Nurse Yglesias: Symptom guidance on state's school symptom decision tree

With symptoms to track and guidelines to be aware of, knowing when to send students to in-person learning is a challenge. Overall, the mantra this school year: play it safe.

While questions abound, Wadena-Deer Creek elementary school nurse Amy Yglesias offers some COVID-19 symptom guidance and when students will need to stay home based on state tools. The elementary and middle high school both use the Minnesota Department of Health decision tree tool.

“We expect more absences this year and we’re totally willing to work with that,” Yglesias said. “I think parents are concerned about their child missing school, which we are too, but this year we understand it’s going to be different so don’t worry about it if your kid is sick, just give us a call and we’ll get work set up or anything like that.”

With a range of COVID-19 symptoms, the state has separated symptoms into more common and less common to guide parents, students and staff when having these symptoms. The more common symptoms are: a fever greater than 100.4, a new onset or a worsening cough, difficulty breathing and new loss of taste or smell.

“Those things (more common symptoms) automatically qualify a child to stay home and then they would have to be home for 10 days or evaluated by a doctor,” Yglesias said.

The Centers for Disease Control and Prevention also notes cough and fever as the “most common symptoms in children.”

The less common symptoms are: sore throat, nausea, vomiting, diarrhea, chills, muscle pain, fatigue, new onset of a severe headache and new onset of nasal congestion or runny nose.

“So those less common symptoms if you have two of those then you need to stay home also,” Yglesias said. “The thing that I think is kind of hard this year is if you have one child that is not feeling well all of your children need to stay home from school.”

Since symptoms for COVID-19 can be similar to the flu, cold and allergies as well as people being asymptomatic, this is where being cautious matters.

“It’s such a challenging time because we don’t know a lot of this information so I think it kind of underscores the importance of us recognizing that there may be a lot we don’t know,” Park Nicollet pediatrician Dr. Andrea Singh said in the media briefing on Sept. 14 in relation to asymptomatic children. “This is going to be a different season in terms of illness in the fall and the potential consequences of sending a child back into school if they do have what we perceive as probably mild symptoms and the consequences that may be reaching beyond the child themselves and effecting everyone else that that child comes in contact with.”

RELATED: How to tell if you have COVID-19 or flu | Dr. Hess: Track new symptoms, get flu vaccine this flu season
| Tri-County community forum: Community effort required for students to have in-person learning

Yes, based on having one less common symptom, one more common or two less common symptoms or close contact with someone who tested positive for COVID-19, as denoted in the decision tree.

“If you do have one of those more common symptoms, yeah, you and your siblings, everyone in your household stays home,” Yglesias said. “You can either decide to get evaluated by the doctor, which they might give you an alternative diagnosis where you’ll be able to come back to school or if they test you for COVID and you’re negative then you can come back.”

For one less common symptom, you could return after 24 hours symptom free and household members do not have to stay home though testing is recommended, according to Yglesias and the chart. For one more common or two less common symptoms, you return after 10 days if not tested or test positive and household members remain home for 14 days. If you test negative you can return after 24 hours symptom free and household members resume activities.

“If you choose not to see a doctor then, yes, you stay home for 10 days and your siblings stay home for 14 just because that’s the incubation period of COVID,” Yglesias said.

The incubation period is the time between getting to the virus and symptoms possibly developing, according to WebMD . COVID-19 symptoms can develop two to 14 days after exposure, according to the CDC .

The length in staying home can also depend on if students are a close contact to a person with a confirmed positive case of COVID-19, which means staying home for 14 days. Only if the close contact person tests positive do household members need to stay home.

"There is no get-out-of-jail-free card for COVID-19 when you've been exposed," said MDH director of infectious disease Kris Ehresmann on Sept. 14. "The incubation period is 14 days ... You have to stay out, even if you have a negative test, as disappointing and frustrating as that is."

Yglesias recommends monitoring the fever throughout the day.

“They are saying that it has to be above 100.4 to be a COVID symptom but we still do go by our guidelines at school if the child has a fever of a 100 we do send them home but if someone’s at home and they’re running a little bit warmer than usual probably would be a good idea to stay home just to monitor and see if it did get higher throughout the day,” Yglesias said. “But I mean there … isn’t a rule saying they can’t come to school but it’d probably just be airing on caution, staying home is a good idea.”

Yes, the guidelines listed in question two apply to students at school or at home.

As long as the student has not been exposed to a person with a confirmed positive case of COVID-19, students can return 24 hours after their symptoms have improved. Household members can return to activities immediately.

Learning will continue as long as the student is well enough. If students are being tested for COVID-19 they will continue with homework until receiving their test results, which currently take about three to five days with Tri-County Health Care. Distance learning would be set up if the test result is positive.

“It depends on the teacher,” Yglesias said. “I put the parents in contact with the teacher and let them decide how they want to do it, if they want to do paper homework or distance learning but we definitely encourage the learning to continue while these kids are at home if they can.”

As of Sept. 21 at WDC, there have been no positive COVID-19 cases in students or staff though both have been tested, according to Superintendent Lee Westrum. A positive case in the school is a rapidly changing factor. The school is watching the case rates daily and works with Wadena County Public Health, Sourcewell and MDH.

“I would say definitely if they have one of those more common symptoms, a fever, the new cough or the difficulty breathing or the new loss of taste or smell, I guess those are the red flags that I would get tested for,” Yglesias said.

You can check for available testing at mn.gov/covid19/for-minnesotans/if-sick/testing-locations/index.jsp .

RELATED: UPDATED: Area COVID-19 testing sites for symptomatic or asymptomatic now identified

“Just a reminder that if you have one kid sick then everybody should stay home until they’ve been evaluated,” Yglesias said.

• Wadena-Deer Creek COVID-19 updates: www.wdc2155.k12.mn.us/wdc-schools-covid-19-updates

• Minnesota Department of Education COVID-19 resources: education.mn.gov/MDE/dse/health/covid19/supstucovid19/