Latest / The SHEA Podcast / COVID-19: Reopening Schools, 7/23

Transcript

COVID-19: Reopening Schools, 7/23 · The SHEA Podcast

• 0:08
  SPEAKER_00: Welcome to the Rapid Response Podcast brought to you by the Society for Healthcare Epidemiology of America, Shay, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:24
  SPEAKER_00: I am Dr.
• 0:24
  SPEAKER_00: Jennifer Hanrahan, infectious disease specialist at the University of Toledo, and I will serve as your moderator.
• 0:31
  SPEAKER_00: Discussion on the podcast does not reflect Shay's perspective, but facilitates communication of multiple perspectives and experiences as we go through this challenging time together.
• 0:41
  SPEAKER_00: Shay is excited to launch the 23rd episode of this podcast, COVID-19 updates what we know now.
• 0:48
  SPEAKER_00: Today's episode will address reopening schools during the pandemic.
• 0:52
  SPEAKER_00: Our speaker is Dr.
• 0:53
  SPEAKER_00: Jason Newland, Professor of Pediatrics at the Washington University School of Medicine in St.
• 0:58
  SPEAKER_00: Louis.
• 0:59
  SPEAKER_00: Thank you for joining us today.
• 1:01
  SPEAKER_00: I would like to get us started with a brief news and guidance update of the week.
• 1:06
  SPEAKER_00: As of July 22nd, there are 14,562,550 confirmed cases of COVID-19, including 607,781 deaths, according to the World Health Organization.
• 1:22
  SPEAKER_00: This week, President Trump is endorsing the use of face masks and calls wearing them patriotic.
• 1:28
  SPEAKER_00: The CDC has issued interim guidance on discontinuation of transmission-based precautions and disposition of patients with COVID-19 in healthcare settings.
• 1:38
  SPEAKER_00: As of July 17th, except for rare situations, a test-based strategy is no longer recommended to determine when to discontinue transmission-based precautions.
• 1:48
  SPEAKER_00: For patients with severe to critical illness or who are severely immunocompromised, the recommended duration for transmission-based precautions was extended to 20 days after symptom onset, or for asymptomatic, severely immunocompromised patients 20 days after their initial positive SARS CoV-2 diagnostic tests.
• 2:05
  SPEAKER_00: The guidance states that for most persons with COVID-19 illness, isolation and precautions can generally be discontinued 10 days after symptom onset and resolution of fever for at least 24 hours without the fever-reducing medications and with improvement of symptoms.
• 2:20
  SPEAKER_00: A limited number of persons with severe illness may produce replication competent virus beyond 10 days that aren't extending duration of isolation and precautions for up to 20 days after symptom onset.
• 2:31
  SPEAKER_00: Consultation with infection control experts should be considered.
• 2:34
  SPEAKER_00: For persons who never develop symptoms, isolation and other precautions can be discontinued 10 days after the date of their first positive PCR test for SARS-CoV-2 RNA.
• 2:44
  SPEAKER_00: In regard to the role for PCR testing to discontinue isolation or precautions, CDC recommends for persons who are severely immunocompromised, a test-based strategy could be better in consultation with infectious diseases experts.
• 2:57
  SPEAKER_00: For all others, a test-based strategy is no longer recommended except to discontinue isolation or precautions earlier than would occur under the strategy outlined previously.
• 3:07
  SPEAKER_00: For persons previously diagnosed with symptomatic COVID-19 who remain asymptomatic after recovery, retesting is not recommended within three months after the date of symptom onset for the initial COVID-19 infection.
• 3:19
  SPEAKER_00: In addition, quarantine is not recommended in the event of close contact with an infected person.
• 3:24
  SPEAKER_00: For persons who develop new symptoms consistent with COVID-19 during the three months after the date of initial symptom onset, if an alternative etiology cannot be identified by a provider, then the person may warrant retesting.
• 3:36
  SPEAKER_00: Quarantine may be considered during this evaluation based on consultation with an infection prevention expert, especially in the event symptoms develop within 14 days after close contact with an infected person.
• 3:47
  SPEAKER_00: For persons who never develop symptoms, the data first positive RTPCR test for SARS-CoV-2 should be used in place of the date of symptom onset.
• 3:56
  SPEAKER_00: In addition, serologic testing should not be used to establish the presence or absence of SARS-CoV-2 infection or reinfection.
• 4:04
  SPEAKER_00: And finally, for healthcare providers, except for rare situations, a test-based strategy is no longer recommended to determine when to allow healthcare providers to return to work.
• 4:13
  SPEAKER_00: For healthcare providers with severe to critical illness or who are severely immunocompromised, the recommended duration for work exclusion was extended to 20 days after symptom onset.
• 4:23
  SPEAKER_00: And that's the news for this week.
• 4:25
  SPEAKER_00: I now want to move on to the discussion with Dr.
• 4:28
  SPEAKER_00: Newland.
• 4:29
  SPEAKER_00: Thank you for joining us today.
• 4:31
  SPEAKER_01: Thanks for having me.
• 4:32
  SPEAKER_00: Dr.
• 4:32
  SPEAKER_00: Newland, for pediatricians, COVID-19 is a little bit different with how it impacts children as compared with influenza or other viruses.
• 4:41
  SPEAKER_00: Can you talk a little about that?
• 4:43
  SPEAKER_01: Yes, Jennifer.
• 4:44
  SPEAKER_01: You know, since the start of that pandemic, we've seen what was different than what we've expected previously with other respiratory viruses when it comes to children.
• 4:52
  SPEAKER_01: Like influenza, RSV, any other respiratory viruses, we think of children as kind of the major player in getting everyone sick.
• 5:00
  SPEAKER_01: We have them in school, they bring them home to us, and we get those illnesses.
• 5:04
  SPEAKER_01: We also know that, especially for influenza, the youngest children can have the most serious illnesses.
• 5:09
  SPEAKER_01: And with influenza, we have over 150 deaths a year in children from this virus.
• 5:15
  SPEAKER_01: The SARS-CoV-2 virus and that and subsequently the COVID-19 illness does not seem to be impacting children as greatly as we have seen with other viruses.
• 5:24
  SPEAKER_01: Now, currently, if you look across the country, the initial reports from the MMWR in April suggests that only about 2 to 3% of all positive cases were in children.
• 5:36
  SPEAKER_01: And these illnesses were mild.
• 5:38
  SPEAKER_01: Most did not require hospitalization, and the illnesses were not the same as you would see in adults.
• 5:44
  SPEAKER_01: So this constellation of symptoms of fever, shortness of breath, and cough, that is probably in over 70, 80% of adult individuals that have COVID-19, is not what you see in kids.
• 5:55
  SPEAKER_01: In children, it's 50% will have a fever.
• 5:58
  SPEAKER_01: You could see some cough, some congestion, vomiting, and diarrhea, headache.
• 6:03
  SPEAKER_01: And what we've subsequently learned is that it feels like just about any symptom that could represent a viral illness can be represented by COVID-19, which I believe is providing us some additional challenges, as we're going to discuss later when it comes to going back to school.
• 6:17
  SPEAKER_01: Overall, the deaths, as I believe, July 4th in children, because there have been deaths, it's not fair to say we haven't seen those, is only like 26 or 27 that's thought to be due to COVID-19.
• 6:30
  SPEAKER_01: Now, of course, a month or six weeks after the start of the pandemic in the United States, we then started learning about this multi-inflammatory syndrome in children, also lovingly referred to as MISC.
• 6:44
  SPEAKER_01: This condition was first identified in the United Kingdom and is this inflammatory-based syndrome that looks somewhat like this Kawasaki disease that we talk about in children, is like a vasculitis.
• 6:56
  SPEAKER_01: And that has been an interesting thing that we've seen some heart involvement, not only just coronary artery involvement, but also myocarditis.
• 7:04
  SPEAKER_01: They are severely ill, requiring blood pressure support.
• 7:08
  SPEAKER_01: And it looks to be a post-infectious complication associated with COVID-19.
• 7:12
  SPEAKER_01: And in some of the places that have been the hardest hit, that kind of missy increase in presentations occur about four to six weeks after the initial outbreak.
• 7:21
  SPEAKER_01: So we have a lot to learn about that.
• 7:23
  SPEAKER_01: But that's been one of the other intriguing pieces of COVID-19 when it comes to kids.
• 7:29
  SPEAKER_00: You know, I think it's an incredibly difficult situation.
• 7:32
  SPEAKER_00: And I think it's obviously going to get more complicated.
• 7:35
  SPEAKER_00: So while kids are not getting COVID in high numbers, it still has impacted healthcare workers, caregivers, and visitors.
• 7:42
  SPEAKER_00: What are some of the challenges of this in children's hospitals?
• 7:45
  SPEAKER_01: Yeah, so this has led to challenges because in the children's hospitals, we are caring for obviously the children, but there's the adults and there's the actual workers.
• 7:53
  SPEAKER_01: And what we've found is while we've had minimal numbers of cases, though, in certain parts of the country they've seen more of the pediatric cases.
• 8:00
  SPEAKER_01: When it comes to the visitors or the family members, you know, there's been a lot of restrictions put into place.
• 8:07
  SPEAKER_01: Well, how do you do that in a children's hospital when you have a four-year-old that's admitted to the hospital with COVID-19 or with something else?
• 8:13
  SPEAKER_01: Because we went into this lockdown mode of limiting the number of visitors.
• 8:18
  SPEAKER_01: And I have to hand it to my infection prevention colleagues here, Dr.
• 8:20
  SPEAKER_01: Patrick Reich and his staff, and Dr.
• 8:22
  SPEAKER_01: Erica Hayes, you know, they've had to make a lot of different decisions to help protect healthcare workers as well as protect the caregivers and visitors with changing data.
• 8:33
  SPEAKER_01: So at one point, only one visitor.
• 8:34
  SPEAKER_01: And you can imagine when you have two parents, for all of you that are parents out there, right?
• 8:38
  SPEAKER_01: Can you imagine not being allowed to be in the hospital with your child and only have one of the family members there?
• 8:43
  SPEAKER_01: Like that's really, really hard.
• 8:44
  SPEAKER_01: But then when we think about the workers, we're hearing like, oh, the kids aren't as impacted.
• 8:49
  SPEAKER_01: That's not going to be a problem.
• 8:51
  SPEAKER_01: But what happens is we bring it into each other and we were giving it, we've seen more this transmission within the hospital among our staff, which I think also will play into the conversation about schools later.
• 9:03
  SPEAKER_01: But that's the other challenge is making sure people are like, no, no, no.
• 9:06
  SPEAKER_01: We could be bringing it to each other while we're caring for our children.
• 9:10
  SPEAKER_01: So I think just like all our adult colleagues have seen from the hospital perspective, we have similar things to deal with, but not to the level, I believe, but also with this additional nuance.
• 9:20
  SPEAKER_00: Yeah, as I said before, this is going to be getting more complicated.
• 9:25
  SPEAKER_00: And now, you know, as we head into August, the American Academy of Pediatricians and CDC are talking quite a bit about going back to school.
• 9:33
  SPEAKER_00: It's really on everybody's minds.
• 9:35
  SPEAKER_00: Can you share your thoughts about this?
• 9:37
  SPEAKER_00: And obviously, we know that these are your personal thoughts based on your experience and not reflective of your institution.
• 9:42
  SPEAKER_01: Yeah, no, Jennifer, this is such the important conversation.
• 9:45
  SPEAKER_01: I'm so glad we're able to talk about that here.
• 9:47
  SPEAKER_01: Right.
• 9:47
  SPEAKER_01: So the American of Pediatrics comes out and really makes some bold strokes that I think for some in the infection prevention community and even some in my own community of the Pediatrian Infection Disease Society, like, wow, you know, they're saying three feet is going to be okay for distancing.
• 10:01
  SPEAKER_01: We really believe strongly in them and our kids getting back to school.
• 10:04
  SPEAKER_01: Um, and so some different recommendations.
• 10:06
  SPEAKER_01: And I think we have to step back and think about what are some of the negative consequences to not going to school?
• 10:12
  SPEAKER_01: Because we all think of school as education and education being paramount, but school for children is so much more than education.
• 10:21
  SPEAKER_01: And that's beyond just the socialization you get, the you know, learning how to have the interpersonal skills that you get by being a person, but you know, it also provides for those in the most vulnerable populations, as we've already learned about the horrible disproportionately impact on people of color, those in the vulnerable groups, that that happens also in school.
• 10:41
  SPEAKER_01: So when you're not going to school, you're lacking some of the ability of food security.
• 10:46
  SPEAKER_01: Those who sometimes actually get some of their access to health care occurs in some school-based clinics.
• 10:51
  SPEAKER_01: We also know that our educators are some of the most important people keeping our children safe.
• 10:57
  SPEAKER_01: They keep them safe because they recognize child abuse and they recognize neglect.
• 11:02
  SPEAKER_01: They see these things, and those reports go down 20, 30 percent.
• 11:05
  SPEAKER_01: That happened during the influenza pandemic, which seems like nothing compared to what we're dealing with now.
• 11:10
  SPEAKER_01: So, first and foremost, in-person school provides huge benefits.
• 11:16
  SPEAKER_01: Virtual school, we definitely know, led to a lot of the haves being able to keep having and the have nots, keeping to have not more.
• 11:25
  SPEAKER_01: Because a lot of these people that didn't have any ability to do this just school stopped.
• 11:29
  SPEAKER_01: So for many, school stopped in March.
• 11:32
  SPEAKER_01: And so taking into account what we talked about first with the lack of having the mild disease and also what looks to be mild transmission or not the similar transmission we see, especially in the younger age group.
• 11:43
  SPEAKER_01: I think the teenagers is a different group.
• 11:46
  SPEAKER_01: The AAP really came out and says, hey, we need to go back to school.
• 11:48
  SPEAKER_01: And we know that we then have to think about well, how do we do that?
• 11:52
  SPEAKER_01: And how do we do that safely?
• 11:54
  SPEAKER_01: And I can say on July 22nd, 2020, living in St.
• 11:58
  SPEAKER_01: Louis, one of the places that where we're seeing a significant increase in cases, that is a real challenge.
• 12:04
  SPEAKER_01: How do you do that?
• 12:05
  SPEAKER_01: And I think the other important piece, and I think the American Academy of Pediatrics and others like myself have to remember is our educators have to feel safe and they have to know they're safe.
• 12:15
  SPEAKER_01: And so I think that's going to be super important as we move forward.
• 12:18
  SPEAKER_00: Yeah, Jason, you raise a lot of important points.
• 12:21
  SPEAKER_00: I mean, as you talk about this, you know, it occurs to me that in the school setting, it's even more difficult than in the healthcare setting.
• 12:28
  SPEAKER_00: And I think that this really raises a lot of questions.
• 12:32
  SPEAKER_00: What about daycares, including before and aftercare of children?
• 12:36
  SPEAKER_00: What do you think about that?
• 12:37
  SPEAKER_01: Yeah, so I think daycares have been a great story, right?
• 12:40
  SPEAKER_01: Like, so you look in New York City where we've learned of these reports of daycares being open throughout the heat of the pandemic.
• 12:46
  SPEAKER_01: I mean, large number of cases and no outbreaks in daycares.
• 12:50
  SPEAKER_01: They did things to mitigate transmission.
• 12:52
  SPEAKER_01: That has been a great story.
• 12:53
  SPEAKER_01: Now, we've also heard about an outbreak down in Texas within a daycare of COVID-19.
• 12:58
  SPEAKER_01: Now, what do we need to learn from that situation versus the other?
• 13:02
  SPEAKER_01: I can tell you that, you know, thinking about can we go back to school safely, I think it's absolutely true, including daycares and aftercare, because we have learned what you can do to make this safe, right?
• 13:13
  SPEAKER_01: I think masking, which I know we're going to get to, is a great strategy.
• 13:19
  SPEAKER_01: I mean, think about this MMWR report that was published on July 14th that occurred in my backyard, one might say, though, three and a half hours away in Springfield, Missouri, where the two hairdressers are cutting hair while they're ill.
• 13:33
  SPEAKER_01: And we know that one hairdresser gave COVID-19 illness to the other hairdresser, but none of their clients, 139 or 140, did not get sick.
• 13:41
  SPEAKER_01: And they're wearing cloth-based masks.
• 13:43
  SPEAKER_01: And that's close contact.
• 13:44
  SPEAKER_01: And I'm sure some of those were more than 15 minutes.
• 13:47
  SPEAKER_01: Now, a gentleman like myself who does not have hair does not need a long time in front of there, but there are definitely some that were.
• 13:54
  SPEAKER_01: So masking's huge.
• 13:55
  SPEAKER_01: We know distancing can happen.
• 13:57
  SPEAKER_01: So these things can be done not only in daycare settings where they're not even doing masks many times and using distancing and cohorting so that we don't have the potential for that spread.
• 14:06
  SPEAKER_01: Those things can happen and make these places safe.
• 14:10
  SPEAKER_00: So, how do you get kids to wear a mask?
• 14:12
  SPEAKER_00: You know, is there like an age limit or how do you make that determination?
• 14:16
  SPEAKER_01: You know, Jennifer, I've evolved on my thinking in masks.
• 14:19
  SPEAKER_01: So I will be the first to admit in March when we were talking about masking and we were, you know, limited supply of masking.
• 14:25
  SPEAKER_01: I'm like, really?
• 14:26
  SPEAKER_01: Like, shouldn't we be saving the mask for the people that need it as they're taking care of these patients?
• 14:31
  SPEAKER_01: And obviously, we learned quickly that the masking's been a super important thing.
• 14:35
  SPEAKER_01: And so then it got into this.
• 14:36
  SPEAKER_01: We'll talk about it in school.
• 14:38
  SPEAKER_01: And I'm thinking of this five-year-old little one running about with a mask on.
• 14:43
  SPEAKER_01: Really?
• 14:43
  SPEAKER_01: Like that's gonna happen?
• 14:44
  SPEAKER_01: Aren't they gonna bite it and chew it?
• 14:46
  SPEAKER_01: And we've heard are they gonna share it with one another?
• 14:49
  SPEAKER_01: But you know, as I think kids have started to watch their parents role model this and they've seen maybe their older sibling do it, we're starting to see more and more and hearing more and more stories that, you know, kids kind of like it, right?
• 15:03
  SPEAKER_01: They want to be a part of it.
• 15:04
  SPEAKER_01: They want to do it.
• 15:05
  SPEAKER_01: And you can teach to that.
• 15:07
  SPEAKER_01: Now, we have the guidance from CDC that under the age of two, not to wear a mask makes sense.
• 15:11
  SPEAKER_01: Those who might have trouble breathing or underlying conditions that lead to it, not asthma, but things that, you know, potentially some mental disabilities or intellectual disabilities that make it harder, they're not going to it, that might not be the case.
• 15:24
  SPEAKER_01: But I really believe that we can teach our kids to mask, probably as young as kindergarten, through school.
• 15:31
  SPEAKER_01: Now, that doesn't mean they're gonna be able to wear their mask all day.
• 15:34
  SPEAKER_01: Heck, I'm 46 years old and I struggle wearing a mask all day.
• 15:37
  SPEAKER_01: So I think there's gonna have to be these innovative times when they're not wearing a mask and they're gonna be distanced.
• 15:43
  SPEAKER_01: Or what we're seeing in our schools is they're giving them some partitions maybe that they're gonna eat at their table with that gives them a little bit of barrier and some distance between that.
• 15:52
  SPEAKER_01: So those things can happen.
• 15:54
  SPEAKER_01: And I can say, like, I have some great pediatric ID colleagues who have really convinced me that that's gonna be important to mask.
• 16:01
  SPEAKER_01: It's also gonna be important because it's gonna give our teachers and educators a sense of safety because we have the literature behind that.
• 16:09
  SPEAKER_01: And then I also think the face shields will be also something that can be utilized, especially for those for the younger individuals as they're learning to read and those pieces, as well as those who might be deaf, who can't see, who need to see the faces.
• 16:21
  SPEAKER_01: I think that's gonna be important going forward.
• 16:24
  SPEAKER_00: That's really important information, you know, and it's interesting.
• 16:27
  SPEAKER_00: I hadn't really thought about the face shields for kids, but it makes sense that that actually might be a really good tool.
• 16:34
  SPEAKER_00: What about play dates?
• 16:35
  SPEAKER_00: If they go back to school or if they don't, do you have advice about play dates?
• 16:40
  SPEAKER_01: So kids need to be around other kids.
• 16:42
  SPEAKER_01: Teenagers need to be around other teenagers.
• 16:44
  SPEAKER_01: How do we do that safely?
• 16:46
  SPEAKER_01: I think number one is I think this concept of the bubble makes sense.
• 16:50
  SPEAKER_01: We definitely know some of these kids are gonna have closer bubbles, and maybe they have a bubble with one or two.
• 16:56
  SPEAKER_01: You know, that bubble might have to shrink if cases continue to rise and we have to kind of pull people back even more.
• 17:01
  SPEAKER_01: So I think blade dates can happen.
• 17:03
  SPEAKER_01: If you have the one or two friends with the kids that are similar and you know their activities, what their belief system is, that can do it.
• 17:11
  SPEAKER_01: I also know where I have friends who are like, Yeah, you know, I have kids that they go and are with others, play dates, hang out, and they're wearing masks and doing distancing.
• 17:19
  SPEAKER_01: Like that's just part of what they do now.
• 17:21
  SPEAKER_01: They just realize that's part of it.
• 17:24
  SPEAKER_01: So I think one, yes, we can still have the children can have play dates, teenagers can have day dates, keep the circles, stress the principles, wear your mask when you're out in public stressing that.
• 17:35
  SPEAKER_01: For the younger kids, yeah, they can be playing distance, but keep the group small so that you know if something would happen that you're not impacting a lot of individuals.
• 17:43
  SPEAKER_00: That's great advice.
• 17:44
  SPEAKER_00: You know, one of the other questions that has come up quite a bit from families is about travel.
• 17:49
  SPEAKER_00: What do you think about kids traveling during the year, especially around some of the holiday breaks and then re-entering the school?
• 17:56
  SPEAKER_01: I think of travel as of what can you control and what can't you control as you go on and when you think about these trips.
• 18:03
  SPEAKER_01: So when you get in an airplane, you can control part of that, but you can't control that, you know, you're sitting in an airplane with a lot of other people and depending on them to wear masks and do all these things differently.
• 18:13
  SPEAKER_01: So you have to decide, I think, that risk of if you're gonna do that or not.
• 18:18
  SPEAKER_01: But I think you can travel with kids, then especially like the fact that we got a car, we can control all of that.
• 18:24
  SPEAKER_01: We can can we can wear a mask, we can do social distancing, we can go to the hotel, wipe things down, avoid things, we can rent a house, we can do this.
• 18:32
  SPEAKER_01: So I think travel can happen.
• 18:34
  SPEAKER_01: We just have to remember those principles: social distance, wear the mask, wash our hands.
• 18:39
  SPEAKER_01: And I think as we come back to our schools, I am not one of the belief that if you've been in, you know, Florida and you're coming back to Missouri, I have to quarantine because quarantining will not matter.
• 18:53
  SPEAKER_01: Because in Missouri, we're seeing a lot of cases.
• 18:55
  SPEAKER_01: If you're having poor habits there, then that doesn't matter.
• 18:58
  SPEAKER_01: I think that we have to focus on ourselves and our families, how we do that in a safe way.
• 19:03
  SPEAKER_00: I think getting people to understand this has been one of the challenge, I think.
• 19:08
  SPEAKER_00: And even healthcare systems don't really understand the masking and the social distancing, right?
• 19:14
  SPEAKER_00: So it's hard to do.
• 19:15
  SPEAKER_01: So true.
• 19:16
  SPEAKER_01: Like we can do things, we just have to do it differently and and be smarter about it.
• 19:20
  SPEAKER_01: And some of the activities that we so want to do, like have the graduation party because we have a senior and it's their senior year and it's such a big thing.
• 19:28
  SPEAKER_01: We shouldn't be having those.
• 19:30
  SPEAKER_01: Uh, I mean, I I think these sorts of things, just like in travel, like I shouldn't be traveling to want to go to a big old bar or a big party.
• 19:37
  SPEAKER_01: Like, that's this isn't the time for that.
• 19:39
  SPEAKER_01: Hopefully, the summer of 2021 is the time for that.
• 19:42
  SPEAKER_01: So that's kind of what I'm trying to hopefully we impress upon people.
• 19:45
  SPEAKER_00: So, what does preparing for fall look like at a children's hospital when you're gonna be dealing with COVID, influenza, and other restroviruses at the same time?
• 19:56
  SPEAKER_00: And also, how do you deal with that in a school setting?
• 20:00
  SPEAKER_01: Well, Jennifer, like all good infectious disease doctors, right?
• 20:02
  SPEAKER_01: Like this is the time to really start talking about vaccination, vaccination, vaccination.
• 20:07
  SPEAKER_01: We know that in influenza, that only about 50% of our population will get the flu vaccine.
• 20:13
  SPEAKER_01: We're all fearful of that in the children's hospital as well as we hit into respiratory season that, you know, with influenza wreaking havoc, and if it's one of those seasons that we've seen in the past, the system will be overrun.
• 20:25
  SPEAKER_01: Now, what I'll say, and what I am going to predict, I'll make some bold predictions, assuming things go the way I hope they will go, is that we will have a mild flu season, we'll have a mild RSV season, and we'll have a mild respiratory virus season in the future.
• 20:40
  SPEAKER_01: Why do I say that?
• 20:41
  SPEAKER_01: Well, number one, our schools have worked diligently to make things safe.
• 20:47
  SPEAKER_01: One of those big safety things is there's going to be a real push to say, look, if you're sick, you're not coming into school.
• 20:53
  SPEAKER_01: Number two, they're going to be wearing masks and they're going to be distancing.
• 20:55
  SPEAKER_01: So if we think about respiratory viruses starting in schools and, you know, going to all of us, well, they're wearing a mask and we're not letting them go to school and be around each other.
• 21:03
  SPEAKER_01: We are going to limit the ability to even spread other respiratory viruses.
• 21:08
  SPEAKER_01: And so I think that we as a children's hospital have to be ready.
• 21:12
  SPEAKER_01: We have to be ready that, especially if our societies can't come together and one might say swim in the same direction to be able to all agree in the practices that are needed.
• 21:23
  SPEAKER_01: I think we could do well at the children's hospitals because we're not going to have the same illnesses we've had in the past.
• 21:29
  SPEAKER_01: And we we saw some evidence when we initially in the pandemic where flu season stopped.
• 21:34
  SPEAKER_01: Like I don't ever recall watching a flu season that kind of was going to kind of dwindle away, just kind of stop.
• 21:40
  SPEAKER_01: And I think that that's important.
• 21:42
  SPEAKER_01: And so this translates to the school setting, really, because the school setting with the mitigation practice will prevent us from seeing a lot of kids in our hospitals.
• 21:51
  SPEAKER_00: So I think what I hear you saying is that infection prevention and immunization actually works and be some benefit from practicing infection prevention.
• 22:01
  SPEAKER_00: We may actually carry some of these lessons into the future.
• 22:05
  SPEAKER_01: You know, Jennifer, that's what we should say, right?
• 22:07
  SPEAKER_01: I mean, uh no one wants to hear the word infection prevention, right?
• 22:09
  SPEAKER_01: Because everyone's like, oh, you know, just as we walk around, oh, infection prevention.
• 22:12
  SPEAKER_01: Oh, but the reality of this, you're absolutely right.
• 22:14
  SPEAKER_01: I mean, that's what's happening.
• 22:16
  SPEAKER_01: That's what the schools are doing.
• 22:17
  SPEAKER_01: The schools are becoming some of the best infection prevention places known to our society.
• 22:21
  SPEAKER_01: And I think you'll see that.
• 22:23
  SPEAKER_01: Um, I really think we'll see that.
• 22:24
  SPEAKER_01: And I obviously I'm half full right now and believe that we'll be able to, you know, band together to do that.
• 22:30
  SPEAKER_00: Well, Dr.
• 22:30
  SPEAKER_00: Nolan, thank you.
• 22:32
  SPEAKER_00: You've said a lot of really useful information, and I think this is going to be really helpful for a lot of people.
• 22:38
  SPEAKER_01: You're welcome, Jennifer.
• 22:39
  SPEAKER_01: Thanks for having me.
• 22:40
  SPEAKER_00: Thank you to our speaker for sharing his perspectives and experiences.
• 22:43
  SPEAKER_00: And thank you from Shay to all healthcare personnel for all that you are doing to respond to COVID-19.
• 22:49
  SPEAKER_00: This podcast can be accessed on Shay's online education center, Learning CE, under the Rapid Response Program.
• 22:57
  SPEAKER_00: You will also find additional resources such as the recorded webinars, healthcare facility outbreak preparedness, and the SHA COVID-19 town halls.
• 23:04
  SPEAKER_00: Additional resources available on Learning CE pertinent to this pandemic include Shay CDC outbreak response training program and the prevention course and HAI knowledge and control.
• 23:16
  SPEAKER_00: This concludes this episode of the Rapid Response Podcast.
• 23:20
  SPEAKER_00: Thank you for tuning in.