Back to School 2020-2021 Update March 18 - CMDHD/MMDHD/DHD#10 Jennifer Morse, MD, MPH, FAAFP Medical Director - District Health ...

Back to School 2020-2021
    Update March 18
      Jennifer Morse, MD, MPH, FAAFP
              Medical Director
         CMDHD/MMDHD/DHD#10

This meeting is for
School and Health                                   If you have questions, please send them to:
                                                    ■ For Roscommon, Osceola, Clare, Gladwin,
Department Staff                                      Arenac, Isabella Counties:
                                                       – info@cmdhd.org
                                                    ■ For Missaukee, Crawford, Kalkaska,
                                                      Wexford, Lake, Mason, Manistee, Oceana,
We have limited time to cover all our topics. The     Newaygo, Mecosta Counties
slides and recordings will be available on our
                                                       – info@dhd10.org
websites within 1-3 days.
• https://www.dhd10.org/coronavirus/                ■ For Montcalm, Gratiot, Clinton Counties
• https://www.mmdhd.org/novel-                         – https://www.mmdhd.org/contact/
  coronavirus/
• https://www.cmdhd.org/novel-
  coronavirus

Please make sure all
  needed information is
       passed to school
secretaries, nurses, etc.

Need for “quarantine after vaccination” guidance in
writing: See FAQ at Michigan.gov/COVIDVaccine

                                                       https://www.cdc.gov/coronavirus/2019-
                                                       ncov/vaccines/faq.html

https://www.michigan.gov/documents/coronavirus/COVID
-19_Vaccine_Public_FAQ_FINAL_710077_7.pdf

Also on CDC at:
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html
■   Fully vaccinated people with no COVID-like symptoms do not need to quarantine or be tested following an exposure to
    someone with suspected or confirmed COVID-19, as their risk of infection is low.
■   Fully vaccinated people who do not quarantine should still monitor for symptoms of COVID-19 for 14 days following
    an exposure. If they experience symptoms, they should isolate themselves from others, be clinically evaluated for
    COVID-19, including SARS-CoV-2 testing, if indicated, and inform their health care provider of their vaccination status
    at the time of presentation to care.
(it also say at that link: For the purposes of this guidance, people are considered fully vaccinated for COVID-19 ≥2 weeks
after they have received the second dose in a 2-dose series (Pfizer-BioNTech or Moderna), or ≥2 weeks after they have
received a single-dose vaccine (Johnson and Johnson (J&J)/Janssen)
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html
Who needs to quarantine?
■   People who have been in close contact with someone who has COVID-19—excluding people who have had COVID-19
    within the past 3 months.
■   People who have tested positive for COVID-19 within the past 3 months and recovered do not have to quarantine or
    get tested again as long as they do not develop new symptoms.
■   People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if
    there is no other cause identified for their symptoms.
■   People who have been in close contact with someone who has COVID-19 are not required to quarantine if they have
    been fully vaccinated against the disease within the last three months and show no symptoms.

Masking after Vaccination
■   The MIOSHA order (in effect until 4/14 unless replaced https://www.michigan.gov/documents/leo/leo_miosha_COVID-
    19_Emergency_Rules_705296_7.pdf ) and the current epi order (https://www.michigan.gov/coronavirus/0,9753,7-406-
    98178_98455-553387--,00.html ) STILL require masks in public/workplaces at this time.
The CDC ALSO still recommends masks in public. See https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html
■   For now, fully vaccinated people should continue to:
      –    Take precautions in public like wearing a well-fitted mask and physical distancing
      –    Wear masks, practice physical distancing, and adhere to other prevention measures when visiting with unvaccinated people
           who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased
           risk for severe COVID-19 disease
      –    Wear masks, maintain physical distance, and practice other prevention measures when visiting with unvaccinated people from
           multiple households
      –    Avoid medium- and large-sized in-person gatherings
      –    Get tested if experiencing COVID-19 symptoms
      –    Follow guidance issued by individual employers
      –    Follow CDC and health department travel requirements and recommendations
■   Fully vaccinated people can:
      –    Visit with other fully vaccinated people indoors without wearing masks or physical distancing*
      –    Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing
           masks or physical distancing*
      –    Refrain from quarantine and testing following a known exposure if asymptomatic

Travel guidance from MDHHS (echoes CDC recommendations)
https://www.michigan.gov/documents/coronavirus/Accessible_-_Safe_Holiday_Travel_Guidance_2222021_FINAL_717620_7.pdf

Updates from MDHHS re: travel…
■ Encouraging ALL returning travelers to get tested (before and after travel)
■ MDHHS offering pop up testing for schools/communities after spring break through
  the ISDs.
    – If your ISD has not heard anything about this from MDHHS/has questions:
       contact MDHHS-COVIDTestingSupport@michigan.gov or MDHHS-
       Binaxnowrequest@michigan.gov
■ More info on school testing at www.Michigan.gov/schoolcovidtesting

Prom, Graduation, etc.
■ Supposed to be FAQ from MDHHS coming soon-nothing new yet
■ ?Coming out with a plan involving testing
■ For now see existing FAQ at https://www.michigan.gov/coronavirus/0,9753,7-406-
  98178_98455-553410--,00.html :
Q: What are the gathering and capacity restrictions that apply to weddings, conferences, or
other social gatherings at non-residential venues? (SO: PROM???)
A: Indoor weddings may not exceed a total of 25 persons, while outdoor weddings may not
exceed a total of 300 persons. If an event has indoor and outdoor components, it must abide
by the requirements for an indoor gathering. Everyone must remain masked at all times unless
they are eating or drinking while sitting in a designated area.
The consumption of food or beverages is permitted only while seated in designated areas.
While eating/drinking, no more than 6 people may be seated together in a group, and groups
must be separated by at least 6 feet; groups may not intermingle.

Q: What are the gathering and capacity restrictions that apply to school events that are open to the
public (e.g., athletic competitions, band/choir concerts, performing arts, etc.) (SO: GRADUATION??)
A: Where school-sponsored events are open to the public – including friends, families, and other
spectators – they are subject to the rules and restrictions applicable to entertainment and
recreational facilities. All applicable masking and distancing requirements must be followed by
everyone at all times.
Patrons/spectators must remain masked at all times unless they are eating or drinking while
sitting in a designated area. The consumption of food or beverages is permitted only while seated
in designated areas. While eating/drinking, no more than 6 people may be seated together in a
group, and groups must be separated by at least 6 feet; groups may not intermingle.
Indoor events are limited to a total of 300 patrons/spectators at any given time and must not
exceed 50% of the total occupancy limits established by the fire marshal. Outdoor events are
limited to an overall total of 1,000 people (including all athletes, participants, staff,
patrons/observers, etc.). All attendees should avoid intermingling and must remain 6 feet apart
from all other groups.
Local health departments, sports organizers, and school districts may have additional rules that
must be followed and may further limit total capacity or number of spectators allowed.

Review of Data

MI COVID Data and Modeling Update:
   March 16 (data as of March 13th unless noted)
https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_105123---,00.html

Where Michigan Stands
• Case rates (143.6, ↑29.8) and percent positivity (5.1%, ↑1.0%) have increased since the previous
  week
• 4.4% of available inpatient beds are filled with COVID patients (↑0.3 %) and trends for COVID
  hospitalizations are increasing
• There were 97 deaths (↓28) between Feb 28 and Mar 6, and death rate decreased to 1.4 deaths
  per million residents (↓0.4)

School outbreaks in our 19 counties/60+ districts
                 1 (down from 2) ongoing* outbreaks, 1 new (stable) outbreaks**

Grade Level                     Number of outbreaks (cases)
Preschool-elementary            no ongoing outbreaks, no new outbreaks

Jr. high/middle school          1 ongoing outbreaks (4 cases) in MMDHD, 1 new outbreak in DHD10

High school                     no ongoing outbreaks, no new outbreaks
Administration                  no ongoing outbreaks, no new outbreaks

*ongoing outbreak = case(s) has been reported within last 28 days
**new outbreak = newly reported within prior week (report week from Thursday to Thursday (new outbreaks reported
to the state by local health departments on Thursdays), website updated by MDHSS on Mondays)

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-545615--,00.html

Questions?

Contact:                              For Missaukee, Crawford, Kalkaska,
Jen Morse, MD, MPH, FAAFP             Wexford, Lake, Mason, Manistee,
jmorse@cmdhd.org                      Oceana, Newaygo, Mecosta Counties
Cell: 989-802-2590                    Kevin Hughes, MA
                                      khughes@dhd10.org
For Roscommon, Osceola, Clare,        (231) 876-3839
Gladwin, Arenac, Isabella Counties:   www.dhd10.org
Steve Hall, R.S., M.S.
shall@cmdhd.org                       For Montcalm, Gratiot, Clinton Counties
989-773-5921, Ext. 1421               Marcus Cheatham, PhD
www.cmdhd.org                         mcheatham@mmdhd.org
                                      989-287-0701
                                      www.mmdhd.org