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MOUNT VERNON – More than three weeks into the school year, Knox County has seen zero confirmed COVID-19 cases among K-12 students or staff.

Local school districts are doing their best to prevent the spread of the novel coronavirus, which has infected at least 257 county residents to date. Students and teachers are required to wear masks for the majority of the school day, and physical distancing is being enforced in hallways, classrooms and cafeterias. All traditional school districts are offering full-time remote learning options for students who choose to participate.

Still, the question looms: What happens if a student, teacher or district staff member tests positive?

Knox Public Health worked with administrators from all six county school districts over the summer to develop a plan, Deputy Health Commissioner Zach Green said.

The plan can be summarized in two flow charts, shown below. The first chart shows what will happen if a student or staff member tests positive:

The second chart shows what will happen if a student or staff member develops COVID-19 symptoms at school:

"Each school district can modify as needed to meet their needs and capacity," Green said in an email. "With that noted, KPH has been working closely with all districts throughout the county to provide clarity and guidance as desired for all school professionals."

All six county superintendents told Knox Pages they plan to follow these recommendations. None mentioned specific modifications they planned to make heading into the school year.

According to Knox Public Health's plan, if a student or staff member tests positive, the infected individual (or their family) will first notify the school, which will then notify KPH.

"KPH will work with the affected school to conduct an investigation to determine close contacts and quarantine those individuals accordingly," KPH spokeswoman Pam Palm said.

"The school will be responsible to advise the other student families through its own internal procedures (e.g., a letter sent home). KPH will contact close contacts and monitor their symptoms daily."

As a part of its investigation, KPH will ask whether or not the infected individual was at school 48 hours prior to symptom onset or the test being conducted. If that is the case, the health department will ask for "seating charts, school flow and any known contacts of the (positive case)," its plan states. Schools will be required to notify parents of students in the infected individual's class that contact tracing may be conducted.

Students or staff who were within 6 feet of the infected individual for 15 minutes or longer during that time will be identified as "close contacts." They will be advised to quarantine at home for 14 days, from the last day they made contact with the infected individual. These individuals will need to self-monitor symptoms during this time.

The infected individual will be advised to quarantine at home following the positive test result. The school should close the areas where the individual recently visited for deep cleaning, KPH's plan states.

KPH will clear the infected individual from isolation to return to school 10 days after symptom onset. The patient will also have to be fever-free for 24 hours.

If a student or staff member develops symptoms of COVID-19 while in school, KPH is advising schools to isolate the symptomatic individual in a "quarantine room" or a similar area. The school will then need to examine the individual's symptoms.

If the person is experiencing vomiting, diarrhea, or fever, schools are advised to send them home immediately. These individuals should stay home 48 hours after the vomiting or diarrhea stops. They must be fever-free for 48 hours without the use of medication before they can return to school.

If an individual is experiencing milder symptoms, such as respiratory (cough, difficulty breathing, congestion or runny nose, sore throat), stomach (nausea, vomiting, diarrhea) or other issues (fever or chills, fatigue, body aches, headache, loss of taste or smell), schools are advised to ask, "Is there a more likely diagnosis?"

These "more likely" diagnoses might include allergy-related asthma, blood sugar, problems, or pre-test nervousness, among others. If this is the case, KPH advises schools to "proceed as usual" for the individual's symptoms.

If not, schools are advised to ask if the individual has two or more of the above symptoms. If so, the student or staff member should be sent home for a minimum of 48 hours "or per school policy," KPH's protocol reads.

Green said the overall goal of KPH's multi-part plan is "for children to return to school in the safest environment plausible and keep sick individuals home until appropriate to return." He noted that local school nurses have been working together and will continue to collaborate with KPH on case management as the school year progresses.

From a public-information standpoint, Knox Public Health is not currently planning to list confirmed cases by school on its COVID-19 dashboard, Palm said, although it may in the future "if the increase in cases warrants it (e.g. there is an outbreak at a specific location)."

The health department is currently listing all positive cases among students and staff in Knox County – both K-12 and higher education – in the "positive students and staff" section of its dashboard.

"These are students and staff which KPH staff are monitoring while they are in isolation," Palm explained. "If a college student is positive and returns to their home outside of Knox County to recover, they are usually not included in this number. However, MVNU and Kenyon will include the total number of positive students and staff on the school website dashboards."

KPH currently lists five individuals as confirmed cases among students and staff. Palm said one Kenyon College staff member and four Mount Vernon Nazarene University students are represented in the data.

Starting this month, KPH will be required to report cases among students and staff to the Ohio Department of Health each Tuesday. The state will publish weekly infection information each Thursday beginning Sept. 17.

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Staff Reporter

Grant is a 2018 graduate of Ohio Northern University, where he studied journalism and played basketball. He likes coffee, books and minor league baseball. He loves telling stories and has a passion for local news.