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Hello, everyone. Thank you for joining us today. Friendly reminder, this line is only for members of the press. If you are a member of the public, please join us on the sfg youtube channel. Please type your name, news outlet, and question exactly as you would like it to be read. Please indicate if you would like a translation in spanish. Please ask only two questions. If you ask more than two questions, we will ask you to prioritize the questions that you would like us to ask. Order of speakers today is dr. Jeannie lee followed by dr. Kathr catherine jane, and with that, id like to turn it over to dr. Jeannie lee. Thank you. Hi. Im dr. Jeannie lee. Im with the School District department of Public Health working on School Guidance. Just to give some background, schools are still closed, according to the San Francisco health order. We are sharing this preliminary guidance because we know that schools need to plan ahead for safely resuming inschool attendance if and when San Francisco Health Officers allow schools to open. The good news is that we have learned a tremendous amount in the last few months about covid19, mostly about how it affects children and teens and about how its transmitted in effective spread of covid19. We know that the risk of illness from covid19 is very low for children, and we know that those, especially those under ten, are less likely to get covid19 as well as less likely to transmit it. In addition, we know whats been working well to prevent covid19 spread in our child cares and summer camps, both locally and nationally, and so the principles in the School Guidance are similar to what weve been using in the best setting. The guidelines were drawn from the best science available to us at this time. It will continue to evolve as we learn more about covid19 and about how it affects children and adolecents. It was developed by the San Francisco department of Public Health with extensive help from sfusd, the catholic schools, and the independent private schools in San Francisco. Its formed by guidelines from a variety of sources, including the centers for disease control, California Department of Public Health, we also referred to guidance from Harvard School of Public Health and the American Association of pediatrics. We say the guidelines will be used as a tool to help schools layout their operational guidelines for opening. They can use them as age appropriate interventions to protect staff, students, and their families. We emphasize preventing transmission of covid19 via respiratory droplets, especially transmissions between adults which we know is at greater risk, using universal distancing, face coverings, and general intervention, and we feel this is better than frequent cleaning and disinfection. That is because coronavirus is easy to kill. Common cleansers are effective, and hand washing breaks the chain of transmission. We recommend that cohorts be of a smaller size in elementary schools. Cohorts can be a larger size in middle school and high school. Finally, these guidelines are about how to keep teachers, staff, and students as safe as possible in schools, but safely reopening schools needs to be a community effort. Even the childrens risks are lower than adults. Children do get covid19, and they do give it to others, so families have a big part to play in keeping children safe at home and in keeping the community safe, because the most common way that a person gets covid19 is from an individual in their home. We all have a duty to wear face coverings, wash our hands frequently, as well as practicing physical distancing and staying away from other people when were ill. Students can do the same, but if covid19 spreads too rapidly in our city, that may not be enough for them to be able to be open safely. We all have a huge debt of gratitude to all of the teachers and school staff for serving on the frontlines, and we owe it to them to do everything we can to keep students, teachers, and staff as safe as possible in the school. So i think this is where i open it up for questions. Thank you, dr. Lee. So at this point, we will start receiving questions via our zoom chat. Please submit all your questions to geaqanda ho geaqandahost sf. Gov. Were just in the process of receiving questions now, dr. Lee. Our first question is from the s. F. Examiner. How will the citys overall response aid schools with hygienic supplies and nurses needed according to the guidelines . Should they bring students back . Im sorry. Can you repeat that question . Yes. How will the citys overall response aid schools with supplies and nurses needed according to the guidelines should they bring students back . Okay. So again, we are relying on the schools to communicate what they need to open, and the persons and resources that they need, so its hard for us to speak to the school in terms of the support that they need, but certainly, we are committed to supporting our schools. Thank you. Our next question, dr. Feng, if you could please respond to this next question in chinese. If you could tell us what kinds of Extracurricular Activities at this point. Interpreter actually, if dr. Feng can explain it, i can support in chinese, too. Oh, dr. Feng, please unmute. Dr. Feng, please unmute. Okay. Thank you. So yes, im dr. Richard feng, and one of the physicians on the department of Public Health, and the question is related to Extracurricular Activities. So so this is an important question, and this is something that all schools are trying to figure out right now. Were having were trying to rely on the science available, and were trying to figure out which Extracurricular Activities are safe, and which ones are not as safe at the moment. We are able to draw upon our experience from summer camps and child cares to to form this decision. Its difficult to try to categorize specific activities, but i think in general i can speak to general principals that weve been applying to consider extracurriculars as something that is safe or not. So in general, activities that can be performed outdoors are for example, like, outdoor exercising, for example, would be considered safer than activities that are performed indoors. In addition, all activities would be safer if they can maintain social distancing. So in general, activities that involve close contact, touching, are less safe. And so it is very possible that what we do would have to be modified to adhere to social distancing. They would have to be performed outdoors as much as possible, and if possible, they should be performed by within the cohort so as to prevent large gatherings of people. Great, dr. Feng. I will translate into cantonese. [speaking cantonese language] [end of translation] interpreter let me repeat. [speaking cantonese languag [end of translation] and dr. Lee would also like to respond to that question, so dr. Lee, if youd like to provide additional information. Yes. So to echo what dr. Feng said, we have certainly principles that we use in our guidance on Extracurricular Activities, and the ones that the specifics we can say is that [inaudible] is a very high activity because weve seen that a large group of adults infected with covid19 while singing, so we are recommending against chorus, and same for wood winds and brass. Other instruments, like string instruments that dont involve the reproduction of respiratory droplets are okay. A lot of people have questions about competitive sports, and i think its safe to say that at this point in time, we are not recommending sports that involve being within 6 feet of each other. [inaudible] interpreter sorry. And because of the emphasis on keeping people in cohorts and keeping people in stable groups and keeping people from mixing, we are probably not going to recommend interscholastic competitions in the future. Interpreter great. Let me provide an interpretation in cantonese, and leo will provide a translation in spanish. [speaking cantonese language] [end of translation] interpreter and ill pass it on to leo. [speaking spanish language] [end of translation] thank you, leo. And dr. Lee, we also have a request to repeat the portion where you spoke about competitive sports as the audio got interrupted. Im sorry . The audio got interrupted on the competitive sports . Yes, so if you could repeat the part where you discussed repetitive sports. Yes. So repetitive sports have certain risk factors, and the main one is that youre allowing cohorts of different students to mix, and that permits the spread of infection. So our rules are that people shouldnt be doing active exercise within 6 feet of each other because, again, the deep inhalation and deep exhalation may be detrimental to students, and we dont want mixed cohorts of students, so thats why we wont be recommending interscholastic sports in the near future for students needing to be in close contact with each other. Thank you very much, doctor, and leo will be translating that into spanish. [speaking spanish language] jeannie l jeanne l [end of translation] thank you, leo. An additional question for dr. Lee from the s. F. Examiner. How many hours of the school day are these ongoing precautions anticipated to take up . That depends on how the schools implement them. So its very hard to say because how much depends on how the schools are going to operationalize them. Thank you, dr. Lee. Thats all the questions that we have received in english. Dr. Catherine james will be joining us be ja will be joining us at 2 00 p. M. For a press conference in spanish. If not, thank you so much for joining us today. If you have any more questions for dr. Lee, please submit them via chat or you can submit them to dr. Feng and i will translate. And doctor, we just received one more question. The question is if a student lives with highrisk people, will the student be required to attend school . Again, that is going to be a decision for the schools to make, and and how they operationalize this guidance. The only thing we say about students and medical conditions is that the school should not automatically exclude a student because they have diabetes, asthma, or another medical condition; that they should allow the students medical care team and family to decide whether inperson attendance would be indicated. Beyond that, we leave it to the schools. Thank you, dr. Lee, and it looks like we have a couple more questions coming in. So norm bigger, the s. F. Public press. Is there a time that sfusd will decide that its safe to reopen based on the number of cases and which the department of Public Health will make a final decision on the case of schools reopening . We dont have a timeline, and a lot will depend on what we see with Community Transmission in the coming weeks. And again, the decision that the decision d. P. H. Will make is whether it is safe for schools to reopen with these recommended interventions in place. The decisions for specific schools or specific School Systems to reopen to inperson attendance is going to probably be based on other factors like do they have these resources to implement these interventions, when will these resources be available, but its two separate sets of decisions. I hope that makes sense. Thank you, dr. Lee. Our next question is from kathy novak at kcbs, and the question is what preparations should teachers be making, and will those preparations differ on the ages of students theyre teaching . So i just want to say that we we put a lot on our teachers, and its not really on individual teachers to make preparation for the schools to be safe. I think that is on the School System or the School Administrations themselves because it really has to be a coordinated layered set of interventions at the school level, and that is beyond the power of a single teacher to make it safe because of the multiple interventions that need to be implemented. So thats that would be my my main message. Thank you, dr. Lee. We have a request for a translation to chinese, so victor will be translating your response for us. Interpreter can you reread the question . Yes. The question is, what preparations should the teachers be making, and will those preparations differ based on the ages of students theyre teaching . [speaking cantonese language] [end of translation] and dr. Lee, i understand that you have further information youd like to provide. If youd like to do that, and then, victor can provide the translation. Thank you. So in terms of different interventions of the schools at Different Levels and age groups, they will differ. For example, we know for our very youngest children, physical distancing is very difficult, not practical for socioemotional learning and just very difficult to enforce for an entire school day. We also know that our youngest students are probably the lowest risk for a covid19 infection and at the lowest risk to spread it. So for that group, our guidance says that we want to prioritize stable cohorts as well as universal masking at this stage, so universal face coverings. For our older students who are more able to physically distance, and brokendown to a more realistic expectation, then we would emphasize that. Well emphasize, and then, by emphasizing that, that allows for a little more overlap in cohorts safely, and again, at this age, we want to continue to emphasize the universal face coverings for everybody as much as possible. We do recognize that the risks to staff and teachers are going to vary a bit by age, and probably the teachers of our youngest students are going to be at the lowest risk of being infected by their students versus our high school teachers. But we also know that the risk of adults and adult transmission probably trumps all of that; that based on what we see locally and nationally in other settings with children, that staff are more or adults are more likely to be the confirmed covid19 case, and adulttoadult transmission, stafftostaff transmission has been more likely than childtostaff transmission. So at all of these ages, were really trying to prevent stafftostaff transmission and spread at any school, and thats emphasized in our guidance. Interpreter thank you, dr. Lee. [speaking cantonese language] [end of translation] interpreter and then, at this point, i will let leo also say it in spanish. [speaking spanish language] [end of translation] next question is from crystal lee ann from sftv. So request for a translation, so either dr. Lee or dr. Feng can take it. We consider city workers to be essential workers and because they work for the city and county of San Francisco. The get tested website can tell people where they get tested. So we are not currently requiring teachers and students to be tested and that is because testing only tells you whether a person is infected at a certain point in time. They could have a negative test and the next day be infected. So unless a School System is willing to do something similar to what weve done in our Nursing Homes and longterm care facilities where were going in and testing everybody every several weeks, that its not thought to be as useful an intervention. That said, we absolutely want to make sure that our school staff and teachers have access to testing and can get tested if they would like to, whether or not they have symptoms. Interpreter thank you, dr. Lee. [speaking cantonese language] [end of translation] [speaking spanish language] [end of translation] well, at this point, i think dr. James might be wrapping up her meeting. Are there any words that dr. Lee or dr. Feng would like to chime in oh, dr. James just joined. We will turnoff the mute. Dr. James, welcome. Thank you for joining us. Sure, thanks for helping me. Actually, weve answered a lot of questions already, but is there anything in particular that you would like to present to our Spanish Speaking community, cantonese speaking community that we havent talked about before . I think we were just talking about schools reopening and where we are right now, the current state of infections in the city. Do you want me to go ahead in spanish, then . Interpreter yes, please go ahead in spanish. [speaking spanish language] [speaking spanish language]. Well, if we have no other questions for our press, we want to thank our press partners, and we want to thank all the doctors from d. P. H. For being here today. Thank you very much, and i hope you had an opportunity to record. Well be sending out the link shortly. Ill translate it into chinese. [speaking cantonese language] [speaking spanish language] thank you, announcer youre watching coping with covid19. Hi, im chris manus and a you are watching coping with covid19. Today joining us is Susan Girardeau of the california Pacific Medical center. And mow to cope with emotional stress of a major daf. Shes here today to talk to us about how to help Young Children cope with this ongoing pandemic. Dr. Girardeau, welcome to the show. Thank you very much. Lets start by talking about some of the issues that 5 to 11yearolds might be facing. What are some difficultties they might be experiencing during this pandemic . The biggest difficulties that all children experience is fear and anxiety and its displayed in a variety of different ways. The kids have a fear of a Family Member getting sick or themselves getting sick. They have a fear of separation. Obviously with our quarantine, all of us at home, children still have a fear of separation in own home, which means from room to room, that they cannot be home alone without a parent. It is very difficult and even at night to sleep in their own bed can be a problem and an issue that is under the umbrella of anxiety. The other parts that play into it is the anxiety of when will this end . As we know currently, we dont know and that is the most difficult. And all kids, their peers, are an important part of their development. So it is often asking when can i go to school . At this point, they are very tired of online school. When can i take my friends and when can i see extended family . Right. What kind of indicators are there that a young child is struggling right now . Particularly behaviors that are really across the age spectrum of 5 to adolescence is sleep disturbances and increase in nightmares and in the younger kids, night terrors. Woe see across the age speck trup, fear of the dark. The other behaviors that we are seeing is the regression in their normal developmenttal tasks. For the younger child and as i referenced sleeping in their own room. Other types of behaviors that parents or caregivers might see are meltdowns over relatively minor issues. Often were seeing a decrease attention and focus, especially with online school. Were also seeing headaches, stomach aches that we typically see when there is stress and trauma. I see. Lets say weve realize add child is having difficulties. Are there specific ways we can talk to them to get them to open up, perhaps phrases or ways to ask questions that will encourage them to share their concerns . There are a number of ways. Number one, the biggest thing that parents can do is to really listen to their child. Often times were rushed. We are working parents, plus as well as now teachers online as well as playmates. So, to pause and really listen to what their fears are. As parents, we often dont get down to a younger childs physical level, look at them and listen to them and talk to them directly. I often use the technique of nailing a feeling and kids often times theyre not going to, especially in times of stress, come up with this feeling that they can name. So, i recommend to parents always of naming three feelings. Happy, sad and mad. And youve been through those three. Not frustration. But just nailing it to those three. Another technique that i highly recommend is to use the third person. In a way such as i have heard other kids say that theyre scared and they dont know why theyre scared. Do you think that happens with you sometimes . This is a way that kids feel much safer in talking about their feelings because they dont feel like theyre on the spot, but other kids are feeling that same way. I understand. Do you think that there is secondary concerns for kids as concerns are gradually lifted . I know one small child frightened to go outside right now. Yes. And were seeing that already right now. Because with as one as restrictions are lifted and were able to go outside, you know, people are Wearing Masks and that can be very frightening. Even if halloween. Many kids wont wear a mask. Children under 2 do not wear masks. Under 7, they dont have to. But over the age of 7, it is highly recommended by the c. D. C. That kids wear masks. That is going to be difficult. So, what ive recommended is for kids to make their own masks. They can make their own designs on the paper surgical masks. And so it is there. They cant put [inaudible] on it, whatever makes it feel a lot safer for them. Other things that i have heard are kids are afraid to go outside. I heard this from a number of families because they havent really been able to do so so theyre afraid they will get sick. I recommend that families start very small steps and the first step is take a ride in the car. That is the first way to go outside, windows down. And if you have a sunroof, open the sunroof and unbuckle the seat belts or car seat and be able to stand up and that is a small step to feel like the outside might be safe. So, it has to be in small steps for the fear it is going to be exacerbated. Absolutely. So, could you tell me a little bit about your book, disaster shock . Yes, disaster shock has been originally written for the 1989 earthquake in San Francisco. This has been a number of disasters since then and families in 1989 gave us the feedback that it was extremely helpful because there was really no literature available on how to help children and families that havent talked to them. Unfortunately our natural disasters increased with tornadoes and the last wildfires affecting northern california. It has been updated again for the pandemic. Right. And finally, what would you say to parents about how to talk to their kids in general . Could you suggest some good ways to reassure them . A few ways that i have been suggesting is, number one, you have to be honest. About what you know. And be able to explain in developmentally appropriate terms what is happening. And that we are all learning. We dont know. There are many things we dont know. But that parents need reassure the kids that they are safe, that the family will be together. But they need to be able to get the kids a little leeway, so to speak. And im not saying not disciplined, but what your discipline techniques may have been before may need to lighten up a little bit because these are very unusual circumstances for adults, but as well as for kids. But i always suggest and recommend that parents be honest with the kids because that is the trust that children have in their parents. Parents must be really aware their kids will hear, they will read their body language and understand the anxiety we all feel, but the parents need to be honest that they the kids will be safe. I understand. Well, thanks for coming on the show, dr. Girardeau. I appreciate the time youve given us today. Thanks again. Youre welcome. And that is it for this episode. Well be back with more pandemicrelated information shortly. Thank for watching

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