This fall, if a student has a fever, cough or other symptom that is commonly linked to COVID-19, they cannot enter a school building.
The Sangamon County Department of Public Health publicly released its guidelines sent to local school districts that say a physician or school nurse needs to evaluate the student to see if they need a test or clear them to go back to school. The same applies to teachers and staff.
But a local health expert says there may not be enough COVID-19 tests for students, teachers and staff who need them.
Dr. Vidya Sundareshan, an infectious disease specialist at SIU Medicine and advisor to the Sangamon County public health department, said hundreds of tests are done in the county every day, but more may be needed.
“If a lot of children are sent back home - we may not have that - we may need up to 1,500 tests a day,” she said. “We don’t know. But you definitely want to be prepared for a higher number.”
Any child can be tested at SIU Medicine’s facility outside the public health department. Only children with sypmtoms who are screened by a medical professional and have an appointment can get tested at Memorial Medical Center Respiratory Clinic.
Uncertainty about testing for children was first raised when the Illinois Department of Public Health closed its testing site at the county health department.
Since then, SIU Medicine took over the county health department site and IDPH opened a drive-through site that operates on Wednesdays through the end of August at the state fairgrounds. No announcement has been made if that site will continue beyond the end of the month.
Springfield School District 186 students are set to start August 31, with some students attending in-person two days a week and others only online. Ball-Chatham, Williamsville and Pleasant Plains have a similar hybrid model, allowing families to opt for some days in-person and some days remote, or all remote. Leaders with Auburn, Rochester and New Berlin schools have decided to start the year completely online.
Sundareshan said the capacity to screen kids, teachers, and others once they go back to school was one topic of discussion with school officials as they determine back-to-school plans. She said the county is looking into other testing options.
The health department has also offered written guidance on policies for testing, quarantining, isolating and returning to school after quarantine. The department sent it to districts in the Sangamon County region in July.
A cover letter shared with NPR Illinois over the weekend from health department’s medical advisors, including Sundareshan, says the department and Sangamon County Board of Health don’t have the authority to force action, but their job is to track data and transmission of the disease.
“We examine medical data and research, and develop guidance,” the letter reads. “We then inform and educate school boards to help them determine whether to maintain or modify school operations. The Local Health Departments also contribute their best to ensure that COVID-19 test capabilities are available in our county and offer continuous guidance as well as training for various issues pertaining to screening and exposure.”
The guidelines pull from existing advice from the Illinois Department of Public Health and Centers for Disease Control and Prevention, and will be updated, according to the document.
“It's a guidance document for individual schools to decide… if they're even able to provide an environment that would have as much risk reduced as possible,” said Gail O’Neill, director of the Sangamon County Department of Public Health.
The guidelines say if a person is exhibiting the following symptoms, they should be sent home: fever of 100.4 degrees or higher, fatigue, muscle or body aches, headache, shortness of breath, cough that is not asthma or allergies, sore throat, congestion or runny nose, new loss of sense of taste or smell, nausea, vomiting or abdominal pain. A school nurse or physician should recommend whether or not to test them for COVID-19.
If a student, teacher or employee tests positive for COVID-19, they must isolate for at least 10 days. The county health department will be responsible for tracking down those who had been in close contact – defined as within six feet of the infected person who is not wearing a mask for 15 minutes or more – and instructing them to quarantine.
If a person is not wearing a mask and is around a masked person with a confirmed case for more than 15 minutes or within closer than six feet, the exposure risk is medium and that person should consider getting tested, according to the guidelines. If both everyone is masked, stays six feet apart and is exposed for less than 15 minutes, the exposure risk is low or minimal, according to the document.
Communicable disease nurses with the coutnty or a primary care physician will determine when a person with a confirmed case is cleared to return to school.
The health department is recommending a symptom-based strategy to determine when a person can be allowed back in school building after testing positive. The person must stay home for 10 days since onset of symptoms and wait at least 24 hours since they last had a fever, without the use of fever reducing medications. They are not recommending a test-based strategy, in which a person must have two negative COVID-19 tests at least 24 hours apart.