Fast track back to class

COEUR d’ALENE — The wait to return to class after a positive COVID exposure has been shortened for Coeur d'Alene students, following a school board vote Monday night.

Four trustees voted to approve and one abstained from voting on an updated Exposed Staff and Students Return to School or Work Early Procedure, which cuts quarantine in half for students who were exposed while wearing masks and who agree to a polymerase chain reaction (PCR) test on day seven. Students who were not wearing masks during exposure or don't agree to be tested will continue to quarantine for 14 days.

"We would be, in a way, incentivizing mask wearing, and looking at kind of rewarding that student in that we want to acknowledge that the emerging evidence is saying if you're both wearing a mask, your risk of contracting COVID-19 is probably a lot lower than if you were not wearing a mask," lead school nurse Nichole Piekarski said. "We feel like this change acknowledges that."

The Centers for Disease Control recommends a two-week quarantine, but with the number of students out from close contact since the start of the school year, district officials began to explore options to allow students to return sooner than 14 days.

Doctors Vanessa Carroll-Ohmes, medical director of Kootenai Health pediatric services, and Beth Martin, pediatrics specialist at Coeur d'Alene Pediatrics, contributed insight and information about their firsthand experience working with young COVID patients.

"All this is really about a balancing act, of risk to benefits, and having the information and to know what are our gains and what are the consequences that come with them," Carroll-Ohmes said.

She said COVID is highly variable in children, ranging from only a slight fever and runny nose to multi-system inflammatory syndrome, which occurs "after the fact" and presents similar to Kawasaki syndrome, a condition that causes inflammation in blood vessel walls.

"I saw a child go into heart failure in about 12 hours," Carroll-Ohmes said. "It was pretty impressive, so I have a high respect for it. On one side, you're like, 'Wow, this is little more than a cold,' to the other, 'Wow, this is scary stuff.'"

She said research suggests COVID is harder on adults than children because adults have special receptors that act as "front doors" that let in the virus.

"Interestingly enough, children do not have this receptor in the same density that adults have," she said. "On a cellular level, that's kind of where our focus is right now."

This doesn't mean they're immune, as they can spread it, but it explains why they many times don't have significant symptoms, she said.

That being said, schools are not the hotbeds they were expected to be. COVID spreads more at parties and gatherings when students are not in school. To that point, Carroll-Ohmes said, school is so much more than learning.

For a lot of these children, she said, this is the only place they're safe, where they get a full meal, where they get exercise and where they socialize.

"This is a place where we're changing lives, and we're impacting them down the road," she said, adding that adverse childhood events, such as a constant disruption of the school structure, can lead to toxic stress that manifests itself as alcoholism, addiction and other issues in the future.

Martin said the 100% correct answer to the quarantine question is the CDC's recommendation of 14 days. But, she said, "it just seems more practical and, I think, prudent to go ahead and test them at seven days."

"If you're going to come down with COVID, it's usually at seven days, that five-to-seven day window," she said. "If you're negative, you have no symptoms, the practicality of the situation is you're probably not going to get it. I can't say that 100% of the time, you could on day 14 come down with symptoms. But I think if you have a pretty strict policy for if they have any symptoms, 'OK, you gotta go get tested again,' you know, I think it would be a pretty safe option for you. And we are doing that for, like I said, our health care personnel. If someone in the office is exposed, we'll get them tested at day seven. If they're negative, we'll let them come back to work before that 14-day quarantine."

Trustee Lisa May abstained from voting because she felt the board was making a decision outside of its purview that strayed too far from the CDC's recommendation. She said she worried the board was treading on "difficult stuff here," as the protocol isn't the recommendation of the CDC or of Panhandle Health District, although Superintendent Steve Cook said PHD is supportive of the trustees to make policy for their students.

"A lot of our decisions lately haven't been technically in our lane," Trustee Tambra Pickford countered. "When I look at this, I look at what has been in our lane, and it's education of our students and having them in the classroom. Currently, we have kids who have been on 14-day quarantine, come back one day only to be quarantined again, so they're out for another 14 days. I know what that looks like. It's not great overall."