ISDH webinar, handouts convey key back-to-school guidance
ISMA’s webinar on COVID-19 testing guidelines and back-to-school resources for physicians, presented by Lindsay Weaver, MD, chief medical officer for the Indiana State Department of Health (ISDH), is now available on the ISMA Online app. ISDH has released a brochure summarizing key points of Dr. Weaver’s presentation, as well as other handouts to assist physicians in serving school-age children, school staff and their families during the pandemic.

Dr. Weaver’s Aug. 19 webinar, “COVID-19 Testing Guidelines and Resources for Going Back to School,” covers topics such as current gaps in testing practices, recommendations for quarantine versus isolation and the importance of keeping immunizations current. To view the webinar, download the ISMA Online app through app stores or here. This and other ISMA webinars are also available for desktop viewing here

Guidelines for length of isolation and quarantine
On Aug. 25, ISDH released “COVID-19: When a student, faculty or staff member can return to school.” The brochure defines terms such as isolation, quarantine and close contact and lists currently recognized symptoms of COVID-19. It also has detailed guidelines for determining how long someone should be isolated or quarantined and when someone can return to school, depending on factors such as whether they are symptomatic, whether they are a close contact to someone with COVID-19, and whether they been tested for COVID-19. A letter summarizing the guidelines and explaining how to use them was sent to schools and local health officials, as well.

In her webinar, Dr. Weaver noted that COVID-19 cases in children since schools have resumed have been linked to out-of-classroom contact rather than instructional activities where precautions against spreading COVID-19 are being taken. 

Other key points from Dr. Weaver’s presentation
Know what COVID-19 resources are available. The main ISDH coronavirus page is In the blue menu bar just beneath the page header photo, click on “Back to School Resources” on the far right. This takes you to the Public Resources page, where clicking on the “Back-to-School Resources” ribbon expands the section to show links to resources for parents and caregivers, resources for school administrators and nurses, and school FAQs. 

There is also a link to a contact tracing toolkit for schools, which has guidelines for how to prepare for COVID-positive students or staff, a checklist for schools to help identify all close contacts of someone who has tested positive, and a tracking sheet for logging and tracking cases and close contacts. Additional tools for higher education are in the works, Dr. Weaver said.

Know the location of nearby testing facilities. ISDH maintains an interactive map with the location of COVID-19 testing facilities across the state. Clicking on a testing site shows requirements, if any, for who can be tested and how to schedule a test. 

Be prepared to see more students and patients. Use virtual options, such as telehealth. 

Prescribe albuterol inhalers with spacers rather than nebulizers. Nebulizers produce aerosol droplets that can spread COVID-19 in schools. 

Be prepared to provide school notes. 

Understand children’s symptoms. Since children with COVID-19 may have much milder symptoms than adults, it’s important to treat symptoms such as a runny nose or a headache in children as indicators of COVID-19, to keep them out of school or send them home and to follow up with testing. 

Physicians’ role in contact tracing. When testing or referring a patient for testing, ask them to go ahead and list everyone they have been in close contact with in the two days before their symptoms started, to have available for the contact tracer if their test is positive. 

If your patient tests positive, encourage them to notify their school, employers, friends and family who may have been exposed immediately and to tell them to expect a text message from a contract tracer using the number 877-548-3444. If the close contact does not respond to the text message or doesn’t complete the linked survey to assess their risk of exposure, contact tracers will attempt to call them up to three times from 833-670-0067.

Why test children for COVID-19? Dr. Weaver noted that testing children is part of Indiana’s conservative approach to preventing the spread of COVID-19 and is designed to keep classes in session for as many days as possible. A positive test result triggers contact tracing and prompts people who receive it to change their behavior as a result. Finally, she said, it’s important to remain diligent about measuring the level of COVID-19 in the population separately from other viruses.