The Behavioral Corner 
Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner; you're invited to hang with us, as we've discussed the ways we live today, the choices we make, the things we do, and how they affect our health and wellbeing. So you're on the corner, the Behavioral Corner, please hang around a while

Steve Martorano 
Hey, everybody, how are you? Welcome to the Behavioral Corner. I'm Steve Martorano. You know, I professionally hang on street corners. I've done it for so many years as a youngster, for nothing. Now I get a little bit of money for doing it, which is just wonderful. The Behavioral Corner we run into people all the time who have great information stories to tell us about our behavioral health, which is a huge topic. Put simply, it's everything that affects us emotionally, physically, psychologically, it's the choices we make, you know, it's our lives. This is a podcast about everything. We are the beneficiaries having a great underwriting partner in Retreat Behavioral Health, obviously, their financial support is crucial for us. But more than that, they are always a resource for great authoritative voices, about whatever matters concerning behavioral health we can come up with. And today we have a perfect example of that. We're going to talk about getting the kids ready for school. It may seem like we've experienced every possible situation that the virus has affected. But we have it and going back to school is a big one. You know what happened last year, nobody went back to school. Well, we're going back to school now. So we thought we would get somebody in who really understands the situation. And tell us what you know, you can prepare before. Lots of kids are back already I understand. But many more will come after the holiday. So we reached out to our great, great friend and resource, Melissa Callahan. She's been a contributor to the program many times over the years. She is Chief Nursing Officer for Retreat Behavioral Health. And I'm telling you, we were just talking before we got on the Corner, about how early on her and I sat down and she said to me, "Boy, we got to get ready, this thing is going to be big, and it's going to be serious.? How long did you say we would be wearing masks during that conversation?

Melissa Callahan 
I said well into 2022 -- that they were not going to come off before 2022. And some people made fun of me like Oh, we got we're spring free in the middle of the summer when a lot of places were able to and I think it just makes sense with science, it makes sense with the type of virus this is that they're going to be here for a while. And if we look at previous viruses that hit other countries, a lot of those people continued masks for years and still do now if they travel anywhere. So masks are something to protect us. And it has shown that it is a simple cloth -- paper that really can make a big difference. It can go a long way.

Steve Martorano 
Yeah, you know, it's extraordinary. We could do a whole show on the sort of phobia about masks and what that's all about. And I just don't you know, the next time you go in for a medical procedure, everybody in the room that's going to be taking care of you is going to be wearing masks, they've been doing that forever. So I don't understand what the big deal here is. But anyway, masks are going to play a big part in what needs to be thought of when kids go back to school. And Melissa, in addition to being an expert, in a health care provider, as four school-aged sons, so she's in the trenches on this one Have your kids going back yet, Melissa?

Melissa Callahan 
No, they go back on Monday. 

Steve Martorano 
Okay, I guess first things first: Parents have to take it upon themselves not to assume that their school is doing everything properly, or what they're doing so they know how to prepare. Is that the first phone call you have to make or the first thing you have to find out is what is the school expects?

Melissa Callahan 
It really is. I think the schools have done an amazing job. They're hit with this controversy, and they're trying to do what's in the best interest of everybody. The children, number one, the staff, number one, number two, the same amount of importance, and they're holding these school boards, and they're trying to update their websites and they're just trying to do the best. They're listening to the CDC, their local health departments, and they're making a decision, and erring on the side of caution can't really be ridiculed. It's in the best interest and it works.

Steve Martorano 
And then you err on the side of caution it should be a foregone conclusion. Unfortunately, it's not in some places. With regard to symptoms that kids would have during any fall or winter school year. Kids get ill. We cannot afford to overlook minor symptoms, can we?

Melissa Callahan 
No, we can't. One thing that's super important is that we have found through the entire pandemic since this virus has arrived in all of the countries and become part of our everyday society that kids have been the most resilient, the most resilient with symptoms. The most resilient with the illness and the symptoms through it. As well as the most resilient in protecting themselves and wearing masks. I think that for health care providers right now it is so very difficult because it's difficult to know, is an allergy? Is this a cold? Is this a sinus infection? Is this COVID? So we have to balance on this fine line? Do you over-test?

Melissa Callahan 
Are you under testing and I think that if society, in general, can step back a little bit and be appreciative that health care providers, whether they're giving you the antibiotic you want when you call, are they giving you the answer that you want, they're trying to do what's best they're trying to read and be educated and try to do use their assessment skills and all of their knowledge from their certifications and their licenses to diagnose correctly? To treat correctly so that we don't over-treat or under-treat, and we really figure out what's going on. Kids in general, are very mild with symptoms. Fatigue is probably the most overwhelming symptom. For anybody right now, even with the most recent variants, Delta you hear the most, but there's definitely lambda, there are other variants that are out there. And fatigue is overwhelming. A lot of people have been presenting more with cough, sinus type of presentation, but most children across the board are not really symptomatic.

Steve Martorano 
So the process would be Johnny gets up, Jane gets up, getting ready for school and there, maybe they cough throughout the night or they had a runny nose. Does mom call the pediatrician and say, should I bring them in? Or just she's, you know, what happens there? How do you know when to keep a kid out of school?

Melissa Callahan 
We know fever is a marker that we've used for COVID. But we also know that a ton of people have had COVID and not presented with fevers. But I think that most school districts are having some level of mask recommendation. Having a mask on whether it's a cold or the flu, or COVID, we know is a very protective mechanism. So if your child wakes up, and they have symptoms of something, allergy, cold, whatever, I would check their temperature. If they were fatigued or not able to eat breakfast, you would treat it like any other time like, "Oh, I should call the pediatrician" to see if they want to see them. Or if they want to wait it out a little bit. If they think it's some virus, whether it be the COVID virus or some other virus. If they're pretty okay looking their skin color looks okay, they don't have a fever. They're eating Okay, they haven't been in high-risk exposure situations, send them to school with their mask as if you would any other time. I think one thing that the mask brought on is that when people had symptoms that in the past, they would have spread to 100 people in a regular day going from their car to WaWa, to their job, the mask has given protection to decrease the spread of the common cold. In last year's season, in the fall-winter season, the common cold, influenza, things that are airborne, decreased dramatically, because we had this simple mask-wearing that was for the big COVID virus. But it really helps everybody in general for viruses in general. And healthcare providers can say that they were busier than ever, but not with the common things that they used to be busy with, with the multiple appointments of bronchitis and sinusitis and all of these infections that are usually rapid during the fall and winter season. We didn't really see last year.

Steve Martorano 
Yeah, raises interesting questions about whether it's a side issue, but whether or very young children are getting the kind of exposure to the garden variety things you just talked about so that they can begin to build an immunity...

Steve Martorano 
Correct. 

Steve Martorano 
...later, so, is this all these ancillary problems. But anyway, let's keep -- we getting back to mask, I know that's no accident. This is the simplest, easiest, most common sense thing to do. Under a lot of different circumstances. Let me ask you about the need to test someone, a child before you send them back to school. There a home administered COVID tests. Are they any good?

Melissa Callahan 
Yes, yes, they're accurate. Pretty much as any of the ones that you're getting when you're going to the health department or these drive-thru places that are testing you. It's pretty much the same quality with the same effectiveness and a percentage of accuracy. There is some user potential error because if you don't put a swab to the correct places, you may not gather the cells. But I think overall it does make people feel better. I don't want people to have a false sense of security like, "I'm negative, oh, I don't have to wear a mask." Let me go around and coughing and do it I'm going to do and I don't have to worry about it because there is a period, we know 48 to 72 hours, sometimes up to five to seven days that someone can convert and go from negative to positive I think one of the most important things without becoming controversial all, we do have to talk about the fact that vaccinations are making a difference. If we look in the hospital settings, I think the average number that's out there across the United States is 85+plus percent of the people being hospitalized for COVID are unvaccinated. So that does not mean that people who are vaccinated or not going to get any variation and are completely protected. What it means is, they're going to do better their symptoms are going to be less, they're going to be able to tolerate it, which is the whole point of vaccination. The whole point of why flu vaccinations exist. And a lot of people have been hesitant, "I already had it." "I don't need the vaccine," or, you know, "I don't work in a setting..." One thing I want people to understand is the reason why we want people vaccinated is that the job of the germ is to become as complex as possible. If you put a blocker up, it wants to find another way to get in. And that's how the variants continue to grow. So we want people vaccinated, so variants don't continue. So we can eradicate minimize COVID virus completely.

Steve Martorano 
It has been such an education. You know, the oldest cliche in the medical field, I think, is something like, "Well, there's no cure for the common cold." And we find out, it's because that virus mutates 

Melissa Callahan 
Exactly. 

Steve Martorano 
Now, it's the only difference between that and COVID, obviously, you don't, you know, it's not fake. But when you get a call, but you can't eradicate the common cold, because it's clever, it will survive. The problem with this virus is it will mutate. It looks to survive, and the hosts won't. It's not about "Everybody gets shot, and it'll go away." It's real. It makes us stronger as a herd...

Melissa Callahan 
Correct. 

Steve Martorano 
...and the virus weakens. So, it's so obvious Anyway, let's talk back to the kids now. Where are they masked or otherwise, at a greater risk of exposure? Let's begin with the school bus. Obviously got to wear masks to go to the school bus. Should they be sitting further apart on school buses? What do you think?

Melissa Callahan 
Yes, I know they use more of the number of three feet versus six feet. So keeping three feet apart is the preference. I know, with my own school district and recommendation is that to be in the same seat, you have to be siblings or live in the same house. And I think that that makes a lot of sense. I think that school buses definitely are a place that you know, is of concern. But I think that the school districts that did go back at the end of last year, were ones that never close to begin with that continued right through all the way through. They proved that the disinfectant they do, the way that they are cleaning and managing really made a difference. If any kids were positive in the school districts, it wasn't because they rode the bus. It's because they went to a party and they hung out. And then they came and then they were, you know, it was placed where they weren't masks and where they will potentially eating which school districts are making very specific recommendations in the cafeterias to decrease because you can't wear a mask and eat food. Whether they're providing food or individually wrapping all food, where they're sitting them in the cafeterias. I think that between the school bus in that area, they focused a lot of time and we've seen the studies, it wasn't spreading through schools. It really was minimal spread. And if somebody got it, it was on their weekends or their nights in their social environment -- where they weren't following the recommendations.

Steve Martorano 
Speaking of a school cafeteria, in our part of the world, the Northeast, we know, it gets cold. And now the fall and winter. Maybe we should be thinking I understand a window open makes a big difference. Is that something the school should be thinking about maybe the kids can wear their jackets when they go in to eat lunch?

Melissa Callahan 
I think it can. I mean, I do think that a lot of schools are made now where they don't really have a lot of windows that open it. I think a lot of the newer schools are kind of like closed in and they use their circulation systems. And I think that the schools looked at that the best they can. Because there were definitely schools that did not open during the pandemic or are not reopening because their ventilation systems were definitely not to the level to be able to manage the respiratory airborne virus.

Steve Martorano 
Old schools and sick buildings and all the neighborhoods that you can imagine those places would be in. My grandchildren wanted to know about masks. So I said do you have any questions and they said, well...kids really sort of more into it. They don't seem to complain as much but they did want to know about recess. "Do we have to wear them when we're out at recess?" Outdoors, they're pretty good, (They're) okay.

Melissa Callahan 
Yes, the outdoors are pretty good. And my recommendation is really in the outdoor setting for any sport or recess. The masks I really don't think are necessary. I think that we really, if we practice, you know, coughing into our elbow, and you know, just not putting our, our cough and sneeze out there into the air. And that's for anything, once again, anything once again, you're going to decrease the transmission. But I think outdoors, letting the kids not have masks and being able to run free and play sports. We saw that sports started a little earlier than I think some school things did. And the kids did really well.

Steve Martorano 
Yes. So after school extracurricular physical activity, if it's outdoors, it's okay. What about, you know, I mean, basketball is a little different for the boys and girls.

Melissa Callahan 
It is and our last basketball season, the kids wore masks throughout the entire season. And I think that the schools making the basis on how many people are positive inside and you know, what I saw our one basketball league they moved everything to outdoors, and they did outdoor baseball the entire summer. You know, so they didn't wear the mask, they were outside and kids did really well with it. And I, you know, there's a lot of good I think that has come out of this virus. And it's hard to say, I mean, I've lost people very close to me from the virus, but it's really made to stop and rethink how we do some things and how we... Outdoor dining in the Northeast Corridor. We never saw outdoor dining like we do now. And, and it's here to stay.

Steve Martorano 
We had Thanksgiving...we had that, you know, those rare moments in November when you get a little Indian summerish. Yeah, we had Thanksgiving dinner out in my daughter's backyard. It was, yeah, you're right. You know, the virus isn't the only thing that can adjust and mutate into different behavior. A couple of other things "podding," creating these pods, were a feature of the first lockdown period where you thought you were relatively safe with these people, this group. People, who carpool their children should be thinking about getting together with their neighbors who go to the same school and doing something like that, right?

Melissa Callahan 
Yeah, absolutely. Absolutely. You definitely saw as things started to lift, and people went into their "quaranteam," I like to say. The people that they were spending the most time with, and they were in vehicles and, you know, in indoor spaces, not with continuous masks on and not doing other high-risk behaviors. It makes sense. Definitely. The less numbers, the better. But that doesn't mean zero numbers. So you're coming from a bus situation to two families, carpooling, you're definitely going to be in a much better situation. But, being mindful people are not necessarily mindful when they find out, you know, Tuesday evening that where they were Saturday night. They were exposed. And what's beginning to happen is -- because there's controversy and there's a lot of thoughts on the vaccine and no vaccine -- they're afraid to tell that they've been exposed. But then what happens is the person exposed if they're positive than they've exposed, and they've exposed then... You know, I said a long time ago, I think one of our second or third conversations is that we have to meet people where they are, then we have to have respect for everybody's thoughts and feelings and fears. And you know, I think we have to help each other. We help each other. I've seen children bond together, come together to have real conversations about COVID and masks and restrictions. And although they don't like it, they're so quickly, easily able to say, "Well, at least we can actually be here." "At least we can actually have the game." "At least we can go here." "At least we can try this." And they are so resilient. They really are. I mean, we kind of made the mask away mostly for the summer and bringing them back. My kids really didn't bad enough. "Okay."

Steve Martorano 
Oh, yeah. Our kids were the same way. "Okay, it's time to go back. this is good."

Melissa Callahan 
Yeah, you're not making me stay just in my home. So already, you know, put my mask on. Let's go.

Steve Martorano 
Yeah. And the siblings are looking forward to a little separation. 

Melissa Callahan 
Yes. 

Steve Martorano 
One more thing about the mask and then we'll just sort of sum up here. Now you've got things to do. What kind of mask is advisable? Because you know, suddenly we had a fashion statement going on with masks. For kids, what do you recommend?

Melissa Callahan 
Listen, anything that a child can put on their face and tolerate is going to help. Yes, there are studies that show a gator or something that's like thinner cotton is not the same level as a medical disposable mask. That should be obvious. But it still works. It still works. People who wear glasses...people who have, you know, breathing issues...you have to just get in what works for the person. Once again, like I said, meet them where they are. If it's covering their nose in their mouth -- maybe it's not tight, maybe it's not sealed, like the nurse in the hospital. But at least that covering makes a difference. And I think for children, whatever is comfortable, that will make a difference for them. Because we don't want them to have fear. We don't want them to have anxiety that's being produced in many adults who are being asked to wear them. If you can make a designer and make it like throwing on a baseball cap, or the cool socks that they wear, it will make them embrace it, even more, it'll make them wear it in tolerated. I have friends who have, they work in daycare settings, with like the littlest of kids. They're like with it. They got it. And some of them embraced making it match their outfits. Other ones are like, it's my mask, just like it's my jacket.

Steve Martorano 
Yeah, kids are amazing. I mean, you know, they haven't picked up any of these habits of the mind. You know, they're all in on this thing. That's great. But a final note, with regard to masking, it has been suggested that you have a conversation with your kids about how to behave, or what to say about other people, other kids who might make fun of you, oh, you gotta wear we got to wear a mask, and I just sort of viral bullying is a problem. What do you tell kids about how to behave? I mean, I know the answer to this. But do you have to prepare them for this? Right?

Melissa Callahan 
You do. And I think it's like everything. Bullying can be created out of anything, any day. And it's generally a person who has their own anxieties and fears, and they're projecting it onto someone else. I think just having your kids understand that you get to make choices, they get to make choices, and you can have judgments about that, but keeping it to yourself is really what's going to get your farthest in this life. And focusing on yourself. It's hard enough to focus on ourselves, what we're doing, how we're doing it, and how we feel about it, let alone letting someone else put on you their thoughts and issues. Like any bullying, the kid goes to school who doesn't have the coolest sneakers, you have to tell them if you picked it out, you wanted it, you're okay doing it, you have to keep saying that, say it out loud. And just kind of own it. And you know, when you walk in the house, at the end of the day, we can kind of debrief about it, we can have a conversation about it, we can say what we agree with what we don't agree with, but we have to be solid in our thoughts and our choices. And you know, you pick your fights and you decide what you feel passionate about. And if you want to wear a mask and you feel good about it and someone else wants to make fun of you, you move away from those people.

Steve Martorano 
The sooner the better. Melissa Callahan is Chief Nursing Officer for Retreat Behavioral Health and a great, great friend of the show. A great source for this information. Thank you so much for your time. I know I pulled you away from 14 other things you were doing. I'm going to have you back real soon because I know we wanted to talk about your professional and the toll it's taking on nursing. There are going to be some real problems coming down the pike...

Melissa Callahan 
There are.

Steve Martorano 
...with the people who've done an unbelievable job. Melissa thanks so much. Always a delight to have you on the program. You know, I love you. 

Melissa Callahan 
Of course. I will come anytime. I always have time for this. 

Steve Martorano 
Thank you, Melissa Callahan. Hey guys, thank you all. Any suggestions for further shows? Please follow us on Facebook and you know the whole thing. Leave us a review too. We'd like to hear from you in that regard to Behavioral Corner. See you next time. Bye-bye.

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