It's normal for school-aged kids to come home with a cough, fever or sore throat, but a return to school during the coronavirus pandemic is far from normal.
"We've been asked multiple times, 'Should we send our children back to school?' It is not a simple yes or no answer," said Dr. Heather Gilliam, a pediatrician at Erlanger Children's Hospital. "Does your child have medical issues? Does your child need to be in school for that interaction? Do they thrive off of that? It's definitely multifactorial."
Hamilton County is set to be the largest school district in Tennessee to resume in-person learning Wednesday. Meanwhile in Georgia, some schools have been open since at least July 30, with several across the region already experiencing outbreaks.
Chattooga County Schools was one of the first districts in the nation to reopen amid the pandemic. After less than two weeks of school, seven students tested positive for COVID-19. The district has not implemented a face mask requirement but is strongly encouraging people to wear them.
When a student tests positive, the local health department is immediately contacted and the contact tracing process begins, according to school officials.
Chattooga County Schools Superintendent Jared Hosmer said Monday that since the first two cases of COVID-19 were announced on Aug. 4, 27 students have been pulled from school by their parents and have enrolled in the virtual program.
Rhequia Walker, a 14-year-old sophomore at Chattooga High School, is one of those students. Rhequia is now on waiting list for the district's virtual program, because she initially signed up for in-person instruction. Her mom, Natasha Wells-Walker, hopes that doesn't interfere with her finishing the year on time.
"I told Rhequia when school started, 'You have a 6-foot bubble. Nobody goes in yours, you don't go in anyone else's,'" Wells-Walker said. "She came home after two days and told me nobody was wearing masks, kids weren't following the rules in the hallways. Everyone was carrying on as usual."
Hosmer told reporters the day after the first day of school that students and staff did a "pretty good job" wearing masks and would stress the importance of social distancing in hallways in-between classes and after school.
After the first weekend of the new semester, two students tested positive for COVID-19.
"Immediately, I pulled rank," Wells-Walker said. "[The district] knew it was inevitable for these kids. There's no way for them to stay 6 feet away from each other. When you go shopping at Walmart, they make you wear a mask. Why aren't public schools doing the same thing?"
As of Tuesday, five people (four staff members and one student) in the Dade County school system had tested positive, just days before they were scheduled to go back to class. Face masks will not be required when school starts there.
In Walker County, teachers are speaking out against the district's reopening plan, which does not include a face mask requirement and will have students going to school five days a week in a traditional setting.
There have been several severe outbreaks in other parts of the state. In Cherokee County, where more than 40,000 students went back to school this month, 826 are already in quarantine due to an outbreak. That same district has been taking heat for a viral photo that went around of seniors posing for a picture outside of school while standing very close together while only a few face masks were worn. One high school announced it was suspending classes at the end of the day Tuesday until further notice.
In Paulding County, nine students have tested positive after a student snapped a photo of a crowded hallway and was later suspended for the photo that went viral. The district has since rescinded the suspension.
Wells-Walker, who is a nurse, said Chattooga County Schools has been very accommodating to her worries and sent Rhequia home with a Chromebook to hopefully start the virtual program soon. She thinks the district should have held off on starting school so early.
After the two positive cases, Hosmer announced Friday there were six cases in the district.
"Six is going to turn into 60," Wells-Walker said. "I don't know what it is with groups of kids, but when they get together, cases start popping up like popcorn. I think there needed to be a little bit more time, and they shouldn't have started in July. Maybe late September. If there's any way Tennessee can do that, they should do that."
Time will tell whether going back to school in Hamilton County will cause a resurgence in COVID-19 cases, and comparing the county to different school districts is a challenge. That's because reopening plans and local outbreaks vary widely from place to place.
In North Georgia, new COVID-19 cases in Whitfield, Gordon, Chattooga, Walker, Murray and Catoosa counties are growing at a faster rate than in Hamilton County, where — following a record-setting July — new cases and hospitalizations have so far stabilized in August.
Still, many experts believe that community transmission in Hamilton County should be lower before attempting any form of in-person learning.
Complicating matters, Gilliam said, is a lack of data and research on COVID-19 in children.
"We know that children can get sick. We know that, unfortunately, children can pass away due to COVID," Gilliam said. "But overall, what we're seeing is a lot of times we don't know children have it, or they don't pass it as easily, or they don't get as sick, which our hope is that's what we see as the school year goes on."
Children often catch four to six colds or upper respiratory tract infections in a normal school year, she said. While physicians are hopeful that there will be fewer childhood infectious diseases overall this fall given the increased focus on hand hygiene and social distancing, those other illnesses will need to be on the list of possible diagnoses, along with COVID-19.
If a child has potentially been exposed to the coronavirus or is showing symptoms, Gilliam said it's "not a bad idea" to take precautions and limit exposure as if they're infected.
Hamilton County Schools will require students in third grade and above to wear face coverings to class but announced this week that it will not conduct temperature checks each day. Gilliam suggests parents perform screenings and temperature checks on their children each morning before leaving the house, as well as practice diligent hand hygiene and disinfecting of high-touch surfaces throughout the year.
"Parents are going to have to be aware. If you know your child is not feeling well, has a runny nose and a cough, and their temperature is 100.4 or higher, please keep them home from school," Gilliam said. "Please don't even put that on the school to have to make that call — don't risk exposing other children."
"And if you're worried your child is sick, call your pediatrician," she said. "They're going to be the greatest wealth of information."
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