Proactive or Reactive?

Updated: Jun 25

Coronavirus - COVID-19 the disease and SARS-CoV-2 virus


Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the name given to the 2019 novel coronavirus. COVID-19 is the name given to the disease associated with the virus. SARS-CoV-2 is a new strain of coronavirus that has not been previously identified in humans.



"it's best to be more cautious,"


Clearly, worldwide, many schools have been closed as a result of the outbreak of Coronavirus-19 Whilst we have not yet reached this point in the UK, The advice from the World Health Organisation (WHO) is that where schools remain open (all educational settings, including nurseries) that children and their families remain protected and informed, the guidance calls for


  • Providing children with information about how to protect themselves

  • Promoting best handwashing and hygiene practices

  • Providing hygiene supplies

  • Cleaning and disinfecting school buildings, especially water and sanitation facilities

  • Increasing airflow and ventilation

The new guidance also offers helpful tips and checklists for parents and carers, these actions include:

  • Monitoring their children’s health and keeping them at home from nursery / school if they are ill.

  • Coughing or sneezing into a tissue or your elbow and avoid touching your face, eyes, mouth and nose

  • Promoting best handwashing and hygiene practices and providing hygiene supplies

  • Encouraging older school-age children to ask questions and express their concerns


“so, what steps does this mean for us at nursery?”


There is insufficient data known about how long this particular strain of virus survives on surfaces, other known coronaviruses can last between a few hours to a few days depending on the surface, the temperature and humidity levels.


I am suggesting the following precautions at Saplings:


1. We will screen all visitors, including parents, extended family members, prospective parents, contractors and ask vital questions to ascertain their well-being and recent history of travel.

2. If a parent is unwell at home for any reason, if a parent is self-isolating, children should be excluded

3. If a child develops a high temperature, parents will be contacted and asked to collect their child, for two reasons: a. to prevent the spread of their infection to others and b. to protect the unwell child when they are most vulnerable from contracting other potential infections

4. Preschool children should be taught how to sneeze, even toddlers can be encouraged to hold their hand in front of their mouth when coughing

5. Staff should ensure children’s noses are kept clean, tissues must be disposed of safely and bins must be emptied regularly BEFORE they become full

6. Staff should use gloves and aprons when dealing with certain bodily fluids including vomit, blood and runny noses

7. Staff must model regular, exemplary handwashing technique and the use of hand sanitiser gel provided


8. Children should be taught how to wash their hands and why it is important to wash their hands. This should be developmentally appropriate to their age. On a practical basis, this means we allocate someone to stand with children who need assistance or observe their handwashing practice and provide them with sound, safe guidance.



9. Staff are required to comply with our ‘Appearance’ requirement, this includes not wearing nail polish to work; removing false nails; keeping nails trimmed short to enable best handwashing and hygiene practice (Staff Handbook 2020: Appearance. pge.10, para 3)

10. Room Leaders are responsible for a daily cleaning routine of their rooms and proper ventilation and the circulation of fresh air, ensuring

i) that staff sanitise rooms at least twice a day, to include

ii) light switches, door handles, telephones, door frame, door edges, taps, soap dispenser, window levers

11. We will provide the hygiene essentials to carry out the tasks to enable safe, preventative hygiene practice, however, staff must act as good ambassadors in reducing wastage of resources, particularly in the light of panic stock piling that will affect supplies of paper and hygiene goods.

12. We will apply an exclusion period of 21 days in the event of contact with or contracting the SARS CoV-2 virus


We view these actions as a safeguarding issue, we all have the responsibility of keeping children safe, of proactively managing our environment to ensure we play a part in reducing the spread of this virus, particularly when the incidence rises over the next few weeks … and it is set to rise for a while!


“to fly or not to fly?”


Ask yourself, is the value of flying that worthwhile?


To remind you of what I said previously, there is little known about how long this particular coronavirus survives on surfaces - from a few hours to a few days depending on the conditions.


So, if your flight has not been cancelled and you are planning to travel during the peak of the outbreak to parts of Europe, in particular, the 4 currently highest case areas of Italy, France, Spain and Germany, consider this precaution: take your own alcohol wipes to clean the areas you personally touch — including your seat belt, tray table, overhead luggage handle, toilet door, inside areas of onboard WC and your armrest. At a pinch, you could always squeeze hand sanitizer (min. 60% alcohol) onto a tissue and use this to clean these surfaces.


Regarding the re-cycled air on planes being a source of transmission, it is generally considered that 50% of the air is re-cycled 20 to 30 times an hour; the hepa filters, if well-maintained by the airline, are generally very effective at eliminating a wide variety of substances otherwise harmful to health. Hepa filters are used in NHS Intensive Care Units and theatres up and down the country very successfully


Other evidence suggests that such filters are imperfect. One 2009 study concluded. “HEPA filters are commonly thought to be impenetrable, but in fact they are only 99.97% efficient at collecting the most-penetrating particle (approx. 0.3 micrometer). While this is an impressive collection efficiency, HEPA filters may not provide adequate protection for all threats: viruses are submicron in size and have small minimum infections doses (MID50). Thus, an appropriate viral challenge may yield penetration that will lead to infection of personnel.


Clearly, amid a pandemic viral outbreak, relying on a well-maintained Hepa filter system to protect you is in my view pushing the boundaries of effective preventative measures to its fullest extent.


Take a look at the Centre for Systems Science and Engineering (CSSE) at Johns Hopkins University COVID-19 Global Case Map (Baltimore, US) new cases in China appear to have stabilised; check-out Europe, which is increasing significantly by the hour. In the time it took me to write this blog post, the number of reported cases increased worldwide by over 800.


If you travel abroad you may find yourself unable to attend work for a long period following your return, some companies and schools have already applied restrictions to protect themselves from forced closure.


Staff and parents at Saplings are now be required to report all plans to fly before going abroad on holiday or for any other purpose, irrespective of the destination. Staff and parents should consider the implications for them of travelling over the next few months.


“Aren’t you overreacting? Why should I be concerned? This is just another flu virus”


Aside of the fact that influenza has been around for over 2000 years, and that during this time, thousands of vulnerable, high-risk people have died each year from the disease, we have become complacent. However, COVID-19 as a disease is very different. For example, unlike most influenza viruses, SARS-CoV-2 appears to have a reproduction factor over twice that of ordinary flu. This means, it is around for longer, over twice more likely to be spread and twice more likely to infect our vulnerable extended family members.


Viral shedding happens when a virus infects someone, reproduces itself, and is released into the environment. In SARS-CoV-2, this ‘shedding period’ is thought to be much longer than that of ordinary flu. It is therefore capable of transmission to far more people over a longer period of time, hence I believe we have a responsibility to be concerned and take proactive preventative measures even if this means our lives have to change and we are required to re-assess our priorities for the sake of those most vulnerable.


Our exclusion period is likely to be 21 days.


Are efforts to contain the virus by telling people to stay at home, stopping or avoiding large public gatherings and preventing travel currently working?


It is as much about facing up to our responsibilities in limiting the spread of the virus, especially knowing we have no real understanding of the aetiology of this variant, that is most important. Whilst for the majority of us who may contract the disease, recovery will simply be, recovery for some is not as easy and many more deaths will occur.


For this reason, we have a responsibility to consider the likelihood of the virus reaching pandemic proportions and take our part in limiting its duplication in our communities, our homes, our families and our setting.


We exist on this, a very small island, amidst a ‘world’ under a considerable threat to our health; should we relinquish the privilege we have enjoyed progressively over a long time now regarding the human right to be free, to choose, to listen? Or should we consider it a right, even in a democratic society, to risk infecting our loved ones, our neighbours, those more vulnerable than we?


My vote is to say 'yes' to being Proactive - what is your vote?





12/03/2020 19:50 Podcast Johns Hopkins Bloomberg School of Public Health

In order to determine and arrive at a policy for the managment of this disease, I have found what I believe is a credible source of information. I have found very little published information about Coronavirus from UK science centres. I have read articles from The Lancet.


I found a good podcast series that I would like to share with those of you wishing to get answers to some of those annoying questions that pop into our minds. Whether or not you agree with any of the answers, is entirely personal choice, however, each podcast has a scientist knowledgeable in the field of public health and infectious disease.


Public Health - On Call


I hope that you find this useful

13/03/2020

The Government have provided a PRESS RELEASE, please follow this link


15/03/2020

As time consuming as this virus is becoming for a small business in the child care sector, amidst panic buying and waiting for 'back orders' for essential hygiene supplies, to playing a juggling act between working out a strategy to enable settings to remain open for parents, some of whom cannot work from home, where not going in to work = not being paid and satisfying everyone in delivering what we believe are informed decisions that we judge to be pragmatic, I am pleased when I discovered the current context - that currently there are 14 cases in Essex; 32 in Hertfordshire and 7 in Cambridgeshire (PHE data as at 9am 15/03/2020)

https://www.gov.uk/government/publications/covid-19-track-coronavirus-cases

I became even more relieved when I realised that the town my 92 year old father lives in has 2 cases. It is for these precious people that we carry on and do everything we can to influence others in the proactive fight to reduce the incidence and keep our doors open.



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