“Being a nurse through a pandemic is not something I thought I would ever do,” Duluth Public Schools District Lead Nurse Crystal Diehl said.
In Minnesota, school nurses have been handling the contact tracing within their schools when a staff member or student tests positive for COVID-19. Each nurse has a starting point when beginning contact tracing. Once they hear someone has tested positive, they reach out to that staff member, student or student’s parent to confirm the case and find out who they’ve been around.
“I start 48 hours prior to either when symptoms started or when the test was taken,” Diehl said.
When it comes to students, nurses will ask the family what days the student was in school; if they rode the bus or attended a child care facility; who their close friends are; if they participated in extracurricular activities; and if they receive special services. Depending on the age of the student, the nurse will talk to the student as well.
Hermantown Community Schools District-Wide School Nurse Sheina Showen said starting with the parents can yield a lot of the information she is looking for.
“The key is trying to identify where that child might have been close to another child within 6 feet for a total of 15 minutes for those days they were in school and infectious,” Showen said.
"They’ve all taken the role on and have been very diligent, thoughtful and hardworking. They’ve all been putting in long days and a lot of hours doing the contact tracing."
— Sarah Miller, Southern St. Louis County Public Health Education Liaison
After the nurses contact the parents and students, Diehl and Showen said they ask administration what classes they were in and look at the seating chart. Showen said Hermantown has seating charts for every class in every grade to help with the contact tracing.
Diehl said when she talks to teachers, she maintains confidentiality.
“I ask, 'How is your classroom run? Do you social distance? Do you feel you spend more than 15 minutes within 6 feet of any of your students? How much time are your students in the classroom?'” Diehl said. “All of that factors into contact tracing as well.”
Diehl said though she tries to maintain confidentiality, sometimes the parents or students have already notified the teacher they tested positive.
“We want to make sure we are protecting the rights of the student or staff who is positive but also protecting the rights of the person who might be a close contact,” Diehl said.
If there is any question about the contact tracing process or if there is a unique situation and the nurses need more direction, they are able to contact their education liaison with St. Louis County Public Health. For Diehl and Showen, that person is Southern St. Louis County Public Health Education Liaison Sarah Miller.
Miller said she touches base with Diehl and Showen at least once daily. She said working with all of the school nurses in her area has been a positive experience.
“They’ve all taken the role on and have been very diligent, thoughtful and hardworking,” Miller said. “They’ve all been putting in long days and a lot of hours doing the contact tracing.”
Miller said the nurses only reach out when they have bigger issues, concerns or questions that don’t fall into the typical box on the decision tree.
“I’m like an extra resource when they have problems,” Miller said.
Diehl and Showen said it can take about one to two hours to complete the initial investigation and less than a full day to complete the process. Anyone who is considered a close contact will receive an email and a phone call to let them know.
“It really just depends on how long it takes to get a hold of the parents,” Showen said. “We also don’t usually find as many contacts with older kids so that typically goes quicker.”
Shown and Diehl both said they don’t do all the contact tracing themselves — they each have a team of nurses to help.
Where many districts have nurses to perform contact tracing, in some smaller schools, that duty has been done by superintendents or principals.
Reggie Engebritson, superintendent of Mountain Iron-Buhl Public Schools and St. Louis County Schools, has taken on the responsibility in her six schools.
“It’s a big chunk of time, but I feel like that’s my job,” Engebritson said. “I don’t have little kids at home anymore so I have time to do it and I'm just really trying to be a support for everybody and I think that is key.”
Engebritson said her principals also help out with contact tracing when needed.
Her biggest challenge, she said, is trying to get people to remember when they first went out with symptoms.
“So we’ve been trying to remind students and staff that if they go out with symptoms to start trying to think about their most recent contacts in case they do test positive for COVID-19,” she said.
COVID-19 was declared a worldwide pandemic in March. Days later, every school in Minnesota was forced to finish the school year online.
This fall, schools were given more freedom to make decisions at the local level. Nearly every school in the Northland opened in September to some sort of in-person learning, whether it was at a hybrid level or full in-person classes for all students. Just two months later, nearly every school has switched more than half, if not all, of their students to distance learning, due to a surge in cases.
“There was a learning curve at the beginning of contact tracing, but I work closely with the Minnesota Department of Health and St. Louis County Public Health and I’ve relied heavily on their guidance,” Diehl said.
The added work nurses have had to shoulder this year takes a physical and emotional toll.
“It’s just so much work. I go home and I’m pretty exhausted by the end of the day and I just need to sit and do nothing for a while,” Showen said. “It’s tiring and it’s exhausting, particularly right now with the way that our numbers are in our area. It’s just everywhere.”
Showen, Diehl and Engebritson all remind the public to follow Centers for Disease Control and Prevention guidelines by wearing a mask, staying 6 feet apart, washing hands frequently and staying away from small and large gatherings. Students will not be able to attend classes in person until COVID-19 numbers decline in the area.