COVID-19 Protocols
Schools need clear procedures to follow when a student or staff member has been exposed to COVID-19 and/or is showing symptoms. Following public health recommendations around screening, testing, tracing, and preparing for positive cases is crucial to prevent any spread.
The key recommendations for COVID-19 protocols are split into three sections below:
Overall health in schools and districts
Checking students and staff members for COVID-19
What to do when there is a positive case.
Key Recommendations: Overall Health in Schools
Health Services
Incorporate COVID-19-related disease prevention and health education into the curriculum.
Prioritize (if possible, expand, don’t cut) needed health services for students, including behavioral and reproductive health, counseling services, and social/emotional supports.
Remind staff and families about existing school policies and guidelines for health.
Take a balanced view of risk — school policies should be guided by supporting the overall health and well-being of all children, adolescents, their families, their communities and school staff.
Clearly communicate the balanced view with the community during all steps of the reopening process.
Immunizations
Existing school immunization requirements should be maintained and not deferred because of the current pandemic.
Although the influenza vaccination (flu shot) is generally not required for school attendance, it should be highly encouraged for all students this year. School districts should consider requiring influenza vaccination for all staff members who do not have health conditions that preclude them from vaccinations.
Determine messages that the school will share about the necessity of immunizations and the option of receiving them from physicians vs. pharmacies vs. school-based immunizations. Communicate this with families.
Partnerships
Develop a communication strategy between school districts and local health departments to facilitate COVID-19-related decision-making.
Jointly develop a testing resource referral list to share with symptomatic or potentially exposed children and adults.
Jointly develop tiered plan for school closure (e.g., classroom, school, district), based on number of COVID-19 cases in school.
Identify a point person at each district or school to partner with the local health department and establish regular communication.
Clarify point persons in schools and health departments to facilitate contact tracing.
Key Recommendations: Checking for COVID-19
Screening
Provide a checklist for use at home and school to review symptoms each morning and in a suspected case.
Ask parents and caregivers to screen their children each morning.
Assess if any materials require translation / interpretation.
Require students and staff to stay home when sick, even without a doctor’s note.
Specify that a positive response to screening questions (e.g. indicating a student should not come to school) will lead to remote learning services and how these will be rapidly implemented.
Testing
With the local department of health, identify local accessible and affordable testing options for children and adults to get tested in the event of symptoms or exposure to people with COVID-19.
Provide education and a testing referral to the family of any student/staff who tests positive.
Confirm reporting and feedback mechanism for students/staff with positive testing results.
Develop a communication plan (mail, email, text, virtual meetings, website) to share testing options and plans for vaccine distribution with families, staff, and students.
Identify school staff to assist in contact tracing and answering family/staff questions related to testing and quarantine.
Leverage state and local data such as local prevalence, positive testing rates, virus levels in sewer waste water (if data is available), and hospitalizations to make decisions.
Key Recommendations: Positive COVID-19 Case
School Protocol
Designate an isolation space for suspected cases and protocol for interactions with that individual that reduce exposure.
Develop a protocol for sanitation of the isolation room.
Ensure the isolation room has adequate ventilation that does not leak contaminated air into other spaces.
Ensure there is sufficient PPE for staff who will interact with the suspected case.
Determine what information will be provided to the students’ parent(s)/caregiver(s), when, and whether by phone or other means.
Develop strategies for reducing anxiety and traumatic responses, such as training staff and students on calming practices (meditation, breathing, journaling, etc.), incorporating soothing materials into isolation rooms (easy-to-disinfect manipulatives such as fidget tools, music, dimmed lights, etc.), and classroom debriefs that allow students to express feelings in response to incidents.
Identify supports for staff mental health and anxiety, including referrals to counseling, check-ins, and staff debriefing of traumatic events.
District Protocol
Collaborate with the local health department to define parameters for classroom or school closure due to a positive case or cases.
Confirm protocol for informing and collaborating with local public health authorities (town, county, or state) to facilitate contact tracing, including those in close contact for at least 15 minutes (typically the entire classroom).
Develop communication plan for staff, parents/caregivers, and community when a positive case is identified (who, when, why?), including privacy policies regarding disclosure of COVD-19 status.
Collaborate with local public health authority to define a timeline for return to school for positive cases (e.g., 10 to 14 days) and consider a protocol for symptomatic individuals who test negative.
Reflection Points for Teams
Are there existing relationships with the local health department that can be leveraged to address COVID-19-related decision-making?
Will a single school closure plan work for the district? Or will different schools require different plans?
What has worked best for communication with families and students in the district to date?
How can we ensure that screening tools can be equitably accessed by all students, families, and staff (e.g. availability of thermometers, access to web-based forms)?
Who is responsible for reviewing this daily screening information, and where/when do they do so (for both staff and students)?
Given school space, and the recommendation that people who are suspected to be infected cannot under any circumstances be isolated together, how many people can the school isolate at a time?
What support does your nursing staff need to carry out these responsibilities?
How will we protect the privacy of students, families, and staff?
Ideas
Consider beginning each school day with a morning health message to the entire school to reinforce healthy behaviors, using language that is positive and affirming and does not shame or create fear.
Have signs with screening checklists at entrances of school buildings.
Develop an online form that staff can fill out as part of a self-screening process.
Consider tracking symptom information from families, perhaps in your existing system for child and staff sick-day policy.
Have daily or weekly briefings to discuss local infection rates and proactively address issues.
Ask health department teams for support streamlining data updates and communications to the community.
Require all returning students to document immunization status.
Share requirements for immunization updates with parents to promote updating of all immunizations.
Identify a local health care partner to provide at-school vaccinations for staff members.
Starting Point Tools
The following resources offer starting points for school leaders to respond to and manage a positive COVID-19 case. These comprise of toolkits, workflows, checklists, and more to provide actionable next steps.
(We will continue to update these as we continue to learn about additional tools)
Positive COVID-19 Case of Staff or Student
This toolkit helps superintendents, principals, and other staff understand the response steps needed once a positive case has been identified through a flowchart with easy-to-follow actions.
Source: Parabola Project
Indicators to Support School Closure & Reopening
Source: Parabola Project
Communication Resources for Schools at a Time of COVID-19 & Beyond
Source: Engage Equitably
Symptom Checklist
The symptom checklist should at least include the following items. If staff or students have any of these symptoms, they should stay home and get a test for active COVID-19 infection prior to returning to school.
Fever (100.4° Fahrenheit or higher), chills, or shaking chills
Cough (not due to other known cause, such as chronic cough)
Difficulty breathing or shortness of breath
New loss of taste or smell
Sore throat
Headache when in combination with other symptoms
Muscle aches or body aches
Nausea, vomiting, or diarrhea
Fatigue, when in combination with other symptoms
Nasal congestion or runny nose (not due to other known causes, such as allergies) when in combination with other symptoms
New rash, especially on the toes or fingers
Exposure to someone recently diagnosed with COVID-19
Suspected COVID-19 Case Workflow
The following workflow is a step-by-step approach to respond to a suspected COVID-19 case in a student:
Case suspected based on agreed upon set of symptoms.
Student sent to / escorted by nurse or other designated staff trained to respond and placed in isolation room.
Student is provided with a medical mask and isolated.
Close off areas visited by the COVID-19-positive individual until cleaned and disinfected, including classrooms, bathrooms, buses, and extracurricular facilities. The area can be used 12 hours after cleaning/disinfecting has occurred.
Consider referencing this table for what surfaces to clean and frequency in the Harvard Healthy Buildings report (p. 39).
Nurse (wearing N95 mask along with a face shield, gloves, and gown) does an assessment of symptoms.
If a case is suspected, call parent/caregiver to pick up student.
Student remains isolated until picked up.
If a staff member remains with the child, the staff member should wear a surgical mask and remain 6 feet apart. Refer to Principle 7 of this guide for more information on masks and PPE.
Provide information on quarantine, testing, and isolation to parent/caregiver when they arrive.
After student leaves, nurse (or other designated person) conducts thorough cleaning and disinfection of isolation space.
While awaiting test results, student should stay in isolation at home.