What symptoms should send a student home? Here’s what the state and a school nurse say.

“I don’t see how anyone can be overly cautious when you’re dealing with health and safety in the pandemic.”

–Adam Glanzman / Bloomberg

Last month, the father of an Arlington elementary school student expressed frustration after his son was sent home from school for sneezing a couple times in class.

He said, despite the sneezes, his fourth-grade son wasn’t symptomatic when he left for school and didn’t have symptoms when he returned home. A message from the school staff, a recording of which was obtained by WBZ, said along with sneezing, the boy was sniffling.

The case brings about a few questions. Namely, when should a student be sent home? And is there such a thing as being overly cautious in these times?

What the state says

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The state guidelines for reopening schools indicate that the most common COVID-19 symptoms, the ones that most of us are probably very familiar by now, include a fever of over 100 degrees Fahrenheit, a sore throat, difficulty breathing or shortness of breath, muscle or body aches, congestion or a runny nose accompanied by other symptoms and not due to allergies, a new loss of taste or smell, coughing without another cause identified, a headache accompanied by other symptoms, and nausea, vomiting, or diarrhea. Sneezing by itself, however, is not among these symptoms.

For a student who does appear symptomatic at school, their teacher is supposed to contact the school nurse, make sure the student keeps their mask on, and have the student removed from class. Then, if the nurse notices symptoms, they have to place the student in a specific waiting room and either have their parent or caregiver pick them up as soon as possible or, if they are unable to, have the student wait in the quarantine room until the end of the school day, per the state guidelines.

The student, according to the guidelines, must then be tested, “even those with mild symptoms.” If they don’t want to undergo the test, they have to wait 10 days from the beginning of their symptoms to return to school, provided that their symptoms have improved and they haven’t had a fever within 24 hours.

What a school nurse says

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When it comes down to whether or not a kid should be sent home from school, even with mild symptoms, it’s a better-safe-than-sorry approach, according to Patty Comeau. Comeau is the lead school nurse for Methuen Public Schools and a leader for the Massachusetts Nurses Association.

“I don’t see how anyone can be overly cautious when you’re dealing with health and safety in the pandemic,” she told Boston.com. “And school nurses are in my opinion in a no-win situation. There’s so many overlapping symptoms with COVID and other maladies that how do you determine what may be causing it?”

Nurses are unable to diagnose a patient, Comea noted. A school nurse evaluates a student and if they have any COVID-19 symptoms, she said, “we have to err on the side of safety.”

“Imagine the position that the school nurse is in if a teacher sends a child down to the nurse for an assessment and the nurse sends the student back to class and then they test positive?” she said. “So that puts a tremendous responsibility on the school nurse.”

As the leader of Methuen’s school nurses, Comeau has told her colleagues to be cautious.

“I would rather send a child home to get tested and get a test result than to take the chance that I’m sending a child with COVID back to a classroom,” she said.

Methuen, like some other districts, is in the middle of a phased-in hybrid approach for the fall. Remote learning began on Sept. 14. Students in kindergarten through fourth grade, and those in ninth grade, began hybrid learning on Oct. 5. On Oct. 26, the rest of the grades are planned to return.

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School and city officials meet weekly, Comeau said, to analyze COVID-19 data, and to make any adjustments to learning as need be.

Having kids physically back in school is a balancing act, Comeau said.

“It’s been great to have the kids back, we all want that,” she said. “We know that that’s the best learning model for children, but unfortunately we are dealing with the pandemic at the same time.”

And it isn’t just the students. COVID-19 affects the ability of teachers to return to the classroom, whether they get sick or have been in close contact with someone who has the virus or was exposed to it. Up until now, the Methuen district has been able to continue with enough staff, but Comeau noted that the state case count has been on the rise recently.

One case in one classroom, student or teacher, means potentially 25 close contacts, considering the entire classroom.

Thinking on her own safety, Comeau said she isn’t worried. She washes her hands, wears her mask, and doesn’t attend large gatherings.

“I do the best I can to protect myself,” she said.

However, she is concerned about the long-term effects of COVID-19. Already, medical staff are finding not just lung damage, but also destruction of the kidneys and heart, as well.

“I think there’s a lot we don’t know about it,” Comeau said.

She encouraged everyone to continue “to put that armor on”: continue to follow the advice of health care professionals, continue to wear a mask and follow other guidelines for stopping the spread, and get a flu shot to help limit the impacts on the health care system. While it may not stop you from getting it, it helps drop the chances, she said.

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