Most Alabama children have not seen the inside of a school building since March 13. When schools reopen in early August, if schools reopen, much will be different about school as we know it. On Tuesday, the Centers for Disease Control and Prevention (CDC) released guidelines on on how schools should reopen in the fall.
The CDC offers these considerations for ways in which schools can help protect students, teachers, administrators, and staff and slow the spread of COVID-19.
The CDC warns that the more people a student or staff member interacts with, and the longer that interaction, the higher the risk of COVID-19 spread. According to the CDC, the lowest risk would be for students and teachers to engage in virtual-only classes, activities, and events. More risk is small, in-person classes, activities, and events. Groups of students stay together and with the same teacher throughout/across school days and groups do not mix. The students remain at least 6 feet apart and do not share objects. Highest risk would be full sized, in-person classes, activities, and events. Students are not spaced apart, share classroom materials or supplies, and mix between classes and activities.
The CDC advises schools to a ctively encourage employees and students who are sick or who have recently had close contact with a person with COVID-19 to stay home. Schools should consider not having perfect attendance awards, not assessing schools based on absenteeism, and offering virtual learning and telework options, if feasible. Staff and students should stay home if they have tested positive for or are showing COVID-19 symptoms or if they have recently had close contact with a person with COVID-19.
The CDC recommends that schools each and reinforce handwashing with soap and water for at least 20 seconds and increase monitoring to ensure adherence among students and staff. If soap and water are not readily available, hand sanitizer that contains at least 60% alcohol can be used (for staff and older children who can safely use hand sanitizer). Encourage staff and students to cover coughs and sneezes with a tissue. Used tissues should be thrown in the trash.
Cloth face coverings are recommended for students and staff, and are most essential in times when physical distancing is difficult. Individuals should be frequently reminded not to touch the face covering and to wash their hands frequently. Cloth face coverings should not be placed on children younger than 2 years old, anyone who has trouble breathing or is unconscious, anyone who is incapacitated or otherwise unable to remove the cloth face covering without assistance. Cloth face coverings are not surgical masks, respirators, or other medical personal protective equipment.
The CDC encourages schools to clean and disinfect frequently touched surfaces including: playground equipment, door handles, sink handles, and drinking fountains) within the school and on school buses at least daily or between use as much as possible. Use of shared objects such as gym or physical education equipment, art supplies, toys, games, etc should be limited when possible, or cleaned between use.
School bus drivers should practice all safety actions and protocols as indicated for other staff including hand hygiene and cloth face coverings.
Cleaning products should not be used near children, and staff should ensure that there is adequate ventilation when using these products to prevent children or themselves from inhaling toxic fumes.
Schools should discourage sharing of items that are difficult to clean or disinfect. Keep each child’s belongings separated from others’ and in individually labeled containers, cubbies, or areas. Schools should ensure that there are adequate supplies to minimize sharing of high touch materials to the extent possible. Schools should assign each student their own art supplies and equipment or limit use of supplies and equipment by one group of children at a time and clean and disinfect between use. Schools should avoid sharing electronic devices, toys, books, and other games or learning aids.
Schools need to ensure that ventilation systems operate properly and increase circulation of outdoor air as much as possible, for example by opening windows and doors. Do not open windows and doors if doing so poses a safety or health risk.
To minimize the risk of Legionnaire’s disease and other diseases associated with water, schools should take steps to ensure that all water systems and features including: sink faucets, drinking fountains, decorative fountains are safe to use after a prolonged facility shutdown. Drinking fountains should be cleaned and sanitized. The CDC recommends that schools encourage staff and students to bring their own water to minimize use and touching of water fountains.
Schools need to space seating and desks at least 6 feet apart when feasible. Turn desks to face in the same direction (rather than facing each other), or have students sit on only one side of tables, spaced apart. Create distance between children on school buses by seating children one child per row and skip rows when possible.
Schools should install physical barriers, such as sneeze guards and partitions, particularly in areas where it is difficult for individuals to remain at least 6 feet apart such as reception desks. Schools should provide physical guides, such as tape on floors or sidewalks and signs on walls, to ensure that staff and children remain at least 6 feet apart in lines and at other times.
Schools should close communal use shared spaces such as dining halls and playgrounds with shared playground equipment if possible. If not possible stagger use and clean and disinfect between use. Schools should add physical barriers, such as plastic flexible screens, between bathroom sinks especially when they cannot be at least 6 feet apart.
Schools are advised to have children bring their own meals if feasible. If that is not feasible then schools should serve individually plated meals in classrooms instead of in a communal dining hall or cafeteria, while ensuring the safety of children with food allergies.
Schools should use disposable food service items: utensils, dishes, cups, etc. If disposable items are not feasible or desirable, ensure that all non-disposable food service items are handled with gloves and washed with dish soap and hot water or in a dishwasher. Individuals should wash their hands after removing their gloves or after directly handling used food service items.
If food is offered at any event, have pre-packaged boxes or bags for each attendee instead of a buffet or family-style meal. Avoid sharing food and utensils and ensure the safety of children with food allergies.
Schools should offer options for staff at higher risk for severe illness (including older adults and people of all ages with certain underlying medical conditions) that limit their exposure risk: telework, modified job responsibilities that limit exposure risk, etc. Offer options for students at higher risk of severe illness that limit their exposure risk such as virtual learning opportunities.
Schools should pursue virtual group events, gatherings, or meetings, if possible, and promote social distancing of at least 6 feet between people if events are held. Limit group size to the extent possible.
Schools should limit any nonessential visitors, volunteers, and activities involving external groups or organizations as possible, especially with individuals who are not from the local community, town, city, or county.
Schools should pursue virtual activities and events in lieu of field trips, student assemblies, special performances, school-wide parent meetings, and spirit nights, whenever possible.
Schools should pursue options to convene sporting events and participation in sports activities in ways that minimizes the risk of transmission of COVID-19 to players, families, coaches, and communities.
Schools should ensure that student and staff groupings are as static as possible by having the same group of children stay with the same staff all day for young children, and as much as possible for older children.
Schools should take steps to limit mixing between groups if possible. Stagger arrival and drop-off times or locations by cohort or put in place other protocols to limit contact between cohorts and direct contact with parents as much as possible.
When possible, use telework) and flexible work hours such as staggered shifts to help establish policies and practices for social distancing (maintaining distance of approximately 6 feet) between employees and others, especially if social distancing is recommended by state and local health authorities.
Schools should designate a staff person to be responsible for responding to COVID-19 concerns (e.g., school nurse). All school staff and families should know who this person is and how to contact them.
Schools should consider participating with local authorities in broader COVID-19 community response efforts such as sitting on community response committees.
Consistent with applicable law and privacy policies, have staff and families self-report to the school if they or their student have symptoms of COVID-19, a positive test for COVID-19, or were exposed to someone with COVID-19 within the last 14 days in accordance with health information sharing regulations for COVID-19.
Schools should establish procedures for notifying staff, families, and the public of school closures and any restrictions in place to limit COVID-19 exposure such as limited hours of operation.
Schools should implement flexible sick leave policies and practices that enable staff to stay home when they are sick, have been exposed, or caring for someone who is sick. Leave policies should be flexible and not punish people for taking time off, and should allow sick employees to stay home and away from co-workers. Leave policies should also account for employees who need to stay home with their children if there are school or childcare closures, or to care for sick family members.
Schools should develop policies for return-to-school after COVID-19 illness. Consult the CDC’s criteria to discontinue home isolation and quarantine for more information on these policies.
Schools should monitor absenteeism of students and employees, cross-train staff, and create a roster of trained back-up staff. Staff should be trained on all safety protocols. Schools should conduct training virtually or ensure that social distancing is maintained during training. Staff should be trained to recognize the signs and symptoms of COVID-19.
If feasible, schools should conduct daily health checks: temperature screening and/or or symptom checking) of staff and students. Health checks should be conducted safely and respectfully, and in accordance with any applicable privacy laws and regulations. School administrators may use examples of screening methods in CDC’s supplemental Guidance for Child Care Programs that Remain Open as a guide for screening children and CDC’s General Business FAQs for screening staff.
Schools should encourage any organizations that shares or use the school facilities to also follow these considerations.
Schools should encourage employees and students to take breaks from watching, reading, or listening to news stories about COVID-19, including social media if they are feeling overwhelmed or distressed. Schools should also promote employees and students eating healthy, exercising, getting sleep, and finding time to unwind. Schools should encourage employees and students to talk with people they trust about their concerns and how they are feeling. Schools should consider posting signages for the national distress hotline: 1-800-985-5990, or text TalkWithUsto 66746
Sick staff members or students should not return until they have met CDC’s criteria to discontinue home isolation. Make sure that staff and families know that they or their families should not come to school, and that they should notify school officials (the designated COVID-19 point of contact) if they or their family become sick with COVID-19 symptoms, test positive for COVID-19, or have been exposed to someone with COVID-19 symptoms or a confirmed or suspected case.
Schools should Immediately separate staff and children with COVID-19 symptoms (such as fever, cough, or shortness of breath) at school. Individuals who are sick should go home or to a healthcare facility depending on how severe their symptoms are, and follow CDC guidance for caring for oneself and others who are sick.
Schools should work with school administrators, nurses, and other healthcare providers to identify an isolation room or area to separate anyone who has COVID-19 symptoms or tests positive but does not have symptoms. School nurses and other healthcare providers should use Standard and Transmission-Based Precautions when caring for sick people.
Schools should establish procedures for safely transporting anyone who is sick to their home or to a healthcare facility. If you are calling an ambulance or bringing someone to the hospital, try to call first to alert them that the person may have COVID-19. Close off areas used by a sick person and do not use these areas until after cleaning and disinfecting. Wait at least 24 hours before cleaning and disinfecting. If 24 hours is not feasible, wait as long as possible.
In accordance with state and local laws and regulations, school administrators should notify local health officials, staff, and families immediately of any case of COVID-19 while maintaining confidentiality in accordance with the Americans with Disabilities Act (ADA). Schools should inform those who have had close contact with a person diagnosed with COVID-19 to stay home and self-monitor for symptoms, and follow CDC guidance if symptoms develop.
COVID-19 is mostly spread by respiratory droplets released when people talk, cough, or sneeze. It is thought that the virus may spread to hands from a contaminated surface and then to the nose or mouth, causing infection. Therefore, personal prevention practices (such as handwashing, staying home when sick) and environmental cleaning and disinfection are important principles.
Country star Amanda Shires to donate funds from single to Yellowhammer Fund
Grammy-winning country musician Amanda Shires will donate all proceeds from a new single to the Yellowhammer Fund, a nonprofit that provides assistance with abortions in Alabama.
Shires and her musician husband, Jason Isbell, partnered on the single “The Problem,” which is set to be released Sept. 28, according to a press release from the Yellowhammer Fund.
The song can be purchased here.
“‘The Problem’ is a song that showcases what loving support looks like through what is often an emotional time,” Shires said in a statement. “The Yellowhammer Fund offers a similar type of support to Alabamians and the Deep South. The fund provides safe options for people in a segment of America where reproductive health is very often at high risk of government interference. Everyone has the freedom to choose how to care for their own body. Individual health care decisions are difficult enough without the added pressure of stigma and ever-changing legal hurdles.”
Laurie Bertram Roberts, executive director of Yellowhammer Fund, said the nonprofit is thankful for Shires help, which comes at a critical time.
“Here in the Deep South, abortion is already incredibly difficult to access, even before a new president is elected or another Supreme Court Justice is appointed,” Roberts said in a statement. “As a fellow southerner, Shires understands those difficulties as well as the negative stigma surrounding abortion. We are thankful that she wrote this song and is telling a story that’s rarely heard.”
“It feels natural to align this song with The Yellowhammer Fund,” Shires said. “Having someone in your corner, offering unconditional support when you’re making hard choices is invaluable. Together, I know we can help make a difference.”
Roberts said at this point the best actions we can take are to go vote, donate to a local abortion fund, and stay active in the fight for reproductive justice.
“Our abortion rights are always on the line — regardless of who is in office — and we must continue the battle to expand access to everyone, no matter what rulings or laws may be in our future,” Roberts said.
Coronavirus task force’s Dr. Deborah Birx says Alabama should extend statewide mask order
Dr. Deborah Birx, coordinator of the White House’s coronavirus task force, said Thursday that Gov. Kay Ivey should extend her statewide mask order, set to expire on Oct. 2. She also responded to a CNN report that cited those close to her as saying she’s “distressed” with the direction the White House coronavirus task force is taking and is unhappy with what she sees as her diminished role in the group.
Birx, speaking at Auburn University, said she met with Ivey and Alabama State Health Officer Dr. Scott Harris earlier in the day to discuss COVID-19 and how the state is responding.
“So we really talked about the importance of continuing mitigation,” Birx said of her talk with Ivey and state officials earlier on Thursday, adding that Ivey was one of the first governors in the South to enact a statewide mask mandate, which she said clearly decreased the spread of the disease.
Birx pointed to numbers, such as the test positivity rate, that have improved since July, but said “we’ve got to do even more.” Asked if the statewide mask mandate was one of the mitigation efforts she suggests continuing into the fall, Birx said she does. “Because if you look at what happened within two weeks of the mask mandate you can see the dramatic decline in cases here in Alabama,” Birx said.
Birx said that when she last visited Alabama in July, the state was suffering from too many new cases of COVID-19.
“I think when I was last here at the beginning of July, it was a very difficult time in general for Alabama. We saw nearly 95 to 100 percent of every county in Alabama, rural or urban, that had more than 10 percent test positivity to COVID-19,” Birx said, adding that today, around 20 percent of the state’s counties have positivity rates above 10 percent.
Public health experts believe positivity rates above 5 percent mean that there isn’t enough COVID-19 testing being done and cases are likely going undetected.
In a statement to APR on Thursday, a spokeswoman for Ivey said Ivey and Dr. Scott Harris would provide an update on the statewide mask order ahead of its Oct. 2 expiration date.
“It is evident that Alabamians are doing considerably well in modifying their behaviors to take the COVID-19 pandemic seriously, and we all remain optimistic that a successful vaccine will be coming soon,” said Gina Maiola, Ivey’s press secretary, in a statement to APR on Thursday. “Our state’s success is largely in part to Alabamians stepping up to the plate when it comes to cooperating with the mask ordinance.”
Maiola said Ivey is leading the way on several fronts “including getting students and teachers back in the classroom, college students returning to campus and businesses remaining open — in fact, Alabama has one of the country’s lowest unemployment rates.”
“This success is a reality because Alabamians are wearing their masks and maintaining social distancing precautions. Governor Ivey and Dr. Scott Harris will continue closely monitoring our progress and provide an update ahead of the October 2nd expiration,” Maiola continued.
Speaking to reporters at Auburn, Birx was also asked about a CNN report on Wednesday that cited sources close to Birx as saying she is unhappy with what she sees as her diminished role on the White House coronavirus task force, that she’s not certain how long she can serve in her position and that she is “distressed” with the direction the task force is taking.
CNN also reported that Birx, who is no longer a fixture at White House coronavirus briefings, views Dr. Scott Atlas, a recent addition to the task force, as an unhealthy influence on President Donald Trump.
Atlas, a neuroradiologist with little experience in public health or epidemiology, has expressed support for the so-called herd immunity “strategy,” which infectious disease expert roundly dismiss as unattainable and a move that would cost millions more lives.
Instead of being a regular presence at White House coronavirus briefings, Birx has spent recent months traveling the country and speaking with governors and university administrators about coronavirus.
Asked Thursday about CNN’s reporting, Birx pushed back.
“Because they wrote that without even speaking to me,” Birx said. “Do I look like a person that’s diminished?”
CNN reported Wednesday that Birx had not responded to requests for comment on the story.
“Yes, I have been on the road. I’ve been on the road not as a spokesperson, but on the road to really understand what’s happening across the country, to be in deep dialogue with mayors, with communities, with governors, with administration school and faculty,” Birx said.
“I’m asked here because I am supposed to be here,” Birx said. “I haven’t been in Washington, and nor was I asked about that, but I’ve actually never been called diminished.”
Asked if she was planning to leave the task force, Birx said, “I have strong tenacity, and I’m very resilient, and we’re in the middle of a pandemic that’s affecting Americans, and as an American, I think I can do the best service to my country right now by serving in this role, working across the agencies, because that’s the experience that I have.”
Asked to clarify whether she planned to step down from the task force, Birx said “no.”
Asked if she was distressed about the direction the task force is taking, Birx said, “well that would be on me, if I was distressed, right, because I’m supposed to be coordinating the groups.”
“So that would be an indication that I’m not doing my job, and I believe that I do my job pretty well every day. I can always learn to do better,” Birx said.
UAB doctor urges public get flu vaccine as COVID-19 continues to spread
As the flu season nears, Alabama health care providers are encouraging the public to get flu vaccines to prevent stressing hospitals, which continue to care for COVID-19 patients.
“We just are really encouraging everyone to go ahead and get vaccinated,” said Dr. Erin DeLaney, assistant professor in the department of family and community medicine at UAB’s School of Medicine, speaking to reporters on Thursday.
DeLaney said physicians are encouraging flu vaccinations, regular hand washing and social distancing because they’re not sure what flu and COVID could look like together.
“We know that there are other respiratory pathogens that together, combined with the influenza virus, can have poor outcomes,” DeLaney said. “And we know that the flu and COVID separately can have poor outcomes, so we’re hoping to protect as many people as we can.”
DeLaney also discussed what will likely be the challenge for the public in attempting to determine whether they have the flu or COVID-19, which would prompt them to seek coronavirus testing.
“Unfortunately, coronavirus and influenza, they will share a lot of the same symptoms,” DeLaney said. “The only thing that’s going to be completely different would be the loss of sense of taste and smell, is specific to COVID.”
DeLaney said the medical community will have to rely on testing to determine between a case of influenza or COVID-19, and recommended that if a person isn’t able to get a coronavirus test they should assume they have COVID-19 and self-quarantine for 14 days.
Taking a clue from areas of the world that have already seen the start of the flu season, DeLaney said it appears that the spread of flu in those areas has been lighter this year, most likely because of what’s being done to protect people from COVID-19, including the wearing of masks, social distancing and regularly washing hands.
“We are hopeful that would also be our same experience as we enter our flu season — that if people are vigilant with COVID that it would protect us from not only the flu but other respiratory pathogens as well,” DeLaney said.
Speaking about the upcoming Halloween holiday, DeLaney said if families decide to go door-to-door with their children, eager for candy, masks should be worn. Masks that come with costumes do not provide protection, however, and DeLaney said they don’t recommend placing cloth masks over costume masks either. Medical providers are encouraging kids to wear Halloween-themed cloth masks instead.
The Centers for Disease Control and Prevention encourages families giving out candy on Halloween not to put the candy in a bowl for children to reach into, but instead suggest placing candy into separate bags and to place the bags outside the home.
She also recommended other outdoor activities in lieu of door-to-door candy gathering.
“So an outdoor pumpkin carving. Playing some Halloween music outside or having different types of activities where people are not going to be gathering closely, or not all touching the same things, would be ideal,” DeLaney said.
There have been 148,206 confirmed cases of COVID-19 in Alabama as of Thursday, when the state added 1,052 new cases, according to the Alabama Department of Public Health. As of Thursday, 2,506 people have died in Alabama from COVID-19, 18 of which were added on Thursday.
Alabama declines to release COVID-19 data associated with child care centers
APR has asked for that data and whether ADPH was aware of the number of cases associated with child care centers statewide.
It was unclear Tuesday the number of confirmed cases of COVID-19 there have been among staff, children and relatives associated with child care facilities in Alabama, because the Alabama Department of Public Health declined to release that data.
“All cases of COVID-19 are required to be reported to the Alabama Department of Public Health under notifiable disease laws. ADPH is aware of cases in entities such as child care but does not report separately from other data,” said Dr. Karen Landers, assistant state health officer, in a message to APR on Tuesday.
APR has asked for that data and whether ADPH was aware of the number of cases associated with child care centers statewide.
Landers noted that ADPH does provide the percentage of cases among age ranges, however. There had been approximately 2,628 confirmed COVID-19 cases among Alabama children 4-years-old and younger as of Monday, according to ADPH’s dashboard, but the department doesn’t specify which of those cases are associated with child care centers, and it was unclear how many cases there have been among relatives or workers connected to child care centers.
While children 10-years-old and older can efficiently transmit COVID-19 to others, the Centers for Disease Control and Prevention in a recent report note that “limited data are available on SARS-CoV-2 transmission from young children, particularly in child care settings.”
The Sept, 18 CDC report looked at three COVID-19 outbreaks in child care facilities in Salt Lake County, Utah, during April 1 through July 10, and found that the 12 children who contracted the disease spread it to at least 12 others outside the centers, and one parent was hospitalized with coronavirus.
In one facility, researchers confirmed five cases among workers and two among children. One of those children, aged 8 months, transmitted COVID-19 to both parents, the report notes. Many of the children had mild symptoms or none at all, researchers found.
“COVID-19 is less severe in children than it is in adults, but children can still play a role in transmission,” the report reads. “The infected children exposed at these three facilities had mild to no symptoms. Two of three asymptomatic children likely transmitted SARS-CoV-2 to their parents and possibly to their teachers.”
While Alabama’s Department of Public Health isn’t releasing data on cases associated with child care centers, many other states are, including Texas, South Carolina, North Carolina, California, Minnesota and Massachusetts.
There have been 332 confirmed cases, two deaths and 14 separate outbreaks associated with child care centers in North Carolina, according to the North Carolina Department of Health and Human Services.
Health officials in California’s Sonoma County traced 30 cases of coronavirus to one child at a child-care center in the county, where 16 students, 11 relatives and three workers tested positive, according to The Los Angeles Times. In addition to that outbreak, there have been 62 other cases at 13 child-care facilities in the county, including 27 family members, 10 workers and 25 students, with 381 cases of children younger than 17 still under investigation, the newspaper reported on Sept. 21.
Reopening child care centers can be done safely, according to an Aug. 28 report by the Centers for Disease Control and Prevention, which that found that in Rhode Island, which reopened child care centers on June 1, there were just 52 confirmed and probable cases among staff, children and relatives across 29 centers between June 1 and July 31.
The report noted that Rhode Island at first limited centers to 12 or fewer students, required staff and students to not move between groups in centers and “universal use of masks for adults, daily symptom screening of adults and children, and enhanced cleaning and disinfection according to CDC guidelines.”
Alabama State Health Officer Dr. Scott Harris on March 19 issued an order closing child care centers through April 5, with exceptions for facilities that provided services to first responders and other workers deemed essential. Harris on March 27 issued a supplemental order allowing centers that cared for 11 or fewer children to reopen.
The Alabama Department of Public Health on Monday published a press release touting the number of open child care centers across Alabama. According to the department, 76 percent of all child care facilities in Alabama are open.
“Alabama is well on our way to reopening the necessary number of child care facilities to enable parents to return to work and resume a more normal schedule,” said Alabama DHR commissioner Nancy Buckner, in a statement. “This is the sixth survey we have conducted and each one has shown tremendous growth in the numbers of open facilities. We have worked hard to encourage child care providers to open by providing support in the form of grants and supplies.”
Asked whether the department is aware of the number of COVID-19 cases among children, staff or relatives associated with child care centers, a DHR spokesperson responded in a message to APR on Monday that “We don’t track that.”
While child care plays a critical role for working parents across the country, the pandemic and subsequent shutdowns have put a strain on the businesses, according to a July 13 study by the National Association for the Education of Young Children, which surveyed more than 5,000 child care facilities in every state.
Among the child care centers surveyed, two out of five said they would have to close without more public assistance, while half of the minority-owned centers said they have to close without more aid, according to the report. A quarter of child care workers said they’d applied for or received unemployment benefits, and 73 percent of centers said they have or will begin laying off workers and/or make pay cuts.
An Aug. 26 study by the Washington D.C.-based nonprofit Bipartisan Policy Center found that 32 percent of parents polled said their child care centers were closed, 14 percent of them permanently, and 22 percent of the parents said they could not return to work in person without childcare.
Even when child care is available to parents, many are worried about sending their children back while COVID-19 continues to spread. Of those asked, 77 percent of parents said they were concerned that sending their kids back would increase the risk of exposing their family to COVID-19.