Back to School During a Pandemic Year 2022-2023 - CMDHD/MMDHD/DHD#10 Jennifer Morse, MD, MPH, FAAFP Medical Director
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Back to School During a Pandemic
Year 2022-2023
Jennifer Morse, MD, MPH, FAAFP
Medical Director
CMDHD/MMDHD/DHD#10
MDHHS Back to School Kickoff Event (https://forms.office.com/Pages/ResponsePage.aspx?id=h3 D71Xc3rUKWaoku9HIl0WdlyfL5- pdDsae6UDUzlypUMEdXQlJZWU9LSE5LM1JWUFNORzRL VkVJRC4u)
Good Article: Covid Funding Pries Open a Door to Improving Air Quality in Schools https://khn.org/news/article/covid-funding-pries- open-a-door-to-improving-air-quality-in-schools/
Pampati S, Rasberry CN, McConnell L, et al. Ventilation Improvement Strategies Among K–12 Public Schools — The National School COVID-19 Prevention Study, United States, February 14–March 27, 2022. MMWR Morb Mortal Wkly Rep 2022;71:770–775. DOI: http://dx.doi.org/10.15585/mmwr.mm7123e2
Masking and Mitigation Considerations
Calculator
• To assist school districts with mitigation strategy decisions
as they navigate the COVID-19 pandemic, The ABC Science
Collaborative has developed a Masking and Mitigation
Considerations Calculator (MC2). By entering a district's
specific size and current community case rates, the MC2 will
estimate the impact of mitigation strategy decisions on the
school district and community.
https://abcsciencecollaborative.org/
School Guidance Materials for 2022-2023: Local Public
Health Department Guidance
• No new recommendations or requirements
• Three guidance documents sent earlier this week:
o 2022-2023 PreK-12 Public Health Guidance PDF
o 07-2022 Parent Illness Guide
o School Line list excel document
o Communication document
• Attempt to incorporate COVID-19 into other infectious disease prevention and response
2022-2023 PreK-12 Public Health Guidance PDF
• Recommend the management of COVID-19 transition from a pandemic emergency
response model toward a more standard approach used in the management and control
of other respiratory viral diseases, such as influenza.
o Modifications may be needs based on variations in COVID-19 levels and the appearance of
more virulent or contagious variants
o Focus should be on basic illness prevention and detecting and responding to in-school clusters
of cases, ongoing transmission in the school, and outbreaks.
• Management will rely less on things like case investigation, contact tracing, and
quarantining of students or staff following school exposures.
10 Basic Public Health Recommendations
1. Require sick students and staff to stay home (see 07-2022 Parent Illness Guide)
2. Report Appropriate Information to the Local Health Department
3. Request Information from Parents and Staff Regarding Illnesses (see School Line list excel
document)
4. Monitor Community Conditions and Respond Accordingly (see Considerations for School
Administrators Regarding Policy Changes to School Infection Control Measures, such as
Mask Use)
5. Incorporate COVID-19 Testing into Your Response Plan
6. Watch Closely for Signs of Illness Clusters or Outbreaks
7. Respond Appropriately to Clusters and Outbreaks
8. School Closure Should Be a Last Resort
9. Be prepared to support students, families, and educators during illness and closures
10. Have a communication plan (see Communication document)
07-2022 Parent Illness Guide
TYPO
• If your child tests positive for COVID-19:
o Tell your child’s of school.
School Line list excel document A resource to assist with tracking call-ins and illness, not a requirement
COMMUNICATION TOOLS
• COVID-19 Communications Tool Kit https://www.nspra.org/covid-19-communications-tool-kit
• Covid-19 testing communications toolkit https://www.covidtestingtoolkit.org/
• Communications for COVID Testing in Schools
https://www.openandsafeschools.org/communications#communications-templates-&-examples
• CDC sample letters for school testing programs https://www.cdc.gov/coronavirus/2019-
ncov/community/schools-childcare/letters-for-schools.html
• Letters for other health issues (consult with your local health department for help editing letters, letters
about additional illnesses, and www.cdc.gov for additional information on each topic):
o Giardia Letter to Daycare Director
o HFMD Letter to Parents
o Influenza Letter to Parents
o Norovirus Letter to Parents
o Pertussis Letter to Parents
o Pertussis Letter to School Staff
o MRSA Letter to Parents
o Chickenpox Exclusion Letter
• Letters for COVID-19 Isolation and Exposure
o Isolation Guidance Letter to Parents/Guardians of Students with COVID-19
o COVID-19 General Exposure NotificationConsiderations for School Administrators Regarding Policy
Changes to School Infection Control Measures, such as Mask
Use (located at end of 2022-2023 PreK-12 Public Health Guidance PDF)
1. What does the available data show regarding the community and district prevalence and transmission?
2. What is the risk tolerance for the possibility of increasing case numbers and necessary isolation in your
students and staff?
3. What is the current COVID-19 or influenza vaccination status of students and staff within individual
schools and across the district, and what is the current vaccine coverage for the surrounding community?
4. What more planning is necessary to address the needs of students and staff who may be at greater risk
for adverse health outcomes?
5. What added guidance is necessary to ensure support for students and staff who may wish to continue
mask wearing?
6. What processes need to be in place for continuous risk assessment and prompt decision-making about
respiratory illness policies and mitigation strategies (including mask use) going forward? What advanced
contingency planning needs to occur to prepare for potential surges and/or outbreaks?
Adapted from: “Considerations for Boards of Education, District Administrators, and other Local Decision-Makers Regarding Potential
Changes to School COVID-19 Policies and Practices”, Connecticut Department of Public HealthSchool Guidance Materials for 2022-2023:
MDHHS (subject to updates)
https://www.michigan.gov/coronavirus/resources/k-12-school-opening-guidance
• MI Safe Schools Testing Program https://www.michigan.gov/coronavirus/resources/k-12-school-opening-guidance/mi-safe-schools-
testing-program
• Community Based Pop-Up Rapid Antigen Testing Events https://www.michigan.gov/coronavirus/resources/k-12-school-opening-
guidance/resources/2-row-resources/community-based-pop-up-rapid-antigen-testing-events
• MI Safer Schools Guidance for K-12 School Settings in a COVID-19 Recovery Phase https://www.michigan.gov/coronavirus/-
/media/Project/Websites/coronavirus/Folder7/MI_Safer_Schools_Guidance_for_Managing_Students_Exposed_to_COVID-
19.pdf?rev=93ae3725e236441b9e238f9bc0ac4597&hash=A63762F5CE7B001AA5ADC0155C2ADC78
• SCHOOL GUIDANCE For School Administrator and Local Public Health Coordination https://www.michigan.gov/coronavirus/-
/media/Project/Websites/coronavirus/School-Guidance---For-School-Administrator-and-Local-Public-Health-Coordinator-
(3).pdf?rev=5f8309ec71b44b52961e5b13d19b7deb&hash=C0B21E76B5EE7A6C18334330B6BF9A90
• Recommendations for Safer School Operations during COVID-19 https://www.michigan.gov/coronavirus/-
/media/Project/Websites/coronavirus/k12-Schools/COVID-19-Guidance-for-Operating-Schools-Safely---April-
2022.pdf?rev=e548b8831c6d48dcb6a3f87aa7801829
• Managing Communicable Diseases in Schools https://www.michigan.gov/coronavirus/-
/media/Project/Websites/mdhhs/Folder2/Folder88/Folder1/Folder188/Managing_CD_in_Schools_FINAL.PDF?rev=e7997871809e4ca
abd00a2e9775de82f
• CDC Schools, Child Care, and Colleges COVID-19 Guidance https://www.cdc.gov/coronavirus/2019-ncov/community/schools-
childcare/index.htmlSchool Guidance Materials for 2022-2023: MDHHS
https://www.michigan.gov/coronavirus/-
/media/Project/Websites/coronavirus/Folder6/School_Quarantine_Guidance_v15.png?rev=16a04499cfec4e959de27ebb2e53aefaCURRENT DATA
End of JulyAlso found through:
https://www.michigan.gov
/coronavirus/stats
CLICK ON
K-12 Aged ISD
Reporting
https://www.michigan.gov/coronavirus/stats/k-to-12-aged-isd-reportingAlso found through:
https://www.michigan.
gov/coronavirus/stats
CLICK ON
K-12 Aged ISD
Reporting
https://www.michigan.gov/coronavirus/stats/k-to-12-aged-isd-reportinghttps://www.michigan.gov/coronavirus
https://www.michigan.gov/coronavirus
July 28, 2022
August 2, 2022
https://www.michigan.gov/coronavirus/stats/data-and-modeling-updatesJuly 1 August 1
MONKEYPOX
About Monkeypox
• Monkeypox is a rare but potentially serious disease that typically begins with a flu-like illness
and swelling of the lymph nodes and progresses to include a widespread rash on the face and
body.
o However, in recent cases, patients have developed rashes without having flu-like symptoms first.
• Monkeypox is caused by a virus that is in the same family as the virus that causes smallpox,
but it typically results in a milder infection.
• Most infections last 2-4 weeks and resolve without specific treatment.
• Monkeypox is caused by a virus that can spread from animals to people. It can spread
between people when someone has contact with someone who is infected with monkeypox
or touches materials that are contaminated with the virus.
• Monkeypox can spread to anyone through:
o Direct contact with monkeypox rash or scabs on a person’s skin.
o Contact with objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by
someone with monkeypox.
o Contact with respiratory secretions during prolonged, face-to-face contact.
o During intimate contact, due to the close contact involved and contact with bedding, clothing,
etc. It is not considered a sexually transmitted infection (STI).About Monkeypox
• The rash can look like pimples or blisters
and may be painful or itchy.
o The sores typically go through several
stages, including scabs, before healing.
o Sores may be inside the body, including the
mouth, vagina, or anus.
• Monkeypox can be spread from the time
symptoms start until all sores have healed
and a fresh layer of skin has formed.
• The illness may last for up to 2–4 weeks and Titanji, Boghuma K., et al. "Monkeypox: A Contemporary Review for
usually resolves without specific treatment. Healthcare Professionals." Open Forum Infectious Diseases. Vol. 9. No. 7.
Oxford University Press, 2022.
• For more information on symptoms, see
www.cdc.gov/poxvirus/monkeypox/sympto
ms.html.As Of August 2nd
Number of Ohio 30
State
Cases Nevada 25
New York 1617 Rhode Island 24
California 826 South Carolina 23
Illinois 533 Wisconsin 19
Texas 485 Puerto Rico 19
Florida 480 Alabama 19
Georgia 455 New Hampshire 13
District Of Columbia 248 Oklahoma 10
Pennsylvania 170 New Mexico 10
New Jersey 155 Nebraska 10
Maryland 149 Missouri 10
Massachusetts 134 Iowa 10
Washington 123 Hawaii 10
Virginia 105 Kentucky 8
Arizona 80 Idaho 5
Oregon 74 Delaware 5
North Carolina 69 Arkansas 5
Indiana 58 Mississippi 4
Louisiana 56 West Virginia 3
Colorado 53 Vermont 1
Connecticut 39 South Dakota 1
Minnesota 38 North Dakota 1
Utah 37 Maine 1
Tennessee 37 Kansas 1
Michigan 34 Alaska 1As Of August 2nd
CasesSort by
LocationSort by location in no order cases in
descending order
United States Of America 6,325
Spain 4,577
United Kingdom 2,759
Germany 2,724
France 2,054
Brazil 1,369
Netherlands 927
Canada 803
Portugal 633
Italy 505
Belgium 482
Peru 313
Switzerland 298
Democratic Republic Of The Congo 163
Israel 153
Austria 135
Nigeria 133
Sweden 102
Denmark 101
Ireland 97
Poland 63
Mexico 59
Norway 57
Chile 55
Australia 45
Hungary 42
Slovenia 37
Greece 33
Luxembourg 30
Ghana 30Vaccination
• Utilizes the JYNNEOS vaccine, which the FDA approved for protection against smallpox
and monkeypox in people ages 18 years and older who are at high risk for monkeypox
infection.
• Can be used in those under 18 with special approval
• CDC is currently recommending the following people should be considered prophylaxis
vaccine:
• People who have had an exposure to monkeypox that puts them at risk for infections within the
last 14 days
• People who know that a sex partner in the past 14 days received a monkeypox diagnosis
• People who have had multiple sex partners in the past 14 days in a jurisdiction with known
monkeypoxMonkeypox
• Cases in Children
o Health officials in the US have confirmed at least 5 monkeypox cases in children
• At this time, the primary risk of spread to children is contact with a household member
with monkeypox
• Risk of rash in students being monkeypox is exceptionally low
• Risks in schools is considered low at this time. Transmission requires extensive direct
contact or prolonged face to face contact.
• Following the general guidance for students and staff that any rash with fever should be
checked by a health care provider and they can return once rash has a diagnosis and known
to not be contagious, is being treated, or has healed is sufficient at this timeBasic Monkeypox Guidance
• Avoid close contact (including sexual contact) and don’t share objects with people
who are sick or have a rash.
• Do not kiss, hug or touch.
• Do not share eating utensils or cups.
• Do not touch the bedding or clothing of a sick person.
• Wash hands often with soap and water. If soap and water aren’t available, use an
alcohol-based hand sanitizer containing at least 60% alcohol.
• Keep your hands away from your eyes, nose, and mouth. If you need to touch your face,
make sure your hands are clean.Monkeypox resources
• What You Need to Know About Monkeypox
https://publichealth.jhu.edu/2022/what-you-need-to-know-about-monkeypox
• Detailed factsheet https://www.centerforhealthsecurity.org/our-
work/pubs_archive/pubs-pdfs/fact_sheets/monkeypox.pdf
• Healthchildren.org: What is Monkeypox?
https://www.healthychildren.org/english/health-issues/vaccine-preventable-
diseases/pages/what-is-monkeypox.aspx
• Frequently Asked Questions https://www.cdc.gov/poxvirus/monkeypox/faq.htmlMonkeypox
• Please be careful with messaging to avoid inadvertently stigmatizing any
community
• Discourage stigmatizing or hate speech in schools; highlight that monkeypox can
infect anyone and that the virus is what is making people sick, not any certain
activity
• Please contact if you have any questions or concerns
• We will notify you if any exposures have occurring in your schoolContacts:
Jen Morse, MD, MPH, FAAFP
jmorse@cmdhd.org
Cell: 989-802-2590
For Roscommon, Osceola, Clare, Gladwin, Arenac, Isabella
THANKS FOR Counties:
Steve Hall, R.S., M.S.
shall@cmdhd.org
JOINING US! 989-773-5921, Ext. 1421
www.cmdhd.org
Any Question?
For Missaukee, Crawford, Kalkaska, Wexford, Lake, Mason,
Manistee, Oceana, Newaygo, Mecosta Counties:
Kevin Hughes, MA
khughes@dhd10.org
(231) 876-3839
www.dhd10.org
For Montcalm, Gratiot, Clinton Counties
Liz Braddock MS, RS
Cell: 616 302 6301
lbraddock@mmdhd.org
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