Le Bonheur infection expert says school OK, provided guidance followed

By , Daily Memphian Updated: August 14, 2020 8:05 AM CT | Published: August 14, 2020 4:00 AM CT

Dr. Nick Hysmith, head of infection prevention at Le Bonheur Children’s Hospital, has seen children sick with COVID all summer and is well aware of outbreaks in other places as schools resumed.

But, if parents and schools follow back-to-school guidelines prepared by doctors at Le Bonheur and University of Tennessee Health Science Center, he sees no reason why schools, particularly elementary schools, should not reopen.

“I still feel comfortable with our students starting back, provided that they follow the guidance that we’ve provided,” Hysmith said Thursday.

The guidance covers most aspects of school safety, including protocols for bus riders, bathroom breaks and protections for adults in schools, plus detailed outlines for what do with when a child tests positive, and how to best serve children with special needs.

“We have put a lot of work and evidence-based advice in our guidance for our community and our surrounding area,” Hysmith said.

“I think that one of the big things that we’ve stated over and over again across the community is that masks are essential and social distancing is essential in any situation where we have gatherings.”

City officials explain coronavirus pool testing pilot

The City of Memphis is testing in charter schools to help children stay in school. It has capacity to test 4,000 students a day. The results are being analyzed in pools at Poplar Healthcare’s laboratory here.

“The tests are administered by third-party medical officials,” said Tiffany Collins, deputy director of general services. “We have tested children as young as 2. Children are very comfortable taking the test. We have not had any pushback from parents.”

School-based outbreaks in other communities, including in Georgia districts and in Corinth, Mississippi, where more than 100 students were in quarantine after the first week of school, likely were caused by breaches in protocol, Hysmith said, including a large party for the senior class in which no one wore masks.

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Masking in particular, Hysmith said, has proven to work, even in other diseases, including flu.

As fall approaches, Hysmith says it will be “immensely important” for people to get flu shots and to get them as early as possible.

“If we start to see a large amount of influenza, due to lags in flu vaccination, then that is going to only confound the problems that we see with COVID.”

As schools resume, the health department is exploring ways to offer saliva-based testing here, which would eliminate the supply chain issues the nation has experienced since the pandemic began for elements needed for the swab test, says Dr. Stephen Threlkeld, co-director the infectious disease control at Baptist Memorial Hospital-Memphis.

“I always caution folks in that it’s never been looked at really extensively on asymptomatic people,” he said.

The test involves spitting through a funnel into a tube. The specimen is sent to Rutgers University for processing. Rutgers alerts the local health department of the positives and also informs the patient, he said.

Saliva testing here would automatically increase the number of tests available, which Threlkeld says would mean more asymptomatic people could be tested.

“The percentage testing is 14, 15, 18 percent. When that is the case, we know pretty much that we are undertesting, and there are people out there – there’s community spread out there that we are not catching.

“The problem with that is when you can’t find those people, you cannot at all stop them from spreading it,” he said.

Since March, county epidemiologist David Sweat says 24% of people in Shelby County have been tested at least once.

Threlkeld says the region and nation need to push federal authorities to get behind rapid saliva test for antigens.

While the test is not as sensitive as the slower saliva test or the deep-nasal swab, he says it is sensitive enough to identify people with large doses of the virus who would be infectious that day.

The test is not available yet, but because it is cheap and people could do it in their homes and have a reading in a few minutes, Threlkeld says it offers an enormous benefit.

“If you have a low-cost test that you can do almost every day, you’re going to catch a lot of people, even if the sensitivity is down lower.”

The reason it is lower, he said, “is that it takes more of the virus to trip that test …

“That’s okay because you’re really trying to find out the people who are the most contagious. You’re really trying to find the people who are going to be a danger to go to school today, to the students around them and the teachers that they’re going to encounter.”

The rapid test, he says, would allow everyone in a classroom, team or workplace to be tested quickly and inexpensively.

“If you’re able to do that, you’re going to catch the people who are the most likely to transmit it. That would open up an entire new day in our preventing this disease,” he said, although he noted it is still critically important to get vaccines.

The back-to-school guidance was put together to help districts plan how their schools would resume, Hysmith said.

While it includes concrete guidance on how children should be screened and under what circumstances a broad dismissal of a class or entire school would happen, it also some gray areas, he said, including how music classes should be conducted.

In those instances, districts are asked to collaborate with the team to look at a specific school setup, Hysmith said.

Those parts of the guidance will be added this fall.


Dr. Nic Dr. Stephen Threlkeld Tiffany Collins
Jane Roberts

Jane Roberts

Longtime journalist Jane Roberts is a Minnesotan by birth and a Memphian by choice. She's lived and reported in the city more than two decades. She covers business news and features for The Daily Memphian.


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