Richmond-Burton nurse resigns after advised to not automatically self-isolate if exposed to COVID-19

Confusion and consternation over apparently conflicting government guidance for school nurses that have close contact with someone testing positive for or showing symptoms of COVID-19 contributed to the sudden resignation of Richmond-Burton High School District 157’s school nurse last week.

Nurse Annette Snyder said she felt instructions for the school nurse to self-isolate after exposure to a positive COVID-19 case only if feeling symptoms could lead to her spreading the virus, according to multiple interviews with Snyder and emails between her and Richmond-Burton High School Principal Mike Baird obtained via open records request.

That protocol differs for other school staffers that come into close contact with a positive case or someone showing symptoms and are not showing symptoms themselves, the emails between Baird and Snyder indicate. The communication also included correspondence with Assistant Superintendent Patrick Enright.

Close contact has been defined by public health agencies as having been within 6 feet of someone who tests positive for COVID-19 for 15 minutes or longer.

Freshmen are set to start hybrid learning plans next week. Under the district’s plans, the school’s students will be split into two groups, which will alternate days of in-person and remote instruction. All Richmond-Burton students are scheduled to be in hybrid learning by Oct. 26.

“To provide further clarification, the health department has decreed that school nurses are considered essential employees and only will be quarantined or isolated if they become symptomatic. Not from exposure,” Baird said in an Oct. 30 email.

Students and staff who are found to have been in close contact with a positive case are required to self-quarantine for 14 days and, if feeling well enough, learn or work remotely during the isolation, according to the district's hybrid learning plan frequently asked questions document on the Richmond-Burton website.

Nursing professionals, or an administrator or other designee, are in charge of deciding who is placed in a school building’s quarantine space and the amount of supervision by a nurse or other personnel required for people there, the document said in regard to students who show symptoms of the virus midday and are awaiting pickup.

In addition to potentially spreading the virus after if exposed, Snyder said she also was concerned by not being able to work remotely or take more than 10 additional paid days this school year if required to self-isolate because of the pandemic.

“Unfortunately, that is the regulation for additional 10 days [and beyond],” Enright said in an email to Snyder. “People need to use their personal sick time. I agree with Mr. Baird that the nature of your job does make it necessary for you to be in the building.”

Baird in a brief phone interview last week said the high school is following all recommendations from public health officials and the school has a plan in place for filling the school nursing vacancy. He declined to discuss the circumstances of Snyder’s resignation, citing an inability to comment on personnel matters.

“It felt like I was supposed to come to work and don’t say anything, and I really didn’t like that. It felt very unsafe and like minimizing the situation going on here,” Snyder said of the instructions. “Being the school nurse, I’m told that even if I’m exposed to a kid with the virus who tests positive, that my job says I have to come into work unless I’m symptomatic.

“If I’m exposed to someone who has [COVID-19], I have to quarantine, I can’t treat more kids coming down to the office who are sick. [Baird] just did not like what I had to say about it. I said I was not willing to work under these circumstances. It’s not a safe environment for me like that.”

District Superintendent Tom Lind declined to be interviewed Tuesday after fulfilling a Northwest Herald open records request containing the emails between Baird, Snyder and Enright. He referred questions to the McHenry County Department of Health or the state health department.

District 157 school board President Michelle Graham in an interview late Tuesday expressed confidence in district administrators’ handling and communication of public health protocols for all school staff.

“I don’t know what situation truly caused her to resign,” Graham said. “The last thing we want to do is let any parents in the community think there is not a safe situation for their kids. I don’t know what the district could have done differently other than follow all the protocols we’ve been given.”

Guidance from public health and state officials is not clear, however, on whether school nurses are valuable enough to ensuring a smooth transition into hybrid learning that they should follow separate, less rigid protocols on coming to work in school buildings than other school staffers after being in possible close contact with a probable or positive COVID-19 case.

McHenry County Department of Health spokeswoman Lindsey Salvatelli said she had no information to provide on this story.

“If appropriate [personal protective equipment] was worn, according to [the Centers for Disease Control and Prevention] risk assessment for health care workers, the school nurse does not need to quarantine,” Melaney Arnold, public information officer for the Illinois Department of Public Health, said in an email that linked to the federal agency’s guidance for health care personnel. “As a critical infrastructure worker, the school nurse may be allowed to work if agreed to by employer and local health department, but would be required to quarantine when not at work.”

But Jackie Matthews, spokeswoman for the Illinois State Board of Education, said something different on when and whether school nurses should self-isolate after potential exposure.

“The IDPH guidance does not differentiate protocols for different types of staff or for whether staff were wearing PPE,” Matthews said in an email, citing interim guidance for schools and day care programs issued Aug. 17 by Gov. JB Pritzker and the state health department.

Salvatelli did not respond to an email requesting information on whether the McHenry County health department had made any agreements with area school districts on allowing school nurses to work after an exposure while wearing wearing recommended personal protective equipment.

Woodstock School District 200 spokesman Kevin Lyons last week initially said his school system would not treat nursing staff any differently than other district staff members after a suspected exposure to a positive or probable case. He later reversed that.

“We are not treating nursing or janitorial staff or others any differently in terms of exposure to COVID-19 positive individuals,” Lyons originally said in an email. “In fact, our policy is the same for students and staff. The virus won’t discriminate so neither will we.”

He later clarified that exposure involving school nurses would be evaluated on a case-by-case basis because school nurses would be wearing personal protective equipment, and added that nurses would be wearing N95 respirators, which more effectively filter particles than other masks, while other staff and students could wear lower-grade face coverings.

Snyder, who would have spent her second year as Richmond-Burton’s school nurse until resigning and said she has worked as a school nurse in Illinois for 13 years, was confident that District 157 would have provided her an N95 mask if she requested one. But she said she still did not feel right about attending work after being in close contact with a positive case. She was provided with face masks and face shields, she said.

She said she considered keeping her job and considering how to deal with an exposure or a depletion of her normal paid sick time or the additional paid sick time available as a result of the pandemic if those situations occurred. But ultimately, the risk felt too great, Snyder said, partly because her husband is 65 and therefore at higher risk of developing severe symptoms of the virus.

“If I did feel exposed in any circumstances, I still felt I needed to quarantine. Plus exposure happens outside of work too,” Snyder said. “I think the district needs to support the nurse and any staff that gets sick anytime during the year. Otherwise people will feel forced to come to work with symptoms or not get paid when they run out of sick days. It’s a recipe for disaster.”