About a month ago I posted a request for information about guidance for school reopening. See the post here: https://microbe.net/2021/02/06/compiling-information-about-covid19-transmission-masks-filtration-schools-etc/
I spent a while looking at the responses and also soliciting some more and ended up with a few really good documents / sites with information about school reopening. These are
- Schools for Health. From the Harvard TH Chan School of Public Health
- National Academy of Sciences “Reopening K-12 Schools During the COVID-19 Pandemic: Prioritizing Health, Equity, and Communities“
- American Academy of Pediatrics “COVID-19 Planning Considerations: Guidance for School Re-entry
- UCSF CARES in particular Section II: School Reopening: Considerations and Best Practices
- CA Dept. of Education page: Coronavirus Response and School Reopening Guidance
Two PhD students in my lab, Kate Lane and Alonna Wright then went through these documents and wrote up a summary of the guidance from these different places and where they agrees with each other in particular. I thought it would be useful to share this here.
Note – these documents and guidance are mostly from 2020 and do not really take into account new information about at the airborne nature of the SARS-CoV-2 virus or about the variants that are spreading globally. But I still think it is useful to see what these documents recommend.
Summary of Guidance on School Reopening
(Note from Jonathan Eisen – the guidances we used here did not really take into account important findings about aerolsolization of the virus and the need for significant attention to ventilation and filtering. But other than that, most of the guidance in these documents seems pretty sound). I will add more about ventilation and filtering soon.
by Kate Lane and Alonna Wright
Policies
- Case monitoring: Monitor and evaluate epidemiological data iteratively to assess disease activity in community based on number of new cases, ICU capacity, and mortality. Schools monitor absenteeism and alert public health officials to any large increases.
- Local task force with school district to include input from school staff, families, local health officials, other community interest to inform decisions
- Support: Schools should continue to provide access to meal programs, health care, and mental health services (including mental health services to staff) even in the event of a school closure.
- Communication and education with teachers, students, community on policies and updates as well as proper use of PPE: removal, washing of face coverings, and handwashing.
Mitigation Practices and PPE
- Masks: All people over the age of 2, who are able to, should wear double layered cloth face coverings, that are freely provided for those who need them.
- Social Distancing: Maximize physical distancing when possible. Ideally 6ft apart, 3ft apart when 6ft is not possible.
- Hand Hygiene: Encourage hand washing and sanitation, and provide facilities and materials to enable this.
- Cohorting: Establish stable cohorts of students and staff that remain in a single room all day. If rotation of staff is needed, rotate the staff between rooms rather than students.
- Limit Overcrowding: Stagger start and end times of cohorts’ school days to limit traffic and avoid overcrowding in halls and entrances. No guests or outside visitors allowed access to campus buildings.
- Meal Times: Provide meals in well ventilated classrooms or outdoors if possible. When meals must be served in a cafeteria, establish staggered meal times with assigned seating 6ft apart.
- High droplet activities: Some reports state not to allow any high droplet activities (singing, exercise, sports) due to high risk, others suggest that they may be done safely outdoors with 15-20ft of distance, a single cohort at a time.
Buildings
- Cleaning: Eliminate high touch surfaces when possible. Frequently sanitize remaining high touch surfaces with EPA approved disinfectants at least daily, or as frequently as possible.
- Ventilation: Utilize outdoor spaces when possible for instruction, recreation, and meal times. Ensure and verify ventilation and air filtration. MERV-13 recommended for HVAC systems.
- Isolation Space: If a student or staff become symptomatic at school, have supervised and comfortable isolation space until arrangements for pick up can be made.
Testing, Contact Tracing, and Quarantining
- Symptom Screening: Symptoms should be self-reported electronically before the start of each school day, rather than school-facilitated daily symptom screenings, such as temperature checks.
- Testing
- COVID tests should be freely available to symptomatic and potentially exposed individuals, without discrimination and regardless of insurance or documentation status
- Sequential testing of a portion of the asymptomatic population, with an emphasis on adult staff, is advised rather than universal testing of every student and staff member.
- Testing must be combined with contact tracing and quarantining for effective mitigation.
- Contact Tracing: Schools are encouraged to partner with local health officials to facilitate contact tracing and notification to potentially exposed individuals.
- Quarantining: Exposed individuals should quarantine at home for 14 days if feasible, but 10 days from last exposure or 7 days from last exposure + negative test 5 days after exposure can be used to decrease burden.
- Plans for COVID-positive cases:
- Develop plans to provide resources to individuals who test positive, including notification of potential exposures through contact tracing, continuity of meal programs, and follow-up testing.
- Develop plans in the event of a large outbreak leading to a school closure, ensure continuity of education, medical, and social services, and meal programs.