In order to reopen schools one must consider infecting students and teachers. One must al recognize that there still is a great deal unknown regarding the transmission of this virus and that there exists a large
Facts
The following is a list of what we call "facts".
In reality there is no real clinical evidence of these "facts" and
for the most part they are putative and lacking in any accepted scientific
basis. However, they represent a reasonable starting point.
1. The virus is believed to be spread from one person to
another by means of aerosolized particle containing the virions. We think. Some
say not on surfaces but there is NO real scientific data showing this. There
are tons of one off examples of things.
2. Asymptomatic patients can aerosolize virions unknowingly.
We now believe that asymptomatics are true carriers. How long can they be
carriers we do not know. Is this a Typhoid Mary syndrome?
3. Masks are not necessarily protective for uninfected
individuals. Virions can still enter the body possibly by attachment to hands
and then to the nasal areas as well as possible entry via the eyes. Also
virions may attach to clothing and las for periods of unknown length.
4. Masks may reduce the virion load aerosolized from
infected individuals. However, many masks are quite limited in this capacity
and there is no clinical proof of the effectiveness of masks on infected
people. Most masks are limited in blocking incoming virions. They may reduce
outgoing but there is NO well described scientific proof.
5. Both children and adults are subject to infection and may
suffer serious sequellae.
6. Primary and Secondary teachers are often in close contact
with students perforce of the nature of teaching in today's education
environment. The proximity is frequent and subjects the uninfected to
significant risk of infection.
7. Teachers are often in compromised physical condition. The
prevalence of T2 diabetes, asthma, obesity, coronary issues, age, stress, and
excess exposure places many teachers at an excess level of risk if subsequently
infected.
8. Students in the current educational environment have been
trained to be interactive and lack significant discipline. Thus, students
present a highly uncontrolled risk factor unless significant mitigation methods
are employed.
9. Parents share in the uncontrolled risk pool. Many parents
have eschewed proper risk mitigation and students may be recklessly exposed to
viral infections. This become an unknowable.
10. Thus the school environment represents a high-risk
environment of totally uncontrolled risk mitigation factors beyond the control
of the teachers who are individually placed at substantial personal jeopardy.
We now present a set of possible proposals for risk
mitigation. Again we must not that despite the publicity of the need for
science and numbers, both are lacking in the real world. There is not clear
scientific understanding of the infection process nor is there any accepted
metrics for infection mitigation. The following are suggestions based logically
upon what we think we know and what may be useful. These are subject to change.
I. Protection of the teacher.
To protect the teacher the
following should be observed:
- The teacher should have face masks as well as eye protection.
- Hand sanitizers should be used and these should be based upon 91% isopropyl alcohol and glycerine. Glove may be a useful alternative.
- Teacher temperatures should be taken daily, once in the start of school and one at the end of the school day.
- RTPCR or equivalent viral tests should be performed weekly. The results should be returned no later than 48 hours after the test is performed and the teacher and school must have access to the results.
- Teachers with possible risk factors should receive monthly mitigation reviews with their physicians.
- Teachers should have physical mitigation interfaces using such devices as desk isolation unites.
- Teachers should remove school attire before leaving the school premise and possibly even shower with disinfectants in a secure facility carefully cleaned. Clothing may be a vector for the virions.
- All school facilities must be cleansed every night prior to the next day classes. The same about student means of transportation. There must be school agents monitoring student behavior on any transportation to minimize spread.
II. Protection of the Student.
To protect the student the
following should be observed.
- Daily temperature tests should be performed and recorded at the beginning and end of the school day
- Weekly RTPCR or equivalent viral tests should be performed and the results made available to the school, teacher, and parents/guardians.
- Students with elevated temperatures and/or positive viral tests should be immediately sent home by initially isolating them and notifying their parents. In the even of an elevated temperature a viral test must be performed withing six hours.
- Notice of an infected students must be sent to all parents withing twelve hours after receipt, time being of the essence.
- Students must be limited in class movement. Isolation by means of barriers must be employed where possible.
- All students must wear
masks of a type adequate to minimize viral spread from an infected student.
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