At the beginning of school closures, we, the ETHS Health Center staff, wrote a letter of recommendation on how to enact social distancing with school being out. Now that Illinois is beginning a phased re-opening, we are sharing an updated version of our original letter.

Our staff consists of doctors, nurse practitioners, nurses, and members of the Evanston Health Department’s Advisory Council. Many of us are Evanston residents and parents of ETHS students and are addressing these very issues in our own homes.

This is an evolving situation and current recommendations are based on the best information that we have available on June 15, 2020.

Coronavirus/COVID-19 is a respiratory virus that might cause no symptoms in some people, fever and cold-like symptoms in others, and more rarely problems with breathing that could result in need of supplemental oxygen or ventilation support. It is very contagious and appears to spread through respiratory droplets and high-touch surfaces. 

Respiratory spread means that people who have the virus can breathe out viral particles and if you are within 6 feet of that person, you can possibly breathe them in. If both people wear face coverings, the risk is reduced because the coverings block the virus from being expelled into the air. 

With high-touch surfaces, objects that are touched by more than one person, the risk is if you touch the same object that an infected person touches and then you touch your eye or nose, you can give the virus to yourself.  The more dangerous outcomes appear to occur in “vulnerable individuals” as defined by the Centers for Disease Control and Prevention (CDC) as people age 65 years and older and others with serious underlying health conditions, including high blood pressure, chronic lung disease, diabetes, obesity, asthma, and those whose immune systems are compromised such as by chemotherapy for cancer and other conditions requiring such therapy.

If you are experiencing any of the following symptoms or had close contact with someone who recently tested positive for COVID-19, please isolate yourself from others and call your medical provider: fever, sore throat, cough, shortness of breath, chills, nausea/vomiting/diarrhea, muscle aches, or loss of the sense of taste or smell. We are open at the Health Center and are available to help all ETHS students, please call us at 847-424-7265.

While Evanston has a lower number of COVID-19 cases than some of our neighbors, it is important to remember that the disease is still here and no matter what phase of re-opening is in place, until there is wide-spread vaccination or effective treatments, our main tools to slow the spread of disease and to protect the vulnerable remain the same:

1. Good hand hygiene
2. Social distancing
3. Using a cloth mask to cover your nose and mouth in situations where social distancing is not possible
4. Being especially careful around vulnerable populations

So what does this mean?

1. Wash your hands when you come in the house, before you eat, before and after entering stores, and of course, after using the restroom. Use good old-fashioned soap and hot water, and save hand sanitizer for when a sink is not available.
2. Wipe down high touch surfaces such as doorknobs, counters, keyboards, phone screens with a disinfectant at least once a day. 
3. No sharing of utensils, plates, water bottles, cups, or any other objects.
4. If you want to hang out with friends, the safest way to do it, is outside with social distancing, meaning that everyone is at least 6 feet apart. If you are outside and closer than 6 feet, you should wear a covering of your mouth and nose.  Currently, Illinois only allows groups of 10 people or less to gather, and whether this number is expanded or contracted depends on the number of cases we are experiencing.
5. Being outside is great for your mental and physical health. Walking, running, rollerblading, biking, and skateboarding with friends are safer with social distancing (and wear your helmet!).  
6. Playing certain sports can happen with social distancing by avoiding touching the same equipment and by avoiding close contact.  At our current stage of re-opening, it is not recommended to engage in any contact sports or to share equipment. More than 2 people touching the same ball or sports equipment are at high risk for COVID-19 transmission, as is close physical contact or any type of tackling. Two people throwing/kicking/touching/hitting the same ball is less risky with the recommendation of good handwashing before and after the activity, frequent hand sanitizing during the activity, and wearing a mask if you will be closer than 6 feet from one another. With increasing temperatures, please plan for increasing discomfort when wearing masks during activities, and if it is too hot to wear a mask, restructure the activity to include 6 feet of social distancing.
7. Avoid gatherings where you can’t practice social distance or the current guidelines, such as cars and stores. Sadly, we still suggest holding off on any indoor gatherings or outdoor gatherings of more than 10 people. If anyone in your home tests positive, regardless of the severity of symptoms, the entire household will be under quarantine. Who wants that? 
8. Take care of your mental health. You still need to sleep 8-10 hours a night (best achieved by turning off phones and screens) and actively try to manage stress. Tools to decrease stress such as meditating, petting a dog, listening to music, and connecting with our support people are more important than ever.  If you are seeing a mental health provider, try to continue visits, even if by phone or video chat. If you need help finding a mental health provider, please call us at 847-424-7265.
9. Take care of your physical health. Eat three nutritious meals a day, turn off screens, get outside, and move an hour a day or more. Many people report stress eating or turning to “comfort foods” during this time. To boost your immune system and stay healthy, substitute water for sugary drinks and try to eat a least one fruit or vegetable with every meal. The Evanston Farmers’ Market remains safely open on Saturday mornings and not only accepts LINK cards but will match up to $25 of LINK money every weekend.
10. Please be kind and respectful to friends who either live with vulnerable populations or are vulnerable themselves. Seeing such friends outdoors, with masking and social distancing allows them to more safely engage in social activities.

Parents/Guardians, we can promote needed precautions without panic. While no one is at zero risk for being sick from COVID-19 virus, children and teens are at low risk for getting very sick.  You can reassure your kids that we will get through this, together, and that your job is to help keep them safe, even if it makes them unhappy sometimes.

Teens wonder, “why should I not go inside people’s houses or have friends sleepover when it is unlikely that this disease will make me sick?” The idea of personal sacrifice to ensure that everyone stays healthy may be a new concept for them to consider. They can understand and can be motivated by the fact that their individual actions have the power to save lives.

The bottom line: If we all stick together and follow the same simple rules like good hand hygiene and social distancing, then we can continue our re-opening and get back doing to the things we love, like sports, travel, gatherings, and even school.

In Good Health,

Lynn Gettleman Chehab, MD, MPH
Pediatrician, NorthShore University HealthSystem
Chicagoland Children’s Health Alliance

Aimee S. Crow, MD
Pediatrician, NorthShore University HealthSystem
Chicagoland Children’s Health Alliance