Coronavirus Frequently Asked Questions: A Sampling

• Are schools a major contributor to community transmission?

The latest data has failed to provide compelling evidence that in-person schooling leads to meaningful increases in infections in communities. While there have been some outbreaks in contexts without strong mitigation measures, there is little to no evidence suggesting spread within schools when effective mitigation measures are in place. Note that some data suggest that transmission rates are lower for younger age students and can be higher for older age students.

For some compiled data and articles on this topic, see our resource on Covid-19 Transmission in Schools.

• We have some testing locations that swab the sinus and some that swab the cheek. Some testing sites are FDA approved and some are not. Can you address those differences? 

• Testing locations may use different modes of acquiring a specimen - in the mouth (saliva), nose, throat, etc. The CDC recommends a nasal swab to the throat, however, other testing methods have been approved for use at this time. In general, the test itself is what has the FDA approval. Some tests that do not have FDA approval will have Emergency Use Authorizations (EUA) from the FDA. This means that because of the urgency and need for testing, the test has been approved without being fully evaluated. If the testing site is not using an FDA approved test, it likely has a EUA.

• What are the different types of testing, what information do they each give us and how do I know which one to take or provide in schools ?

  
  

  Currently, there are different types of testing that are not all created equal.

  • Surveillance Testing is most useful for the county: it is designed to support the local city, county, and state in their reopening efforts as a whole. Surveillance Testing shows us what the percentage of Covid-19 positive folks on our campus is. 
  • Screening Testing (with rapid results) helps us to stop those who are positive from entering campus at all. Because Covid tests only reflect an individual’s status at the moment of the test - and one could become infectious anytime after the test - in order to be effective as ‘screening’ tools tests would need to be administered several times a week at minimum.
    
    

  For more details, see our Joffe Toolkit on Testing resource document.

• What indicators will show us it’s actually safe to bring students back on campus? 

• The CDC advises that school officials should make decisions about school reopening based on data. Levels of community transmissions and the school’s capacity to implement appropriate mitigation measures to protect students, teachers, and all staff are the 2 primary indicators. If the school is unable to provide students and staff with an environment that aligns with all state and local guidelines, they should not reopen. For example, if a school cannot commit to cohorting students and teachers, providing additional cleaning and disinfecting products, screening all individuals, or any other prevention measure, that school should not reopen. If a school is confident they can reopen following all of the guidelines outlined by the local and state departments of health, they should then work with the DPH to understand community spread. The CDC recommends communities with none to minimal levels of community transmission continue to operate. However, the CDC recommends school closure when community transmission is not contained. To better understand community transmission, many states have created county “monitoring lists.”  They look at specific indicators such as hospitalizations, positivity rate of tests, number of new cases each day, etc. to determine the transmission of COVID-19 in a specific county. 
• See the CDC’s infographic outlining these key indicators for schools here.

• How many symptoms does a person need to have to be considered a suspect COVID-19 case?

  • One. Students and staff exhibiting one or more COVID-like symptoms are considered suspect cases and should be immediately isolated, and evaluated. Schools should evaluate each symptomatic student/staff to determine if this symptom is new or if it is part of an existing condition for this student/staff.

• If the sick person has a known condition causing the symptoms, e.g., allergies, migraine, etc., is taken into consideration?

  •  Every symptomatic person should be evaluated by their healthcare provider on a case-by-case basis and decisions to test for COVID-19 should be based on their personal health history. Every new symptom onset should be evaluated. Diagnostic testing is strongly encouraged whenever an individual experiences COVID-like symptoms. There is a possibility of having COVID-19 and other health conditions at the same time. Early diagnosis can aid in preventing further transmission. Individuals who’ve undergone testing should remain home away from others while waiting for COVID-19 test results. 

• If a student or teacher tests positive, with or without symptoms, will we need to close a class or an entire school?
• Not necessarily. Next steps are determined according to local health department guidelines and on a case-by-case basis. Schools/Public health departments will conduct contact tracing to determine who, if anyone, may have had close contact with the person who tested positive and will provide guidance to the school, including whether a school or class closure is recommended. Whenever a positive case is confirmed on campus, the school should perform a thorough cleaning of areas where the person spent time, especially high-contact surfaces. 

• If someone develops symptoms at school that could be COVID-19, what needs to happen? 

• Students who develop symptoms of illness while at school should be separated from others right away, in an isolation room. Any students or staff exhibiting symptoms will immediately don a face covering (if they are not already wearing one) and wait in an the isolation area until they can be transported home and assessed in consultation with their primary care provider. 

• Is there any evidence suggesting that someone is more likely to be asymptomatic if they contracted COVID from an asymptomatic person?
• There is currently no evidence to suggest that someone is more likely to be asymptomatic if they contracted COVID from an asymptomatic person. The virus that causes COVID-19, SARS-COV-2, impacts each person differently and although some people are asymptomatic, there is no evidence currently to assist in predicting if someone will be asymptomatic or symptomatic. In short, the reason some people are asymptomatic and why others are not is unknown. What is known is that some people are at increased risk of becoming more seriously ill than others including older adults and those with underlying health conditions. A recent study of asymptomatic cases was recently published by South Korea, which reveals that some asymptomatic people are actually considered pre-symptomatic, meaning they developed symptoms days later.  

• A kid wakes up with a cough and a fever and the family decides to keep him home from school. The next day, the family reports the child feels fine, no symptoms, and hasn’t had a fever for 24 hours, and no fever-reducing medicine. When can that child come back to school? 

• The CDC recommends anyone with symptoms of COVID-19 isolate for at least 10 days from the onset of symptoms. In this case, the 24 hours of symptoms could indeed be indicators of COVID with quick resolution.
• Our first recommendation is to confirm if your local department of public health has clear guidelines around this. Search on your public health website and school-related policies for phrases such as ‘decision pathways’, ‘exposure management’, ‘return to work’, and ‘return to school’. In lieu of specific guidance at the county or state level, an “abundance of caution” approach would suggest we follow CDC guidelines and isolate the previously-symptomatic individual until criteria for ending home isolation are met. 

• What is the definition of close contact for the coronavirus disease?

  
  

  The CDC defines a close contact as someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.

• How long is the current quarantine period? Didn't the CDC make changes to shorten this?

This will depend on your local health department directives. 

In general, CDC currently recommends a quarantine period of 14 days, so this is the baseline for most health departments currently. On December 2, 2020, the CDC adjusted their recommendations:

Summary of CDC Changes:

• Most effective quarantine period is still 14 days following last date of exposure

• New acceptable alternatives are one of the following:

• 10 day quarantine if no symptoms, with continuity of mitigation strategies (masks, distancing, etc.)
• 7 day quarantine following negative diagnostic test and no symptoms, with continuity of mitigation strategies (masks, distancing, etc.)

• Is testing recommended for close contacts? 
• Yes, testing is recommended for people who have been in close contact with an infected person, but a negative test will not shorten their quarantine period. A test will provide data about whether or not that close contact is themselves infectious, which can be vital to initiate additional contact tracing. 

• If a close contact to a case tests negative for COVID-19 during their quarantine, does their quarantine end, thus allowing them to return to school? 
• No. A close contact to a case must complete their quarantine period regardless of test results. Those who test positive would need to complete isolation criteria based on current guidelines. 

• What is the difference between quarantine and isolation? 
• Isolation and quarantine are measures taken to physically separate people to reduce the risk of spreading the virus. Isolation separates those believed to be able to spread COVID-19 to others – those who have tested positive or have symptoms of COVID-19. Quarantine separates those who are believed to have been exposed to someone with COVID-19 because they are at risk of becoming ill and spreading the virus before symptoms develop. 

• If children are sitting at tables with at least 6 feet of distance between them, with nothing in between them and not wearing masks, would they be considered close contacts if there was a positive case at the table? 
• This is not recommended, but if it is assured that they were at least 6 feet apart, they may not be considered close contact. The CDC has updated their definition of a close contact to include someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period (starting from 2 days before illness onset).

• What is the isolation guidance for someone who is showing signs of COVID-19 and waiting for test results? 
• Someone showing signs of COVID-19 who is awaiting test results should remain in isolation generally either until the test results are determined to be negative, they meet time and symptom-based criteria for release from isolation, or they have a positive test result that was received after more than 10 days. Guidelines for the discontinuation of isolation will be outlined by your local health department, so ensure your policies align with county and state regulations.

• What is the guidance for a student living in a house with someone who has tested positive for COVID-19 and is in isolation? Do household members, including the student, need to quarantine? 
• Students who live in a house with someone positive for COVID-19 and can separate themselves from the infected person will need to quarantine for 14 days since last exposure to the infected person. If they are unable to separate from the infected person in the household, the student will need to quarantine for the entire isolation period of the family member (at least 10 days) plus an additional 14 days to assure they do not develop symptoms. See the CDC Quarantine Calendar to view images that may be helpful in understanding the different lengths of time for quarantine. 

• Can close contacts be grouped in the same classroom instead of excluding them? 
• This is not recommended at this time.

• Would students be considered a close contact to a case if they are seated in their classroom 3 feet apart, not wearing masks, but do have Plexiglass shields surrounding their desk and workspace? 
• Plexiglass shields, similarly to face shields, do not serve as a substitute to mask-wearing. Three-sided Plexiglass shields, if appropriately sized and used so they extend well above each child’s head and have sides that extend well beyond the sides of the child’s head, likely would decrease the risk of virus spread, though this has not been studied. In a situation where students’ desks are at least three feet apart and have appropriate Plexiglass shields between them, when used in combination with mask-wearing, the students might not be considered close contacts, depending on your local health department’s guidelines.

• During cold winter days, what is the guidance for ventilation in classrooms?
  
  

Schools and districts should continue to ensure effective implementation of core mitigation strategies for reducing the risk of transmission of COVID-19 as specified by the Centers for Disease Control and Prevention (CDC): masking, physical distancing, hand hygiene, cleaning and disinfecting, and contact tracing. Additionally, the CDC recommends that schools and districts adopt secondary mitigation strategies, such as maintaining building ventilation systems, to the extent feasible.

Suggestions from the CDC:

• Open windows and doors to the extent the building’s design permits. On cold weather days, keep windows open at least a crack to provide some supply of fresh air. 
• Communicate with your school community that increasing outside air will affect schools’ indoor temperatures. Encourage families and caregivers to send their students to school with plenty of warm layers in winter, as classroom temperatures could fluctuate throughout the day.
• Consider using portable HEPA air purifiers in occupied spaces. 

• For additional guidance on Air Quality decision-making this year, see our page dedicated to this topic here.

• We have a student who will be traveling out of the country.  Should we require a 14 day quarantine? Should we allow them to return to campus if they get tested 7 days after they return from travel?
  
  • Option 1: Require all families who travel out of the country (or even the state) to complete a 14 day quarantine before returning. Testing negative should not end the quarantine early. 
  • Option 2: Require only families who travel to a CDC Level 3 country to quarantine for 14 days. 
  • Option 3: Encourage families to share any major travel plans with the school. Travel outside the county for a day trip to the lake or a family camping trip is a lot different from flying on a plane to another state or country. For that reason, contact the local Dept. of Public Health for each case and ask for their recommendation. 

• Some states/county health departments have created policies around this. Here are a few different ideas to consider: 
• Many schools opt to combine Option 2 and 3. Option 1 can be tricky: Say you require a child to quarantine for international travel when it is not a CDC or local health department requirement. The country they traveled to has minimal COVID-19 transmission. Meanwhile the city your school is in has moderate to high COVID-19 transmission. Why should that child quarantine while all your other children are engaging? It would be essentially arbitrary for the child that traveled to quarantine if the local outbreak is considerably worse -- this decision could possibly lead to discrimination claims. Instead, by contacting the Department of Public Health for each major travel incident, you are able to discuss and get a clear recommendation. Here is some language you could include in your new family policies: “During the COVID-19 pandemic unnecessary or leisure travel may be risky for you, your family, and our community. Families should inform the school of upcoming out of state travel including international travel. The school will work alongside the Department of Public Health to determine if exclusion from school is recommended.”

• For more travel-related questions, see our dedicated FAQ here.

• Is spraying your hands with alcohol better than hand sanitizer? 

• There is no evidence that spraying your hands with alcohol is more effective than hand sanitizer. Spraying alcohol may actually be dangerous, especially around children as it may be sprayed improperly, in the wrong direction, and could linger in the air. Hand sanitizer with at least 60% alcohol is effective when hands are not visibly dirty and soap and water are not available. However, washing hands with soap and water is the MOST effective choice and should be made available across the school.  

• How frequently should restrooms be cleaned for in person learning? We are trying to think through bathroom breaks for kids and janitorial needs?
•  In general, we consider restrooms 'high-touch' areas so would recommend implementing a rotation throughout the day to clean several/multiple times in a day. In addition, you could consider assigning bathrooms, scheduling bathroom breaks, staggering use to limit numbers, limiting occupancy within bathrooms, and/or installing reminders about hand hygiene and mask-wearing while in the bathroom, etc. - all of these things will act as layers of mitigation and risk reduction.
• The CDC has some good information about cleaning and disinfecting.

• Are there special considerations or recommendations regarding the use and disinfection of restrooms in or attached to the classrooms? Does the teacher need to clean it every time it is used? Does the student need to wear a mask while in the restroom?
  • Staff should assure the bathrooms are cleaned and disinfected routinely using disinfectants that are EPA approved against the virus that causes COVID-19, while paying special attention to high-touch areas. Masks should be worn in the bathroom, including single-use restrooms. 

• Does playground equipment need to be cleaned while in use (i.e. every time a different child uses a slide, swing, etc.)? 
• Current studies indicate the risk of catching COVID-19 through touching objects is low. While increased cleaning measures are not harmful, normal and standard cleaning will do for playground equipment.
• Schools should emphasize routine hand hygiene before and after equipment use for more effective prevention, as well as emphasizing mask use, maintaining distancing, and remaining in cohorts as much as is feasible. 

• Other than standard disinfection practices, are there other recommendations regarding shared musical instruments? 
• Schools may consider suspending musical practices and performances that involve singing or playing wind instruments. If such events are held, musicians should be spaced as far apart as possible given the setting; ideally that would be farther than 6 feet apart. Students also should not share mouth pieces and instruments should be cleaned and disinfected between uses if shared among students.
• Some state and county public health departments have specific guidelines around which musical instruments or activities are currently allowed for use, and what the distancing guidelines are during practice. Ensure you review your local school reopening guidelines for specifics about music class and practice.

• What is the guidance around classroom libraries or shared books? Is there a "quarantine" time in between one student using and putting it back in the library or guidance on sharing and disinfecting? If the students share books, how do the books need to be cleaned? 
• Current studies indicate the risk of catching COVID through touching objects is low. While increased cleaning is not harmful, schools should emphasize routine hand hygiene for more effective prevention.
• Studies have shown that, while surfaces may retain virus particles for a period of time, there has been no evidence of the virus surviving past 72 hours. Out of an abundance of caution, some schools have opted for a short ‘quarantine period’ where students can drop used books into a ‘used book bin’ or ‘quarantine bin’ for 24-48 hours (or 72 hours to be more conservative) before being returned to circulation.
• This is a great resource that addresses quarantining books.

• Is it OK for parents to touch schoolbooks or student homework from the school, or should they let it sit for an extended period of time? Do they need to wear gloves to touch students’ books or homework? 
• The level of risk of potential exposure to the virus by touching objects is low, per current evidence, so there is not currently a recommendation to let items sit for an extended period of time. Parents, along with all staff and students, need to maintain good hand-washing practices and avoid touching their faces.

• Can teachers and students exchange paper? Can teachers hand out printed tests and such? Can students turn in written homework and other work?
  • Deciding if work will be completed virtually on devices vs. on paper is a decision that the school should make following careful consideration of how COVID-19 is spread. COVID-19 is spread primarily through person-to-person via respiratory droplets from the mouth and nose. To spread COVID-19 through surfaces such as paper, an infected individual must expel droplets onto the paper and then another individual must touch the paper and then touch their eyes, mouth, or nose. Frequent handwashing and avoiding touching one’s eyes, mouth, or nose can break the chain of transmission.
  • If you are considering using paper worksheets or tests, children should not share paper documents. Some ideas are to give children their own set of worksheets on their desk when they enter in the morning. Rather than having student volunteers pass out paper or send paper to the front, children can walk up and drop off the paper in a designated space to promote physical distancing. Teachers handing out tests should be sure to wash hands before doing so. 
  • If you are considering completing work virtually, students should have designated devices. If students are sharing devices, it presents a similar situation where the device becomes a potential transmitter of the virus. To prevent this, the device should be cleaned and disinfected after each use.

• We will be having our students eat lunch in their classrooms. As of now, they will be wearing their masks all day. Are there any specific guidelines to follow when they remove their masks to eat their meals?
• The CDC recommends eating within classrooms only when 6 feet of distance is maintained between students, and ideally ensuring students are facing in the same direction. Eating outside should be considered when the weather permits. Food should not be shared and all individuals should practice proper hand hygiene before removing masks and eating, and after eating before placing masks back on. Procedures should be implemented to ensure regular tables or desks are wiped down after eating.
• One creative option we’ve seen schools implement is a shorter ‘quiet eating’ period with masks down, followed but a socializing period with masks back on.

• We go into greater detail about Lunch / Food in our "Food and Play" recorded training, available as a part of our "Wings" monthly membership. Find out more about that membership option here.