New guidelines from school nurses’ association says students should wear masks throughout school day 

  • Danielle Gerrior, 31, a registered nurse at the Elliot Hospital in Manchester.

Monitor staff
Published: 8/12/2020 5:09:37 PM

All students and staff should wear masks throughout the school day, according to new guidance from the Hampshire School Nurses’ Association that was reviewed by state health officials.

That recommendation is at odds with some of the plans recently adopted by school districts across the state, and the difference illustrates the challenge local schools will have in setting clear policies.

As students return to school in the fall during a global pandemic, school nurses will play a critical role in preventing outbreaks at New Hampshire schools. They’ll be tasked with making critical decisions about when to send students home from school and how to screen staff and students for the virus. If there is a confirmed case, school nurses will often be the first to know and will make take the first steps to stop the virus from spreading.

Yet, until this week there were few codified recommendations for the schools’ frontline workers.

The state published reopening guidelines in July, which laid out some preliminary recommendations for the fall. Paula MacKinnon, the president of NHNA, said while the document is mostly in line with the recommendations from her association, it was too general and left too much discretion to individual school districts.

The recommendations released Wednesday were reviewed and approved by the Bureau of Infectious Disease Control within the state Department of Health and Human Services, the nurses’ association said. The intent was to give more specific guidance on how schools should operate from the time they open until a potential COVID-19 vaccine comes on the market.

Among the recommendations is a call for all staff and students older than two to wear a face mask throughout the school day and while on the school bus. In the Franklin School District guidelines for reopening, masks are required only when social distancing isn’t possible, which is also what the state’s reopening guidelines recommended. The John Stark School District is requiring masks only for students in grades three and up.

Jake Leon, a spokesman for the Department of Health and Human Services, said the recommendation for students and teachers to wear masks in school is not official guidance from the state. That recommendation goes farther than anything contained in the “Back to School Guidance” issued by state officials last month.

MacKinnon hopes now that more cautious guidelines are recommended, districts will update their mask policies.

MacKinnon recognizes that it may be difficult for younger children to wear masks at first. She suggests parents start getting their children accustomed to wearing masks for long periods of time before the school year starts.

“We feel children can be taught,” she said. “For a child that needs to wear eyeglasses, it’s hard for them to get used to it at first. It’s simply a habit and practicing gets them into that habit.”

MacKinnon also said she hopes mandating masks in schools will encourage parents to also wear masks, similarly to how anti-smoking curriculums encouraged students to question their parents’ smoking habits.

“We are teaching the science of the pandemic,” she said. “We’re not getting political.”

The document also expanded on school screening procedures. In addition to daily screening for staff and students before they enter the school building using a set of questions (like “Have you traveled outside of New England?”), the document recommends that parents screen their children before sending them to school. The document also recommended a third screening procedure that checks for mild symptoms before entering their first classroom.

The report outlined several COVID-19 scenarios and how school nurses should respond. For example, if a student starts experiencing any of the multitudes of symptoms associated with COVID-19 – like a headache – nurses should have the student put on a surgical mask, wait in an isolation room, and contact their parents for immediate pickup.

Anyone who has traveled outside of New England, come in contact with someone suspected of having COVID-19 , or answered yes to any of the screening questions should also be sent home, according to the document.

The symptoms associated with COVID-19 are extensive and can indicate something as benign as allergies or a common cold. Critics argue sending students home for a symptom like fatigue will cause students to unnecessarily miss school.

The most recent guidelines from the CDC do not recommend screening students for symptoms because “many of the symptoms of COVID-19 are also common in other childhood illnesses like the common cold, the flu, or seasonal allergies.”

MacKinnon said school attendance cannot be the top priority right now.

“We need to decide what is our ultimate focus – does the mitigation of the virus supersede the school days the child might miss?” she said. “At this point in time, in the middle of a pandemic, the answer is yes.”

The document recommends that school nurses stock up on an arsenal of personal protective equipment, such as N95 masks, face shields, and scrubs. Nurses should also develop an isolation room, with its own bathroom, proper ventilation, and a door to close in case a student comes to the office presenting symptoms of the virus.

If a vaccine for COVID-19 becomes available in the future, the document also recommended that nurses develop a plan for administering it to students, although they did not offer specific guidance for such a plan.

Editor’s note: This article has been changed to clarify that state officials within the Department of Health and Human Services reviewed the recommendations and did not issue them directly.


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