NORWAY — Western Maine Health pediatrician Kate Herlihy has looked after SAD 17 students for close to 20 years, first as a volunteer, then as a healthcare provider to SAD 17’s uninsured students, and finally as the district’s medical director, where she oversees the health center at Oxford Hills Comprehensive High School and attends monthly (which are currently on COVID-19 hiatus) meetings with staff on health matters or providing didactic presentations.

Dr. Herlihy, pediatrician with Western Maine Health, has been instrumental in providing medical care for SAD 17 for close to 20 years. Courtesy Brewster Burns

During her tenure Herlihy has been at the forefront of helping SAD 17 consider and adopt policies surrounding student health. And when COVID-19 was detected in Maine last March, one of the first things she did was reach out to the district’s administration about closing schools to protect families.

“The superintendent was responsive,” Herlihy said. “Our district had one of the leading responses to the pandemic in the state. [Superintendent] Rick Colpitts and I joined our peers [other doctors and school administrators] to study the pandemic and determine our protocols.”

Herlihy describes a collaboration at the state level to meet the public health crisis. She serves on an advisory group that includes other pediatricians, family practitioners, leaders of MaineHealth, Maine’s Center for Disease Control and Maine Care and other stakeholders that communicates regularly with Maine’s Department of Education, developing protocols on the virus and possible exposure of students in schools, as well as other institutions like youth sports and summer camps.

As school districts across the state waited over the summer for the DOE to announce its decisions on guidelines to reopen schools, Herlihy was firmly on the side of letting kids attend in person.

“My answer when people asked was ‘yes, reopen. But with strict guidelines,’” she recalled. “And that meant wearing masks. Some people gave me funny looks at first, but kids aren’t the ones that have an issue with it. Adults struggled with it.”

Herlihy felt it important for kids to participate in peer activities, like the fall sports season, also under strict guidelines. Many questioned the scope of the restrictions but schools could only be so flexible—the DOE drove those decisions and continues to adjust them as COVID-19 surges.

Following a September virus outbreak well north of Oxford Hills at the Rumford mill ND Paper, the county’s status was changed from green to yellow, forcing schools into remote learning for a brief period and disrupting fall sports. Once the outbreak was contained, the DOE and CDC reverted to green and SAD 17 was allowed to welcome students back to school after Oct. 9.

With increasing cases throughout the state and five more counties (Waldo, Somerset, Washington, Franklin and Androscoggin) categorized as yellow, phones in doctors’ offices are ringing off the hook. Parents concerned with their children’s health are right to start by reaching out to their providers with a call, Herlihy said.

“First, we talk with parents for information on how their child may have been exposed,” she said, adding that asking about exposure means one should assume there has been exposure. “It’s often based on rumor, where the parent knows of someone who has been in contact with someone who was infected.

“The first thing to do is monitor for symptoms. If the child shows any symptoms, they should arrange for them to be tested at a drive-through facility. If the child is asymptotic, they should start a fourteen-day quarantine and be tested after five-seven days.”

Even if after a week someone tests negative they should remain in quarantine for another seven days, as many who have COVID-19 never develop symptoms, she explained.

According to the American Center for Disease Control, the first symptom is generally fever followed by a dry cough and shortness of breath. Patients may suffer from fatigue, inflammation or muscle pain, experience congestion and sore throat, lose their sense of taste and smell and develop GI distress and diarrhea. Patients who have trouble breathing or show signs of hypoxia will require immediate emergency care.

Eight months into the pandemic, Herlihy continues to pay close attention to how the virus spreads and is treated. Early, healthcare workers struggled to care for Americans infected with the virus in part because the early available data about it was so thin. Thankfully, reports of mutations in different regions have not become the factor that many feared would occur.

One adjustment to treatment has been providing patients with oxygen to assist with respiratory distress before having to resort to put them on a ventilator.

“We are still on the learning curve with this,” she said. “But we know we don’t have to use the biggest guns in our arsenal. We’re finding successful treatments using hand guns [oxygen] and not bazookas. We’re finding new ways to deal with it and we know more about mortality rates for kids with COVID.

“Some techniques have not been effective as first touted. IV treatment with monoclonal antibodies, for instance. The jury is still out on it; some believe there are positive effects but more testing with [new] drugs is necessary.”

With hope in the form of soon-to-be-available vaccines on the horizon, dealing with fatigue in all corners has become as big a concern as the virus itself.

“Parents are stressed. They have to screen their children for symptoms every day,” Herlihy said. “They don’t know their immediate future – economically, whether their kids can go to school. It brings on anxiety and sometimes depression. They don’t have a cure for when their kids struggle themselves.

“And the kids would rather be in school. They want to see other kids, talk with their friends. They don’t care about wearing a mask.”

In Herlihy’s sphere – healthcare – there is no escape from COVID fatigue.

“Healthcare workers are on edge,” she said. “They are taking care of people but they worry about themselves and their families. They are always one call away from a phone call that could abruptly change their own lives.”

And medical workers have to continually take their time during any patient interaction to educate the patients about the virus.

“They [still] ask if this is like the flu? It’s not and there is no cure. Some question if face coverings and social distancing necessary? They are! COVID is more contagious and more deadly than the flu,” Herlihy said. “There are still some cynics. And what I tell people is this: ‘Since March the virus has killed more Americans than the American Revolution, World War l and the Korean and Vietnam Wars did. Plus the number of Americans killed in the 9-11 attacks, and Americans killed in terrorist attacks worldwide over the last 25 years, and those who died of the flu in the United States in 2019.’

“And many of those COVID deaths could have been prevented if only more people had worn masks and followed social distancing.”

Herlihy looks forward to distribution of vaccines, which are projected to become available by January of 2021. By late spring anyone who wants to be vaccinated will be able to regardless of their occupation or health risk level.

“Health care workers and first responders will be vaccinated first,” she said. “And long-term care. Then those who work in essential jobs, and those with health conditions that put them at higher risk.”

Asked if she is concerned about a vaccine developed and distributed in such a brief period of time, Herlihy answered quickly.

“I have no fear of getting vaccinated against COVID-19,” she declared.

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