Operational Guidance for K-12 Schools and Early Care and Education Programs to Support Safe In-Person Learning

Fatima Fokina

COVID-19 Community Levels and Associated Prevention Strategies

CDC’s COVID-19 Community Levels help communities and individuals make decisions on what COVID-19 prevention strategies to use based on whether their community is classified as low, medium, or high. These levels factor in a combination of COVID-19 hospitalization rates, healthcare burden, and COVID-19 cases. COVID-19 Community Levels treat schools and ECE programs the same as other settings in their community. Schools and ECE programs should follow guidance based on the COVID-19 Community Level of the community in which they are located.

School and ECE program administrators should work with local health officials to consider other local conditions and factors when deciding to implement prevention strategies. For example, school and ECE-specific indicators—such as student and staffing levels or student and staff vaccination rates—can help with decision-making. Additional community-level indicators that might be considered for use in decision making about COVID-19 prevention are pediatric hospitalizations, results from wastewater surveillance, or other local information.

When the COVID-19 Community Level indicates an increase, particularly if the level is medium or high, schools or ECE programs should consider adding layered prevention strategies, described below, to maintain safe, in-person learning and keep schools and ECE programs safely open. Schools and ECE programs may choose to add layered prevention strategies at any COVID-19 Community Level, based on local or facility needs.

If a school or ECE program is experiencing a COVID-19 outbreak,pdf icon they should consider adding prevention strategies regardless of the COVID-19 Community Level. For example, those with an existing screening testing program may increase the frequency of testing, regardless of the vaccination status of the population. They may also put in place prevention strategies recommended at medium and high COVID-19 Community Levels (for example, masks) even if the community the school or ECE program is located in is at a lower COVID-19 Community Level. Schools and ECE programs that are experiencing outbreaks should work with their state or local health department in accordance with state and local regulations. Health departments should provide timely outbreak response support to K-12 schools and ECEs.

With decreasing or low COVID-19 Community Levels, schools and ECE programs can consider removing prevention strategies one at a time, followed by close monitoring of the COVID-19 Community Level in the weeks that follow.

Masking

Wearing a well-fitting mask consistently and correctly reduces the risk of spreading the virus that causes COVID-19. Universal indoor mask use is recommended at a high COVID-19 Community Level.

Anyone who chooses to wear a mask should be supported in their decision to do so at any COVID-19 Community Level, including low. At a medium COVID-19 Community Level, people who are immunocompromised or at risk for getting very sick with COVID-19 should talk to their healthcare provider about the need to wear a mask and take other precautions (for example, avoiding high-risk activities). Since wearing masks or respirators can prevent spread of COVID-19, people who have a household or social contact with someone at risk for getting very sick with COVID-19 (for example, a student with a sibling who is at risk) may also choose to wear a mask when the COVID-19 Community Level is medium. Schools and ECE programs should consider flexible, non-punitive policies and practices to support individuals who choose to wear masks regardless of the COVID-19 Community Level.

At a high COVID-19 Community Level, universal indoor masking in schools and ECE programs is recommended, as it is in the community at-large. When the COVID-19 Community Level is high, people at risk for getting very sick with COVID-19 should also wear masks or respirators that provide greater protection, such as N95s or KN95s.

Schools with students at risk for getting very sick with COVID-19 must make reasonable modifications when necessary to ensure that all students, including those with disabilities, are able to access in-person learning. Schools might need to require masking, based on federal, state, or local laws and policies, to ensure that students with immunocompromising conditions or other conditions that increase their risk for getting very sick with COVID-19 can access in-person learning. For more information, visit the U.S. Department of Education’s Disability Rightsexternal icon webpage. Students with immunocompromising conditions or other conditions or disabilities that increase risk for getting very sick with COVID-19 should not be placed into separate classrooms or otherwise segregated from other students.

Because mask use is not recommended for those younger than 2 years old and may be difficult for very young children or for some children with disabilities who cannot safely wear a mask, ECE programs and K-12 schools may need to consider other prevention strategies—such as cohorting and avoiding crowding—when the COVID-19 Community Level is high. A critical prevention strategy is promoting vaccination among those who are eligible (for example, caregivers) because the risk for people who have not been vaccinated is lower when the people around them have been vaccinated. ECE programs may choose to implement universal indoor mask use to meet the needs of the families they serve, which could include people at risk for getting very sick with COVID-19.

For more information about masks please visit Types of Masks and Respirators.

Testing

Diagnostic Testing

Diagnostic testing is intended to identify current infection in individuals and should be performed on anyone that has signs and symptoms consistent with COVID-19 and/or following recent known or suspected exposure to the virus that causes COVID-19. Schools and ECE programs can promote and offer diagnostic testing for people with symptoms of COVID-19 or who came into close contact with someone with COVID-19. If people who have COVID-19 are identified early and isolate at home, schools and ECE programs can help prevent the spread of COVID-19. Choice of viral tests can include laboratory-based testing, point-of-care rapid testing, or self-testing. Schools and ECE programs should consider the varying minimum age for using Emergency Use Authorized (EUA) COVID-19 tests.

For more information on COVID-19 tests, visit:

In addition to diagnostic testing offered by schools where feasible, people should be encouraged to test at home or in the community (for example, at a testing site or healthcare provider office) if they have symptoms or have had close contact with someone with COVID-19. Anyone who tests positive or has symptoms should follow CDC recommendations for isolation to stay home from their school or ECE program. People who come into close contact with someone with COVID-19 should follow CDC recommendations to quarantine, get tested, and wear a well-fitting mask. Recommendations for close contacts depend on vaccination status or history of prior infection. Those who come to school or an ECE program with symptoms or develop symptoms while at school or an ECE program should be asked to wear a well-fitting mask while in the building and be sent home and encouraged to get tested if testing is unavailable at school. Schools and ECE programs can consider offering home-test kits if someone comes to school with symptoms of COVID-19 or develops symptoms at school, that can be used to test at home or at school in accordance with Clinical Laboratory Improvement Amendments (CLIA) requirements.

Screening Testing

Screening testing identifies people with COVID-19 who do not have symptoms or known or suspected exposures, so that steps can be taken to prevent further spread of COVID-19.

At medium and high COVID-19 Community Levels, consider implementing screening testing in schools and ECE programs. Maintaining screening testing infrastructure during a low COVID-19 Community Level, even at a reduced volume, will help by more easily allowing for testing to scale up when the COVID-19 Community Levels are medium or high. Schools can also consider implementing screening testing for high-risk activities such as indoor sports and extracurricular activities, returning from breaks (for example, holidays, spring break, at the beginning of the school year), and for those serving students who are at risk for getting very sick with COVID-19, such as those with moderate or severe immunocompromise or complex medical conditions. The type of test used can vary and includes at-home testing (self-testing), point-of-care rapid testing, or laboratory testing. Schools and ECE programs that choose to rely on at-home test kits for screening testing should ensure equal access and availability to the tests; establish accessible systems that are in place for ensuring timely reporting of results to the school or ECE program; and communicate with families the importance of remaining at home if they receive a positive test. Communication strategies should take into account the needs of persons with limited English proficiency who require language services, and individuals with disabilities who require accessible formats.

For more information about testing, see Overview of Testing for SARS-CoV-2, the virus that causes COVID-19 and What to Know About COVID-19 Testing in Schools.

Screening testing should be done in a way that ensures the ability to maintain confidentiality of results and protect privacy. Consistent with state legal requirements and Family Educational Rights and Privacy Act (FERPA)external icon, K-12 schools and ECE programs should obtain parental consent for minor students and assent/consent from students themselves, when applicable.

Test to Stay Programs

Test to Stay (TTS) programs are an alternative to traditional at-home quarantine for close contacts who are not up to date with COVID-19 vaccines. Test to Stay combines contact tracing and frequent testing to allow those who have been exposed to attend school in person. CDC continues to recommend TTS as an important strategy schools should consider in order to support in-person learning. TTS strategies have not yet been evaluated by CDC in ECE programs.

Students eligible for and participating in TTS should wear a well-fitting mask, follow testing recommendations from their school, and monitor for COVID-19 symptoms for 10 days after the date of last close contact to reduce the risk of spreading COVID-19. Schools should work with their local jurisdictions to determine which TTS strategies would work best for them based on their population and level of resources to reduce the risk of transmission.

Cohorting

Cohorting is the practice of keeping people together in a small group and having each group stay together throughout the day, while minimizing contact between cohorts. In areas with a high COVID-19 Community Levels, this can be used to limit the number of people who come in contact with each other. It is important to ensure any use of cohorting for learning is designed to support inclusion of English language learners, students with disabilities consistent with their Individualized Education Program (IEP) or 504 plans, and other underserved students, and not result in segregation. In areas with high COVID-19 Community Levels, schools and ECE programs can also discourage crowding indoors to reduce the risk of spreading COVID-19.

Ventilation Improvements

Schools and ECE programs can take additional steps to increase outdoor air intake and improve air filtration. For example, safely opening windows and doors, including on school buses and ECE transportation vehicles, and using portable air cleaners with HEPA filters are strategies to improve ventilation. Schools and ECE programs may also consider holding some activities outside if feasible when the COVID-19 Community Level is high.

Case Investigation and Contact Tracing

Although universal case investigation and contact tracing are not routinely recommended for health departments as part of COVID-19 response, they can be useful strategies in response to a school or ECE outbreakpdf icon. If case investigation and contact tracing are done in school or ECE settings, investigations should focus on people who started having symptoms or tested positive for COVID-19 in the last 5 days. Schools and ECE programs should ensure that people identified with COVID-19 are provided with information about isolation and treatment. Notification of close contacts should focus on those who were exposed in the last 5 days. Health departments can aid with outbreak investigations and help decide if case investigation and contact tracing are needed.

Case investigation and contact tracing are important components of Test to Stay (TTS) programs. Schools that implement TTS strategies should continue to conduct contact tracing to allow those identified as close contacts and would otherwise need to quarantine at home to remain in an educational setting for in-person learning.

Schools and ECE programs that are not conducting contact tracing should use other methods to inform people who might have been in close contact with someone with COVID-19 in the school environment of their potential exposure and the actions they should take to remain safe and reduce transmission. Timely notification to all students, children, and staff in a classroom, cohort, or other school-based group with a potential exposure could include a phone call, email, or letter.

Quarantine

Quarantine is a strategy used to prevent transmission of COVID-19 by keeping people who have been in close contact with someone with COVID-19 apart from others. Recommendations for close contacts to quarantine, wear a well-fitting mask, and get tested will vary depending on vaccination status and history of prior COVID-19 infection. Regardless of the current COVID-19 Community Level, people who have come into close contact with someone with COVID-19 should follow the recommendations outlined on the COVID-19 Quarantine and Isolation webpage. This includes in K-12 schools and ECE settings. K-12 schools may consider TTS, which can keep those who would otherwise need to quarantine in in-person learning.

For children not yet eligible for COVID-19 vaccination who cannot wear a mask, or may have difficulty consistently wearing a well-fitting mask, it is safest to quarantine for a full 10 days. For more information, see Isolation and Quarantine in Early Care and Education Programs.

Considerations for High-Risk Activities

Due to increased and forceful exhalation that occurs during physical activity, some sports can put players, coaches, trainers, and others at increased risk for getting and spreading the virus that causes COVID-19. Close contact sports and indoor sports are particularly risky. Similar risks may exist for other extracurricular activities, such as band, choir, theater, and other school clubs that meet indoors and entail increased exhalation. At all COVID-19 Community Levels, schools and ECE programs can consider implementing screening testing for high-risk activities such as indoor sports and extracurricular activities. Schools and ECE programs may consider temporarily stopping these activities to control a school or program associated outbreak, or during periods of high COVD-19 Community Levels. ECE programs may also consider layering prevention strategies, such as masking, when close contact occurs, such as during feeding and diapering young children and infants.

Considerations for K-12 Residential Dorms and Overnight Child Care

While shared housing, such as K-12 residential dorms or overnight child care, is considered a congregate setting, it is considered a low-risk congregate setting due to the lower risk of severe health outcomes (such as hospitalizations and death) for children and young adults. Therefore, CDC recommends shared housing facilities follow the general population guidance for isolation, quarantine, and recommendations under COVID-19 Community Levels.

In specific circumstances where the student population may be at risk for getting very sick with COVID-19, schools may opt to follow isolation and quarantine guidance for high-risk congregate settings, which includes recommendations of a 10-day period for isolation and quarantine. Schools and ECE programs should balance the potential benefits of following that guidance with the impact these actions would have on student well-being, such as the ability to participate in in-person instruction, food service access, and social interaction.

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-childcare-guidance.html

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