My opinion is that this statement lacks signature by specific doctors, committees, and reviewers. If I was on that team, I would have added comments on the following:
1. Community-based infectious disease threat is needed on a real-time basis. This function needs to reside in the county public health authority and build upon real-time contact tracing systems that identify potential and currently confirmed cases. OCHCA needs to work with OCDE and all school districts to make this happen ASAP. 2. Assuming you can align the community contagion assessment, the school health programs need appropriate school nurse and physician staffing by doctors who have graduated from US medical schools. The City of Chicago assigned such teams to every K-12 school in their jurisdiction during the epidemic of 1918-1919 with testing and medical assessment of each and every child in each and every school. In 2020, surely, the state and county should mobilize public health emergency funding to allocate such staff. 3. Assuming that the medical teams are assigned to each school, the teams should be tasked with weekly testing of each and every classroom, all pupils, all faculty, and all administrators as part of community based disease surveillance. This may or may not involve pooling of samples to run as an aggregate, as Dr. Fauci has been discussing recently. 4. Given the amount of testing required, I would suggest that rapid diagnostics be moved from urgent care centers into each school health program such that these rapid tests can be executed by the assigned licensed school health teams. Once multiple weeks of negative results are established, testing frequency could be modified according to the threat assessment in item 1. A very deep understanding of either the medical regulations or the educational code are needed to review such recommendations. Here are my credentials: I have held a California medical license for 25 years. I am a board-certified pediatrician, formerly involved with the AAP in the mid and late 1990s, retired from clinical duties, and do not have a profit motive for referral of patients. I am not building nor own a multi-site pediatric group seeking referrals for employee or contractor physicians. I have no financial or political conflicts of interest. I am not aligned with any political party and am registered as "No Party Preference". I sat for two one-year terms as a student representative on the Los Alamitos Unified School District Board of Education from 1983 to 1985. During that time I was involved in opposing recall of the board of education, which dealt with school closures and sales of school sites in the post-Prop 13 realignment of California school funding. I also was one of three student candidates considered for the California State School Board in 1984. I am an alumnus of K-12 public education in Los Alamitos Unified, an Orange County school district. I have many relatives and friends who have cumulatively served for centuries of day-to-day classroom and administrative experience in public K-12 education. We need to protect the schools and the children with cogent thoughtful insight written by a team of infectious disease, virology, epidemiology, public health, and community based pediatricians. Plus, those guidelines need input from attorneys, review by operations, review by union representatives, and review by parents. All local school districts in OC are recommended to convene an expert committee to review the above recommendations and execute these tasks or equivalent tasks to safeguard our community's children. I have recommended these steps privately for four months and encouraged OC Board of Supervisors, OCHCA, and several school districts to consider these steps. It is appropriate for OCHCA and OCBOS to coordinate on these needs in order to assure that school health programs are appropriately funded to support K-12 education in the 2020-2021 academic year. Please implement the public health recommendations and medical recommendations that are nearly unanimously supported by the OC medical and public health community.
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My name is Sarah Lopez Korc, I am an ER physician at a level 1 trauma center, currently battling breast cancer and a parent to two children who currently attend the Newport Mesa School District.
As a parent of three small children who have been home schooled for almost 4 months, I understand the frustration that families are feeling who want to resume their normal life. I get it, because I want the same thing too. I recognize that as parents we have different ideas of what are appropriate amounts of social distancing and how to protect our kids. But our school districts need to find a balance between all of these opinions, that ensures the safety of our community, along with helping our individual families stay healthy. As an ER physician, I was taking care of many patients who became infected with COVID-19. Our understanding of SARS-CoV-2 and COVID-19 is constantly evolving, given the novelty of this virus and disease. Although there are few reported cases of pediatric patients younger than 20 years old requiring hospitalization, and even death, we do know that some develop “ground glass opacities” and don't fully understand the impacts of contracting this virus. We also know that kids have been identified as “vectors” or carriers for this disease that can be passed along to more vulnerable family members. As a newly diagnosed cancer patient on chemo, I suddenly find myself part of this ‘vulnerable population’ at only 40 years old. I can tell you that I have taken care of 30 and 40-year-old parents, who by their history had no medical problems or serious illness, only to need admission to the hospital and require ICU care. I remember one particular parent who was 43-years-old, a father who was close to my age, gasping for air while I was getting ready to intubate. He had no medical problems and did not understand why he had become so ill from the virus. I can tell you that this virus is mercurial, and we still don’t understand why it causes severe symptoms in some patients and not others. What has been clear by studies and data from other countries, is that masks worn by everyone, proper hand hygiene and social distancing can slow down the transmission rate and prevent infections. These simple interventions in the grand scheme of things can really save lives. If done properly it can allow us to return to a ‘normal’ that allows us to be with others. I know that there were mixed messages from the CDC about masks in the beginning, but I also know that at the same time my hospital was struggling to find facemasks and at one point had 3 days’ worth of supplies to take care of the growing number of patients. So, I would like to know that the Board's COVID-19 response will take into consideration the kids, teachers and parents that make up our OC community. I know that my child, who will be in kindergarten, will struggle with a face mask in class. But can we use face shields that also block saliva droplets, recognizing that we can have a different approach for elementary, junior high and high school children. Will there be orientations on proper face mask use for staff? How will class rooms be set up for social distancing and to minimize transmission? How are teachers and staff going to be protected from the many children they will encounter? What are the hygiene policies? What will happen if someone tests positive for COVID? I am like many parents who want our children to return to school, but it must be with our communities’ best interest in mind, recognizing the different needs of our OC families. In particular, families and districts who are being disproportionately affected by this virus because of the inability to self-isolate at home, or socially distance in their living situation. We must also recognize that in 2 months, or even in 2 weeks, this could all change and be willing to be flexible and nimble in response to new information. Sincerely, Sarah Lopez Korc Sarah Lopez, MD, MBA Patient Safety Officer Harbor-UCLA Medical Center Assistant Clinical Professor of Emergency Medicine |
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