Pediatrician says schools can reopen safely if prepared
Lexington pediatrician Caitlynn (Taylor) Iddings, who grew up in Versailles and now lives here with her family, says she worries about teachers and keeping them safe as Woodford County Public Schools continue preparing for a return to in-person instruction later this month. However, given the low number of people who have tested positive for COVID-19 in Woodford County compared to other communities in Kentucky and elsewhere, Dr. Iddings said schools can reopen safely if recommended guidelines to stay healthy are followed. “We’ve been living this for five months now at our office (Pediatric and Adolescent Associates) and have managed to keep everyone safe and no one’s gotten infected,” Iddings said. “So I think if we can do it on that large scale, where we’re seeing 300 patients a day … we can certainly manage to keep our teachers safe if we have appropriate planning. So that’s really why I reached out” to school district leaders. Dr. Iddings said she offered to help with planning for a return to in-person learning after watching a recent school board meeting and hearing many medical questions about a student re-entry to school. While she understands why some teachers have concerns about a return to in-person instruction, “I think we can do it and I think we need to try,” said Iddings of reopening schools. She said it’s important for teachers to learn how to stay safe by wearing masks and following “healthy at school” guidance. Teachers with underlying health issues like diabetes, who are at a higher risk of becoming very sick and possibly dying as a result of COVID-19, should probably teach virtually rather than being in-person, she said. She said parents of children living in multigenerational homes may also want to choose the virtual learning option to keep vulnerable grandparents safe. “That’s why there should be the option,” she said. Overall, Iddings said she’s less worried about children because most of the pediatric patients who have tested positive for the virus aren’t very sick and some don’t have any symptoms at all. She said many kids who have symptoms are not getting a cough (a common way to spread the virus), but instead are having gastrointestinal symptoms like diarrhea. That’s probably related to how the virus binds to the ACE (angiotensin-converting enzyme) receptors in the lungs, she explained. She acknowledged a return to school will be more of an issue for middle and high school students because unlike kids in elementary schools, they do not stay in the same classroom all day. “But I think we can still do it,” she said. “It’s going to be everyone following the rules. “… Masks are going to have to be worn.” If a student doesn’t want to wear a mask, the parents need to choose the virtual learning option, she added. Because it’s very, very difficult for non-medical facilities to obtain N95 protective masks, the district has 750 KN95 masks, primarily for preschool and kindergarten teachers and support staff, schools Superintendent Scott Hawkins said. (Preschool and kindergarten students are not required to wear masks in the district’s current re-entry plan.) The KN95 masks are described by the Centers for Disease Control and Prevention as a safe alternative to the N95 respirator (mask), according to the Kentucky Department for Public Health. Its guidance for using KN95 masks stated the KN95 provides greater filtering than a normal mask, but does not fit tightly enough to provide the protection of an N95 mask. Hawkins said he appreciates the additional guidance and information on reopening school that a pediatrician can provide. “They’re seeing patients every day,” he explained, “so (from her perspective) are there things that they’re doing that are reducing risk that we could potentially implement?” Given the unknown number of asymptomatic cases, Iddings said, “I think we have a lot more of the virus out there and lot more community spread than we have realized over the last five months.” Therefore, she thinks the number of confirmed cases in Kentucky is “not representative of the actual morbidity and mortality that we’re seeing.” In terms of Woodford County’s low COVID-19 numbers, she lauds residents for wearing masks and following social distancing guidelines to limit the spread. But she worries if teenagers aren’t in school, some will go to pool parties “and that’s where we’re going to have issues.” So if they’re in school and following the rules – not at a social gathering with 50 other teens – they may actually reduce the spread of the virus, she added. “We still need to be very cautious and give the virus the reverence that it needs,” Iddings acknowledged. She also understands why some parents are uncomfortable about sending their children back to school and why some teachers are worried about putting themselves at risk. Iddings said she’s reviewed many studies that recommend sending kids back to school if the coronavirus numbers are reasonable, but also knows “we’re learning more and more every day.” A lot of kids who test positive are getting the coronavirus from an adult at home, where they don’t social distance or wear a protective mask, Iddings said. “The large majority of cases that we are seeing,” she said, “they’re not from the daycares.” Her two youngest children, Claire, 3, and Henry, almost 6 months, will continue in daycare (they’ve been going since June 15), and her 7-year-old daughter Anna will be a second-grader at Southside Elementary School – “that’s the plan,” she said. “We tried the virtual learning last year,” said Iddings, “and it was fine – only because I was on maternity leave and I was able to sit there and walk her through every single step. But we’re not going to have that luxury come August. I’m back at work. My husband works.” Iddings said other families will face their own challenges if kids are not back in school. Some teenagers will be helping their younger siblings with schoolwork and not be involved in after-school sports or other activities, which may lead to depression because they’ve lost their support system and have those additional at-home responsibilities, she said. “We have had a large up-tick in kids who are showing symptoms of depression and anxiety,” said Iddings. She said a lot of that stems from them being social beings and losing their support systems. “When you’re a kid, a month feels like forever,” she explained. So being at home during an ongoing pandemic with seemingly no end can feel overwhelming, she added. If children are not in school, “it’s going to create a really big issue for a lot of families,” Iddings said. Among the issues are kids gaining weight because they’re not getting out or being active in sports, she added. Her biggest worry as a pediatrician is kids who do not have a good support system at home, Iddings said. She blamed a drastic drop in the number of child abuse and neglect cases being reported to teachers (and other adults in schools) not seeing the bruises and the kids who are dirty or hungry. “That worries me,” she said. “… I worry about the (parents) that are working two jobs and their kids are home alone and they don’t have enough money to even pay the bills or feed them … and there’s no one to intervene with them and be their advocate.” A 2004 graduate of Woodford County High School, Iddings said her interest in becoming a pediatrician goes all the way back to when she was about 8 years old. “I’ve just always enjoyed kids and science, and so that’s always been sort of the goal of mine from the time I was at Northside Elementary School – all the way through,” said Iddings. She said several teachers cultivated her interest in science, including Kathy Armstrong. “I love learning and reading …, which you have to keep doing as a doctor,” added Iddings. “… and then you get stuff like novel coronavirus, and you have to learn and read more every day just to stay ahead of things.” In an email to the Sun, Dr. Caitlynn Iddings said the views expressed in this article are based on her own personal and professional opinions, and data she has collected. They do not represent the views of Pediatric and Adolescent Associates as a whole, she said.