Frequently Asked Questions
Added Dec. 11, 2020
We are considering forming a pod with a local family for the Christmas and new year holiday. We would like to get tested before entering the pod and before socializing with others once we have formed the pod. Can you advise on timing related to when we should take the pre-pod test?
Generally, you want to submit your test about 72-96 hours before starting the pod interaction to permit time to have negative results in hand before getting together.
If family is visiting from outside CA and wants to get tested shortly after arrival (e.g. 4-7 days), what is the best testing option for them (in terms of location, timing, and accuracy)?The best options in my opinion include a home-based PCR testing kit (e.g., Labcorp Pixel if adult, Picture Fulgent Genetics if child), or an in-person rapid antigen or PCR test such as those offered by Carbon Health or Dignity Health/Go Health Urgent Care clinics.
At what point do you get concerned about having kids in school, given community rates (is that new cases rate? incidence rate?)?
Typically we would want to see the test positivity rate maintained <5%. Currently, it is 2.5% in San Francisco county.
Someone is sick in my household, can my child come to school?
According to SFDPH guidelines, yes, a child may come to school unless they have tested positive, were identified as a close contact or are exhibiting illness symptoms themselves. We rely on our families to use their best judgement and strongly encourage anyone showing illness symptoms to get tested immediately. If the sick individual is a student that attends La Scuola, we ask that families keep any other siblings at home until the sick individual is tested.
My child has a sibling not at La Scuola that is sick, can my La Scuola student still come to school?
Yes. We strongly encourage anyone showing illness symptoms to get tested immediately. SFDPH has no requirement to keep the healthy La Scuola student at home unless they test positive for Covid, are identified as a close contact or are exhibiting illness symptoms.
Our nanny is the only person who we’ve had in our home or seen in person since March. She lives alone and follows all CDC guidelines, but she lives in a neighborhood in which COVID cases have spiked. How can we best mitigate the risk to her and to our family?
The best way to mitigate the risk to her and to your family is to continue to maintain a tight pod, mask and physically distance, avoid breaking the pod with new entrants, and isolate and test if symptoms develop among anyone in the pod.
What are your thoughts on the vaccine? How do we know that they are safe and free of long-term side effects? Will you vaccinate your child and, if yes, with which vaccine? Should a vaccine be mandatory to enroll at the school?
I am heartened by the evidence of effectiveness of the vaccines, and will be taking a vaccine myself when it is my turn in line. I would suggest adults get the vaccine when it is available, and am recommending it to patients. The safety profile of the vaccines are very good so far, with some exceptions for people with severe allergic reactions to vaccines or Guillain-Barre Syndrome, which is thankfully rare. The evidence for effectiveness in children remains pending at this time; the Pfizer vaccine will start enrolling kids this month, and Moderna will do a separate pediatric trial shortly thereafter. Once we have results from those trials, we can speak in a more data-driven way about the safety and benefits to children. Requiring vaccination is a matter of state laws, which La Scuola is required to follow; at present, the COVID vaccine is not on the required vaccination state list for childcare or schools. I recommend reading a summary of current evidence from the vaccine studies from The New England Journal, available here: http://dx.doi.org/10.1056/NEJMe2034717
Can you recommend a protocol for seeing family members? Like for Christmas, we have a week before Christmas - if we all isolate + get COVID tests, can we see elderly grandparents?
While the recommendations are to avoid such activities as much as possible, for people who will definitely participate in such activities, it is better to continue masking especially indoors, isolate, and get COVID PCR or rapid antigen testing beforehand, though that is still not an absolute guarantee of safety.
Other private schools have opted to close given the recent rise in cases. Why has La Scuola opted to remain open, given the increased risk?
La Scuola continues to follow the scientific evidence and guidelines from federal, state, and county departments of public health. The data continues to show low risk among K-8 populations despite higher risk among high school populations, and current models indicate schools can remain a priority as other activities are reduced during the new shelter-in-place, to balance the risks of long-term detriment to educationagainst the risks of in-person schooling responsibly.
Would Sanjay be willing to host another session and take us through the latest data, including the new vaccine results?
Yes, perhaps waiting until the results of pediatric vaccine trials are available.
Many parents are choosing to participate in activities such as air travel, play dates, sleepovers, gatherings, holiday celebrations, outdoor dining (when it was open) and team sports. Given that our family is not participating in activities like these, how can we best protect ourselves and the school community?
We plan to reiterate guidelines for safety among the community, continue to have the longer winter break period to enable isolation of families before returning to in-person school, and offer testing opportunities.
Added Nov. 13, 2020
Are rapid tests acceptable or does La Scuola require PCR tests in order for a student to return to school after illness?
La Scuola will welcome back students on campus with negative test results from either the rapid test or the PCR test. While, if a student tests positive from the rapid antigen, we would work with the SFDPH and ask the child to take a PCR test before determining next steps.
Dr. Basu shares that the negative predictive value is very good for both sets of tests, rapid and PCR. If the rapid test is negative, that’s great news and it is fairly safe for the child to return to school. The positive rate is the problem for the rapid tests. The rapid tests often have false positives, and so a person may be kept out of school while the PCR test will often be negative despite the positive rapid antigen.
After flying, what is the right amount of time to wait before getting a Covid test?
Generally 4-7 days from the day of potential exposure are recommended for testing.
Have you seen a higher level of effectiveness of keeping COVID numbers down with the use of the tracing app?
In the United States, rather than creating a single contact tracing app, the decision to support Exposure Notifications is made by each state’s public health authority. The Google/Apple COVID-19 exposure notification feature has not currently been turned on for California, and is currently being used in only 11 of 57 states and US territories. The slow uptake may cast doubt on the viability of containing COVID-19 in the near-term with contact-tracing apps, which would likely require the majority of people (about 60% or more) to participate. Further discussion of digital contact tracing can be found in a research article in the journal Science: http://dx.doi.org/10.1126/science.abb6936
Which Covid test is most recommended for children?
PCR testing is more recommended than antigen tests. Antibody tests are not recommended.
Which Covid test is most recommended for adults?
PCR testing is more recommended than antigen tests. Antibody tests are not recommended.
Added Nov. 6, 2020
Could you share your thoughts on the India study that found children were big drivers of transmission (https://science.sciencemag.org/content/early/2020/09/29/science.abd7672)? It seems like the largest study in terms of the number of people and given the high #s of asymptomatic cases (maybe more in kids?), I'm wondering if we're collectively underestimating this risk. I am currently pregnant and are worried about exposure now and during newborn months to the rest of the family.
The India study showed that children could be involved in the transmission, but with two caveats: most transmissions to children was parent-to-child transmission or adult-to-adult transmission within the same age groups among extremely high-risk environments with a very high incidence rate and without masks; and secondly, that child transmission was not a major portion of the overall transmission, contrary to (mis-)representation in some media outlets. The key figure is below, which shows how many people were infected (bottom axis) by people of each age group who were infectious (left axis), revealing the most transmission again was among adults infecting other adults of the same age or parents infecting children, and that infectiousness was particularly among those above age 18 years old.
Added Oct. 29, 2020
With the new CDC report on the definition of close contact does that change the school's approach and communication of close contact?
The Centers for Disease Control and Prevention released new guidelines regarding what counts as “close contact” with someone who has COVID-19. The expanded definition includes brief but repeated exposure to others with the virus that adds up to 15 minutes over a 24-hour period. SFDPH is currently evaluating their position and will be advising La Scuola on any change to how the school defines Close Contact.
Previously, the CDC defined close contact as spending 15 consecutive minutes or more within six feet of someone with COVID-19. The new CDC guideline does not change the communications text or instructions around close contact when such contact happens, but does change how the school will keep track of close contact, in that cumulative exposure within 24 hours will be taken into account, potentially broadening the number of people who will be communicated with to quarantine and follow standard subsequent steps if a positive case occurs.
Shouldn’t all children be required to have a flu shot to minimize unneeded absences?
It is highly recommended for all children over the age of 6 months to receive a flu vaccine; however, there are some conditions that may prevent a person from safely receiving a flu vaccine (e.g., Guillain-Barre syndrome). La Scuola is bound by local, state, and federal regulations and laws regarding how they can phrase a recommendation versus a requirement to vaccinate; at present, the California and SF vaccine requirement laws do not apply to the flu vaccine. Nevertheless, based on publicly-reported data, La Scuola is in the highest tier for vaccine compliance among schools (95-100% of students fully vaccinated in the latest dataset, covering the 2018-2019 school year).
Where can we get a rapid 15-minute kids turnaround test in San Francisco?
PCR antigen tests are recommended. Rapid antigen tests are discouraged due to increasing reports of false positive and false negative results.
What if my child has symptoms and our doctor won't refer for a test?
When parents share that their child has symptoms in line with Covid-19, they will be:
- Asked to stay home, along with any siblings,
- Contact their healthcare provider,
- Get tested for Covid-19
If the healthcare provider does not advise that the child get tested, La Scuola will ask for a doctor's note clearing the child to return to school. If the sibling has no symptoms, the sibling would also be able to return to campus.
I am curious for more detail on the SFDPH guidance that influenced the sibling policy for an impacted cohort and why the potential for infection isn't a concern?
The SFDPH and CDC have no quarantine requirements for any siblings or family members that have been close contacts of an individual that has tested positive (what is referred to as a “contact of a contact”) unless they also test positive. The quarantine requirement only applies to those that have had close contact with an individual that has tested positive (what is referred to as a “close contact”). The La Scuola policy is one step more cautious than the SFDPH and CDC, however, in that it requests that household members get tested if in contact with the person who has tested positive, to minimize the risk of infection before the non-positive sibling can return to in-person school. Please refer to www.lascuolasf.org/reopening for more details.
Could you talk a little about the risks of carpooling within classes, plus siblings that are in other grades? What’s the level of additional risk or how should we approach it?
Carpooling within classes/pods with masks on is considered a low risk activity, essentially adding no further risk beyond that of typically being within a pod for regular school activities. Being with siblings of other grades/ages is unlikely to meaningfully increase risk given that the full household is likely already exposed to that sibling, and others in the pod are likely effectively exposed to that sibling as well, such that the circle of exposure is essentially extended to include that person. Yet this does not appear that such extended pods have elevated risk meaningfully in prior studies including differently-aged siblings crossing pods in communities with low incidence rates (<10 cases per 100,000 people per day), as evidenced in particular by results from New York City's school reopening [NYC is at 7.9 and SF is at 4.9 cases per 100,000 people per day]. The risk may be more in communities with substantially higher incidence rates [such as in Boston, at 16.7 cases per 100,000, though even in this setting the carpooling itself or the cross-aged sibling aspect was not noted to increase the risk; rather, the overall community rate was amplifying risk for adults transmitting to other adults].
Why is travel by air even just by a family member deemed to be so dangerous that it requires a 14-day quarantine? Large family gatherings for the holidays, indoor activities nearby seem to pose much larger risk?
Large family gatherings or indoor activities in which people are unmasked and in close contact for prolonged periods are certainly of high concern. Travel by air has recently been reviewed by the Journal of the American Medical Association and you can find the summary here: https://jamanetwork.com/journals/jama/fullarticle/2771435
The bottom line is that infection within the airplane is considered unlikely, particularly with masking and ventilation systems on commercial airliners, but due to the much higher rate of COVID in communities outside of the Bay Area in the US, the risk of being in those other locations outside of the airplane [the destination trip itself] greatly heightens the risk of transporting COVID back to the Bay Area. For that reason, SFDPH currently advises: "you quarantine for 14 days upon return to San Francisco if during your travels you interacted within 6 feet of individuals outside your household when you or those around you are not wearing face coverings at all times. The more interactions that were indoors, the larger the number of people involved, and the longer the duration of such interactions, the greater the risk. In addition, DPH recommends that you quarantine for 14 days upon return if you traveled on planes, buses, trains, or other forms of group/public transportation where face coverings were not worn at all times by you and those around you while in these enclosed spaces."
La Scuola does not currently anticipate any changes to the travel quarantine policy, but will be working closely with SFDPH on when will be appropriate to update.
Added Oct. 13, 2020
What happens when a family has more than one child at La Scuola and one child is symptomatic?
In the case where a family has more than one child at La Scuola and siblings are in other cohorts, whether on the same campus or a different campus, if a child is symptomatic, the symptomatic child will be isolated in a designated location until a parent or caregiver can pick them up. The student will be sent home with instructions to isolate for 10 days and a negative COVID-19 test result will be required prior to returning to campus. The school must be notified of the results and will work with the individual on a campus return date in conjunction with SFDPH. The cohort will remain open and no specific communication with the health department is required.
We require any asymptomatic sibling to quarantine at home until the symptomatic child’s Covid-19 test results are back.
If the symptomatic child’s test results are negative, the symptomatic student would follow standard handbook protocol on when they can return and the asymptomatic child may return to campus assuming they are also symptom-free. From our handbook: Children may return to school after they have been symptom-free for a minimum of 24 hours and/or are accompanied by a doctor’s note. For example, if the child leaves the school on Monday with a fever over 101, she/he should not return until at least Wednesday.
If the symptomatic student tests positive for Covid-19, SFDPH will be notified immediately to facilitate contact tracing. The student must isolate at home for at least 10 days after first symptoms occurred.
A symptomatic student may return 10 days after testing positive AND symptoms have improved and if it has been at least 24 hours since the last fever without the use of fever-reducing medications.
In this case, the sibling may be considered an individual who cannot avoid having close contact (for instance a caregiver or someone who cannot maintain any distance at home) and would be required to quarantine for 24 days (quarantine for 14 full days after the day that person completed their 10-day self-isolation). SFDPH quarantine and isolation guidance details can be found here.
This same protocol would apply in the case of any two family members or more that are at La Scuola.
Do you have any data on COVID cases in daycares and preschools in San Francisco?
The California Department of Social Services regularly updates Covid-19 Positive Cases in Child Care Facilities.
My young children are going crazy and they need to have a play date. How can we do one safely?
Making decisions about risk can be complicated. If you decide to have social interactions outside your household, please see these tips from the CDC:
- Clean hands often using soap and water or alcohol-based hand sanitizer.
- Avoid people who are sick (coughing and sneezing).
- Put distance between your children and other people outside of your home. Keep children at least 6 feet from other people.
- Children 2 years and older should wear a mask over their nose and mouth when in public settings where it’s difficult to practice social distancing. This is an additional public health measure people should take to reduce the spread of COVID-19 in addition to (not instead of) the other everyday preventive actions listed above.
- Clean and disinfect high-touch surfaces daily in household common areas (like tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, and sinks).
- Launder items including washable plush toys as needed. Follow the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.
- Make sure your children are up to date on well-child visits and immunizations.
- Although most children get no or mild symptoms when they have COVID-19, some children are at higher risk. For some families, children with health conditions or disabilities may be feeling an intense need for social interactions. If you are feeling overwhelmed, reach out to La Scuola or others and let them know. The San Francisco Human Services Agency also has a 24-hour Crisis Line For Parents at (415) 441-5437. Source: SFDPH.
What does ventilation look like at each campus?
At our Dogpatch campus, we have an HVAC system with Merv 13 filters in place which will be replaced every two months (typically replaced every 6 months). In addition, each classroom is equipped with an air purifier with HEPA filters changed 1-2 times per month and is efficient for 800 square feet, the maximum size of our classrooms.
At our Fell campus, we rely on a large number of windows to cool the space / circulate the air and a steam / radiator heating system. Three is no forced air in the building. Each classroom is equipped with an air purifier with HEPA filters changed 1-2 times per month and is efficient for 800 square feet, the maximum size of our classrooms.
At our Mission campus, we rely on a large number of windows to cool the space / circulate the air and a forced-air heating system throughout. The furnaces will be equipped with Merv 13 filters. Each classroom is equipped with an air purifier with HEPA filters changed 1-2 times per month and is efficient for 800 square feet, the maximum size of our classrooms.
What are we using to clean on campus? How did we change our cleaning procedures?
Across all three campuses, our facilities team cleans throughout the day and we have a janitorial crew that comes each evening. They both use Quat20 at the recommended dilution.
At our preschool campus and for grades Kindergarten and 1, where there are more manipulative toys or sleep mats available for children, a diluted chlorine solution is used regularly, as recommended by the Department of Social Service and the SFDPH. We continue to wipe down common areas and high touch surfaces throughout the day.
Are face shields considered face coverings?
When we refer to face coverings, we are referring to cloth face coverings (defined below). Face shields may be worn in addition (and will be provided to our teachers that are more comfortable wearing them) but they are not required. Only cloth face coverings are currently required for our teachers and anyone over two.
What is a cloth face covering? A cloth face covering is a material that covers the nose and mouth. It can be secured to the head with ties or straps or simply wrapped around the lower face. It can be made of a variety of materials, such as cotton, silk, or linen. A cloth face covering may be factory-made or sewn by hand or can be improvised from household items such as scarfs, T-shirts, sweatshirts, or towels.
Someone I met up with tested positive for COVID-19. We haven’t touched and have only met outdoors, what is the risk and what should I do next?
We are learning more about COVID-19 each week. At the current time, there is minimal risk to outdoor, no-contact interactions where people are six feet apart at all times with their faces covered, and no food or objects are shared. If you think you spent more than 10 minutes within 6 feet of that person while THEY were not masked, then you should quarantine for 14 days. See Guidance for Isolation & Quarantine. If you develop any symptoms of illness, call your healthcare provider, get tested and isolate according to the instructions in Guidance for Isolation & Quarantine. Source: SFDPH
How will the school support students whose parents make the hard choice to keep them home, or who have to stay home for quarantine?
We are activating all of our resources to support our students and families during our return to campus. While we cannot predict the future, we know that some families may choose not to attend in-person classes. Should students not be able to attend in-person classes, Distance Learning will be available for our K-8 students. In a Distance Learning setting, students will receive a blend of synchronous and asynchronous learning.
What will happen if someone tests positive?
SFDPH is finalizing its protocols for this, and we will follow these. We will share more information when we have it from SFDPH, but families can be certain that we will scrupulously implement all the steps required for our community’s safety.
What can students, families, and staff do?
- Be aware of symptoms of illness and stay home if you are not feeling well.
- Continue to follow best practices for prevention of the spread of viruses, including COVID- 19 and the common cold or flu: wash hands frequently; do not touch eyes, nose or mouth with unwashed hands; cover mouth and nose when sneezing or coughing; and get a flu shot.
- Respect the privacy of students and staff, and take steps to prevent discrimination.
- Parents and guardians, ensure your contact information is up-to-date in the event that large group notifications are sent by phone, email, and text message. More information.
- Keep yourself up-to-date on what the SFDPH, California Department of Public Health and the Centers for Disease Control (CDC) suggest.
- Discuss your child’s questions and concerns with them and help them practice good prevention. Depending on your child’s age, some helpful resources may include: “Just For Kids: A Comic Exploring The New Coronavirus” and “How to Talk to Kids About Coronavirus.”
If a case is detected that impacts a school, what are some possible steps we might take?
- Work with the San Francisco Department of Public Health to evaluate exposure risk and make decisions regarding quarantine.
- The decision to close a school would be made on a case-by-case basis in collaboration with the Department of Public Health, and would take into account the general safety of all students and staff.
Will we have extended care at Elementary and Middle School?
We are actively working on what that may look like and will keep you updated on any news. Extended Care will be highly dependent on SFDPH regulations for mixing of student cohorts. Our traditional Extended Care would remix groups of students; if we are allowed to remix groups to some degree, we may have some flexibility to offer the Extended Care program. If SFDPH regulations are such that we are able to offer Extended Care, we will plan to start the program as soon as we can while ensuring our regular school day is operating effectively