August 16th, 2020

Re-Opening in Wyoming

I'm a public health trained school nurse who practices health education, prevention and promotion. Even with imperfect knowledge and fully understanding that science is inherently self-correcting, it is my obligation to know most everything about this unusual disease of COVID-19 as I would hand, foot and mouth, strep throat, diabetes, etc. I am a small part of an entire team of caring, dedicated professionals whose business it is to keep school children healthy and safe and learning every day.

It is undisputed this virus is extraordinary in its capability to transmit explosively. The case count went from 4 million to over 5 million in just 17 days and we know our country has been affected more than all others by its wrath. With 4% of the world’s population, we have 25% of SARS-COV-2 cases and deaths. This is catastrophic and no one should minimize this pandemic in any way.

I do not think schools with attendant large groups should open unless we have near absolute fidelity to all the public health measures promoted AND until testing improves to best tell us the penetrance of viral spread. We need to better understand when and where transmissibility is the greatest. We must better surveil schools. Being ill-prepared from the beginning with a lacking coordinated national strategy, we have non-specific although fully well-intentioned plans to open school doors. Even the masks allowed will be of varying effectiveness.

In addition to safety measures, appropriate, frequent, high volume and low cost rapid antigen tests will get us out of this crisis. Otherwise we are chasing an angrier and larger tiger and responding reactively rather than proactively. If UW can test staff and students, why is it different to not have a comprehensive and fully accessible testing plan with elementary and secondary school students and all staff? Unequivocally children suffer and spread. This elusive piece of the puzzle is still being fully determined and quantitated but we know children are not “virtually immune”.

We are in this continuing awful tragedy because we place little funds and muscle behind genuinely implementing and enforcing what we know works virtually absolutely – masks and eyewear, distancing, hand hygiene, avoiding large groups and to be outside. Most schools do not offer the infrastructure to employ these five simple methods well. Re-entry as planned is hollow as outbreaks will occur as said recently by state health officials. We accept this gathering inevitability too late, after the virus has found more wood to burn and cases go undetected.

We are fortunate in Wyoming that cases are lower than surge toxic burns elsewhere but that does not give us a pass to handle this crisis differently. And I will heartily and professionally render quality care if doors open for full in person education. I now better understand worst case scenarios but I will forever be an optimistic yet worried school nurse. I think we should smartly redirect and repurpose staff, space and resources so that small groups can be properly distanced and monitored for all the other prevention measures needed to combat this mysterious enemy.

I end where I began. Lamentably in our current environment, public health professionals are resigning from positions. The work is high stress, filled with pressure, complaints and outright unacceptable bullying, threats and harassment. I bow to all who have the commitment, ongoing concern, to those who are courageous to clearly and regularly inform the public of mitigation thresholds to promote health education, prevention and promotion. Sadly, we are doing the best we can with what we have but regrettably that is not enough.

Teresa Wright reminds all that August is National Immunization Awareness and Children’s Eye Health and Safety Month.

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