1. Can you synthesize what we know about the current impact of COVID-19 in our country and the greater D.C region? (Dr. Kevin Creamer)
   
   The COVID-19 pandemic has resulted in at least 250 million cases and 5 million deaths worldwide. Here in the US after a very significant surge due to the Delta variant this past summer, things are starting to look better. As more and more adults and adolescents become vaccinated the number of cases has gone down, but 60 to 70,000 cases per day is still a big concern. Locally we're doing better than the nationwide average, mostly due to a high vaccination rate. Montgomery County just recently stopped its indoor mask mandate.
   
   Almost 430 million doses of vaccine have been administered in the US. All three approved vaccines have been shown to be quite effective in not only decreasing the risk of infection but more importantly decreasing severe illness, hospitalization and death. Given our robust vaccine surveillance system, we also know the vaccines have a tremendous safety record. 
    
2. Can you please summarize the available data on the health outcomes between fully vaccinated adults vs. unvaccinated adults?  What do the latest statistics show in terms of the impact of being vaccinated in helping prevent infection, serious illness, hospitalization, and death from COVID-19? (Dr. Kevin Creamer) 
   
   Reassuring data from the CDC showed the vaccines were very useful against the more infectious Delta variant reducing infection rates, hospitalization, and death in vaccinated adults, when compared to unvaccinated adults.
   
   
   
   We also know that the COVID -19 vaccine protects against subsequent infection 5X better than natural immunity.
   Beyond the significant health benefits of the vaccines during the pandemic, they also have profound implications by minimizing school disruptions, and the associated social, emotional and educational impacts, in a highly vaccinated population.
    
3. What does the data tell us about the importance of booster shots?  (Dr. Kevin Creamer)
   
   The need for boosters was anticipated even as the vaccines were being rolled out. Data suggests a modest waning of antibody response over time, thus the recommendation for the booster. Boosters of all three approved vaccines are now recommended for certain populations here in the US. There’s even a recommendation to consider mixing and matching the Johnson & Johnson vaccine with either the Moderna or Pfizer. Currently groups older than 65, the immunocompromised, people with occupational exposures, and residents of long-term care facilities are eligible. It is likely that the general population will also become eligible once more data is available. We can also anticipate serial boosters perhaps annually in the future. The side effects and safety profile of the boosters are similar to what many people experience with their second shot of either Pfizer or Moderna vaccines.
    

4. How many cases of COVID-19 have we had this school year and broken down by Lower School and  Middle & Upper Schools? (Nurse Kirstie Abernathy)

   Lower School - 3  cases (only 1 requiring class quarantine, the other 2 were from outside exposures and did not affect students or staff here on campus)

   Upper School - 1 case - identified during the back to school testing clinic before the first day of school and before any other Barrie School families might have been exposed
    

5. I understand that you have been testing on campus every other week so far this fall and weekly now that we have moved into November.  What do the data from these tests show and what have we learned? (Nurse Kirstie Abernathy)

   *Please note there is often a variation in the total number of people tested as we sometimes have community members test in a given week who are not routinely tested.
    

6. Given where we are with the rate of transmission in our region and on the Barrie Campus, do you anticipate closing school this winter, especially between Thanksgiving Break and the Holidays? (Head of School Jon Kidder)
   
   In a word, No.  We do not anticipate closing between Thanksgiving and Winter Break. Unless COVID transmission rates dramatically increase or something unexpected occurs like a new variant, our overall safety protocols and our weekly testing have been designed specifically to keep our community healthy and with students, faculty, and staff on campus.

1. Starting with older students for whom we have much more vaccination safety data, can you please share what we know about the data on vaccinations for 12 to 18 year olds? (Dr. Kevin Creamer)
   
   There's one estimate that 42% of US children have already had COVID. It’s important to note that the pandemic has also taken a toll on children's education and mental health. By now more than 9 million US children older than 12 ( >100 million worldwide) have been vaccinated against COVID-19 and the data reveals the vast majority of reactions were mild, with arm pain, fever and headache being the most likely.
   
   
   
   While the Delta virus caused a surge in pediatric hospitalizations this summer, vaccinated adolescents had a 10-fold reduction in hospitalizations when compared to unvaccinated.
   
   
   
   By September the data revealed a 93% reduction in hospitalizations for adolescents and none of the vaccinated adolescents required ICU care, compared to roughly one third of unvaccinated teenagers.
   
   
    
2. I am a parent of both a Middle School student and an Upper School student at Barrie.  Can you please share how you are planning to keep the upcoming May Extended Study Week trips safe for students and faculty?  (Jon Kidder)
   
   We will be announcing the Extended Study Trips to 6th to 12th Grade students shortly.  While the slate of experiences is pretty exciting, I have been sworn to secretary so stay tuned. In terms of safety protocols, there will be a few trips that will require all students to be fully vaccinated in order to participate.  These will include trips that are traveling for multiple days through multiple states, staying overnight, and interacting with members of the broader public in connection to the educational goals of those experiences. Most of the trips will be staying in our local region and will not require vaccination.
    
3. Can you talk about what the data show about the risk of myocarditis in teens as a result of receiving the COVID-19 vaccine?  (Dr. Kevin Creamer)
   
   Much has been reported on the concern for myocarditis secondary to the vaccines. Myocarditis is an inflammation of the heart and can be quite serious. Although it's a rare condition, we know that COVID-19 infection can cause myocarditis in sick children and adults. 
   
   Current data suggest one is 16 times more likely to get myocarditis from COVID than from the vaccine. 
   
   Myocarditis associated with Moderna and Pfizer vaccines is more common in males, particularly adolescents and young adults. The rate is roughly 13 cases per million doses and is usually associated with the second dose. The vast majority recover without incident and there have been NO deaths in adolescents due to this complication. 
    
4. What are the current vaccination rates for faculty and staff on campus?  For students 12 year and older?  (Jon Kidder)
    

    

5. Can you summarize the outcomes from the clinical trials on vaccinations for 5 to 11 year olds? Did the clinical trial include enough children to ensure the vaccine is safe for 5-11 year olds? (Dr. Kevin Creamer)

   Since the beginning of the pandemic almost 2 million US children ages 5 to 11 have been infected with COVID-19. That represents about 9% of all US cases and resulted in over 8,000 hospitalizations and unfortunately 94 deaths. That puts COVID-19 in the top 10 causes of death for children in this age group. Now the FDA and CDC have granted emergency use authorization for the Pfizer vaccine for children 5-11.
   
   The Pfizer study of vaccine safety and efficacy is a robust study of 3000, 5 -11-year-old children. It concluded that two separate 10 micrograms shots ( 1/3 of the adult dose)  given 21 days apart was over 90% effective at preventing symptomatic COVID-19. The dose is not weight-based, it is age-based and was the dose that resulted in the best immune response. The most common reactions were pain at the ejection site, fatigue and headache. Most were mild or moderate and there were no serious side effects including myocarditis or anaphylaxis, which is a severe allergic reaction. Since myocarditis is more common in adolescents and adults than children between 5 and 11, it is not surprising that there were no cases of myocarditis in the vaccine trials for these younger children. It is anticipated that the likelihood of myocarditis due to the vaccine in this population will also be much lower.
   
   Prior to approval, the data was also used to perform extensive computer modeling, and the FDA panel concluded that the benefits far outweigh the risks.
   
   For perspective, before the FDA’s approval of the meningitis B vaccine for adolescents over 15 years ago they reviewed safety data from six clinical trials which included approximately 3,100 vaccine recipients, another subtype tested took 7 trials and 4500 patients.
   
   Since the approval by the CDC of the Pfizer vaccine for children 5-11, the American Academy of Pediatrics has issued a policy statement recommending all eligible children without contraindications be vaccinated without delay. 
    

6. Our family is grateful that Barrie was able to organize a vaccine clinic so fast.  Can you please share exactly how the vaccine clinic will work on campus on Saturday, November 13th and also how you anticipate other vaccine clinics will work in our region? (Nurse Kirstie Abernathy)

   The vaccine clinic on Saturday will be similar to the one we held last Summer for our students, campers and family members ages 12 and up. 

   All participants must register ahead of time for an appointment time using the unique link from the pharmacy for our school’s clinic.

   All parents must be present AND complete the consent form for the vaccine. This consent form must be printed and brought to the clinic.

   Please also bring a photocopy of your insurance card. This is be helpful in keeping this moving along during the clinic and will avoid the pharmacist having to spend time writing this information out by hard at the time of vaccination.

   
    What to expect during the clinic:

   Check in at the registration table to verify ID, consent form, and insurance information

   Student will receive the vaccine

   Students must wait 15-30 minutes post vaccination to monitor for any adverse reactions to the vaccine

   
   I am not sure how other vaccine clinics will work around the region but schools who have partnered with Safeway (like we have) found it to be a great experience for all those involved.
    

7. If, after getting vaccinated, my child were to have an adverse reaction, what are some of the signs/symptoms I should watch out for? Given this, is there currently an observation period post vaccination like with older populations? (Nurse Kirstie Abernathy) 

   The most common reactions in this age group were pain at the injection site, fatigue and headache. Reactions were mostly mild or moderate. It is important to note that children 5-11 years old had short-term side effects less often than older adolescents and adults. These symptoms usually go away in a day or so on their own. But you can ask your pediatrician about ways to help your child feel better.
   
   Anaphylaxis:

   Symptoms of anaphylaxis (a potentially life-threatening allergic reaction) often occur within 15-30 minutes of vaccination, though it can sometimes take several hours for symptoms to appear.

   This is why there is an observation period post vaccination to closely monitor and treat these symptoms right away. 15 minutes for most children.30 minutes for: People with a contraindication to a different type of COVID-19 vaccine  People with a history of non-severe, immediate (onset less than 4 hours) allergic reaction after a previous dose of COVID-19 vaccine. People with a history of an immediate allergic reaction of any severity to another vaccine (non-COVID-19) or injectable therapy. - BRING EPIPEN

   
   It is reassuring to know that there were no serious adverse events related to the vaccine, including anaphylaxis or myocarditis based on the safety data from the 5-11 year olds who received the vaccine, although the latter likely was too rare for detection in a trial of that size.
    

8. My now 11 year old daughter contracted a serious case of COVID-19 in the spring of 2020. Our pediatrician is working to secure data on safety for children who experienced the same condition. Have you heard any guidance related to the vaccine and children ages 5-11 who have had COVID-19 and recovered? (Dr. Kevin Creamer)
   
   As I said earlier, we know that the COVID-19 vaccine protects against subsequent infection 5X better than natural immunity. The CDC and AAP also recommend children with prior COVID-19 infection get vaccinated. The COVID-19 vaccine can be given at the same time as other routine vaccines but should be done in a different injection site. 
    
9. Our family has a 4 year-old and a toddler.  Can you share what we know about the FDA’s plans for vaccines for 0-4 year old kids? Do we know what age brackets are likely to be next for clinical trials?  (Dr. Kevin Creamer)
   
   Clinical trials are underway for children and infants as young as 6 months old. 
   
   Once they are fully enrolled and observed over a period of months, we will get data presented. I’ve heard this could be as soon as late winter or early spring.
    
10. I have heard that many schools in our region have already mandated vaccination for eligible students.  What can share approximately how many schools have taken this action? (Head of School Jon Kidder)
    
    In the data I have seen, about a quarter of all independent schools in our region currently mandate the vaccine for 6th to 12th grade students.
    
    Given what I am hearing now in terms of planning for next year, I expect that number to be closer to 80% for students who are eligible to be vaccinated.
     
11. While I understand that your Task Force may not have made a decision yet about whether or not you will mandate a vaccine for eligible students next year, parents would like to understand the thought process behind your decision making on this issue.  What can you share at this time?  (Head of School Jon Kidder)
    
    I want to be as clear as possible that this is the biggest question the Barrie COVID-19 Task Force is investigating right now -- and I imagine the same is true for all the independent schools in the country who have not yet mandated vaccination.
    
    Our goal as a Task Force is to monitor the constantly evolving guidance from the CDC, the American Academy of Pediatrics, and the Maryland Department of Health among others. We understand that vaccination amongst children and adolescents is a sensitive matter amongst all families and we are striving to balance this alongside maintaining a robust public health response for everyone -- especially people who are immunocompromised and rely upon very high vaccination rates in order to maintain their basic health.
    
    We also want to be straightforward that it is becoming increasingly challenging to offer a robust academic program without having everyone in our community vaccinated -- especially in terms of experiential learning opportunities off-campus. We are still reviewing data before making a decision and will communicate with our community in mid-January regarding our decision.

1. Given that we anticipate many more students will be vaccinated on campus in the coming weeks, will the current safety protocols change for children 4 years old and younger who are not yet eligible for the vaccine? (Nurse Kirstie Abernathy)    
   
   No. We are not changing any of our current mitigation strategies or protocols at this time since there will be classes with a mix of vaccinated and unvaccinated students - especially in our toddler and primary classes. Our goal is to continue to keep everyone safe - especially those who are still not eligible to be vaccinated yet. 
    
2. Will the classroom safety protocols be different between 3 and 4 year olds who are not yet eligible for the vaccine and vaccinated 5 year-olds who are in the same class together? (Nurse Kirstie Abernathy)
   
   No. The safety protocols will remain the same for all students. The only difference will be the quarantine exemption for fully vaccinated students who may be exposed -otherwise all safety precautions and protocols will remain the same. 
    
3. What will be the protocol for 5 and 11 year olds who will soon be vaccinated?  (Nurse Kirstie Abernathy)
   
   I actually posed this question directly to the County Outbreak team last week and their response was as follows:
    
   "Currently, we face mixed status with older student classrooms. The guidance there indicates that as long as fully vaccinated students are symptom-free and have not tested positive, they would be exempt from quarantine and can remain in class as long as they take the following safety precautions:
    

   Continue to wear a mask around others Get tested 5-7 days after exposure  Monitor for symptoms of COVID-19 for 14 days following an exposure. If they experience symptoms, they should isolate and be tested for COVID-19.

   
   Guidance is subject to change and it's possible younger students may have alternative indications, but this is the most up-to-date information”
    
   Please be aware of the following for Lower School Students: 
   While fully vaccinated students are not required to quarantine, due to the unique nature of our Lower School classroom structure, and the likelihood that there may be a mix of vaccinated and unvaccinated students in the class, the entire class would need to transition to virtual learning if the majority of the students in the class are required to quarantine due to being unvaccinated and/or under the age of 5 years. There is not a hybrid option in Lower School. 
    
    What that looks like here at Barrie for fully vaccinated students:
    

4. How will policies on testing, masks, and gatherings change once most school aged children are fully vaccinated (which it looks like they will be by the end of this year)? (Head of School Jon Kidder)
   
   As Dr. Creamer pointed out earlier, getting children, adolescents, and adults fully vaccinated dramatically reduces serious health risks.  And even when most people in our community get fully vaccinated, we still need to do everything possible to protect people in our community who are immunocompromised because breakthrough infections are real.
   Our safety protocols are working, and to maximize the health and safety of our entire community, we plan to continue testing, masking, and socially distancing until transmission rates decline significantly.  This means we will almost certainly continue these protocols through the end of this school year.
    
5. My family is planning to travel during the upcoming holiday season.  Can you please review Barrie’s Travel Policy and expectations for faculty, staff, and families during the upcoming Thanksgiving Break, Winter Break, and Spring Break? (Nurse Kirstie Abernathy)
   
   As a reminder. Our current travel policy is based on the recommendations set for by the CDC for both Domestic and International travel. The requirements to test and quarantine are based on vaccination status with the exception that car travel within the same household does NOT require testing or quarantine. See our school travel policy for details for planning Holiday travel for your family. 
    
6. Can you remind parents of how the testing will work after each of the upcoming holiday breaks? (Nurse Kirstie Abernathy)
   
    ALL students, faculty and staff are REQUIRED to submit proof of a negative PCR test prior to returning to school after Thanksgiving break and Winter break. This test will need to be obtained on your own - off site. Some options for testing include:
    

   You may test at a provider of your choice OR at a recommended same day PCR testing site: Quality First Urgent Care is close to campus, professional, turns around the results quickly, and is highly recommended by the School Nurse.  You can also review the Comprehensive List of Testing Sites throughout our region so you can find one conveniently located to your home.

   
   The test should be obtained no more than 3 days prior to returning to school. Results must be emailed to covidresults@barrie.org by 5pm on Monday November 29, 2021 and Monday January 3, 2022.
    
7. I have heard that the flu and other non-COVID respiratory diseases impacting children’s health are likely to be much more prevalent this winter.  Can you talk about which illnesses are prevalent in hospitals that we should be aware of and can do to prevent them during this upcoming season? (Dr. Kevin Creamer)
   
   At the onset of the pandemic almost all the routine respiratory viruses that we typically see in a seasonal pattern mysteriously disappeared. The theory is that the lockdowns and the isolation of children into their own homes or small communal pods radically reduced the routine viral transmission. This summer we saw a radical resurgence of these viruses, filling the nation’s Children's hospitals to capacity. The viruses such as RSV (Respiratory Syncytial virus), Enterovirus and Rhinovirus were the culprits along with ongoing surges of the Delta variant. As of the last few weeks, these viruses are now also starting to abate. Unfortunately as we enter Flu season we may see a combination of hospitalizations due to Influenza, COVID and a host of the routine viruses that we see in winter time.
   
   Prevention includes the same precautions urged during the pandemic. Stay home when you are sick! Maintain social distancing, wearing of masks in indoor spaces especially when within 6 ft and hand hygiene. All diminish the spread of these viruses.

Questions answered by Dr. Kevin Creamer, Barrie School’s Consulting Physician and Board Certified Pediatrician
 
Q. What can you share about the current status of Pandemic?
 
We are about 18 months into this worldwide pandemic that has changed all of our lives. Over 214,000,000 people worldwide have tested positive for COVID-19 and in the U.S., we are at almost 39,000,000 cases with just under 650,000 deaths. 
 
We are currently in the midst of yet another surge!, A.k.a. the 4th wave or the pandemic of the unvaccinated.
 
Q. What do epidemiologists and doctors currently know about the Delta variant?
 
There are many COVID variants out there and more are likely to follow. Viral transmission in the unvaccinated population is the primary driver of mutations that lead to variant strains. The WHO and the CDC track both, “variants of interest” and the more problematic, “variants of concern”. For example, the Lambda variant is of interest, but has yet to be raised to the level of concern.
 
The Delta variant is definitely a concern! It now makes up the majority of local area transmission, 98% nationwide. Because it creates a thousand times more virus in people's noses, it has an incredible transmission rate, at least twice the original strain.
 
Q. What do we know about breakthrough cases of fully vaccinated individuals? Is it possible for these individuals to carry a viral load and infect others?  
 
Fully vaccinated patients can catch and spread the Delta variant.Breakthrough infections in fully vaccinated people are usually mild in 96% and moderate in another 3%.
 
Q. If fully vaccinated people can still get COVID-19, what is the point of getting vaccinated?
 
In a real-world, 1-month snapshot from Wisconsin in July (with roughly 50% of residents vaccinated). The vaccinated population was roughly 3X less likely to be infected, 4X less likely to be hospitalized, and 10 X less likely to die. Since young children aren’t eligible for vaccination yet, we need to decrease their exposure by striving to have all adults they come in contact with be fully vaccinated.
 
Q. What do we know about the impact on COVID-19 cases and children?
 
Hospitalization rates for children are going up and are particularly high in regions where vaccination rates are low and standard public health measures like masking are not required or banned. That’s almost 3X higher when compared to states where vaccinations are relatively higher and more likely to implement masking requirements.
 
According to the American Academy of Pediatrics, the number of child and adolescent COVID infections and hospitalizations in the first week of August were comparable to the worst weeks of last winter, prior to the vaccine rollout. In the South, where vaccination rates are lagging, there was a 10-fold increase in the number of children infected weekly since June. It appears that the Delta variant is more dangerous because it’s more infectious not because it causes more severe disease. Locally, the fraction of hospitalized children requiring ICU care has remained stable. Overall less than 2.0% of children testing positive for COVID infection are hospitalized.
 
Other respiratory viruses, which virtually disappeared during the height of the early pandemic are now back. Viruses such as RSV and rhinovirus are now prevalent in the community and muddy the water with regards to COVID. When a child is ill, the symptoms can be quite similar, so testing and school avoidance for any symptomatic illness is the safest approach.
 
Q. Why did the American Academy of Pediatrics make such a strong stand on the importance of students being in classrooms?  
 
The last year of remote and hybrid learning has taught us all a lot about the unanticipated consequences of public health measures that keep children isolated. Beyond the impairments to optimal learning, children also suffered social, emotional, psychological, and physical health consequences. 
 
While the American Academy of Pediatrics strongly recommends the return to in person learning this school year, one must recognize that the majority of the students returning to the classrooms remain vulnerable because they're not eligible for the vaccine. The best way that parents and schools can make children as safe as possible is to surround them with vaccinated individuals in the home, school and their close contacts. In addition to following standard public health measures of masking, hand hygiene and social distancing.

Q. Some mention of herd immunity was made.  My understanding is that especially with Delta variant, transmission and community spread can happen even among the vaccinated.  Would like to hear from our Dr. expert, the interpretation of herd immunity for COVID at this time.  Seems vaccines will protect vaccinated, but not unvaccinated or those ineligible for vaccines.  And those who are vaccinated may reduce their care around masking or distancing.  Seems we may need to plan/prepare for indefinite masking and distancing regardless of Montgomery County community spread numbers or Barrie community vaccination numbers.  Can you comment? 

Agreed, since there are breakthrough infections and spread in vaccinated populations we need to maintain vigilance until vaccination rates are uniformly high and community spread has stopped. I defer to the CDC to determine and declare when and if herd immunity has occurred.

Questions answered by Jon Kidder, Head of School

Q. What kind of social gatherings will Barrie School host on campus this year and what kind of activities will have to wait for the future?  Can you explain the thinking behind this?
 
For the fall and winter, we are planning to keep on-campus social gatherings with families and students to a minimum.  
 
The reason is simple -- the Delta variant means that mixing large groups of people can lead to increased transmission and this can lead to childhood illness and more quarantines for classrooms.
 
I know this can be disappointing, but we need to prioritize health and consistent in-person learning for our students.  This means no Fall Candlelight Socials, no Fall Festival, and no on-campus events involving large groups.
 
The PTO is still exploring hosting a small number of carefully selected events that involve smaller groups of people when we can safety socially distance.  
 
And the PTO is definitely planning ways to build community online.  Please join us at Tuesday night’s zoom meeting.
 
Q. You shared last spring that Barrie School would not offer the Covid-19 Tuition Credit Program again this year.  Can you explain why?
 
Yes.  Last spring, we shared that the purpose of the Tuition Credit Program was to give families as much support as possible during the early phase of the pandemic given the uncertainty of how many days would be in-person vs. virtual.
 
We spent $100,000 on this program last year and I’m glad we did.  
 
This year -- given all the additional support structures we will be talking about tonight, we are investing all that money back into your students’ classrooms and into faculty and staff salaries.
 
 
Q. TRANSPARENCY/DISCLOSURE: Will the school continue its policy to notify the entire school community when there is a positive case on campus? 
 
Yes, we will….because transparency during a public health crisis is crucial.  
 
When we have a confirmed positive case:
 
We immediately call the Montgomery Health Department and start contact tracing.
 
We call all families whose children were in direct contact with the person who tested positive and we explain the Health Department’s quarantine requirements.
 
When we have a confirmed positive case, here is what we will not do:

• We won’t share identifying or personal information that would compromise the privacy of the individual who tested positive or the people who may have been exposed.  
• We won’t bombard families with communication overload by sending an email to everyone about every case -- that only leads to more anxiety and fear.  Just like last year, we will post the broad details at the top of the COVID-19 section of our website and include information in the weekly newsletter.

For example, we could share: “We had a confirmed case in an elementary classroom, but we won’t share if that person was a student or a teacher.”

• Lastly, after a positive case, we all need to avoid playing the game of “Guess Who?”  

Our families, our teachers, and especially our students do not need additional stress during this pandemic.

All this aside, I do think context is important. Many families from last year remember that we had 21 classroom quarantines last fall when the Montgomery County Health Department’s policy was to quarantine any class with a kid who had COVID-like symptoms. Including the sniffles. Nobody wants to go back to that and the County rules have changed so we don’t have to.
 
Now, let’s talk about confirmed positive cases.
 
I’d like everyone in the meeting tonight to hold up a finger representing the number of positive cases we had during the regular academic year last year.
 
Take a look at the guesses.
 
Now, Kirstie, how many confirmed positive cases did we have last year?
 
To be clear, we do not know what Delta will mean in the future.  For example, we had four positive cases at Camp in early August -- two of which were from fully vaccinated counselors.  
 
We also had a fully vaccinated Middle/Upper School community member test positive last week following our all-school screening test on Friday.  That person was not in close contact with anyone and is currently quarantined.
 
The good news is that Montgomery County's Health Department has changed its policies and will only quarantine a group of close contacts after a confirmed case.

Questions answered by Kirstie Abernathy, R.N., School Nurse

Q. Which health organizations does Barrie School look to for guidance?  How do you decide what to do if these organizations don’t always agree with one another?
 
The Barrie School COVID taskforce seeks guidance from several different sources in order to stay abreast of best practice. The CDC is the main source used to provide broad guidance for our general health and safety protocols, however we also seek the expertise of the American Academy of Pediatrics since they are an medically based organization that focuses specifically on the health and wellness of children - which is the population we serve. 
 
Furthermore one or more members of the taskforce participate in medical briefings sponsored by Independent School management team (ISM) where a panel of medical experts give relevant and up to date guidance on protocols for private and independent schools in particular.
 
Lastly we must also be sure to abide by state and local mandates since the other agencies mentioned defer to state and local jurisdictions for certain policies.

Q. What are Barrie School’s mitigation strategies to keep our community of students, parents, faculty, and staff safe as we return to school this fall? 
 
At Barrie we truly believe that our mitigation strategies work in keeping our students and staff safe. Universal masking, social distancing (as appropriate based on age), daily symptom screening, hand hygiene, utilization of outdoor spaces and enhanced ventilation are all layers of protection. 
 
While we cannot eliminate ALL risk, these protocols significantly decrease the risk of COVID transmission within our school community.
 
Q. What kind of filters and ventilation do you have for classrooms? 
 
Classrooms have Medify HEPA air purifiers to clean and filter the air. The filters in the HVAC systems of all of our buildings were upgraded last summer to a MERV13 filter. The highest rated filter by American Society of Heating, Refrigeration, and Air-Conditioning Engineers (ASHRAE). 
 
We also encourage teachers and staff to keep windows open for increased ventilation and air flow throughout the classroom.

Q. Can you talk to us about general bus safety procedures?  Will the Barrie school buses have windows open throughout the year, and will there be assigned/distanced seats for contact tracing purposes?
 
Students must remain masked on the bus at all times. Students are distanced (as feasible) with only siblings sharing the same seat. Assigned seats are used to be able to contact trace in the event of a positive case or exposures. Drivers have hand sanitizer on board for students to use when boarding and getting off of the bus. 
 
Windows will be opened (weather and safety permitting) in each section of the bus to increase ventilation and air flow. 

Questions answered by Dr. Kevin Creamer, Barrie School’s Consulting Physician and Board Certified Pediatrician and Kirstie Abernathy, R.N., School Nurse

Q. What do we know about the health and safety benefits of universal masking? 
 
A recent North Carolina universal mask study of >100000 students found that the student-to-student transmission rates of COVID in schools, where universal masking was required, resulted in a less than 1% transmission rate despite high transmission rates in the community. In contrast, data from communities where masks weren't mandated in schools, the secondary transmission rate was 13 to 16%.
 
Nationwide as of mid-August, only 45 to 55% of eligible adolescents were vaccinated. That NC study also found that 50 to 75% of in-school transmission occurred as a result of middle and high school sports and therefore it was suggested to incentivize vaccination of children over 12, (no shot > no play) or submission to serial testing.
 
Q. What are our masking requirements for indoors and outdoors? 
 
Masks are required for all student and staff indoors at all times except for eating or napping (for younger students)
Masks are also required outdoors whenever students are unable to distance themselves from others. Masks may be removed while outdoors to have a mask break away from others. 
 
Q. How will you adapt the masking for younger children?
         
Toddlers start to wear masks once they are over the age of two but we recognize that this can be a challenge for this age group so their masks wearing is less consistent than other grades. Teachers are great about helping students gradually get used to wearing masks by modeling it and by continuing to encourage use of the mask throughout the day. 
 
We work with students to help them be able to properly wear their masks throughout the day because we understand that each student is different and (just like with potty training) some may take longer to adjust to having to wear a mask for an extended period of time.
 
Primary students and students 5yrs and older are expected to wear masks properly and consistently throughout the day. 
 
Q. In the letter a week or so ago, you mentioned that the Learning Villages will be larger this year.  Can you explain when students will be staying with their individual class and when they will interact with other classes?  
 
The only difference between the learning villages from last year to this year, is that each student population (toddler, primary, lower elementary etc) will function as one large learning village rather than separate classroom learning villages. 
 
This means that there are times in which students from one class may interact with students from another class (but still within their same larger learning village cohort) during extended day programs, specials or after school enrichment activities. 
 
We will maintain this larger learning village model, but will not mix learning villages (ie- upper elementary will not mix with lower elementary and toddler classes will not interact with primary classes) 

Q. For the learning villages, does this mean that my child will interact with a total of 75 children at times for Primary?

No, all of the Primary children will not be together at any time. However, small groups from different classes in the Primary level may be combined  (i.e. Extended Day) which is really the only time students from other classes would be together.

Questions answered by Dr. Kevin Creamer, Barrie School’s Consulting Physician and Board Certified Pediatrician

Q. What do we know about the safety data regarding vaccines?   
 
We are the very fortunate beneficiaries of incredible scientific breakthroughs in both treatment of COVID -19 and prevention with the novel mRNA vaccines, all available in record time. The most encouraging news this week is the FDA has granted full approval for the Pfizer vaccine, which will hopefully encourage the 90 million or so Americans (over the age of 12) who have been hesitant to receive the vaccine, to do so.
 
51% of the US population (171 million) is now fully immunized with another 10% partially immunized. That leaves roughly 160 million Americans unvaccinated, about 50 million of whom are children under the age of 12. In comparison, roughly ¼ of the world’s population is fully vaccinated but only <2% low-income countries*. ( * more Variants likely)
 
The vaccines are doing a remarkable job preventing serious illness, hospitalization, and death. Currently greater than 90% of patients hospitalized with COVID-19 are unvaccinated. For fully vaccinated Americans the overall estimated risk of hospitalization was <5/100,000 with even fewer deaths.
 
Booster vaccination doses are now recommended for immunocompromised adults in the US. Soon the CDC and FDA will likely approve a plan to roll out boosters for those vaccinated Americans at least 6-8 months after completing their vaccine series. The data suggests that boosters primarily aimed at the original COVID virus dramatically increases antibody protection to include all the variants thus far.
 
Q. As I'm sure this issue is on everyone's mind - do you have any sense of when the vaccine will become available for children under 12? 
 
With regard to vaccination approval for 5-11-year-olds, Dr. Fauci believes there will be sufficient data to analyze by mid-to-late fall and possibly result in a EUA by winter.
 
Q. Once that happens, how will the access to the vaccines help reduce the health risks for children?
 
Once the COVID vaccines are authorized for children ages 5-11, the first steps will be educating parents regarding vaccine safety and efficacy and encouraging them to get their children vaccinated as soon as possible. Widespread vaccination of that population along with ongoing efforts to vaccinate older children and adults will eventually lead to decreased restrictions perhaps as soon as next spring. 
 
All of the decisions regarding social distancing, masking and screening testing will be dependent on the degree of community spread and the prevalence, contagiousness, and virulence of the prevalent strain at that time.

Q. What is the School’s policy on vaccination for children and adolescents?
 
Our longstanding policy on all vaccines for children and adolescents is to follow the rules set by the Maryland Department of Health.
 
For example, the Maryland Department of Health mandates that all 7th graders throughout the state must be vaccinated with the Dtap.
 
This is a vaccine fully approved by the FDA for children to prevent serious disease caused by Diphtheria, Tetanus, and Pertussis.  
 
We strictly follow this mandate unless a student has a documented medical or religious exemption -- and these cases are rare.
 
Once the FDA fully approves the vaccine for children in each age category, the Maryland Department of Health will make a decision on a vaccine mandate and this will impact children throughout the state.  
 
Although I can’t predict the future, I do not expect this process to be completed during this school year -- but I do think the chances are good that it will happen before next school year for the fall of 2022.
 
In the meantime, we are in the process of encouraging all families to vaccinate their children for all the reasons Dr. Creamer explained earlier.  
 
Vaccination is working well so far with students 12 and older at Barrie, which I will explain in a minute.

Q. How many students are currently vaccinated on campus?
 
Vaccination data is still being reported to Kirstie from parents and from the Maryland Department of Health database.  
 
Of the 62 students we currently have data on who are 12 and older, 60 are fully vaccinated -- which is 97% so far.
 
We are still awaiting data from the rest of our MUS students and this vaccination rate will likely fluctuate up and down as we receive definitive results from all families.  
 
We will report more info in a few weeks when we can share the totals.

Questions answered by Jon Kidder, Head of School, and Kirstie Abernathy, R.N., School Nurse

Q. Can a parent personally ask (in confidence) their child’s teacher if they have been vaccinated?
 
While teachers are more than welcome to share their own vaccination status, the school will not share this information even with their consent simply to allow each individual to reserve the right to disclose this information at their own discretion. We know that posing this question is not a HIPAA violation, however we want to be sure that their privacy is also protected in disclosure of their own status. 
 
To be clear, we do ask that parents not ask their teacher directly about their vaccination status as that can make a person very uncomfortable.
 
Q. How many Barrie faculty and staff are currently vaccinated? 
 
89 of the 93 full and part time employees at our school are fully vaccinated.  
 
This represents 96% of all faculty and staff, including extended day workers, bus drivers, and substitute teachers.
 
Q. Will Barrie School require vaccinations for all employees now that the FDA has fully approved the Pfizer vaccine?
 
Yes.  
 
Now that the FDA has fully approved the vaccine, all Barrie employees will be required to become fully vaccinated within the next 60 days.  Any employee who qualifies for a medical or religious exemption will need to test every week.
 
I want to repeat that.  96% of all Barrie employees are already fully vaccinated and the remaining individuals must get vaccinated with both shots by Monday, October 4, or test every week.

Q. Was that change from CDC recommendations? The change as far as testing vaccinated staff members.
The CDC does not currently recommend testing vaccinated individuals for screening purposes, however given the variant and rise in vaccinated individuals testing positive we are recommending this for our school community to help keep students who may not be able to be vaccinated safe.
 

COVID Screening Matrix

Q. Will Barrie School conduct frequent testing for students and employees on campus this year?  Yes, see the COVID Testing Calendar for on-campus testing dates: 

COVID Testing Calendar

Q. If we didn’t test through the school last week, I’m assuming we’ll be able to participate in school testings later this year? 

Yes! Please see the Testing Registration Instructions to register students who missed the last clinic:

COVID-19 Testing Registration Instructions

Q. What are your thoughts as a physician on the benefits of screening tests?
 
Obviously since most students are unvaccinated, they'll need to be screened to keep the spread of COVID in schools low. Current CDC guidelines for testing of fully vaccinated individuals are if they've had a recent exposure, are symptomatic, and especially after recent travel.  Roughly 50% of the fully vaccinated patients infected with the Delta variant have come back from recent travel. 
 
I agree with Barrie’s plan to initially screen everyone to ensure we are all starting with a "clean slate” since people have been gathering and traveling from summer activities.  And the plan to test older students and adults most frequently given the fact that they interact with the most people.

Q. Is it possible for a COVID test to be positive because someone actually has RSV? Can adults contract RSV or are they mainly for children?

Highly Unlikely. Both are from different families of viruses and are tested using very accurate PCR testing.

Q. It would seem necessary because of the nature of the virus, that if there was a positive case on a bus, that everyone would be contacted. Is that not the case? 

All riders on the bus will be contacted about the case and advised whether or not they will need to quarantine. 

The entire bus may be quarantined depending on where the student was sitting in relation to other students on the bus, including length of time on the bus with the ill student. 

Q. I'm not aware of the literature around anterior nasal swabs causing emotional harm to younger children. 1) Can you share some links after the meeting? 2) Will you consider offering testing on an opt-in basis during orange and red periods for families who are comfortable with having their young children tested?

Quote from the CDC: "The burden of testing is likely to be higher for younger children and therefore screening testing may be more feasible and acceptable for older children and adolescents." Also see: CDC Guidance on Testing.

Q. If a child tests positive in the class, if we test our child 3-5 days and they’re negative we still need to quarantine the full 14 days?

Yes. You must still quarantine for 14 days - even with a negative test. 

Questions answered by Dr. Natosha Speight, Director of Student and Family Services

Q. How can parents, faculty, and staff work together to support the social emotional wellness of our students?  

• First, I would like to share that our faculty and staff receive annual training surrounding social and emotional well-being supports for our student community, and themselves. During Faculty Week, this year’s faculty training focused on recognizing, understanding and managing trauma symptoms and are available resources.
• As we collaboratively support our students well-being we have some protocols in place:
• All of our students receive direct social and emotional learning supports. 
  • In the Montessori program and classes, our Lower School counselor conducts weekly Social and Emotional Learning groups and lessons with students. 
  • In the Middle and Upper School, our Advisory program utilizes community building circles and social emotional learning themes to support our students social and emotional well-being, growth and development. 

In addition to these direct support services,

• We have a Referral process in which we incorporate accessibility, open communication, collaboration, and confidentiality to ensure that the social and emotional needs of our students are met to support and maximize academic and educational success. Our Student Support Services Team collaborates and consults with all teachers/faculty and staff, and meets with students and families who report academic, behavioral changes and/or emotional concerns. Accommodation plans and/or Care plans are created as needed.

Q. How can I identify the signs and symptoms of pandemic related stress and depression in my child or adolescent?  
 
While it’s difficult to identify pandemic related stress, there are some common signs of trauma that I want to quickly go over of what you may see in your child or adolescent. This will not be an exhaustive list and varies depending on age/stage, and if there were already some mental health or learning challenges, some of these symptoms may be even further exacerbated.

• Anxiety: Children/Adolescents may be hyper-alert, hyper-sensitive, excessively worrisome, and fearful.
• Changes in Learning and Readiness: Attention concerns and difficulties; lack of focus, being more “spacey,” weary; delays in self-care skills, organization skills.
• Behavior Problems/Challenges: Reactive and over-reactive behaviors (increased arguments, negative attitudes/moods), aggression, mood swings, defiance.
• Depression: More than feeling “just sad,” feeling empty, loss of interests, being withdrawn or isolated--not due to physical pandemic requirements, feelings of worthlessness or excessive guilt, suicidal thoughts or tendencies, sometimes symptoms can also appear as anger. 
• Lack of Self-Regulation: Poor executive functioning skills; challenges with and/or poor organization, focus/memory challenges.
• Disrupted Relationships: Weakened or regressed social skills, being withdrawn, changes in desires to engage; children or young person may appear stressed and distressed.

A presentation of one sign should not be cause for concern. However, a cumulative effect and presentation of signs is more of a concern. Please remember to pay attention to changes and differences in behaviors. Upon noticing any changes, seek out the necessary supports to adequately address any  concerns or challenges.
 
Q. How can my family get support?  
 
The Student Support Services Department is available to assist all Barrie students, parents, caregivers and families; and each team member can be reached via email and through the Student Support Services web page.

Questions answered by Emily Lund, Head of Lower School

Q. How will lunch and recess work for Lower School students?  Can you explain the reasoning behind why microwaves were removed from classes? 
 
Classes will eat lunch outside whenever possible.  Students will be spread out at tables or on mats (picnic style). All classrooms will have a designated playground for recess and only one class at a time is permitted on the playground. 
 
Microwaves are still in classrooms but we are not allowing students to use the microwaves just to limit the germ transmission. Asking the teacher to warm up 20 lunches isn’t feasible so we ask that you use a thermos to keep foods warm. 
 
Q. How will specialist classes and Extended Day work for Lower School students?
 
Classes will not be combined for Specials. However, Extended Day will be by learning village which means that Lower Elementary will be together, Primary together and Toddlers will also be together. Those Extended Day groups will not cross over with another.  
 
Q. Do you have any practical advice for issues like playdates and birthday parties in terms of balancing health and safety alongside the need of students to socialize and connect off campus?
 
Social connection is so important. It just needs to be done safely. I suggest that if you do have playdates or birthday parties that you do them outside and require masks regardless of vaccination status. Use hand sanitizer or wash hands if possible. We were successful last year with our protocols so I recommend sticking with those both on and off campus.
 

Questions answered by David Weiner, Interim Head of Middle and Upper School

Q. For Middle and Upper School students, how will athletics, electives, field trips, and after school / extracurricular activities work? 
 
We plan to continue middle and upper school athletics this year with COVID precautions put in place, specifically wearing masks (either inside or outside) at all times. The only caveat to this is if there is a heat advisory, which means that students may choose to take off their masks. 
 
Field trips will be approved on a case by case basis by the school nurse, Kirstie Abernathy, and me, with particular attention given to whether field trips are outdoors and if three feet of social distance between students can be maintained. 
 
Middle School Extended Day will continue as normal with COVID precautions in place. As for other extracurricular activities, such as the school play this fall, sanitization of spaces, mask wearing, and maintaining social distance is of the utmost importance and has already been conveyed to faculty and staff. 
 
Q. How is the Middle and Upper School planning to maximize the chances of running the Calleva Retreats this fall? 
 
The MUS Retreats are happening on Thursday, October 6 and Friday, October 7 at Calleva Outdoors, a local summer camp and organization committed to outdoor education. 
 
Students will participate in paddle boarding, kayaking, and other outdoor activities designed to connect and bond students and teachers together.
 
All Calleva instructors are fully vaccinated and all activities will be outdoors with masks. These measures will help ensure the health and safety of our students and faculty. 
 
Q. For the Extended Study Week trips this spring? 
 
In a normal year, the week-long ESW trips occur in late March before spring break.  
 
However, we want to do everything possible to make ESW experiences happen this year and we have good news to share tonight.
 
We have decided to move this program to the week of May 23rd when COVID-19 cases are anticipated to be lower and the opportunities to travel will improve significantly. 
 
We will announce our trip destinations in the mid-fall according to our regular timeline.

Questions answered by Kirstie Abernathy, R.N., School Nurse

Q. What happens when a teacher or student tests positive for COVID-19? 

Q.  What will happen if a student tests positive (vaccinated or unvaccinated)? 

Q. What will happen to a class or cohort if a student becomes ill and gets a COVID test?

Q. What are the Montgomery County Health Department’s criteria for school quarantines?  

Q. Who will and will not need to be quarantined under specific situations? Classmates, siblings?  What is the worst case scenario for the length of a quarantine?

For all of these questions, please consult:

Criteria for School Quarantines

Questions answered by Jon Kidder, Head of School, Emily Lund, Head of Lower School, and David Weiner, Interim Head of Middle and Upper School

Q. A lot of parents are under the impression/assumption that Barrie will have another preemptive shift to virtual schooling during the holiday season to mitigate risks of an outbreak. Do you see that as a possibility and under what circumstances will we transition to virtual learning this year? 
 
We are doing everything possible to avoid extended closures this year.
 
None of us can see the future and it is possible we may need to close the campus for a period of time if the pandemic significantly worsens in our region.
 
That said, the combination of:

• fully vaccinated faculty and staff, 
• a smart and common sense testing strategy, 
• and strict hygiene protocols is designed to keep students and teachers exactly where they ought to be….which is on campus in classrooms.

Q. If my student’s class needs to transition online during a quarantine, how will this work?  How soon after a quarantine will the teachers transition to online learning?
 
If a class is quarantined, teachers will have one day of planning and then class will begin at 9:00 on the second day. Teachers will send out a schedule of online classes along with the zoom link.
 
Q. How will Lower School teachers support an individual student who is quarantined while their classmates are still at school?
 
We do not ask our teachers to run a hybrid classroom (both online and in-person) which is difficult in the Montessori environment.  
 
Last year, teachers would Zoom regularly with students who were at home and often zoomed the student in for special lessons or circle time. You would work with your teacher to schedule times that work for your family and the class.

Q. How does virtual schooling work with T1/T2s?

Toddlers typically Zoom for about 15 minutes.  They sing songs, read stories, and just chat with one another just to keep them connected. Teachers will also provide activities and websites that provide ideas to do at home with your child. 

Q. When might my student’s Middle and Upper School class need to go virtual? If my student’s class needs to transition online during a quarantine, how will this work?  How soon after a quarantine will the teachers transition to online learning?
 
The only time that a whole class in middle and upper school may need to quarantine is if a student tests positive and the other students in the class are deemed “close contacts” by our school nurse. As a reminder, “close contacts” are individuals who have interacted directly with someone who has COVID-19 for more than 15 minutes in a 24 hour period. 
 
We are doing everything possible to avoid having a whole class quarantine because all students must wear masks, we are sanitizing tables and chairs after being used, and students must always remain 3 feet apart. 
 
If a quarantine does happen, teachers will have one full day to prepare for distance learning online. On the second day, students can log on through Zoom and attend their classes virtually following the normal daily schedule. 
 
Q. How will the School support an individual student who is quarantined while their classmates are still at school?  Under what circumstances will they be able to Zoom into class like we did last year?
 
Teaching hybrid classes consistently is exhausting for our teachers and takes away from the overall student experience. However, if a student is quarantining as a result of a positive COVID-19 test or because they are a “close contact” of someone who has tested positive, they can login to class virtually through Zoom. I want to be clear that students may not login to class virtually for any other reason other than the two situations just mentioned. 

Questions answered by Emily Lund, Head of Lower School, and David Weiner, Interim Head of Middle and Upper School

Q. How can I support my student’s teacher this year? 

Lower School

I think the best way to support the Lower School teachers is to trust  them, trust the process, and  truly partner with them. 
 
Our teachers are so wonderful about supporting parents and for you to reciprocate whether it's with your time, a bouquet of flowers for the classroom for students to arrange, or with special materials or projects for the classroom, truly any support would be greatly appreciated. 
 
 Middle and Upper School 
 
One of our central values at Barrie is to always assume positive intent. Especially in a once in a century pandemic, it is important to assume that our teachers are doing the best they can and that they have the interests of your children in mind. If you have a concern, please follow up with the teacher directly in the spirit of partnership and collaboration. Our teachers love working with parents to ensure that all of our students’ needs are met. 
 

• Parent visits inside of the classrooms are prohibited. 
• Essential visitors* must be pre-approved by a division head, administrator, or supervisor.
• Essential visitors will be asked to complete a visitor questionnaire.
• Essential visitors must follow Barrie’s safety protocols including use of face coverings, physical distancing, and staying home when sick.

*Essential visitors are defined as vendors and other personnel who must come to campus for continued campus maintenance and operations, job interviews, or admission tours. 

Q. Will I be required to take my child’s temperature and report symptoms daily?

YES. You will be required to complete the online screening questionnaire daily via SNAP (the schools electronic health record system) . This is REQUIRED in order for your student to be allowed to be dropped off each morning and must be done prior to boarding the bus. 

Click here for instructions on how to complete the daily screening tool. 

Q. What do I need to do if my child is ill and will need to miss school?

You MUST notify the school nurse at nurse@barrie.org and the appropriate Administrative Assistant for your child’s division for daily attendance purposes:

Lower School Front Office: montessorifrontoffice@barrie.org 

Middle and Upper School Office: lwilliams@barrie.org 

Questions answered by Kirstie Abernathy, R.N., School Nurse

Q. Can you remind me of the school’s policy if my family travels out of the region by car? By bus, train, or plane?
 
Traveling within the US by car within your same household, does not require quarantine or a test. If traveling by air, bus, or train and unvaccinated, the student or staff member would need to test 3-5 days after traveling and remain home for a full 7 days. If fully vaccinated, there is no test or quarantine requirement for domestic travel. 
 
If traveling internationally, all unvaccinated individuals must test 3-5 days after travel AND quarantine for a full 7 days even with a negative test result. For vaccinated individuals, they should test on day 3-5 and then may return to work/school once a test is negative. 

Q. If a child or parent has to fly to another state (such as for medical treatment), can the child return to school sooner than 10 days with proof of a negative test?

• Unvaccinated traveler (domestic or international) - quarantine and test 3-5 day after traveling, may return to school on Day 8 with a negative test
• Vaccinated traveler (domestic) - no testing or quarantine required

Q. Could you advise if we travel by plane but are vaccinated we still need 3-5 days to test?

If it is domestic travel and you are fully vaccinated, no need to test or quarantine.

Q. What is the policy for out of state travel?

Domestic Travel: Any travel by train, bus, or plane outside of the greater Maryland area (excludes VA, DE, PA, DC, WV)  

Car travel within the same household is excluded from this requirement.

Q. What is the travel policy for international travel?

See CDC Guidance on International Travel