Below is the Duval County Public Schools Decision Tree for Covid-19 Exclusion Guidance, which the schools use to decide who is excluded from school or sent home because of symptoms and the criteria for school reentry. I am also attaching the Observation Instructions that parents receive when their child is sent home with an illness.
These are both provided by Elizabeth Trisotto, FNP and Director of School Health Services for Duval County Public Schools. She gives permission for these guidelines to be distributed to NEFPS members. They are quite useful to pediatricians to guide families, reinforce the criteria for isolation and return to school, specifically required by students in DCPS. These do not apply to other counties!
Of importance is the highlighted PCR in row 3 of the tables. It is important to understand that if a child has symptoms but is tested negative and has not seen a health care provider they will only be allowed to return to school if the negative test is a PCR test (and also meet the fever-free, symptom improvement criteria). If they go to a center that does a rapid antigen test and it is negative they cannot return to school unless they are subsequently cleared by a health care provider.
I had a case this week where the child was sent home with a mild tummy ache and headache and was fine as soon as her parent picked her up. They took her to a clinic later that day and paid $150 for a Covid test. The rapid antigen test was negative but when they took her to school on Friday she was not allowed in because it was an antigen test and not PCR. They then had to see me to clear her to return. So, the parent had spent $150 to make sure she could return to school only to find that they had to spend more money to see me the next day and still missed work! The DOH sites all do PCR test for free and the turn around time is now 24 to 48 hours. Those results suffice for reentry to school without seeing a health care provider, if the child meets the other criteria. Understanding this is vital for pediatricians who do not do testing in their offices and are referring elsewhere for testing.
Laura Beverly, MD
UF Health Pediatrics/Pediatric Primary Care