Teachers and others working in schools fear contagion risk
By JULIE MINDA
July 31, 2020
Mental health therapist Tim Hron moderates CHI Health's virtual assembly for teachers preparing to return to the classroom this fall during the COVID pandemic.
School districts and administrators across the U.S. have been working closely with their state and local health and education departments and other agencies to determine whether their schools will use distance learning, in-person learning or a hybrid of the two modes when classes resume in a few weeks.
Teachers, parents and support personnel in the education community have expressed strong concerns about returning to face-to-face learning, absent a vaccine for COVID-19. To help teachers prepare to resume in-person school, CHI Health of Omaha, Nebraska, on July 28 hosted a "virtual assembly" called "Inspiring Hope in a Changing Classroom."
CHI Health school-based mental health therapist Sheila St. Amant engages in a discussion of mental health considerations with the virtual assembly moderator. Part of the virtual assembly was live and part of it was virtual.
During the two-hour videoconference which drew an audience of over 450, infectious disease and mental health experts from the system discussed COVID-19 safety precautions, shared tools to combat student and teacher anxiety, emphasized the importance of teacher self-care and covered other timely topics.
CHI Health has created a website with a recording of the virtual conference. That webpage also has a link to CHI Health's mental health resources.
Mary Williams is public relations director for CHI Health, a 14-hospital network serving Nebraska and Southwest Iowa that is part of Chicago-based CommonSpirit Health. Her department developed the conference. "As people are preparing for back to school, we saw there were a lot of anxious teachers and parents. They were seeing a lot of information on television and social media – some of it inaccurate – and they didn't know what to believe," Williams said.
"We thought we would help give teachers and others the tools to return to school and the science to make informed decisions – to make better decisions," she added.
Tim Hron, a mental health therapist at CHI Health - Creighton University Medical Center Bergan Psychiatric Associates, moderated the assembly which included live and prerecorded content. "We think that fears will be reduced if people understand the facts," he said.
CHI Health - Creighton University School of Medicine infectious disease expert Dr. Renuga Vivekanandan explained the current understanding of the origins, characteristics, symptoms and transmission methods of the coronavirus. She said that while the caseload for children has been low and they are at relatively low risk for bad outcomes, the adults who work with and live with the kids are at significantly higher risk of severe illness or death from COVID-19. Therefore, she said, it is imperative for everyone in the school environment to follow the precautions recommended by health authorities: masking, social distancing at 6 feet or more, and hand hygiene. She also emphasized the importance of staying home when sick.
There were more than 500 questions submitted before and during the event. Topics tackled by Dr. David Quimby, a CHI Health - Creighton University School of Medicine specialist in infectious diseases, included spacing desks to lower contagion risk; how to maintain hygiene protocols among very young children; how to wear, disinfect and store masks; how to pass papers; and whether air purifiers help protect people in school buildings. Quimby also emphasized how important it is for individuals to pay attention to their bodies and to take seriously even low-level symptoms they may have.
Quimby said that at the pandemic's onset months ago the health care community had faced the uncertainties and fears the education community is now facing as schools reopen. He said he and his colleagues have learned a lot in the last several months and have so far staved off outbreaks in their health care facilities by observing the guidelines recommended by health authorities. He also noted that initial information coming from other countries tends to show that those without ample precautions in place had coronavirus outbreaks when schools reopened, whereas countries that put in place protective measures did not have such mass spread.
Dr. Monica Arora, a CHI Health child and adolescent psychiatrist, said children may have anxiety about the pandemic and about the social unrest that has been occurring across the U.S. They may be feeling worried or sad, they may have loss of concentration or refuse to go to school. Young children may regress to thumb sucking and older children may try to isolate themselves. Children may exhibit defiant behaviors.
Arora said to help students deal with such emotions and behaviors, teachers and other school staff should focus on building trusting relationships with students. The teachers should ensure that students know it is safe and welcomed to openly discuss their fears and perceptions. Questions about the pandemic and the precautions being taken should be addressed in an age-appropriate manner, she said.
During a live dialogue, Hron and CHI Health school-based mental health therapist Sheila St. Amant expanded upon Arora's prerecorded presentation, also emphasizing the importance of teachers establishing structure and routines and of the teachers helping children to hone their coping skills. This can include teaching breathing exercises, encouraging students to get adequate sleep and exercise and creating safe spaces where they can go when they need time to calm themselves. St. Amant has been providing integrated school mental health to students at Holy Name School in Omaha since 2012.
CHI Health mental health therapist Karen Williams said in a prerecorded presentation that it is important for teachers to ensure they help themselves to feel safe and calm so that they can convey these feelings to students. "I think self-care is important, now more than ever," she said.
She encouraged teachers to develop a routine to reduce their anxiety and stress. She mentioned getting adequate sleep, eating nutritious food, exercise, going outside periodically, journaling, praying, meditating and practicing gratitude as healthy coping strategies. She said these types of self-care activities have been shown to improve resilience and recommended that teachers find ways to weave these practices into their day.
Williams also demonstrated some breathing techniques useful to release tension.
She said, "Life was stressful before, and now it is even more so. So, we need to take really good care of ourselves and give ourselves permission to feel what we're feeling. And then we can choose what to do about those feelings. You matter – and taking care of yourself matters."
In addition to the online resources for educators and students, CHI Health is providing two copies of the book A New Norm and accompanying teacher guides to every elementary school in Nebraska and Southwest Iowa. The book is designed to help kids navigate complicated emotions. CHI Health also is providing all school districts in Nebraska and Southwest Iowa with its annual "Better You ̵ Healthy Minds Magazine" for parents, this year in online format.
Reopening decisions fraught with complexity for schools
For months, government agencies and school administrators have been mulling the questions: Can schools safely resume in-person learning for the 2020-2021 school year, absent a vaccine for the coronavirus? And, should they?
To make the decisions, school districts across the nation have been poring through the guidance of governmental health and education agencies at the national, state and local levels; responding to the regulations on the matter issued by state and local government bodies; consulting health experts in their communities; and gathering the input of teachers, other school staff, parents and other community voices.
July found school districts across the U.S. releasing their plans for the start of the school year. According to information from the Centers for Disease Control and Prevention, models that can be used, and their associated level of contagion risk, are:
- Lowest risk: Students and teachers engage in virtual-only education and activities.
- More risk: Small, in-person classes, activities, and events, with infection control precautions in place. Hybrid virtual and in-person class structures, or staggered/rotated scheduling may be used to reduce risk.
- Highest risk: Full-sized, in-person education without precautions in place.
According to Education Week, as of Aug. 4, 35 states are largely allowing individual districts to make reopening regulations and decisions; five states have ordered that some in-person instruction be made available to students; seven states have ordered or recommended closures to in-person schooling; one has regional closures in effect; two are allowing only hybrid or remote instruction; and two are undecided.
According to press coverage, many major school districts across the U.S. are not reopening for in-person classes until coronavirus cases drop, because of the fear of contagion. Los Angeles; Dallas; Houston, Chicago; Washington, D.C.; and Miami-Dade County have said they would start the school year with online-only education. New York City hopes to open its schools Sept. 10 using a blended approach of in-person and online education, but hurdles remain.
For schools that do have a full or partial in-person component to their plans for the new school year, the Centers for Disease Control and Prevention has developed resources and safety protocols. In one of the resources, a guide for school administrators for grades kindergarten through 12, the CDC advises that schools develop thorough plans for reopening that include extensive COVID-19 mitigation strategies; contingencies for if and when teachers, students or family members test positive for COVID; protocols for working with state and local health departments to do contact tracing in cases of positive tests; and communication and education strategies to help everyone in the school community understand and adhere to protocols. The CDC resources include information on what is known about the virus, best practices in mitigation and what is known from other countries' experiences reopening schools.
The CDC's resources explain that reopening – when it is feasible to do so — is important because schools are a critical part of communities' infrastructure, providing not just educational instruction, but also such services as school meal programs; social, behavioral and mental health services; and a safe space for children.
The Donald Trump administration has heavily favored reopening schools for in-person learning. But, even given all recommended mitigation measures, there are no guarantees of a wholly safe environment when teachers, other staff and students return to in-person education. The American Federation of Teachers has said teachers may strike if they believe that schools are not adequately prepared to provide a safe environment for in-person schooling.
The National Academies of Sciences, Engineering and Medicine has said that even weighing the health risks of reopening in-person school, "school districts should prioritize reopening schools full time, especially for grades K-5 and students with special needs." The authors said without in-person instruction "schools risk children falling behind academically and exacerbating educational inequities." It says the communities hit hardest by the virus also are the communities that have the least resources and greatest challenges when it comes to making the most of remote learning.
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