“Doesn’t make us feel good”: Dr. Rai on coronavirus spread among kids

Prevea Health President and CEO Dr. Ashok Rai talks back-to-school learning plans.
Published: Aug. 4, 2020 at 8:19 AM CDT
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GREEN BAY, Wis. (WBAY) - “I think what parents need to understand is that it’s more than the child at risk here, it’s the entire staff.” That’s the message from Prevea Health President and CEO Dr. Ashok Rai on decisions regarding virtual back-to-school learning plans.

Dr. Rai joined us on Action 2 News This Morning to talk about the possibility of delays, the risk of spread among kids, and safety on the school bus and in the lunch room.


“Every school district has to have a different plan because everybody has different resources. I think what parents need to understand is that it’s more than the child at risk here, it’s the entire staff. All of that needs to be taken into account. The science keeps changing. We keep learning more about the spread of the virus. The plans that are put in place are there to prevent a spread, prevent a breakout. So if there already is a breakout, like we are in the midst of in Brown County and the state of Wisconsin, the best laid plans aren’t going to work as well as we’d hope them to. I think we really need to understand whatever they decide today will likely change tomorrow, two weeks-three weeks-six weeks down the line. So we have to be flexible, we have to be understanding. The superintendents, the school boards have had weeks, maybe a couple of months to work on something that generally would take years to plan for.”


“We’re starting to get some research back from articles that were published in the Journal of American Medical Association, Lancet, the MMWR, all showing that spread among children is a lot more prominent than we thought it would be. They’ve actually started to isolate the virus from younger children and then realize it’s a replicating virus and there’s actually more of it there than in some adults. In other words, they’re spreading it to adults a lot more frequently. Why didn’t we know this in the beginning? Well, number one it takes awhile to study it. Number two, what’s one of the first things we did in February and March when we realized this was putting society at danger? We protected our children. We did not know what the effect was going to be. So the first people to isolate, the first people to stay at home, was our children. And we really didn’t start introducing children back into society until May, June, July when school was officially over and they were done virtual learning, and then we got to see when they got to cohort again together in camps and situations like we saw in Georgia, that spread was more prominent. Once again, research takes a little time to get published. But what we’re finding out now doesn’t make us feel good. If you asked me about this two weeks ago, I would have said, ‘under 10, not as big of a risk.’ Now we’re realizing it’s actually a large risk.”


“I think that everything we’ve talked about, there’s certain factors that need to be there. Number one, I’d love to see the delay if there’s still a significant breakout. So we’d have enough time to whatever arbitrary date’s been set, whether it’s Sept. 1 or Oct. 1, to get Wisconsin, get Brown County in a better place where school plans can work better. So maybe there should be a delay. But if anything, there should be a phase-in aspect to everything. We recommended this, the federal government recommended this in April. The state of Wisconsin recommended it in April and May with the Badger Bounce Back Plan. We need everybody to understand that the concept of phasing in is experimenting, making sure there’s not a spread, and then going ahead to the next step and then the next step. And that’s a safer way to re-enter society. Maybe it’s a safer way to re-enter school.”


“I think every school district is looking at different ways to mitigate spread on a school bus. It’s a concern. They’re looking at spacing kids out on there, having more runs. Cohorting students. In other words, siblings have to sit together. Probably not a popular choice among siblings, but they’ll have to sit together and space out the best they can. Is it an ideal environment? No. But we’re looking at mitigating a spread. So as long as, once again, what’s going on in the community is under control, hopefully we can keep what’s going on in the school bus under control as well.”


“So really the purpose of the mask, once again, is to prevent the transmission of the disease. If we’re trying to protect the teacher, the only mask we know of--and a mask alone would not suffice, we would other personal protective equipment to create that full level of protection like we have in health care--would be an N95 that has been fit-tested. So it’s not an N95 that you buy at the hardware store. It’s one that you have in health care that you’ve actually sat in a chamber and they’ve fit-tested it to you to make sure nothing is leaking in and around it. Those resources aren’t really available to teachers, and once again, we’re still in a nationwide N95 shortage. So that really should be towards those in health care who have to response to known COVID situations. It would be great if we had enough of that to put a teacher in. But understand, outside of the N95 we’re talking about a gown, we’re talking about a face shield on top of the N95. Probably not that most ideal situation to be sitting in for eight hours straight for a classroom, or six hours straight for a classroom. Especially when you haven’t been exposed to that situation like we have in health care.”


“The study is interesting, and hopefully we’ll have more studies like that. Remember, it’s a new virus so we’re learning every day. They’re looking at directional flow of HVAC systems and getting people upwind or downwind to make sure they would be safe. So if a school was able set up their lunchroom in a way that the virus was, for in essence, was blowing in another direction, that would be great. There’s some evidence, although a single study, that it could help. Right now I would say that anything that could help would be a good idea. And it couldn’t cause harm to have people facing all in one direction.”


People gathered on Lake Butte des Morts over the weekend for a Sand Bar party.

“It’s frustrating. Obviously I think that some people think if you’re outside that’s an OK environment. Yes, if you’re outside there’s less chance of spread. But that’s still when you’re still getting some kind of normalcy of physical distancing. There’s a big difference of 20 people at a pool that are spread out versus 1,000 people that are packed together like that. There’s no amount of dilution that’s going to prevent the spread of COVID-19 when you’re that close together and you’re that many people outside. Obviously, you know, it’s not a good situation. It’s not a smart situation. We will hope for the best and there’s no spread, but statistically there probably will be some.”


“Say you know you’ve been exposed to COVID, you have to quarantine for 14 days no matter what. That’s because for you to turn positive for the virus, it can happen anywhere between two-to-14 days. Getting tested the next day probably not worthwhile. Literally, you’d have to be tested every day from day two-to-14, which is not practical. The best thing you can do in that wedding situation is make sure you’re physically distanced. Make sure people are masking. Make sure you’re outside as much as possible. Even then, you’re going to be at risk and putting other people at risk.”


Wisconsin is listed as one of the states in the federal “red zone” where there are serious outbreaks of coronavirus.

“There’s a variety of maps out there, even within the federal government. The CDC having one. Also other outside organizations, such as Harvard, publishing these maps with colors. Really when you get to the red area they’re talking about whether your percent positivity is high, your case loads, your cases per 100,000, and if it’s increasing versus decreasing. In a lot of those categories Wisconsin is not doing well. So it’s labeled red on a few different maps. It does mean that we’re in a situation now that would be considered an outbreak or a hot spot by a variety of different definitions. And Wisconsin definitely is on that upward swing, unfortunately.”


“Hopefully every gym is following the state mandate. If you’re following the state law, people are masking in there. So it makes it a much safer environment. You should still be physically distancing within the gym. They should be still spreading equipment out. They should still be masking. If a gym is not masking, number one they are violating the state law. Number two, they’re not doing what’s right for their customers and for their employees. Working out in a masks, remember it’s a short period of time, most workouts are an hour, hour-and-a-half long, and masks have been tolerated for that time period. They’ve been studied in situations like that. Because remember, when you’re working out--such as an aerobic exercise, we’ve shown that the virus can actually spread farther. So if there’s an environment that needs mitigation more, it’s a gym. Because you are exhaling just as much as a singer would. Your six feet now is 10 feet. It could be even longer. So gyms should definitely be masking going forward, and it is the law.”


“I wish we had it six-eight-10 weeks ago, but we didn’t. We have it now. Hopefully we start to see the effects of this, if people comply. A mandate only works if people actually follow it. And there are some businesses already not doing their job. And some people not doing their job. But if everyone wears that mask, hopefully we’ll start to see that percent positivity start to come down in the next two-to-three weeks. That’s about how long it will take. It may actually take a little longer to see the effect of it. Hopefully we’ll start to see the effect of it. That along with physical distancing and washing our hands and testing if symptomatic and testing if exposed, all of those things need to ramp up significantly if we want to get back to a normal fall, which includes school.”

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