CASPER, Wyo. — Natrona County Health Officers Dr. Mark Dowell and Dr. Ghazi Ghanem said on Wednesday, July 8 that having students and staff wear masks, face coverings, face shields and bandanas is their recommended approach to keep schools open if and when they open in the fall.
“We all have the same goal,” Dowell said during the Natrona County School District Board of Trustees work session on Wednesday. “Keep the kids in school.”
NCSD Superintendent Mike Jennings said that the most recent statewide health orders require face coverings for students in K-12 in setting where at least six feet of distance cannot be maintained.
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Ghanem said that health officials fully expect there to be cases of COVID-19 in schools this fall, but the goal is to think about how to deal with that. The doctors said their main concerns are that students could bring the virus home to more vulnerable populations and that COVID spikes could test the limits of hospital capacity.
Ghanem added that he anticipates that ultimately, COVID will have a low overall mortality rate, estimating that people will have about a 0.5% chance of death related to the virus. He’s concerned not only about people dying from COVID-19 but how people hospitalized for COVID take up limited hospital resources such as intensive care unit beds.
If hospitals fill up with COVID patients, Ghanem said that could lead to situations in which people experiencing heart attacks, strokes or other conditions are not able to be treated.
He added that COVID-19 is different from influenza in that there is no vaccine available for COVID, people don’t have immunity from COVID and “when influenza hits, we do not have 30 patients in the hospital.”
Dowell noted that when COVID patients are hospitalized, they tend to be in the hospital for a long time and that there is no absolute cure health care providers can provide.
Ghanem acknowledged that COVID is not stressing the high limits of hospital capacity in the state but that “it may happen.”
He noted that Texas Medical Center, the largest medical center in the world, has seen 90-100% capacity recently as Texas deals with COVID-19.
Trustee Kevin Christopherson said that while Texas Medical Center may have be pushing the limits of their ICU capacity, the majority of ICU patients are not COVID patients.
“We’re not saying the whole ICU is going to be COVID,” Ghanem responded, reiterating that the concern is that someone with a condition like a heart attack would have no place.
Trustee Dave Applegate asked the health officers to give an idea of what data they would look at which would lead them to force schools to move from a model which accepts students in-school to one which only allows some or no students to come to school.
Dowell and Ghanem said that there is not single criteria they could point to, but Ghanem noted that if he had to consider one data area, it would be hospital capacity.
“The goal is having enough chance to keep the schools as open as we can,” Dowell said. “If it starts making all adults sick, we’ll have to change what we do.”
Dowell added that towards the goal of keeping schools open, “The more masking the better.” He encouraged schools to make mask wearing “a school spirit thing,” adding that schools could have students design their own masks.
“We can get creative with that,” he said, noting that schools in Europe have found success getting students to wear masks.
Jennings said that he has communicated with summer school teachers working with second graders who haven’t found it to be a major problem getting students to wear face coverings.
Christopherson asked the doctors to explain which type of masks are effective. Dowell said that while M95 masks are the best, that “obviously” isn’t going to be something most students would wear.
He said the next best option is surgical masks followed by cloth face coverings. Dowell said that bandanas are not as good “but better than nothing.” Face shields are another option.
Ghanem said that if someone with COVID-19 is wearing a mask, that “probably decreases transmission 70%” if others around them are not also wearing masks. But if both the source individual and those around them are wearing masks, the likelihood of transmission is probably decreased by about 90%.
He added that the recommendation about six feet of social distancing is based on reducing transmission through droplets of bodily fluids.
“Nobody thinks six feet is cut in stone,” Ghanem added.
Trustee Dave Applegate said he’s recently read about COVID-19 being possibly “airborne” and expressed some confusion on this point since droplets can spread the virus.
Ghanem explained that “airborne” doesn’t refer to the virus being spread via the droplets within six feet but rather refers to situations in which the virus could potentially spread longer distances such as down a hallway at a hospital. He noted that the Wyoming Medical Center attempts to deal with the virus as if it could be airborne as much as possible.
“Really, all that we have are masks,” Ghanem said.
He acknowledged that mask wearing may be a challenge for younger children, but that not attempting to implement them in schools would be “risking a major failure.”
“When you put on masks, [you] can actually protect most everyone,” Ghanem told the trustees.
Dowell added that the goal is to limit the spread of the virus until a vaccine is available, which he said he expects will happen in less than a year. He said that the rate of spread across the United States has accelerated. He said it took about 99 days for the U.S. to record the first million COVID cases in the country. The third million cases took only about 23 days.
“We don’t want people to die,” he said. “They will die if we don’t do these things. Our goal is just simply to keep people from getting it until we get the vaccine.”
Christopherson noted that Wyoming has recorded 21 COVID related deaths, which he considered to be a low number. He added that many of these individuals had pre-existing conditions and that their death happened “just a little bit sooner” than would have otherwise happened.
He added that highway deaths in the state have been higher but that people still take the risk of driving.
Ghanem responded that health officials think about the health of the population at large. While individuals may take risks such as choosing to drive despite the number of highway fatalities, it would be irresponsible for health officials to treat the virus in this way.
He added that when it comes to schools, health officials are thinking not only about students and not only the vulnerable family members they may live with, but also people like teachers.
Ghanem said that if schools are not careful about their approach and if an outbreak occurs, teachers may not want to come to work for their own safety. He said that if, for example, 10% of school district teachers became sick, other teachers might not want to take the risk of coming to those buildings.
Applegate noted that it is not the school board’s decision whether masks will be required in schools. He said that the district should focus on clearly communicating expectations to the community.
Casper-Natrona County Health Department Executive Director Anna Kinder said that the CNCHD will be rolling out education campaigns surrounding not only the use of face coverings, but other things such as COVID-19 testing.
Applegate suggested NCSD work on their communication strategy as well.
Dowell said that the use of face coverings isn’t a huge ask if people want schools to open in the fall and stay open.
“What’s the big deal?” he asked. “This isn’t a big deal, this is a small thing to do to try to keep the schools open. That’s our recommendation. We’re docs, we’re scientists. We’re doing our best.”
NCSD Board Chair Rita Walsh thanked the doctors for providing their input.
“We take it very seriously,” she said.
The Latest Statistics from the Wyoming Department of Health:
What to do if you are feeling sick: In the wake of the COVID-19 outbreak, the Casper-Natrona County Health Department says that people who are feeling sick or exhibiting symptoms should contact their primary physician.
If you do not have a primary care provider, and live in Natrona County, please contact the COVID-19 hotline, operated by the Casper-Natrona County Department of Health. The line is open Monday – Friday 8:00 am – 5:00 pm 577-9892. Hotline services are intended for Natrona County residents and may not be able to provide specific information to persons calling from out of county.
Officials ask that you please do not self-report to the Emergency Room. Persons experiencing problems breathing should call 9-11.
For general inquiries and non-symptom related questions about COVID-19, please contact the Casper-Natrona County Health Department via email: email@example.com
- Practice Social Distancing by putting distance between yourself and other people. This is especially important for people who are at higher risk of getting very sick.
- Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.
- Avoid close contact with people who are sick
- Stay home if you’re sick
- Cover coughs and sneezes. Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
- Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
A list of area closures attributed to COVID-19 are available here.