COVID testing site:

Symptom(s) required to get tested

PCR tests only
Prior registered required (need to call)
Phone: (615)284-1284
Drive up testing
Testing site open from 10am to 2pm, Mon - Sat (closed on Sundays)

Vanderbilt Walk in Clinics:

PCR and rapid (*rapid tests should not be done if asymptomatic)

Must be symptomatic, even if a family member has tested positive
Call ahead to make an appt for PCR test
The two closest locations to Harding are:

Belle Meade, 5434 Harding Pike, Nashville
Bellevue, 7069-B Highway 70S, Nashville:

Open daily: M-F: 7:30am to 7:30pm; Sat and Sun: 8:00am to 5:00pm
Phone: (615)875-1000

Complete Health Partners:

Open everyday, 9:00am to 7:00pm
No symptoms required
Appointments required; can make appt online
PCR and rapid tests (*rapid tests should not be done if asymptomatic)
Address: 6746 Charlotte Pike, Nashville

Does Harding Academy restrict travel during breaks and or require quarantine upon return?

We encourage all families to follow the CDC recommendations and guidelines on traveling within the US and internationally. Currently there is not a requirement to quarantine after travel, but there are some recommendations based on where you are traveling to. Please click here to check on a specific country you may be considering traveling to. It is important to note that with the significant increase of cases in our country, the CDC’s travel guidelines may change, so please keep that in mind and keep an eye on that as you make your decisions as a family. If they return to recommending a 14 day quarantine after international travel then we will return to that as well.

During Thanksgiving, Winter or Spring Break if a family member tests positive for COVID-19, or learns that their Harding Academy student was determined to be a close contact of a positive case of COVID-19, should we inform the school?

Yes. Even if it occurs during one of the breaks from school the school nurse, Moira Clark, should be informed of these situations. This will allow her to help determine when your child can return to campus, as well as give her the opportunity to advise the family about next steps. She will also alert the teachers if your child will not be returning to campus right after break, but will need to be a remote learner.

Weekly Snapshot
	Total Tests	Active Positive	Recovered Positive	Student Quarantine	Fac./Staff Quarantine
10.23.2020	94	3	7	27	5
10.30.2020	110	5	7	24	5
11.6.2020	138	3	11	19	4
11.13.2020	160	3	14	22	9
11.18.2020	171	2	16	14	6

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