New school COVID guidance issued

The Department of Health Services (DHS) released Guidelines for the Prevention, Investigation, and Control of Covi-19 Outbreaks in K-12 Schools in Wisconsin. The guidance is in addition to the Education Forward and Reopening School Building Risk Assessment Tools released by DPI in June.

Outbreak Prevention Measures

Whenever possible, the CDC recommends maintaining at least a 6-foot distance between all students and staff throughout the school day. Strategies to assist include staggered arrival/departure times, in-person and virtual classroom rotation, student cohorting, and increased use of outdoor space – weather permitting.

All students and staff who are able to properly and safely wear and remove a cloth face covering should wear one. Cloth face coverings should NOT be placed on children under age 2, anyone who has trouble breathing or is unconscious, incapacitated, or otherwise unable to remove the covering without assistance. Wearing a cloth face covering may be dangerous or stressful for individual with intellectual or developmental disabilities.

Daily home symptom screening of students by their parents, guardians, or caregivers is recommended. Students should not attend school when they are sick. Teachers and staff should self-monitor for signs of illness.

Teachers should remind students how and when to properly wash their hands, how to wear a face mask or face covering, how to cover coughs and sneezes when unmasked. School administration should ensure handwashing and hand-sanitizing supplies are readily available throughout the school for staff and student use.

School administrators should limit the number and types of visitors to buildings.

Encourage eligible students, parents and guardians, teachers and staff to stay up to date on routine and seasonal vaccines. “It is especially important to receive an influenza vaccine to avoid becoming ill with both COVI-19 and influenza.”

Detecting Cases and Outbreaks in Schools (K-12)

The guidance discusses detecting cases among students (for parents), among students (for teachers and staff), detecting cases among students and staff (for school-based health care providers), detecting additional cases (for local and tribal health departments), and detecting outbreak cases in other public health jurisdictions.

Case and Outbreak Investigations in Schools

The next section of the guidance provides details on conducting investigations into infections and outbreaks. The section discusses:

• Establishing contact with the school
• Making a Line List
• Contract Tracing
• Case and Conduct Interviews
• Goals for the Case Interview
• Goals for the Contact Interview
• Identifying Close Contacts
• Public Health Follow Up
• Contact Tracing Roles and Responsibilities
• Contact Tracing Support (Local health departments)
• Notification of Families and Staff

Case and Outbreak Mitigation Measures

Teachers and school-based health care providers are encouraged to use a liberal approach when determining whether to send a child home due to illness since illness may mimic a number of other childhood viral infections. Students should be sent home if:

• They have taken any medications (for example, ibuprofen, Tylenol) to reduce fever in the last 24 hours.
• They have tested positive for COVID-19, with or without having symptoms, and have not yet finished their isolation period per public health recommendations.
• Have been diagnosed with COVID-19 by a health care provider, and have not yet finished their isolation period per public health recommendations.
• Within the last 2 weeks, they have come in close contact with anyone who has COVID-19.

OR with the last 24 hours, they have experienced the following symptoms above their baseline:

• Either cough, shortness of breath, difficulty breathing, new loss of smell or taste OR
• At least two of the following symptoms:
  • Fever (measured or subjective), or chills or rigors
  • Myalgia (muscle aches)
  • Headache
  • Sore throat
  • Fatigue
  • Muscle or body aches
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

If a student develops symptoms during the school day, the school-based healthcare provider or staff should:

• Immediately isolate the ill student to a pre-designated room or assigned area away from others
• Call the student’s parent or guardian to inform them their child is ill, and will need to go home or be picked up as soon as possible
• Provide the student or parent/guardian a short handout in their primary language that includes the following information:
  • Signs and symptoms of COVID-19 infection
  • School policy on exclusion and return to in-person instruction
  • Instructions on in-home isolation measures (offered in multiple languages)
  • Information regarding quarantine recommendations for siblings and household contacts
  • Recommendation to seek medical evaluation and/or testing for COVID-19, influenza, and other childhood infections
  • Instructions on what to do if serious symptoms appear
  • Contact information for the school and the local health department
• Be prepared to answer questions that the student or parent/guardian may have.
• Clean and disinfect the isolation area, student’s desk, locker or other areas and surfaces following CDC guidance.
• Consult with the local health department for next steps.

If a teacher or staff member develops symptoms during the school day, they should:

• Report their illness to their supervisor(s) and leave work as soon as possible. It is essential that after the ill person has left, all relevant areas should be cleaned and disinfected following CDC guidance. This includes the isolation area, the staff member’s desk or work area, and any other areas and surfaces the teacher had likely touched.
• Maintain at least a 6-foot social distance from others.
• Continue to wear a mask or face covering, if medically possible.
• Perform hand hygiene and disinfect frequently-touched surfaces.
• Seek medical evaluation, including COVID-19 or other relevant testing.
• Contact their medical care provider and/or the local health department with any questions.
• Refer to relevant DHS, CDC, and health care provider resources for next steps.
• Be prepared to provide a list of activities and close contacts to the local health department

Isolation and Quarantine

Since isolation and quarantine are the primary strategy for COVID-19 outbreak mitigation, the guidance offers directives on how to isolate and quarantine students and staff based on their proximity to a COVID-19 case.

The CDC has provided specific cleaning recommendations, but today’s guidance gives recommendations of how schools should respond to a case of COVID-19 for classroom cleaning and disinfecting. When possible, schools should consider temporary classroom, school or district-wide closures or dismissals linked to cases in the school when:

• Other outbreak mitigation measures were implemented, and ineffectual at halting outbreak transmission, and/or
• Logistics of in-person instruction have been seriously impacted due to staff and/or student absences, and/or
• Classroom or school-wide cleaning and disinfection needs to be completed, and/or
• Extensive contact tracing is needed to identify all contacts (e.g., in response to a case that attended a large school event).

School administrators should consider temporarily halting in-person instruction in an individual school when:

• The number of absences among teachers or school staff is impeding student instruction, ability to provide student lunch, or other vital school functions, or
• A greater number of classrooms or student cohorts are absent than present, or
• School-wide cleaning and disinfection needs to be conducted, or
• Contact tracing is being conducted to identify close contacts and additional cases from multiple classrooms/cohorts especially when multiple cases need to be traced, or
• Other outbreak mitigation measures were implemented, and were ineffectual at halting transmission between classmates.

School administrators should consider temporarily halting in-person instruction across a school district when:

• The local, county, state or the federal government recommend closure, or
• The number of absences among school and district staff is impeding vital district functions, or
• Contact tracing is being conducted to identify close contacts and additional cases from multiple schools (e.g., in response to a large outbreak linked to a multi-school sporting event), or
• Other outbreak mitigation measures were implemented, and were ineffectual at halting transmission at schools in the district.