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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