9 School Manual CORONAVIRUS UTAH.GOV . I I . 9( UTAH DEPARTMENT OF -- I LT22: LOCAL HEALTH DEPARTMENTS HEALTH l; J. 3 Responding to COVID-19 in your school There are many things to think about as schools reopen during the pandemic. Schools are not only a place of learning for students, but workplaces for teachers and employees. Decisions about how to respond to COVID-19 in schools will be made to protect both the immediate and long-term health and safety of students, teachers, and employees. The goal of the Utah Department of Health (UDOH) and Utah’s 13 local health departments is to provide a safe learning environment for students and a safe workplace for teachers and employees. COVID-19 spreads very easily and quickly. Even if you are doing everything right, your school may see cases of COVID-19. The more people a student, teacher, or employee interacts with, and the longer that interaction is, the more likely COVID-19 will spread in your school. The spread of COVID-19 in your community will also impact your school. The two most important things you need to know are: 1. What to do if a student, teacher, or employee is exposed to COVID-19 or tests positive. 2. How to make a healthy learning environment and protect your school. COVID-19 is a new disease. We learn more every day about COVID-19 and the best ways to stop it from spreading. We know this can make it very hard for school administrators, teachers, employees, and families to know what to do. This manual provides public health recommendations to help you make informed decisions about how to protect your school and prevent the spread of COVID-19. Guidelines may change as we learn more about COVID-19. Schools and public health need to be willing to adapt to these changes as we learn more about the best ways to keep students, teachers, and employees safe and schools open for in-person learning. 1 Table of Contents COVID-19 School Manual This manual contains the entire collection of COVID-19 school handbooks from the Utah Department of Health and Utah’s 13 local health departments. Administrators can use the manual in its entirety or use each handbook as a stand alone resource to provide guidance for appropriate personnel. Table of contents Responding to COVID-19 in your school • Part 1: Schools are essential to our communities • Part 2: COVID-19 in a school setting • Part 3: Keeping your school open if a student, teacher, or employee is exposed to or tests positive for COVID-19 • Part 4: Testing students, teachers, and employees for COVID-19 Prevent the spread of COVID-19 in your school • Part 1: Create a healthy learning environment • Part 2: Cleaning • Part 3: Considerations for schools as employers COVID-19 outbreaks in schools and school closures 2 Table of Contents Responding to COVID-19 in your school Part 1: Schools are essential to our communities • The education sector and decision making process for schools. • Why is it important to open schools for in-person instruction? • Everyone must help to prevent the spread of COVID-19 in our schools. Part 2: COVID-19 in a school setting • What do we know about COVID-19 and children. • Symptoms of COVID-19. - Screening students for symptoms of COVID-19. - How do parents know if their child should get tested for COVID-19? - What to do if a student gets sick at school. • Students, teachers, and employees who are at higher risk. • Privacy laws and how student, teacher, and employee information will be protected. Part 3: Keeping your school open if a student, teacher, or employee is exposed to or tests positive for COVID-19 • What happens if a student, teacher, or employee tests positive for COVID-19? - Contact tracing in schools. • What is the difference between quarantine and isolation? • How long do students, teachers, and employees have to isolate at home? • Your school needs to be prepared for times students or teachers must isolate at home. • Scenario examples when someone tests positive for COVID-19. - A teacher tests positive for COVID-19. - A student tests positive for COVID-19. - A student on a school sports team tests positive for COVID-19. • What happens if a student, teacher, or employee is exposed to someone with COVID-19? - Contact tracing in schools. • Point of Contact (POC). • What does a close contact exposure mean in a school setting? • Schools will determine close contact exposures. - Understanding the date of exposure. - Questions the POC may need to ask to find out who was exposed to COVID-19 at school. • How long do students, teachers, and employees have to quarantine? • Scenario example: How to determine when someone can end quarantine. • Students who have an exposure to COVID-19. • Will students be quarantined every time they have a close contact exposure at the school? 3 Table of Contents Part 3: Keeping your school open if a student, teacher, or employee is exposed to or tests positive for COVID-19 (continued) • Teachers or employees who have an exposure to COVID-19. • Extracurricular activities and COVID-19. - If a student who participates in school activities, sports, or clubs tests positive for COVID-19, will the whole group, team, or club be quarantined? - Why can students go to school during quarantine, but not participate in other activities? - What precautions can we take to make sure students are able to participate in school activities, sports, and clubs? • Safety precautions for students, teachers, and employees who have been exposed to someone with COVID-19. • What happens if students, teachers, or employees are exposed to COVID-19 more than once? • Scenario examples of when someone is exposed to COVID-19. - Students who are at higher risk for severe illness from COVID-19 are exposed to someone at school who tested positive for COVID-19. - A student is exposed to someone in his personal life who tests positive for COVID-19. - A school employee is exposed to someone in his personal life who tested positive for COVID-19. Other employees are able to do his job while he quarantines. - A school employee is exposed to someone in her personal life who tested positive for COVID-19. There are no other employees who can do her job while she quarantines. - A school employee lives with someone who was exposed to COVID-19, but the school employee was not exposed to the person who tested positive. - A student has a family member who was exposed to someone who tested positive for COVID-19, but the student was not exposed to the person who tested positive. Part 4: Testing students, teachers, and employees for COVID-19 • Is testing for COVID-19 free? • What are the types of COVID-19 tests? 4 Table of Contents Prevent the spread of COVID-19 in your school Part 1: Create a healthy learning environment • Attendance policies for students. • Prepare your school for in-person learning. • Engineering and ventilation controls. • Find risks in your school. - Training. - What is a COVID-19 hazard? - The 4 health behaviors everyone should practice in your school. - Creating a hazard assessment for your school. - Assess the risk in each space. - Sample hazard assessment of student drop off and pick up. hat are the hazards in the sample assessment of drop off and pick up areas? How can drop off and pick up areas °W be modified to reduce the chance a student, teacher, or employee will be exposed to COVID-19? • Ideas to prevent close contact exposures, reduce hazards in the school or workplace, and make your learning environment healthier: - Cafeterias - Classrooms - Drop off and pick up - Face coverings - Hygiene practices and symptom checking - Large group gatherings (such as assemblies and performances) - Recess and playground - Restrooms - School courses that would increase the risk of exposure - Special education, related services, or school counseling (school psychologist, speech language pathologist, etc.) - Transitions - Transportation - Visitors, volunteers, and non-regular employees Part 2: Cleaning • Regular school cleaning to prevent COVID-19. • Cleaning after a positive case of COVID-19. Part 3: Considerations for schools as employers • Sick leave. • Travel. • Help your students, teachers, and employees. • Helpful resources. 5 Schools are essential to our communities. Most people who are exposed to COVID-19 are asked to quarantine for 14 days. There are certain situations where employees who have been exposed to COVID-19 may need to keep working until they get sick or have symptoms of COVID-19. These are employees with jobs in sectors that are critical to the state being able to get essential services to all Utahns. ! In Utah, we consider the education sector critical to the long-term health and economic success of our state. We recommend students, teachers, and other employees who work in the education sector follow the quarantine and isolation guidelines for essential or critical infrastructure sectors. This means public health has modified quarantine guidelines for students, teachers, and employees who are exposed to someone who tests positive for COVID-19. This does not mean students, teachers, and other employees who work in the education sector do not need to isolate or quarantine if they test positive or are exposed to COVID-19. Parents may choose to send their child to school during quarantine if their child does not have any symptoms of COVID-19. Teachers and employees at the school may also go to work during quarantine if their employer allows it. This is called modified quarantine for schools. Students are not allowed to participate in extracurricular activities while on modified quarantine. If a student, teacher, or employee tests positive for COVID-19, he or she will not be allowed to go to school or work until the health department has cleared them from isolation. Who is considered part of the education sector? • Students • Teachers • Employees • Paraprofessionals • School nurses • Volunteers 6 Who is involved in the decision making process for schools? There are many people and organizations involved in the plans for reopening schools. • Utah State Board of Education (USBE) • State and local health departments • Local education associations (school districts and charter schools are also known as LEAs) • State and local government officials • School administrators • Parents • Eligible students (students who are 18 years old or students of any age who have taken postsecondary classes) • Teachers • Employees who work in the education sector 7 Why is it important to open schools for in-person instruction1? Schools play an essential role in the infrastructure and well-being of our state and our communities. Schools provide safe and supportive environments. • When they are in school, children benefit from important routines, structure, and support services. • Schools are essential for the economic health of communities. Schools give jobs to teachers and other employees and allow parents, guardians, and caregivers to be able to work. • Schools provide critical psychological, mental and behavioral health (psychological counseling, mental and behavioral assessment) services to children who may not have access to these services outside of school. Schools provide critical instruction and academic support that benefit students and communities in both the short- and long-term. • Schools provide age-appropriate instruction and support students’ academic development. • In-person instruction allows teachers and students to communicate better. It also provides students with critical academic services which are not always available or accessible if students are not in school. Some examples of these services are school-based tutoring, special education, and other specialized learning supports. 1 https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/prepare-safe-return.html 8 Students benefit from the interpersonal interactions they get in school. • Social interaction for children in grades K-12 is important not only for emotional wellbeing, but also for children’s language, communication, social, and interpersonal skills. • Schools provide part of children’s foundation for socialization. When children are out of school, they may be separated from their social network and peer-to-peer social support. • Teachers are able to more actively participate in student learning and provide feedback. • In-person instruction may be even more important for students with more learning needs. Children with disabilities may not have virtual access to the support they need, such as specialized instruction, related services, or any additional support required by their Individualized Education Programs (IEPs) or 504 Plans. • Students may also not have access virtually to quality English Language Learning (ELL). When schools are closed to in-person instruction, disparities in educational outcomes could become wider. • Some families may not be able to fully participate in distance learning because of computer and internet access issues or lack of support due to parent, guardian, or caregivers’ work schedules. Families may rely on school-based services that support their child’s academic success. • The achievement gaps which existed before COVID-19 closures, such as disparities across income levels and racial and ethnic groups, could get worse and cause long-term effects on children’s educational outcomes, health, and the economic wellbeing of families and communities. • Students who rely on key services, such as school food programs, special education and related services (speech and social work services, occupational therapy), and after school programs can’t access these programs and services when school buildings are closed. • Students are put at greater risk for poor health and educational outcomes. For more information about reopening schools around the world, visit https://www.cdc.gov/coronavirus/2019-ncov/community/schoolschildcare/prepare-safe-return.html. 9 Everyone must help to prevent the spread of COVID-19 in our schools. Students should: • Tell their parents or teacher if they feel sick or have symptoms of COVID-19. • Stay home from school and other activities if they feel sick or have symptoms of COVID-19. • Stay home from school and other activities (called isolation) if they test positive for COVID-19. • Follow the quarantine guidance if they are exposed to someone with COVID-19. • Wear a cloth face covering or mask at school. • Practice physical distancing as much as possible. • Wash their hands with soap and water often. Parents should: • Check their child for symptoms of COVID-19 every day before school. • Take their child’s temperature every day before school. If their child has a temperature of 100.4º F (38º C) or higher, the child has a fever. If parents do not have a thermometer, they should check their child’s skin to see if it feels warm or is red, or ask if he or she have chills or are sweaty. • Keep their child home from school if he or she feels sick or has symptoms of COVID-19. • Follow the quarantine guidance if their child or anyone who lives in their home is exposed to someone with COVID-19. • Before the school year starts, tell the school if their child has a health condition that puts him or her at a higher risk for severe illness from COVID-19. The health department will call parents of students who are at higher risk for severe illness from COVID-19 if they are exposed at the school. • Review and update their child’s plans (Individual Healthcare Plan, Individualized Education Plan, 504 plan) with the school. • Help their child clean his or her cloth face covering or mask. Teachers and employees should: • Stay home from school or work if they feel sick or have symptoms of COVID-19. • Follow the isolation guidance from the health department if they test positive for COVID-19. • Follow the quarantine guidance if they are exposed to someone with COVID-19. • Understand privacy laws and how these laws relate to any information the school is given by the health department. • Tell their employer if they have a health condition that puts them at higher risk for severe illness from COVID-19. • Provide a safe learning environment for students by following their school plan for reopening. • Prepare curriculum plans in case they have to isolate or quarantine. • Encourage students to wash their hands with soap and water often. • Wear a cloth face covering or mask at school. • Practice physical distancing as much as possible. 10 School administrators should: • Decide who the COVID-19 point of contact (POC) will be at the school. The POC will work with the health department on contact tracing in the school. It is a good idea for schools to have several employees who are trained as backups for this role. Provide any needed support or equipment to the POC so he or she can work with the health department on contact tracing. • Understand the privacy laws that protect student, teacher, and employee personally identifiable information (PII). • Make sure all teachers, employees, and the school POC understand privacy laws and how these laws relate to any information the school is given by the health department. This includes privacy laws that protect students, teachers, and employees. • Write a plan for how to reopen the school and prevent the spread of COVID-19. • Provide a safe learning environment for students, teachers, and employees. This includes considering their emotional and social needs. • Write a plan that addresses the needs of students, teachers, and employees at higher risk for severe illness from COVID-19. This plan may include how the school will handle parent requests for alternative learning arrangements, remote learning, and work re-assignments. • Review plans (Individual Healthcare Plan, Individualized Education Plan, 504 plan) for students with special healthcare needs with the student’s parents and update care plans to help lower the risk of exposure to COVID-19 in the school. • Provide resources to parents and students who choose or need to continue remote learning. • Wear a mask at school and work. Point of contact (POC) at each school should: • Work with the local health department and school administrators to identify students, teachers, and employees who may have been exposed to someone with COVID-19 in the school. • Provide a list of students, teachers, and employees who are at higher risk for severe illness from COVID-19 to the health department when there is an exposure at the school. The health department will call parents of students, teachers, and employees who are at higher risk of severe illness from COVID-19 if they are exposed at the school and to tell them what to do.. • Understand privacy laws and how these laws relate to any information the school is given by the health department. This includes privacy laws that protect students, teachers, and employees. • Protect the privacy of the student, teacher, or employee who tests positive or is exposed to someone with COVID-19 as much as possible. • Notify the parents of students, eligible students, teachers, and employees if they have been exposed to someone with COVID-19 in the school. • Provide guidance on when and how to quarantine, check for symptoms, and when to get tested. • Work with school administrators to prevent the spread of COVID-19 in the school. 11 Health departments should: Health Department • Call students, teachers, and employees who test positive for COVID-19. • Protect the privacy of the student, teacher, or employee who tests positive or is exposed to someone with COVID-19 as much as possible. • Conduct a case investigation to find out if a person who tests positive was at school up to 2 days before he or she got sick or tested positive. • Provide isolation guidance to students, teachers, and employees who test positive for COVID-19. • Work closely with the POC and school administrators on contact tracing in the school. • Get a list of students, teachers, and employees who are at higher risk for severe illness from COVID-19 from the POC. • Call students, teachers, and employees who are at higher risk for severe illness from COVID-19 who were exposed. • Provide quarantine guidance to students, teachers, and employees who are at higher risk for severe illness from COVID-19, as well as anyone living with a person who tests positive for COVID-19. • Tell the POC at the school the names of students, teachers, or employees who have tested positive for COVID-19. • Notify the POC when the student, teacher, or employee is no longer under isolation and can return to school. • Provide guidance to the POC and school administrators on how to prevent the spread of COVID-19 in the school. Community members should: • Everyone should wear a face covering when they can’t physical distance. • Stay home if you are sick. • Get tested if you have symptoms of COVID-19. • Follow quarantine and isolation guidelines if you test positive for or are exposed to COVID-19. • Consider volunteering with community organizations to help families in your community without the resources necessary to quarantine or isolate. • If you are an employer, follow the recommendations in the COVID-19 Business Manual to protect your employees and reduce the risk of exposure in your business. 12 What do we know about COVID-19 and children2? The science available right now suggests children are less likely to get COVID-19 than adults. When children do get COVID-19, they usually have a less serious illness. Reports suggest there are different things that affect the number of children who get COVID-19, such as age and other factors. • Adolescents aged 10-17 may be more likely to become infected with COVID-19 than children younger than age 10. However, adolescents do not seem to be at higher risk of getting severe illness from the virus. • Children and adults with certain health conditions are at increased risk of severe illness from COVID-19. Severe illness means they may need to be in the hospital, intensive care, need a ventilator to help them breathe, or may even die. • Children with intellectual and developmental disabilities are more likely to have additional health conditions that put them at increased risk for severe illness from COVID-19. • Although rare, some children have developed multisystem inflammatory syndrome (MIS-C) after exposure to COVID-19. According to the Centers for Disease Control and Prevention (CDC), as of May 20, 2020, most of the children hospitalized with MIS-C had recovered. 2 https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/prepare-safe-return.html 13 Symptoms of COVID-19 If students, teachers, or employees have any of the 6 symptoms of COVID-19, which make them eligible for testing, they should call a healthcare provider and get tested for COVD-19, even if the symptom is mild. Testing locations can be found at https://coronavirus.utah.gov/testing-locations. Even if they don’t have symptoms, students, teachers, and employees need to be very careful and take precautions at school because many children and adults may be asymptomatic. This means they have no signs or symptoms of the virus but can still spread it to others. If you can’t do a temperature check on a student, teacher, or employee, ask the person if he or she is feeling feverish (the person’s skin may feel hot or be red, or he or she may have chills or be sweaty). Fever Cough Decrease in sense of smell or taste Sore throat (temperature of 100.4°F or 38°C or higher or feeling feverish) Shortness of breath Muscle aches and pains Visit the Centers for Disease Control and Prevention (CDC) website to find out other symptoms that may be associated with COVID-19. 14 Screening students for symptoms of COVID-19 There are many illnesses with symptoms like COVID-19, especially in children. Students with chronic health conditions like asthma or allergies may have a cough or runny nose without being infectious. Researchers have not found a single symptom or set of symptoms, that are only seen in children diagnosed with COVID-193. Students, teachers, and employees who are sick should not go to school. This is a good idea for any illness, not just during the COVID-19 pandemic. It is important to have school policies that encourage and support students, teachers, and employees to stay home when they are sick. This will help keep schools open for in-person learning. However, if students stay out of school for longer than necessary as outlined in your policies (for example, being fever-free for 24 hours without medicines) based on COVID-19 symptoms alone, it may lead to unnecessary student absences. 3 https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/symptom-screening.html 15 How do parents know if their child should get tested for COVID-19? Children who are sick at all should not go to school. Parents should check students for symptoms of COVID-19 every day before school. This quick assessment can help parents check for symptoms of COVID-19. It is not meant to replace any advice from a healthcare provider. If at any time a parent has questions about their child’s health, they should seek advice from a healthcare provider. If your child has a health condition that puts him or her at higher risk for severe illness from COVID-19, you should call a doctor or healthcare provider for advice. Part 1: Symptoms Does your child have any of these symptoms? • Fever or temperature of 100.4º F (38º C) or higher. If you do not have a thermometer, check your child’s skin to see if it feels warm or is red, or ask if he or she has chills or is sweaty. • Sore throat • Cough - if your child normally has a cough because of allergies or asthma, is this cough different than normal? • Shortness of breath • Muscle aches or pains • Decrease in sense of smell or taste Yes, my child has at least 1 of those symptoms. No, my child is sick, but does not have any of the symptoms listed above. If you answered YES, move on to part 2. You answered NO, your child does not have one of the 6 eligible symptoms of COVID-19 for testing. Follow your school’s sick policy. Most likely this will mean to keep your child at home until he or she has been fever-free (for 24 hours without medicine) and has not had any symptoms of sickness for 24 hours. If your child does not seem to be getting better, or is getting worse, your child should see a doctor right away. Part 2: Has your child been exposed to COVID-19? Has your child been in close contact to someone who tested positive for COVID-19, in the last 2 weeks (14 days)? This means he or she was closer than 6 feet or 2 meters (about 2 arm lengths) to the person for 15 minutes or longer. If your child came into close contact with someone at school who tested positive for COVID-19, the school or health department would have likely notified you and asked that your child quarantine. YES NO If you answered yes to any questions in both parts 1 and 2, Your child has one or more symptoms of COVID-19 but was not you should call a doctor or healthcare provider right away. Your in close contact with someone who tested positive. child may need to get tested for COVID-19. You should call a healthcare provider to find out if your child Your child should not go to school until he or she has seen a should be tested for COVID-19. doctor or healthcare provider because your child was in close contact with someone who tested positive for COVID-19. 16 What to do if a student gets sick at school Some students may get sick when they are at school. Schools should isolate students who get symptoms of COVID-19 from other students, teachers, and employees. Work with your school nurse to designate the areas you will need to respond appropriately to sick students in your school. Consider having 3 separate areas for students if possible. • Sick area (for students who get sick or hurt at school, but do not have symptoms of COVID-19). • Well student area (for students with scheduled medical needs, such as students who receive insulin or medication at school). • Isolation area (for students who have symptoms of COVID-19. This should be separate from other students). Separate students who have symptoms of COVID-19 from other students, teachers, or employees to an isolation area: • The student should stay in a separate room (like a sick room in the office) and away from other students. • Call the student’s parents and ask them to come pick up their child from school right away. • If the student’s parents are unable to get their child before school ends, and the student must ride a school bus home, everyone on the bus should wear a mask and physical distance as much as possible. • Any rooms the student was in for 15 minutes or more should be cleaned using the cleaning guidelines starting on page 85. • Schools will decide which PPE (such as a mask or gloves) employees (paraprofessionals, teacher aides, school health staff ) who help or interact with students who get sick at school need. Employees who come into close contact with sick students should wear the PPE recommended by their school. 17 Some students, teachers, and employees may be at higher risk for severe illness from COVID-19 People of any age with the following conditions are at increased risk of severe illness from COVID-19: • Cancer • Chronic kidney disease • COPD (chronic obstructive pulmonary disease) • Immunocompromised (weakened immune system) from solid organ transplant • Obesity (body mass index [BMI] of 30 or higher) • Serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies • Sickle cell disease • Type 2 diabetes Based on what we know now, people with the following health conditions might be at increased risk for severe illness from COVID-19: • Asthma (moderate to severe) • Cerebrovascular disease (a disease which affects blood vessels and blood supply to the brain) • Cystic fibrosis • Immunocompromised state (weakened immune system) from blood or bone marrow transplant, immune deficiencies, HIV/ • AIDS, use of corticosteroids, or use of other immune weakening medicines • High blood pressure or hypertension • Liver disease • Neurologic conditions such as dementia • Pregnancy • Pulmonary fibrosis (having damaged or scarred lung tissues) • Sickle cell disease • Thalassemia (a type of blood disorder) • Type 1 diabetes i Children who have special health care needs or are medically complex are also at higher risk for severe illness from COVID-19. These children may have neurologic, genetic, or metabolic health conditions or a congenital heart disease. Smoking may also increase the risk of severe illness from COVID-19. For more information on who may be at higher risk for severe illness from COVID-19 and what precautions these individuals should take, visit https://www.cdc.gov/coronavirus/2019-ncov/ need-extra-precautions/people-with-medical-conditions.html. 18 Privacy laws and how student, teacher, and employee information will be protected As schools reopen, it is important to make sure administrators, employees, and parents understand privacy laws and how they apply during the COVID-19 pandemic. What laws protect student, teacher, and employee privacy? Public health laws COVID-19 is reportable by law, under Utah Code Annotated § 26-6-1 et seq., the Utah Communicable Disease Control Act, and Utah Administrative Code R386-702 Communicable Disease Rule, to the Utah Department of Health or the local health department in the health district where the individual lives. This means a person’s COVID-19 test results must be reported to public health by the provider or testing location where the person was tested. A person’s test result is considered private health information and is kept confidential by public health. Public health agencies are allowed, by law, to disclose the name of a person who tested positive to a school if it is necessary to protect the health and safety of students, teachers, and employees. The information that is disclosed by the health department to the school is strictly confidential and protected under Utah Code § 26-6-27. EDUCAT IONAL RECORD If the information is about an employee, Utah Code § 26-6-27 continues to protect the privacy of the information even after it is shared with the school’s point of contact (POC). The POC must maintain the confidentiality of the employee while acquiring information necessary to assist the health department to contact others who may have been exposed. The POC must emphasize the importance of not re-disclosing the information to anyone else and that all notifications will be made by the POC or the health department. If the information is about a student, the information, once shared with the POC becomes protected by FERPA. The POC must ensure that this information remains confidential and is shared only with those who have a need to know to assist the POC in carrying out the responsibility to notify others who may have been exposed. The POC must emphasize the importance of not re-disclosing the information to anyone else and that all notifications will be made by the POC or the health department. 19 The POC and the school officials cannot release the private health information disclosed by public health under any circumstances. This includes the name of the person who tested positive for COVID-19. The POC may need to share the identity of the person who has tested positive for COVID-19 with other school officials to determine the identity of individuals who have been in close contact with the person who has tested positive for COVID-19 and the risk level of those individuals. This must be limited to the least number of school officials possible and each must be notified that the information is confidential and cannot be redisclosed or shared with anyone else. Other laws schools need to consider There are other laws that protect the privacy of students, teachers, and employees. Schools are responsible to work with their legal counsel to understand these laws and how they apply during the COVID-19 pandemic. Schools must follow all regulatory requirements and governing structures that apply to an educational setting. Some of these laws may include: • Family Educational Rights and Privacy Act (FERPA) • Utah Code Annotated § 53E-9-101 et seq., Student Privacy and Data Protection • State and federal labor laws CONFIDENTIAL There are very few circumstances when the name of an individual who tested positive for COVID-19 may be released. If this situation were to occur, the determination to release this information and to whom it may be released will be made on a case-bycase basis by the local health officer. The Family Educational Rights and Privacy Act (FERPA4) is a federal law that protects the privacy of student education records. FERPA gives parents certain rights about their children’s education records. When a student turns 18 years old or if a student attends a postsecondary institution (such as a college) at any age, the student becomes an “eligible student.” This means the student, not the parent, becomes the only person who has rights to the student’s educational record. In some cases, FERPA information can still be provided to the parents of eligible students without a written consent. CONSENT FERPA says that in most cases, a parent or eligible student must give his or her written consent, or permission, before a school can give out any personally identifiable information (PII) from an education record. 4 https://studentprivacy.ed.gov/sites/default/files/resource_document/file/FERPA%20and%20Coronavirus%20Frequently%20Asked%20Questions.pdf 20 Personally identifiable information (PII) • This is information that can be used to identify who a student is, such as a student’s name or identification number. •P II includes information that directly or indirectly identifies a student. This means PII does not just include information that has a student’s name on it. If someone can use a piece of information that does not say who the student is, with a different piece of information, and is able to link the pieces of information together to know who the student is, all of the information is considered to be PII. i Under FERPA, a school is allowed to disclose student PII to the health department on a case-by-case basis if it is necessary to protect the health and safety of the student or others, without the written consent of an eligible student or parent or guardian. The United States Department of Education oversees FERPA and has published Frequently Asked Questions (FAQs) regarding FERPA and COVID-19 which is linked within this document and may be consulted for more information in addition to specific guidance by a school’s legal counsel. What information can a school disclose when someone in the school tests positive for COVID-19? A school may disclose that someone at the school tested positive for COVID-19, as long as the facts alone or in combination with other information released, do not identify the person. The school may not publicly release the PII of the student such as the student’s name or whether they tested positive for COVID-19. 21 Keeping your school open if a student, teacher, or employee is exposed to or tests positive for COVID-19 COVID-19 is spreading in many Utah communities. This means students, teachers, and employees are likely to be exposed to COVID-19 in their personal lives. It’s also likely that they will be exposed to someone with COVID-19 multiple times during the school year. It is important everyone do their part to help slow the spread of COVID-19 so schools can remain open. If you follow public health guidance, you are more likely to keep students, teachers, and employees safe and your school open for in-person learning. If one of your students, teachers, or employees tests positive for COVID-19, it does not mean he or she did anything wrong. It also does not mean your school did anything wrong. If you have questions about what to do after a student, teacher, or employee is exposed to COVID-19 or tests positive, call your local health department. You can find your local health department at https://ualhd.org/. If a student, teacher, or employee tests positive for COVID-19, does the school need to close? No. In most cases, schools do not need to close for in-person learning. Schools may consider hybrid or remote learning options to protect students, teachers, and employees. Local education agencies (LEAs) should work closely with the local elected school board and the health department before making the decision to temporarily transition to hybrid or remote learning options. Only when the school can’t provide a safe learning environment will the school need to consider temporary remote learning or closure. This might happen if there is an outbreak in a classroom or at the school and too many students, teachers, or employees are sick to provide the necessary services to keep the school open. Local education agencies (LEAs) should work closely with the local elected school board and the health department before making the decision to temporarily move to remote learning or closing a school due to COVID-19. 22 What happens if a student, teacher, or employee tests positive for COVID-19?  If a student, teacher, or employee tests positive for COVID-19, he or she should isolate right away. This means the person needs to stay at home and away from other people as much as possible. The student, teacher, or employee should not go to school or work. People who have been in close contact with someone who tests positive for COVID-19 are at an increased risk of getting infected and infecting others. Close contact means someone was closer than 6 feet or 2 meters (about 2 arm lengths) to a person who has COVID-19 for 15 minutes or longer. Contact tracing is how public health workers find the close contacts of someone who has COVID-19. Case investigation and contact tracing in schools (K-12) 2020-2021 LHD monitors isolated individual and notifies school POC when individual testing positive has been cleared to return to school Local Health Department (LHD) conducts disease investigation Tasks prior to school opening • LHD issues isolation notice for the individual testing positive • Provide contact information for each POC to the LHD • Quarantine notices may also be issued to other individuals in the same household • Compile a list of high-risk individuals within each school School POC notified about positive case and other related household contacts School ensures/increases preventative measures to slow the spread of COVID-19 following individual school’s plan, as outlined in USBOE handbook Key: Local Health Department (LHD) School POC complies list of high-risk contacts and provides list to LHD LHD contacts high-risk individuals & their parent/guardian(s) to provide education & assist families in making informed decisions to protect their student • Identify a POC for each school School POC compiles list of others potentially exposed at school School POC sends informational letter education packet to all individuals identified as being potentially exposed, including information on self-monitoring & when to get tested for COVID-19 Release of positive individual Action for exposed individual School Point of Contact (POC) High-risk individuals self-monitor for symptoms & get tested for COVID-19 if needed Individuals self-monitor for symptoms & get tested for COVID-19 if needed LHD conducts additional investigation(s) if needed 23 Contact tracing in schools Each school should have a COVID-19 point of contact (POC). The POC works with the health department on contact tracing. The POC will notify eligible students, parents, teachers, and employees if they were exposed to COVID-19 at school. 1 People who are tested for COVID-19 will get their test results from the healthcare provider or testing location where their sample was collected. 2 T he health department will call anyone who tests positive for COVID-19. It may take a few days for the health department to call the person who tested positive. They will ask the person who he or she may have been in close contact with up to 2 days before he or she got sick or tested positive. 3 T he health department will notify the POC at the school if a student, teacher, or employee who works in the school or with students tests positive for COVID-19. The health department gives the name of the person who tested positive and the date of last exposure to the POC. 4 T he POC collects and provides a list to the health department of students, teachers, or employees who are at higher risk for severe illness from COVID-19 known to have come into close contact with the person who tested positive. The health department will notify the parents of students, teachers, or employees who are at higher risk and provide guidance on how long they should quarantine, how to check for symptoms, and when to consider testing. 5 T he POC will notify any other eligible students or students’ parents, teachers, or employees who may have been exposed to the person who tested positive. The POC will provide guidance on how long they should quarantine, how to check for symptoms, and when to consider testing. In most cases, the school may only notify the parents of an eligible student (a student who is 18 years old or a student of any age who has taken postsecondary courses) if the eligible student has signed a written consent. There are some situations where parents of eligible students will be notified without a written consent. 6 Only students, teachers, or employees who came into close contact with the person who tested positive will be notified of a possible exposure. 24 What is the difference between quarantine and isolation? Quarantine is for people who may have been exposed to COVID-19, but aren’t sick yet. Isolation is for people who are sick or who have symptoms of COVID-19. Quarantine You may be asked to quarantine for 14 days if you were exposed to COVID-19. This means you were in close contact with someone who has COVID-19. Close contact means you were closer than 6 feet from someone who has the virus for 15 minutes or more. Quarantine keeps you away from others so you don’t infect someone else without knowing it. Symptoms of COVID-19 may appear 2-14 days after exposure. This is why you will be asked to quarantine for 14 days if you are exposed to COVID-19, because it can take 14 days for you to get sick. If you are asked to quarantine, you should stay in your home and not go around other people as much as you can. i Modified quarantine for schools In Utah, students, teachers, and employees who work in the education sector who are exposed to COVID-19 may follow the same quarantine guidelines for essential or critical infrastructure settings. This means parents may choose to send their child to school during the 14-day quarantine. Teachers and employees may continue to work during quarantine if their employer allows it. However, if a student, teacher, or employee lives with someone who tested positive (called a household contact), he or she will not be able to go to school or work during the 14-day quarantine. If you get sick or have symptoms of COVID-19 while on quarantine, you should isolate and call a healthcare provider right away. You should be tested for COVID-19. 25 Isolation 24 Fever Free for If you have symptoms of COVID-19 or tested positive, you must isolate. This means you stay at home except to get medical care. If you tested positive for COVID-19, you must isolate until you are fever-free for 24 hours and it has been at least 10 days since you first got sick or tested positive. This means you did not use medicine to lower your fever. AND Hours 10 At least Days Without Medicine If you are sick or have tested positive for COVID-19, try to stay in a different room in your home from other people. You should also try to use a different bathroom than other people. If you can’t stay in a different room or use a different bathroom, stay as far away from other people in your home as possible. Wear a surgical mask if you need to be around other people. Try not to use the same personal items as other people. Clean surfaces that are touched often (phones, doorknobs, light switches, toilet handles, sink handles, countertops, and anything metal). Everyone who lives in your home should quarantine for 14 days if someone in your home tests positive for COVID-19. Students who live with someone who tests positive must quarantine for 14 days. They can’t go to school until the 14-day quarantine is over. How long do students, teachers, and employees have to isolate at home? Anyone who tests positive for COVID-19 must isolate until his or her symptoms get better and he or she has been fever-free for 24 hours without medicine AND it has been at least 10 days since he or she first had symptoms or tested positive. Students, teachers, and employees should not go to school or work until they have completed isolation. 24 Fever Free for Hours AND 10 At least Days Without Medicine 26 Your school needs to be prepared for times when students or teachers must isolate at home. SUBSTITUTE TEACHER 10 Days Being prepared to respond to COVID-19 in your school may require lesson planning in advance. You should also have a plan to provide another learning option for students who must isolate at home, or if parents choose to quarantine children who have been exposed to COVID-19 at home. School policies should allow students to make up any missed classwork without penalty if they are sick or need to quarantine5. This will be a critical aspect of schools being able to stay open for in-person learning. With an increase in the spread of COVID-19 in Utah, it is likely some students and teachers will need to isolate at home. The time frame for isolation is the amount of time someone is infectious and can pass the virus to other people. A student or teacher who tests positive for COVID-19 will be required to isolate at home for at least 10 days, depending on when his or her symptoms start to get better. This does not mean someone will only be sick for that amount of time. Some people who get COVID-19 are sick for a long time. You need to be prepared in advance to continue student instruction without disruption. This can only happen if schools are well prepared. Will the health department notify the school if a student, teacher, or employee tests positive? Health Department Yes. The health department will notify the point of contact (POC) at the school if a student, teacher, or employee at the school tested positive for COVID-19. The POC will work closely with the health department on contact tracing. 5 https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/symptom-screening.html 27 Will the health department notify the school when a student, teacher, or employee is done with isolation? It depends on the situation. The health department will notify the school point of contact (POC) when a student, teacher, or employee who works at the school or with students has finished his or her isolation and can return to school or work. This means the person can no longer spread the virus to other people. The health department will only notify the school if the employee works at the school. If the employee does not work at a school or with students (for example, he or she works at a school district office), the employee may return to work after he or she has been fever-free for 24 hours and it has been at least 10 days since he or she first got sick or tested positive. Schools should not require a COVID-19 test result, a doctor’s note, or a note from the health department for students, teachers, or employees who are sick to prove they are ill, qualify for sick leave, or to return to work or school. This places a burden on the healthcare and public health systems. Employers do not need a doctor’s note to get the tax credits under the Families First Coronavirus Response Act. Should students, teachers, or employees provide proof of a negative COVID-19 test result before returning to school? No. Studies show people may test positive long after they are infectious (sometimes more than 45 days after). This means a person who at one time was sick with COVID-19 could still test positive, even though he or she can’t spread the virus to other people anymore. This makes it hard for students, teachers, and employees to know when they can return to school or work if their school or employer requires a negative test result. NEGATIVE COVID-19 You should not ask students, teachers, and employees who are sick for a COVID-19 test result, a doctor’s note, or a note from the health department to prove they are ill, qualify for sick leave, or to come back to work. This places a burden on the healthcare and public health systems. Students and employees may not have health insurance, access to a healthcare provider, or the financial means to get a doctor’s note or a negative test result. 28 Scenario example A teacher tests positive for COVID-19. Mrs. Watkins is a 2nd grade teacher. Mrs. Watkins tested positive for COVID-19. She must isolate at home. She can’t go to work until her symptoms start to get better and she has been fever-free for 24 hours without medicine AND it has been at least 10 days since she first had symptoms or tested positive. • The health department called Mrs. Watkins to find out who she had been in close contact with, about 6 feet or 2 meters (about 2 arm lengths) for 15 minutes or more. • Anyone in close contact with Mrs. Watkins up to 2 days before she got sick or tested positive should quarantine for 14 days. Anyone who lives with Mrs. Watkins’ must quarantine for 14 days. This means the person should stay home and away from other people as much as possible. The health department will tell the people who live with Mrs. Watkins how long to quarantine and when to get tested. Mrs. Watkins was at school 2 days before she got sick and tested positive for COVID-19. The health department called the school to tell them Mrs. Watkins tested positive for COVID-19. The health department will notify anyone who is at higher risk if he or she was exposed to COVID-19. The school will notify anyone else who was exposed in the school. 29 The students in Mrs. Watkins’ class should quarantine for 14 days from the date of exposure. The parents of the students will decide if their children will go to school during their 14-day quarantine. The students can go to school as long as they do not have symptoms of COVID-19 or test positive. This is called a modified quarantine for schools. The exception to this, is that students can’t go to school if the person who tested positive lives in their home. It is very hard to stay away from someone who is sick in your home. The students’ families do not have to quarantine UNLESS the student who was exposed to COVID-19 tests positive. If the students in Mrs. Watkins’ class go to school, they must be extra careful and take safety precautions. They can still get sick with COVID-19 or expose others to the virus. For a list of safety precautions students must follow if they go to school while quarantined, go to page 45. No one else at the school was in close contact with Mrs. Watkins. No other students, teachers, or employees need to quarantine. No one else had a close contact exposure to COVID-19. The school does not need to notify any other parents in the school about the exposure. Only those students, teachers, or employees who need to quarantine will be notified. Health Department The health department will notify the school when Mrs. Watkins has finished isolation and can return to school. 30 Scenario example A student tests positive for COVID-19. Pearl is an 8th grade student at a junior high school. Cole is Pearl’s brother. He is a 5th grade student at an elementary school. Pearl tested positive for COVID-19. Pearl must isolate at home. She can’t go to school until her symptoms start to get better and she has been fever-free for 24 hours without medicine AND it has been at least 10 days since she first had symptoms or tested positive. The health department called Pearl’s parents to find out who she had been in close contact with, about 6 feet or 2 meters (about 2 arm lengths) for 15 minutes or more. Anyone in close contact with Pearl up to 2 days before she got sick or tested positive should quarantine for 14 days. 14 Days Pearl’s family must quarantine for 14 days. This means they should stay home and away from other people as much as possible. The health department will tell Pearl’s family when they can end quarantine and when to get tested. Even if Pearl’s family never gets sick or they test negative for COVID-19, they must finish their 14-day quarantine. Pearl’s brother Cole must quarantine for 14 days because someone who lives in his home tested positive for COVID-19. Most of the time, students can go to school even if they have been exposed to someone who tested positive for COVID-19. However, students can’t go to school if someone in their home tests positive for COVID-19. It is very hard to stay away from someone who is sick in your home. Even if he doesn’t get sick or tests negative for COVID-19, Cole must finish his 14-day quarantine. No one else in Cole’s class or his school needs to quarantine. His school does not need to tell other parents, teachers, or employees that Cole’s sister tested positive for COVID-19. 31 Pearl was at school 2 days before she tested positive for COVID-19. The health department called the school to tell them Pearl tested positive for COVID-19. The health department will notify anyone who is at higher risk they were exposed to COVID-19. The school will notify anyone else who was exposed in Pearl’s school. The students in Pearl’s classes should quarantine for 14 days from the date of exposure. The parents of the students will decide if their children will go to school during their 14-ay quarantine. The students can go to school as long as they do not have symptoms of COVID-19 or test positive. This is called a modified quarantine for schools. The exception to this, is that students can’t go to school if the person who tested positive lives in their home. It is very hard to stay away from someone who is sick in your home. Their families do not have to quarantine UNLESS the student who was exposed to Pearl gets sick and tests positive for COVID-19. 14 Days Pearl’s teachers should quarantine at home for 14 days from the date of exposure. If there are not enough substitute teachers to help with their classes, the school can let Pearl’s teachers go to work if they do not have symptoms or test positive for COVID-19. The teachers’ families do not need to quarantine UNLESS the teacher (the one they live with) tests positive for COVID-19. If students, teachers, or employees go to school during the 14-day quarantine, they must be extra careful. They can still get COVID-19 and expose others to the virus. For a list of safety precautions students, teachers, and employees must follow if they go to school or work while quarantined, go to page 45. No one else at the school was in close contact with Pearl. No other students, teachers, or employees need to quarantine. No one else had a close contact exposure to COVID-19. Health Department The school does not need to notify any other parents, teachers, or employees in the school that a student tested positive. Only the parents of students, teachers, and employees who were exposed will be notified. The health department will notify the school when Pearl has finished isolation and can return to school. 32 Scenario example A student on a school sports team tests positive for COVID-19. Sam is a 12th grade student at the high school. He plays on the school football team. He is 18 years old. This means he is an “eligible student” and can legally make his own decisions. At the beginning of the school year, Sam signed a written consent form that gave the school and health department permission to tell his parents if he was exposed to or tests positive for COVID-19. Sam tested positive for COVID-19. He must isolate at home. He can’t go to school or play football until his symptoms start to get better and he has been fever-free for 24 hours without medicine AND it has been at least 10 days since he first had symptoms or tested positive. The health department called Sam and his parents to find out who he had been in close contact with, about 6 feet or 2 meters (about 2 arm lengths) for 15 minutes or more up to 2 days before he got sick and tested positive. Anyone in close contact with Sam should quarantine for 14 days. Sam’s family must quarantine for 14 days. This means they should stay home and away from other people as much as possible. The health department will tell his family when they can end quarantine and when to get tested. Even if his family never gets sick, or they test negative for COVID-19, they must finish their 14-day quarantine. Sam was at school and football practice 2 days before he tested positive for COVID-19. The health department notified the school that Sam tested positive for COVID-19. The health department will notify anyone who is at higher risk they were exposed to COVID-19. The school will notify anyone else who was exposed in the school or at football practice. 33 The students who were exposed at school or football practice should quarantine for 14 days from the date of exposure. The parents of the students will decide if their children will go to school during their 14-day quarantine. The students can go to school as long as they do not have symptoms of COVID-19 or test positive. This is called a modified quarantine for schools. Students cannot particpate in extracurricular activities while on modified quarantine. Students who are quarantined are not allowed to go to football practice during their 14day quarantine. The students’ families do not have to quarantine UNLESS the person who was exposed at school or at the game gets sick and tests positive for COVID-19. Any teacher, employee, or volunteer who was exposed at school or football practice should quarantine at home for 14 days from the date of exposure. If there are not enough substitute teachers to help with their classes, the school can let Sam’s teachers go to work if they do not have symptoms or test positive for COVID-19. Coaches, other employees, and volunteers who were exposed at football practice are not allowed to go to football until their 14-day quarantine is over. The families of the teachers, employees, or volunteers who were exposed do not need to quarantine UNLESS the person they live with who was exposed at school or football practice tests positive for COVID-19. If students, teachers, or employees go to school during the 14-day quarantine, they must be extra careful. They can still get COVID-19 and expose others to the virus. For a list of safety precautions students, teachers, or employees must follow if they go to school while quarantined, go to page 45. Only those students, teachers, or employees who were exposed will be notified. Health Department The health department will notify the school when Sam has finished isolation and can return to school. 34 What happens if a student, teacher, or employee is exposed to someone with COVID-19? If a student, teacher, or employee was exposed to a person who tested positive for COVID-19, the health department and the school will work together on contact tracing. Contact tracing is how public health workers find the close contacts of someone who has COVID-19. Contact tracing in schools Each school should have a point of contact (POC). The POC works with the health department on contact tracing. The POC will notify eligible students, parents, teachers, and employees if they were exposed to COVID-19 at school. 1 People who are tested for COVID-19 will get their test results from the healthcare provider or testing location where their sample was collected. 2 T he health department will call anyone who tests positive for COVID-19. It may take a few days for the health department to call the person who tested positive. They will ask the person who he or she may have been in close contact with up to 2 days before he or she got sick or tested positive. 3 T he health department will notify the POC at the school if a student, teacher, or employee who works in the school or with students tests positive for COVID-19. The health department gives the name of the person who tested positive and the date of last exposure to the POC. 4 T he POC collects and provides a list to the health department of students, teachers, or employees who are at higher risk for severe illness from COVID-19 known to have come into close contact with the person who tested positive. The health department will notify the parents of students, teachers, or employees who are at higher risk and provide guidance on how long they should quarantine, how to check for symptoms, and when to consider testing. 5 T he POC will notify any other eligible students or students’ parents, teachers, or employees who may have been exposed to the person who tested positive. The POC will provide guidance on how long they should quarantine, how to check for symptoms, and when to consider testing. In most cases, the school may only notify the parents of an eligible student (a student who is 18 years old or a student of any age who has taken postsecondary courses) if the eligible student has signed a written consent. There are some situations where parents of eligible students will be notified without a written consent. 6 Only students, teachers, or employees who came into close contact with the person who tested positive will be notified of a possible exposure. 35 What does a close contact exposure mean in a school setting? A close contact exposure means a person was closer than 6 feet or 2 meters (about 2 arm lengths) from someone who tested positive for COVID-19 for 15 minutes or longer. Anyone who was in close contact with a person who has COVID-19 up to 2 days before he or she had symptoms or tested positive is considered exposed and should quarantine for 14 days. 6 Feet For 15 Minutes In a school setting, close contact exposure means: • Anyone in a classroom or in a school bus who sits 6 feet or 2 meters in the front, back, or to the side of the person who tested positive. • A teacher, employee (such as a paraprofessional or bus driver), or visitor who was 6 feet or 2 meters for 15 minutes or longer from the person who tested positive. • Anyone who was closer than 6 feet or 2 meters for 15 minutes or longer to the person who tested positive during extracurricular activities (sports, dances, clubs); during a school gathering (assemblies, dances); or during lunch or free periods. i If the health department or point of contact at the school are unable to determine who was in close contact with the person who tested positive, everyone in the classroom, school bus, lunch or free period, extracurricular activity (sports, dances, clubs), or school gathering (assemblies, dances) will be considered exposed and may follow a modified quarantine for 14 days. 36 Schools will determine close contact exposures The point of contact (POC) will work closely with the health department to determine who came into close contact at school with the person who tested positive. The POC may need to talk with a teacher or coach to understand who a student was in close contact with. Sharing this information must be limited to the least number of school officials possible and each must be notified that the information is confidential and cannot be re-disclosed or shared with anyone else. CONFIDENTIAL To protect the privacy of the person who tested positive as much as possible and help with contact tracing efforts, schools may want to consider: SEATING CHART Asking teachers to have written seating charts and student groupings in advance for classroom activities. Students should have assigned seats on buses if possible. This includes if a bus is used to take students to an activity, field trip, or sports events. OFFENSIVE LINE oaches may want to consider advance written C plans for practices that include student names and groupings for each activity or drill. Coaches and activity directors should keep a roster of attendance at activities, practice, and games. The prevention strategies implemented at the school will have a direct impact on the ability of the POC to know who was exposed to COVID-19. 37 Understanding the date of exposure The date of exposure is when the person who tested positive for COVID-19 was first considered infectious and could spread the virus to others. This date begins up to 2 days before the person had symptoms or tested positive. Anyone who came into close contact with the person who tested positive from the date of exposure until the person was no longer at school needs to be notified he or she may have been exposed to the virus. The health department will give the POC the date of exposure. Questions the POC may need to ask to figure out who else was exposed at school: Does the student ride a school bus to and from school? Is there assigned seating on the school bus? If so, who sits within 6 feet of him or her to the front, back, and to the side? What classes does the student have? Are any of his or her classes off-campus? Does he or she have release time? Does the student have assigned seating during class? Who sits within 6 feet of him or her in the front, back and to the side? A re students in the class grouped into cohorts or pods? Are students able to physical distance? What lunch period does the student have? Is there assigned seating during lunch? If so, who sits within 6 feet of him or her in the front, back, and to the side? What extracurricular activities at the school is the student involved in? These activities may include sports teams, drill, clubs, theater, choir, or other activities. Did the student attend any school gatherings like assemblies, spirit nights, dances, or parent teacher conferences? Does the teacher, coach, or organizer of the activity keep a roster or attendance tracking sheet? Are students at the activities grouped into cohorts or pods? Are students able to physical distance? Are there other times during the school day when the student is in close contact with other students, teachers, or employees? 38 How long do students, teachers, and employees have to quarantine? Anyone who had a close contact exposure should quarantine for 14 days from the last time he or she was in close contact with the person who tested positive for COVID-19. Public health may recommend a person who was exposed to COVID-19 get tested. However, even if the test is negative, he or she must finish the 14-day quarantine. If a person who is on quarantine develops symptoms of COVID-19, he or she should isolate and call a healthcare provider right away. He or she will need to be tested for COVID-19. 14 Days How to determine when someone can end quarantine6? • The POC will work closely with the health department to find out the last time someone had close contact, 6 feet or 2 meters (about 2 arm lengths) with the person who tested positive for COVID-19. • The person who was exposed should quarantine for 14 FULL days after the last time he or she had close contact with the person who tested positive. • The quarantine should end at the same time of day the person started quarantine. For example, if the quarantine started at noon, he or she should stay quarantined until noon on day 14. This may be confusing to some people. • You may need to explain quarantine starts at the time he or she is told to quarantine. • The next day at the same time (24 hours later) is considered one day. • Quarantine will end at the same time, 14 days later. Last close contact with person who has COVID-19 Last day of quarantine 14 DAY QUARANTINE Please note if your quarantine starts at noom on day 1, then it would end at noon on the last day 6 https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html 39 Students who have an exposure to COVID-19 Students who had an exposure to COVID-19, but who do not have symptoms, may go to school. This is called a modified quarantine for schools. Parents will decide if they want to send their children to school during the 14-day quarantine. Eligible students do not need their parents’ permission to go to school. Students can go to school as long as they don’t have symptoms and follow safety precautions to prevent the spread of COVID-19. If a student gets sick or develops symptoms of COVID-19 during quarantine, his or her parents should call a healthcare provider and get their child tested for COVID-19. Testing locations can be found at https://coronavirus.utah.gov/testing-locations/. If a student comes to school during their 14-day quarantine, he or she should stay home and away from other people as much as possible when the student is not at school. He or she should not go to extracurricular activities, family gatherings, religious services, or other activities until the 14-day quarantine is over. Even if the student tests negative, he or she must finish the 14-day quarantine. Some parents may choose to quarantine children at home who have been exposed to COVID-19. You should have a plan to provide another learning option for students who must isolate or quarantine at home. Will students be quarantined every time they have a close contact exposure at the school? Yes. Every time a student has a close contact exposure at school or in his or her personal life, the student should quarantine for 14 days. Public health has modified quarantine guidelines for students, teachers, and employees who are exposed to someone who tests positive for COVID-19. Students are able to use a modified quarantine each time they are exposed. Students may have multiple exposures during the school year. This is why it is so important for everyone, including members of the community, to take as many precautions as possible to keep schools open and their communities safe. 14 Days 40 Teachers or employees who have an exposure to COVID-19 If a substitute teacher is available who can provide quality education with minimal disruption to student learning or there is someone else who can do employees’ jobs, teachers and employees should quarantine for 14 days after the last time they were in close contact with the person who tested positive. However, if having a substitute teacher will negatively impact student learning or there is not another employee who can do the job of the person who was exposed, teachers and employees who have had an exposure to COVID-19, but who do not have symptoms, may go to work. This is called a modified quarantine for schools. They can work as long as they don’t have symptoms and follow safety precautions to prevent spread of COVID-19. If a teacher or employee gets sick or develops symptoms of COVID-19 during quarantine, he or she should call a healthcare provider and get tested for COVID-19. Testing locations can be found at https://coronavirus.utah.gov/testing-locations/. If teachers or employees go to school or work during their 14-day quarantine, they should stay home and away from other people as much as possible when they are not at school or work. They should not go to extracurricular activities, family gatherings, religious services, or other activities until the 14-day quarantine is over. Even if the teacher or employee tests negative, he or she must finish the 14-day quarantine. Extracurricular activities and COVID-19 The Utah Department of Health understands how important school extracurricular activities are to students, their families, and our communities. Participation in school sponsored extracurricular activities and sports helps students succeed in school, lowers students’ risk of substance use, and provides social and emotional benefits that help students throughout their lives. This is why we are asking students, schools, families, and community members to take extra precautions to slow the spread of COVID-19 in their communities. It will take everyone working together and taking precautions to make sure students get to participate in these important activities. 41 If a student who participates in school activities, sports, or clubs tests positive for COVID-19, will the whole group, team, or club be quarantined? If a student tests positive for COVID-19, the student will need to isolate at home. The student will not be able to go to school or participate in school sponsored extracurricular activities or sports. Anyone who was in close contact, 6 feet or 2 meters (about 2 arm lengths) with the student will be quarantined for 14 days. This may include other students who sit closer than 6 feet from the student in class, other participants in events who were in close contact, or teachers and coaches. With their parents’ permission, students are allowed to go to school during their quarantine. However, students are not allowed to participate in other activities while they are on modified quarantine, even if they test negative for COVID-19. Why can students go to school during quarantine, but not participate in other activities? Although there is a risk that students who go to school after they have been exposed to COVID-19 may spread the virus to other students, schools are taking every precaution to reduce that risk as much as possible. It is recommended schools keep the same students together in groups or cohorts as much as possible; seat students as far away from others as they can; have students, teachers, and employees wear face coverings; and modify spaces and processes to promote physical distancing. Schools will be doing their best to try to limit the number of students each student is in close contact with. It is not recommended students be allowed to participate in activities, sports, or clubs while quarantined because it increases the number of people they may expose to the virus that causes COVID-19. Example of a possible exposure in a high school class with 25 students in it. • The teacher and the students wear face coverings. • The teacher has spaced the desks as far apart as possible. • Student desks face forward to avoid face-to-face contact. • The teacher has the students stay 6 feet apart when they enter and exit the classroom. • The teacher has procedures for how students move throughout the space to make sure they are 6 feet apart as much as possible. • If the teacher has the students work together, students only work with those in a 6 foot radius. 6 Feet If a student in THIS classroom tests positive, only the students who sit in a 6 foot radius of the student who tested positive will need to quarantine. The teacher has done a good job to reduce the spread of COVID-19 in the classroom. 42 x2 Example if a student who is quarantined is allowed to participate in football practice. • The football team has 60 students on it. • The team is made up of students from different grades. Each student has 8 classes. Many of the players are not in the same grades or classes as each other. • Every day, football practice is 2 hours long. • The team spends the 2 hours running drills. Students often come into close contact or have the opportunity to be exposed to bodily fluids from students they are not in the same grade or classes with. • Students, coaches, and training staff do not wear face coverings and do not practice physical distancing. At THIS football practice, many students may be exposed to COVID-19 without knowing it. Those students may then expose other students in the school or members of the community. 43 What precautions can we take to make sure students are able to participate in school activities, sports, and clubs? Schools should follow the specific requirements for extracurricular activities from the Utah High School Activities Association, Utah State Board of Education, and the Utah Color-Coded Phased Guidelines. We encourage everyone to do everything they can to make sure students have the opportunity to participate in extracurricular activities. These are additional ideas students, families, community members, schools, activity directors, coaches, and training staff may consider implementing. Everyone should wear a face covering in public and when you can’t physical distance, even outside. You don’t need to wear a face covering outside if you can physical distance from others who do not live in your home. Activity directors, coaches, and training staff should encourage students to wear a face covering, physical distance, limit the number of people they come into close contact with in their personal lives, and the number of places they go where they may be in large groups. All participants, activity directors, coaches, training staff, and spectators wear a face covering at events, practices, and games as much as possible. Space participants and coaches 6 feet apart as much as possible at activities, practice, and games. Consider placing markers 6 feet apart to make it easy for participants and coaches to practice physical distancing without having to think about it. People are more likely to practice health behaviors when they are easy. Place markers in both home and away sections, to keep everyone safe. Limit spectators to only the families of participants, and not the general public. Group bleachers or seating areas to keep household groups 6 feet from other people who do not live in their home. Provide enough space for 5-7 people to sit in each group, separated by 6 feet from the next seating group. Consider blocking off every other row of seating. Place markers 6 feet apart in typical areas of congestion (outside restrooms, at entrances and exits, in front of concession stands). Provide hand sanitizer at concession stands. Only serve individually packaged items or grab and go items at concession stands. Have automatic hand sanitizer stations outside restrooms. Students may not understand the severity of many students being exposed to the virus. Influential adults should consider explaining to students, parents, and community members the effect many students being exposed would have on their events or sports seasons. Influential adults may also consider using the students in their circle of influence as school and community leaders to encourage other students, their families, and members of the community to take precautions at all times. Positive peer influence may help everyone in the school adopt more personal safety measures to stop the spread of the virus in the community, even when they are not at school. 44 Safety precautions for students, teachers, and employees who have been exposed to someone with COVID-19 6 Feet For 15 Minutes • Check students, teachers, or employees for symptoms of COVID-19 before each school day or work shift, including taking their temperature if possible. If you do not have a thermometer, ask if their skin feels warm or look to see if it is red, or ask if they have chills or are sweaty. • Ask the person who was exposed to self-monitor for symptoms during the school day or work shift. • If a student feels sick or has symptoms of COVID-19 during the school day, he or she should leave the classroom right away. - The student should stay in a separate room (like a sick room in the office) and away from other students. -C all the student’s parents and ask them to pick up their child from school right away. - I f the student’s parents are unable to get their child, and the student must ride a school bus home, everyone on the bus should wear a mask and physical distance as much as possible. -A ny room a student was in for 15 minutes or longer should be cleaned using the cleaning guidelines starting on page 85. • If a teacher or employee gets sick or has symptoms during his or her work shift, the teacher or employee should be sent home right away. -A ny room the teacher or employee was in for 15 minutes or longer should be cleaned using the cleaning guidelines starting on page 85. • Students, teachers, and employees must wear a face covering or mask at all times in the school or workplace for 14 days after their last exposure to the person who tested positive. • Students, teachers, or employees should stay home and away from other people as much as possible when they are not at school or work. They should not go to extracurricular activities, religious services, sporting events, family gatherings, or other activities until their 14-day quarantine is over. • Students, teachers, or employees should try to stay 6 feet away from other people and practice physical distancing as much as possible in the school or workplace. • Wash hands with soap and water often. If soap and water are not available in the classroom or workplace, use an alcohol-based hand sanitizer that is at least 60% alcohol. • Clean and disinfect all areas more often (such as, offices, bathrooms, common areas, and shared electronic equipment). • Students, teachers, and employees should not share headsets or other objects that may be near their mouth or nose. • Work with maintenance staff to improve ventilation by increasing air exchanges in rooms. • Close common areas like breakrooms where employees are likely to be in groups. • Students, teachers, and employees should stagger breaks and not share food or utensils. 45 What happens if students, teachers, or employees are exposed to COVID-19 more than once7? COVID-19 is spreading in many Utah communities. This means students, teachers, and employees are likely to be exposed to COVID-19 many times during the school year. If students, teachers, or employees are exposed to COVID-19 again (a new exposure) within 90 days of testing positive for COVID-19. Students, teachers, or employees who are not sick do not need to quarantine and may go to school or work. They do not need to be tested again for COVID-19. They should also follow these guidelines for 14 days from the date of their last exposure: • Take his or her temperature before school or work. Check for symptoms of COVID-19 every day. • Wear a face covering at school or work when physical distancing is not possible. • If the student, teacher, or employee gets sick or has symptoms of COVID-19, he or she should quarantine for 14 days and call a doctor or healthcare provider to determine if he or she should get tested for COVID-19 AGAIN. Even if the student, teacher, or employee tests negative for COVID-19, he or she needs to finish the 14-day quarantine. If students, teachers, or employees are exposed to COVID-19 again (a new exposure) and it has been more than 90 days since they tested positive for COVID-19. Students, teachers, or employees should quarantine and check for symptoms for 14 days. If they get sick or have symptoms while on quarantine, they should isolate right away, call a doctor or healthcare provider, and get tested for COVID-19 again. If students, teachers, or employees who tested negative before and completed quarantine are exposed to the virus again (a new exposure), they should quarantine for 14 days AGAIN. x2 Students, teachers, or employees can return to work after they finish the 14-day quarantine. If they get sick or have symptoms while quarantined, they should isolate right away, call a doctor or healthcare provider, and get tested for COVID-19. 7 https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/contact-tracing.html 46 Scenario example Students who are at higher risk for severe illness from COVID-19 are exposed to someone at school who tested positive for COVID-19. Remmie and Kendon are 1st grade students at an elementary school. They are in the same class. They both have health problems that put them at higher risk for severe illness from COVID-19. Remmie and Kendon were exposed to someone at school who tested positive for COVID-19. Health Department The health department called the school to tell them who tested positive for COVID-19. The school gave a list to the health department of students who are at higher risk for COVID-19 who are in the same class as the person who tested positive. Remmie and Kendon are on this list because they are at higher risk and were exposed to the person who tested positive. The health department called Remmie and Kendon’s parents. The school will notify anyone else who was exposed in the school. Remmie and Kendon should quarantine for 14 days from the date of exposure. Their parents will decide if Remmie and Kendon will go to school during their 14-day quarantine. Remmie and Kendon can go to school as long as they do not have symptoms of COVID-19 or test positive. This is called modified quarantine for schools. The exception to this, is that students can’t go to school if a person who tested positive lives in their home. It is very hard to stay away from someone who is sick in your home. 47 14 Days Remmie’s parents decide she will quarantine at home for 14 days. She does not go to school. The school gives Remmie schoolwork to do while she is at home, so she doesn’t get behind. Her family does not need to quarantine UNLESS Remmie tests positive for COVID-19. Kendon’s parents decide to let him go to school. As long as Kendon does not have symptoms of COVID-19 or test positive, he can go to school. His family does not have to quarantine UNLESS Kendon tests positive for COVID-19. Kendon, his family, and the school must be extra careful and take safety precautions. He can still get sick with COVID-19 or expose others to the virus. For a list of safety precautions they must follow, go to page 45. 48 Scenario example A student is exposed to someone in his personal life who tests positive for COVID-19. Caesar is a 10th grade student at the high school. He goes to a family party. One of his cousins who was at the party tested positive for COVID-19. Health Department 14 Days The health department called Caesar’s parents to tell them their family had close contact with someone who tested positive for COVID-19. This means Caesar and his family were closer than 6 feet or 2 meters (about 2 arm lengths) from his cousin for more than 15 minutes. The health department will tell Caesar’s parents what to do next, how long to quarantine, and when their family should get tested. Caesar should quarantine for 14 days from the last time he had close contact with his cousin. His parents will decide if he can go to school during quarantine. He can go to school as long as he does not have symptoms of COVID-19 or test positive. This is called modified quarantine for schools. The exception to this, is that students can’t go to school if the person who tested positive lives in their home. It is very hard to stay away from someone who is sick in your home. The rest of Caesar’s family should also quarantine for 14 days because they had close contact with his cousin. This means they should stay home and away from other people as much as possible. They should not go to work, school, church, other family gatherings, or anywhere else unless they must. If they need groceries or other supplies, only one person from the family should go to the store while they are quarantined. If they need to go outside their home, they should wear face coverings. 49 Caesar’s parents choose to let Caesar go to school. If Caesar goes to school, he must be extra careful. He can still get COVID-19 and expose others to the virus. For a list of safety precautions Caesar must follow if he goes to school, go to page 45. The other students in Caesar’s classes do not need to quarantine UNLESS Caesar gets sick or tests positive for COVID-19. The school does not need to notify other students, parents, teachers, or employees that Caesar was exposed to someone with COVID-19. 50 Scenario example A school employee is exposed to someone in his personal life who tested positive for COVID-19. Other employees are able to do his job while he quarantines. Mr. Penna is the custodian at an elementary school. The health department called Mr. Penna and told him he was exposed to someone who tested positive for COVID-19. This means Mr. Penna was closer than 6 feet or 2 meters (about 2 arm lengths) for 15 minutes or more from the person who tested positive. The health department will tell Mr. Penna what to do next, how to quarantine, and when to get tested. Even if Mr. Penna tests negative, he must finish his14-day quarantine. Mr. Penna calls his employer to let her know he was exposed to COVID-19 and needs to quarantine. 14 Days Mr. Penna should quarantine at home for 14 days from the last time he had close contact with the person who tested positive. Essential employees are allowed to work if there is no one else to do their job and their employer lets them. Mr. Penna quarantines at home and does not go to work. He stays at home and away from other people as much as possible. The other employees at the school are able to help do his job so he can quarantine. r. Penna’s family does not need to quarantine UNLESS Mr. Penna gets sick or tests positive for M COVID-19. No one at the school where Mr. Penna works came into close contact with the person who tested positive for COVID-19. No one else needs to quarantine. The school does not need to notify anyone at the school that Mr. Penna was exposed to COVID-19. 51 Scenario example A school employee is exposed to someone in her personal life who tested positive for COVID-19. There are no other employees who can do her job while she quarantines. Mrs. Johnson is a food service worker at a junior high school. The health department called Mrs. Johnson and told her she was exposed to someone who tested positive for COVID-19. This means Mrs. Johnson was closer than 6 feet or 2 meters (about 2 arm lengths) for more than 15 minutes from the person who tested positive. The health department will tell Mrs. Johnson what to do next, how long to quarantine, and when to get tested. Even if Mrs. Johnson tests negative, she must take extra safety precautions for 14 days after she was last exposed to the person who tested positive. Mrs. Johnson calls her employer to let her know she was exposed to someone who tested positive for COVID-19 and should quarantine. 14 Days Mrs. Johnson should quarantine at home for 14 days from the last time she had close contact with the person who tested positive. However, essential employees are allowed to work if there is no one else to do their jon and their employer lets them. The people who live in Mrs. Johnson’s home were not in close contact with the person who tested positive. They do not need to quarantine UNLESS Mrs. Johnson gets sick or tests positive for COVID-19. 52 There is no one else who can do Mrs. Johnson’s job while she quarantines. Her employer lets Mrs. Johnson go to work as long as she does not have symptoms or test positive for COVID-19. Mrs. Johnson needs to take extra safety precautions when she goes to work. She can still get sick with COVID-19 and expose other people to the virus. For a list of safety precautions Mrs. Johnson must follow if she goes to work, go to page 45. No one at the school where Mrs. Johnson works came into close contact with the person who tested positive for COVID-19. No one else needs to quarantine. The school does not need to notify anyone at the school or workplace that Mrs. Johnson was exposed to COVID-19. 53 Scenario example A school employee lives with someone who was exposed to COVID-19, but the school employee was not exposed to the person who tested positive. Ms. Borski works at the school district office. Her roommate was exposed to someone who tested positive for COVID-19. Health Department The health department called Ms. Borski’s roommate to tell her she was exposed to someone who tested positive for COVID-19. Ms. Borski’s roommate must quarantine for 14 days. The health department did not call Ms. Borski. She was not in close contact to the person who tested positive. Ms. Borski does not need to quarantine UNLESS her roommate tests positive for COVID-19. She can go to work. Ms. Borski does not need to get tested for COVID-19. Ms. Borski does not need to tell her employer her roommate was exposed to COVID-19 and is quarantined. 54 Scenario example A student has a family member who was exposed to someone who tested positive for COVID-19, but the student was not exposed to the person who tested positive. Gia is a 3rd grade student at an elementary school. Gia’s mom works at a grocery store. Health Department The health department called Gia’s mom to tell her she was exposed to someone who tested positive for COVID-19. This means Gia’s mom was closer than 6 feet or 2 meters (about 2 arm lengths) to the person who tested positive for 15 minutes or more. The health department will tell her what to do next, when she can end quarantine, and when to get tested. 14 Gia’s mom should quarantine at home for 14 days from the last time she was in close contact with the person who tested positive. Days Gia was not in close contact with the person who tested positive for COVID-19. She can go to school. She does not need to quarantine UNLESS her mom tests positive for COVID-19. Gia does not need to get tested for COVID-19. Gia’s mom does not need to tell the school she was exposed to someone who tested positive for COVID-19 and is quarantined. No one at the school needs to be notified that Gia’s mom was exposed to someone who tested positive for COVID-19 and is quarantined. 55 Testing your students, teachers, and employees for COVID-19 The Centers for Disease Control and Prevention (CDC) and the Utah Department of Health DO NOT recommend testing all students, teachers, and employees at schools. Testing should only be done if students, teachers, and employees have symptoms of COVID-19. Testing may also be done if public health has referred a student, teacher, or employee to testing because they had a close contact exposure to someone who tested positive for COVID-19. At this time, the Utah Department of Health only does asymptomatic testing (testing people who do not have symptoms) for certain groups of people. Some of these groups include people who had a close contact exposure to someone who tested positive for COVID-19, first responders, vulnerable populations, long-term care facilities, communities where many people do not have access to testing, Tribal Nations, and in areas or facilities where an outbreak has happened or is likely to happen. Students, teachers, and employees with symptoms of COVID-19 should call a healthcare provider to get tested. Testing locations can be found at https://coronavirus.utah.gov/testing-locations. i Symptoms of COVID-19: If you can’t do a temperature check on a student, teacher, or employee, ask the person if he or she is feeling feverish (the person’s skin may feel hot or be red, or he or she may have chills or be sweaty). Fever Cough Decrease in sense of smell or taste Sore throat (temperature of 100.4°F or 38°C or higher or feeling feverish) Shortness of breath Muscle aches and pains 56 Is testing for COVID-19 free? Most people will not have to pay for COVID-19 testing. You should not be asked for payment when you go to a testing location. If you have health insurance The Families First Coronavirus Response Act ensures the cost of getting a COVID-19 test is covered at 100% if you have health insurance and you have a medical reason to be tested. This means you have symptoms of COVID-19, you have had close contact with someone who has COVID-19, or you have a referral from a healthcare professional or the health department to get tested. If you have health insurance, you should not be charged for a test no matter what testing site you go to. Healthcare providers are required by federal law to post a cash price for COVID-19 tests. This is to inform health insurance companies what to pay if you get tested by a provider that is out-of-network. If you are insured and have been charged for a test, please email the Utah Department of Health at COVID19TestingCoverage@utah.gov. If you do not have health insurance: If you are uninsured and are a U.S. citizen and a Utah resident, you qualify for COVID-19 testing coverage through Medicaid. Medicaid COVID-19 testing coverage for the uninsured covers the COVID-19 tests and all testing related services including doctor appointments (both in-person and through telehealth), ER visits, and any services performed in order to diagnose COVID-19, including X-rays, etc. Testing and other services will be paid for back to the date of your services. You must apply for this program at https://medicaid.utah.gov/covid-19-uninsured-testing-coverage/. If you are uninsured and do not qualify for the Medicaid option, there are locations that will provide testing free of charge. If you need help finding a location that provides free testing, please call the Utah Coronavirus Hotline at 1-800-456-7707 or use the chat feature on the coronavirus.utah.gov website. If you are being tested for a non-medical reason: You may be charged if you are getting tested for employment, travel, or non-medical reasons. Testing for general workplace health and safety (such as employee ‘return to work’ programs), public health surveillance, or any other purpose not primarily intended for diagnosis or treatment of COVID-19 or another health condition are not included in the requirements of the Families First Coronavirus Response Act and may not be covered by your health insurance. Check with your health insurance company for coverage details before you get tested. 57 What are the types of COVID-19 tests? There are three types of tests related to COVID-19. COVID-19 Test PCR test: A PCR test tells you if you have COVID-19 right now and could spread it to other people. A PCR test looks for the genetic material of the virus. It is a very accurate test. A healthcare worker uses a nasal swab to collect a sample from your throat, behind your nose. Antigen Test Antigen test: An antigen test is a new kind of COVID-19 test. You can get results in minutes. An antigen test looks for proteins found on or within the virus. It tells you if you have COVID-19 right now and could spread it to other people. Like a PCR test, a healthcare worker uses a nasal swab to collect a sample from your throat, behind your nose. Antigen tests are very accurate. However, there is a higher chance of having a false negative test result. This means if you test negative for COVID-19 with an antigen test, you may also need to get a PCR test to make sure you don’t have COVID-19. Blood Draw Serology or antibody test: Serology, or antibody tests, may be able to tell if you have ever been exposed to the virus that causes COVID-19. A positive antibody test does not guarantee immunity to COVID-19. A sample of your blood is collected and is used to see if your body has made antibodies to the virus. Your body makes antibodies when it fights an infection. Antibodies in your blood mean, at one time, you were exposed to COVID-19. Antibody tests find these antibodies in your blood and tell you if your immune system has responded to the infection. 58 Should students, teachers, or employees get an antibody test? Right now, we don’t know if people who have recovered from COVID-19, or who have antibodies for it, are immune and protected from getting it again. Schools and employers should not require students, teachers, or employees to have an antibody test to come to school or work. Having your students, teachers, or employees get antibody testing may be expensive and does not tell you if he or she could spread the virus to other people. There has been some confusion about asymptomatic spread and antibody testing. Asymptomatic means a person is sick right now with COVID-19, but does not have any symptoms. People can spread the virus without knowing they are sick or when they have very mild symptoms. Antibody tests are not the right test to find out if someone without symptoms has COVID-19 right now. A PCR or antigen test tells you if someone is infectious and sick with COVID-19 right now. If someone tests positive for COVID-19 antibodies, the person should get a PCR or antigen test to know if he or she is infectious right now and can spread the virus. If a student, teacher, or employee wants to get an antibody test, he or she will need to ask a healthcare provider to order the test. Antibody tests may also be available through private companies. There may be a cost for this test. . ! Schools and employers should not require students, teachers, or employees to have an antibody test to come to school or work. 59 If COVID-19 can be spread by people without symptoms, why shouldn’t all students, teachers, and employees be tested? At this time, only people with 1 or more symptoms of COVID-19 are able to get tested in Utah. Public health may also tell someone who is not sick to get tested if he or she was exposed to the virus. Testing for COVID-19 is most accurate when someone has symptoms. Testing students, teachers, or employees who are asymptomatic can increase the chance of an inaccurate test result. It may also give a false sense of security. For example, if a person who is not sick or who does not have symptoms of COVID-19 was tested, he or she could test negative but then be exposed to COVID-19 later. The person may not realize he or she needs to be tested again and could spread the virus to other people without knowing it. If a person who is asymptomatic and was exposed to COVID-19 chooses to get tested, he or she should wait at least 5-7 days after their last exposure to get tested. This lets enough of the virus build up in his or her body to be detected by the test. Getting tested before this time may result in a false negative test result. This means the person tested negative but is really positive and can infect others with COVID-19. However, even if the test is negative, anyone exposed to someone who tested positive for COVID-19 should remain quarantined for the full 14-day period. Some testing sites in Utah may not test people who are asymptomatic (this means they do not have symptoms), even if they were exposed to COVID-19. It’s always best to call a healthcare provider or testing site first, to make sure you are able to get tested. The decision about who can be tested for COVID-19 is made by a healthcare provider, the Utah Department of Health, and the health systems in Utah. 60 If a student, teacher, or employee tests positive for COVID-19, does he or she need a doctor’s note or a negative test result to go back to school or work? No. If a student, teacher, or employee tests positive for COVID-19, the health department will tell the person how long to isolate. In some situations, the health department may also call the point of contact (POC) at the school to let him or her know the person who tested positive has finished their isolation and can return to school. Studies show people may test positive long after they are infectious (sometimes more than 45 days after). This means a person, who at one time was sick with COVID-19 could still test positive, even though he or she can’t spread the virus to other people anymore. This makes it hard for students, teachers, and employees to know when they can return to school or work if their school or employer requires a negative test result. You should not ask students, teachers, and employees who are sick for a COVID-19 test result, a doctor’s note, or a note from the health department to prove they are ill, qualify for sick leave, or to come back to work. This places a burden on the healthcare and public health systems. DOCTOR’S NOTE Students and employees may not have health insurance, access to a healthcare provider, or the financial means to get a doctor’s note or a negative test result. If a student, teacher, or employee tests negative for COVID-19, does he or she need a doctor’s note to go back to school or work? No. The Utah Department of Health does not recommend schools or employers require evidence of a negative test result to come back to work. This places a burden on the healthcare and public health systems. If a student, teacher, or employee has been asked by the health department to quarantine for 14 days because he or she was exposed to someone with COVID-19, the person will need to finish his or her quarantine even if the test result is negative. The student, teacher, or employee should not go to school or work if he or she has been asked by the health department to quarantine. 61 Create a healthy learning environment. COVID-19 is spread mainly by close contact between people. Close contact means a person was within 6 feet or 2 meters (about 2 arm lengths) for 15 minutes or longer of someone who tested positive for COVID-19. It is very hard to prevent close contact in a school setting. You won’t always be able to prevent close contact, especially between young students. However, if you think about how people use the spaces in your school and modify them to reduce close contact as much as you can, you decrease the chance of exposures in the school. This plan guides you through what you should do to keep your school safe and the spaces in your school healthier. The plan begins with what you should do to get your school ready for in-person learning. You can use these recommendations and ideas to make it less likely students, teachers, and employees will be exposed at school. The Utah State Board of Education (USBE) has specific state requirements for schools at https://www.schools.utah.gov/coronavirus. Attendance policies for students The easiest way to protect students, teachers, and employees from COVID-19 is to ask any person who is sick to stay home and not come to school. Students may be afraid to miss school if they are sick, for fear of having their grades or citizenship grades lowered. Students may also be worried about falling behind in their classwork or they may not have the resources or support at home to do their schoolwork. Students may also not realize that even mild symptoms can mean they have COVID-19 and can spread the virus to others. It is important to review your school attendance policies. Consider a non-punitive attendance policy which allows students to stay home without the absence hurting their grades when they are sick, under isolation, or asked to quarantine. Make sure students know about the attendance policy so they aren’t afraid to stay home if they are sick. 62 Prepare your school for in-person learning. Custodians and maintenance employees should be the first employees back in your building. Allow plenty of time for them to prepare the building before you allow other employees to return. The CDC uses a list of things you can do to lower the risk to students and employees. This list is called the hierarchy of controls8. They are listed from the best ways you can control and stop the spread of COVID-19, to the ways that are least effective. Use a combination of these controls to best protect your school. Some of these include engineering controls (ventilation and how you set up the spaces in your school and workspaces), policies for your school and workplace, and personal protective equipment (PPE). Your hazard assessment will tell you what kind of COVID-19 workplace hazards you have, or may get. This will help you decide what to do to lower the risk, or what type of PPE are needed for specific job duties. 8 https://www.cdc.gov/niosh/topics/hierarchy/default.html 63 Engineering and ventilation controls9 You may want to improve the engineering controls using the building ventilation system. Increase ventilation rates. Make sure ventilation systems are working properly. Increase outdoor air ventilation. Use caution in highly polluted areas. If you have fewer people in the building, this increases the effective dilution ventilation per person. Disable demand-controlled ventilation (DCV). Open minimum outdoor air dampers more (as high as 100%) to reduce or get rid of air that is recirculating. In mild weather, this will not affect temperature or humidity. However, this may be hard to do in cold or hot weather. Improve central air filtration to the MERV-13 or the highest compatible with the filter rack, and seal edges of the filter to limit bypass. Check filters to make sure they are within service life and have been installed correctly. Keep systems running for longer hours. It is best to run them all the time if you can (24 hours a day, 7 days a week). This makes the air exchanges in the building space better. Consider running the HVAC system at maximum outside airflow for 2 hours before and after the school day, in accordance with industry standards. Generate clean-to-less-clean air movements10 Re-evaluate the position of supply and exhaust air diffusers and/or dampers and adjusting zone supply and exhaust flow rates to establish measurable pressure differentials. Have staff work in “clean” ventilation zones that do not include higher-risk areas such as visitor reception or places where people may be exercising. Consider using portable high-efficiency particulate air (HEPA) fan/filtration systems to help enhance air cleaning (especially in higher-risk areas). Make sure exhaust fans in restrooms work and operate at full capacity when people are in the building. Consider using ultraviolet germicidal irradiation (UVGI)11. Use this technique as an additional way to kill airborne virus in the upper-room air of common areas, in accordance with industry guidelines. Some of these recommendations are from the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Guidance for Building Operations During the COVID-19 Pandemic. Learn more about ASHRAE guidelines at https://www.ashrae.org/. 9 https://www.ashrae.org/ 10 https://www.ashrae.org/File%20Library/About/Position%20Documents/Airborne-Infectious-Diseases.pdf 11 https://www.cdc.gov/niosh/docs/2009-105/default.html 64 Find risks in your school. You must give students, teachers, and employees a safe and healthy learning environment and workplace. You should find out where and how people might be exposed to COVID-19 in the school. You can find out if there are risks for students, teachers, and employees to be exposed to COVID-19 by doing a thorough COVID-19 hazard assessment of your school. You should hold a training for teachers and employees so they understand your school’s plan to reopen for in-person learning and what will be involved in the hazard assessment of your school. It is very important every employee understands what the school is doing and what they can do to keep the school safe. Ideas to consider for this training: • Hold all meetings, trainings, and professional development virtually. • Your employees know their jobs best. Consider having all employees complete a hazard assessment of their workspaces and work processes. Identifying and modifying spaces or processes used in your school that increase the chance a student, teacher, or employee may be exposed to COVID-19 is a critical part of your school’s COVID-19 response. • Make sure everyone understands what poses a threat and why. Work together to come up with ways you can decrease the risk of COVID-19. Provide this training in plain language, if you can. Employees may have limited knowledge about COVID-19 and how it spreads and limited knowledge about eliminating workplace hazards. If you have employees whose preferred language is not English, you may want to provide this and other trainings in other languages. What is a COVID-19 hazard12? A COVID-19 hazard is something in the physical environment (workplace hazard) or in the way we do things (work process hazard) that increases our chances of being exposed to COVID-19. The best way to reduce exposure is to eliminate the hazard, if you can. However, many times it may be too costly to fix the problem. Even if you can’t eliminate the hazard completely, there are usually things you can do to reduce the risk. You can often reduce the risk of exposure with very simple modifications. The Utah Department of Health (UDOH) has 4 main health behaviors that reduce your risk of exposure to COVID-19. These 4 simple health behaviors reduce the risk of exposure in EVERY workplace, work process, situation, or scenario you may find yourself in. Keep these behaviors in mind as you respond to risks in your school or workplace. 12 https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html 65 6 Feet 1 2 3 4 The 4 health behaviors you should practice in your school: 1 Wash your hands for 20 seconds with soap and water: - After you blow your nose, cough, or sneeze. - After you use the restroom. - Before you make or eat food. - After you touch animals or pets. - Before and after you care for another person who needs help, such as a child. - Before and after school or work. - Before and after you take breaks at work. - After you put on, touch, or take off a cloth face covering or maks. If you do not have soap and water, you can use an alcohol-based hand sanitizer with at least 60% alcohol. Children under 6 years old should be supervised when they use hand sanitizer. 2 Physical distance. COVID-19 is mainly spread by close contact. Stay at least 6 feet or 2 meters (about 2 arm lengths) from people who do not live in your home as much as possible. We know this isn’t easy in a school setting. If you can’t stay 6 feet away from other people, stay as far away as you can. Any distance between you and other people can help. 3 Wear a face covering or mask. Cloth face coverings are effective at reducing the spread of COVID-19, especially when both people who may come into close contact are wearing a face covering. It is important to remember that even when you wear a face covering, you still need to physical distance. Sometimes when people hear this, it makes them wonder if face coverings are actually an effective way to reduce the chances of getting COVID-19. Cloth face coverings are very effective13. If you wear a mask AND physical distance, the chance of being exposed to COVID-19 is much lower. 4 Stay home if you are sick. Students, teachers, and employees should not go to school or work if they are sick. They should stay home until they are feeling better. 13 https://pws.byu.edu/covid-19-and-masks 66 You can begin your hazard assessment as soon as custodial and maintenance staff say the school is prepared for employees to return. Remember, COVID-19 is spread mainly through close contact. Close contact means a person was within 6 feet or 2 meters (about 2 arm lengths) for 15 minutes or longer of someone who tested positive for COVID-19. It spreads through respiratory droplets from person-to-person. The good thing about doing a hazard assessment in a school, is that schools function on routine. With few exceptions, when, by whom, and how the spaces in the school are used, is planned out in advance. The work processes teachers and students use also function on routine. Almost everyone who attends or works in a school does the same thing, with the same people, in the same place, at the same time every day. It may seem overwhelming before you get started, but doing a hazard assessment in a school will be easier than doing one for the workplaces and work processes of other employees who do not work in the school. Creating a hazard assessment for your school: • Make a schedule for the week. Each day should be broken into 15 minute increments. - Administrators should create a schedule that starts at the time the first teacher or employee usually arrives at the school and ends when the last employee usually leaves. - Teachers and employees should create a schedule that starts when they arrive at the school or workplace and ends when they leave. • Make a list of the spaces in the school used by students, teachers, and employees. - Administrators should also make a list of shared spaces, or common areas of the school. This may include the front office, cafeteria, pick-up and drop off zones, playgrounds or areas used for recess, hallways, bathrooms, breakrooms, and other shared spaces. - Teachers should make a list of the spaces in the school they or their students use during the day. This may include the classroom, the playground, the cafeteria, teacher workrooms, the library, and any other shared spaces teachers or students use. - All employees should make a list of the spaces in the school or the workplace they use throughout the day. This may include offices, other worksites, transportation vehicles, other vendor locations the employee visits as part of his or her job duties, and any other spaces the employee uses during the workday. 67 Assess the risk in each space. Once you have a list of the spaces students, teachers, and employees use throughout the day, it is important to think about how the setup of the spaces or the way people use them may increase the risk of exposure to COVID-19. Use your schedule to write down the spaces you use at different times during the day. Administrators should create a separate hazard assessment for each shared space. Use these questions to assess possible threats to the health of students, teachers, and employees for each space in the school or workplace at each time of the day. Who uses the space? Do students, teachers, employees, or outside visitors use the space at the same time? Do students from different grades or classrooms use the space at the same time? How many students, teachers, or employees are in the space at one time? What is the space being used for? Are the people using this space able to physical distance? Are the people in this space in close contact for 15 minutes or longer when they are using the space? How long are the people using the space in close contact? Will the people using the space wear masks when they are in close contact with other people? Are people in the space exercising or physically playing, eating, drinking, or doing other activities where respiratory droplets from their eyes, nose, mouth, or body could get on someone else? Is the space cleaned after each use? Are people able to wash their hands with soap and water right before and after they use the space? Where do the people using this space go next? 68 Sample hazard assessment of student drop off and pick-up. _____________________________________________ _____________________________________________ Who uses the drop off and pick-up areas? Teachers, students, parents or visitors, and employees. How long are the people using the space in close contact? Briefly. _____________________________________________ Do students, teachers, employees, or outside visitors use the space at the same time? Yes. _____________________________________________ Do students from different grades or classrooms use the space at the same time? Yes. _____________________________________________ How many students, teachers, or employees are in the space at one time? Many. Every student who comes to school, any teachers on morning duty, any visitors to the school. _____________________________________________ What is the space being used for? Student drop off and pick-up. _____________________________________________ Are the people using this space able to physical distance? Yes. There is enough space people could physical distance. However, students, teachers, and employees rarely physical distance in drop off and pick up areas. _____________________________________________ Are the people in this space in close contact for 15 minutes or longer when they are using the space? No. However, students often rush through the entrance doors at the same time. _____________________________________________ Will the people using the space wear masks when they are in close contact with other people? No. Students, teachers, and employees will be required to wear masks when they enter the school. _____________________________________________ Are people in the space exercising or physically playing, eating, drinking, or doing other activities where respiratory droplets from their eyes, nose, mouth, or body could get on someone else? Yes. Students often run to the entrance doors from their cars. Students often eat as they are entering the school. Many students are finishing breakfast as they enter the building. _____________________________________________ Is the space cleaned after each use? No. Most of the drop off and pick up area is outdoors. _____________________________________________ Are people able to wash their hands with soap and water right before and after they use the space? We do not know if students wash their hands right before they come to school. Students are able to wash their hands once they get to school. However, students rarely wash their hands right after they enter the school. This includes students who are eating as they enter the building. _____________________________________________ Where do the people using this space go next? When students get to school, they go outside on the playground, to the cafeteria to eat breakfast, to the office, to the library, or to their classroom. 69 What are the hazards in the sample assessment of drop off and pick up areas? How can drop off and pick up areas be modified to reduce the chance a student, teacher, or employee will be exposed to COVID-19? Hazard: Many people who do not live in the same home come to, and enter, the school at the same time. Everyone in the drop off and pick-up areas and who enters the school is exposed to different people in their personal lives. This many different, possible exposures being in the same place or entering the school at the same time, increases the risk of exposure in the school. Ideas to reduce the number of people who do not live in the same home entering the school at the same time: • Have different drop off and pick up times for each grade level. • In areas of higher community spread, have a designated drop off and pick up time and area for each class. Consider having classroom teachers meet students outside at the designated time and location outside the school and take students directly to the classroom or to the playground, if time and scheduling permits. This way, when students are at school, they are only in close contact with the other students in their class. - This recommendation would be challenging for students who need to eat breakfast at school. It would also be challenging for parents who need to drop their children off earlier because of work schedules. If you consider using this approach, you will need to plan to accommodate situations such as these. Hazard: Drop off and pick up areas have the potential for close contact exposures. People are social by nature, especially students. Social interaction usually involves close contact between people. Plan for areas of the school where students, teachers, or employees naturally are in close contact and interact with their friends, neighbors, or colleagues. You should try to control movement in these areas and limit close contact as much as possible. 70 Ideas to reduce the potential for a close contact exposure in drop off and pick up areas: • Students, teachers, and employees should put on their face covering before they exit their vehicle and enter the school. No one should enter the school without wearing a face covering or mask. • Place markers at least 6 feet apart for teachers or employees who oversee drop off and pick up areas to stand. It is a good idea to also place another marker 6 feet from where the teacher or employee will stand. It is common for students or parents to take the opportunity to talk to a teacher in drop off and pick-up areas. People are more likely to practice health behaviors when they are easy to do. Having a spot marked off by the teacher will remind students and parents to physical distance and keep teachers and employees safe. • Create a student drop off and pick-up process that promotes physical distancing. Place markers 6 feet apart at the entrance and exits of the school. Students should not get closer than 6 feet to the person in front of them as they enter or exit the school. Place markers where students should be dropped off and picked up. After they exit their vehicle, students should stand on their marker and wait until the person in front of them has moved to the next spot. • Place markers 6 feet apart where students who ride the bus will enter and exit the school. Bus drivers should place markers in the bus 6 feet apart for students to stand when they enter or exit the bus. Students should stay seated until the row in front of them has moved to the next marker. Students, teachers, and employees should put on their face covering or mask before they enter the bus and should wear it any time they are on the bus. Hazard: Even if you improve hygiene practices after students get inside the school or are in the classroom, there are many opportunities for students, teachers, and employees to spread germs beforehand. People are more likely to practice health behaviors when they are easy to do. Plan to make good hygiene practices before entering the school easier. Ideas to promote good hygiene practices in drop off and pick up areas: • Students should eat or drink only in designated areas. Students should not exit their vehicle while eating. • Ask parents to have students wash their hands before they leave home or use hand sanitizer before they exit their vehicle. • Consider having automatic hand sanitizer stations at entrances and exits. You may consider posting a video on your school’s website of hygiene practices people should use before they enter the school. • Consider having teachers or employees who oversee drop off and pick up areas provide students with hand sanitizer before they enter the school, or have a designated employee at entrance and exits to provide students with hand sanitizer. • Clean high-touch surfaces more often, such as door knobs and handles. 71 Ideas to prevent close contact exposures, reduce hazards in the school or workplace, and make your learning environment healthier14. To reduce the chance of exposure at the beginning of the year, you may want to provide information to families to help them understand your policies, procedures, and give them strategies to keep their families and the school safe. Sometimes health information is hard to understand, especially for people who have lower literacy levels. Many people have an easier time understanding information from videos or other formats. Consider different ways you can provide information to families, including translating materials into other languages depending on the needs of your school community. Cafeterias: • Record seating and attendance to support contact tracing. • Keep the same students together in cohorts. Assign cohorts to the cafeteria by times or areas. • Decrease lunch times. Have separate times for lunch recess. • Place floor markers and lines to show the flow in lunch lines and areas. • Consider staggering lunch hours to reduce the number of students in the cafeteria at one time. • Use outdoor eating areas as much as possible. • Have students wash their hands before they eat. If soap and water are not available, use an alcohol based hand sanitizer that is at least 60% alcohol. • Increase how often you clean and disinfect high-touch areas. • Consider having sack or boxed lunches students can eat in classrooms or outside. Have a plan for how lunches will be distributed. Prepare and distribute sack or box lunches for students to eat in classrooms or outside. • Use paper cups and personal bottles instead of water fountains. • Avoid any self-serve food or drink options, such as hot and cold food bars, salad or condiment bars, and drink stations. • Consider having students eat lunch in the classroom. Reserve the cafeteria for students with food allergies. This will help students stay safe and avoid exposure to students they normally would not have been close to. • If your school must use the cafeteria, space students 6 feet apart. Stagger students so they are not sitting face-to-face on each side of the table. • Schools should clean and disinfect food line areas, tables, and chairs between uses. • Schools should encourage students and employees not to share food or utensils and use disposable food service items (utensils, trays) as much as possible. If use of disposable items is not possible, make sure employees wear gloves when they touch any food service items and equipment that can’t be thrown away. • Wash items you can’t throw away with dish soap and hot water or in a dishwasher. • Employees should wash their hands for 20 seconds with soap and water after they remove their gloves or after they touch used food service items. • Use touchless payment methods if possible. If touchless payment is not possible, provide hand sanitizer to students and employees to use after they touch money, cards, or keypads. 14 https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/cloth-face-cover.html 72 If you offer food at events: • Consider having pre-packaged boxes or bags for each person at the event, instead of a buffet or family-style meal. • Provide tissues and no-touch trash cans. Classrooms: 6 Feet • Keep the same students together as much as possible when they are at school, such as a cohort of students. • It is very hard to prevent close contact in a classroom setting. You won’t always be able to prevent close contact, especially between young students. However, if you think about how students use the spaces in your classroom and modify them to reduce close contact as much as you can, you decrease the chance of exposures in the school. • Assign seats to students and small groups to support contact tracing • Develop and provide educator training for how they can implement strategies to identify and mitigate risk in a classroom setting. • Keep the same students and teachers or staff with each group or class as much as you can. • Try to keep as much space between desks as you can. • Identify and use large spaces (auditoriums, gyms, and outdoors) to maximize physical distancing. • Move nonessential furniture and equipment out of classrooms to increase the space students have to physical distance. • Seat students facing forward. • Consider using other ways to separate students, such as plexiglass barriers, if possible. • Place floor markers or post signs so students know how to move around the classroom without coming into close contact with other people. • You may need to consider changing the way you group students when they work together. Even in the classroom, it is important to keep students in the same small groups as much as possible. Everyone is exposed to different people in their personal lives. Every time you can reduce the possible exposures a student may have, you should. • You may need to allow more time for transitions so students can maintain physical distancing. • Provide explicit instruction and give students ideas about how to physical distance when they play and learn. Students are more likely to practice physical distancing at recess and when they play with other children in their personal lives if you teach them how they can stay safe and have fun at the same time. • Try to get students to use water fountains as little as possible. Provide disposable cups or other ways for students to stay hydrated. • Prop open doors so people do not have to touch them. • Clean high-touch surfaces often, especially after transition periods. • You may want to build in time for more outside breaks for students throughout the day, when they can get mask-free time. 73 What is a cohort, and how does it work15? One strategy administrators can consider is cohorting (or forming “pods”). Cohorting keeps groups of students, and sometimes teachers or employees, together throughout the school day to minimize exposure for students, teachers, and employees across the school environment. Students and staff in a cohort only have potential close contact exposures with others in the same cohort. This practice may help prevent the spread of COVID-19. • Decreases opportunities for exposure to COVID-19. • Helps make contact tracing more efficient. • Only a single cohort may need to be quarantined or isolated, instead of many students throughout the school. • Cohorting can be used in a traditional school model where all students attend school inperson, full-time, or as part of a hybrid school model (students attend in-person school on an alternating schedule). • Different strategies may be needed for elementary, middle, and high schools. Cohorting is commonly used in many elementary schools, where students have the same teacher and classmates all day and all year. • How schools implement this in secondary schools looks different across schools. Some schools choose to keep cohorts in one classroom, and have teachers move between classrooms. Other schools may assign students to specific days or weeks for in-person instruction. What is an alternating (hybrid) schedule16? Students attend school in-person part of the time and attend virtually part of the time. From what we know right now, alternating schedules can help reduce contact between students, teachers, and employees. However, while alternating schedules may reduce the spread of COVID-19, there may be additional costs for lesson planning, childcare costs for parents, and other potential costs. More research is needed on the layered impact of alternating schedules with other COVID-19 mitigation strategies (such as physical distancing, cloth face coverings, proper hygiene, and cohorting) as well as the impact of alternating schedules on students’ learning and well-being. 15 https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/prepare-safe-return.html#cohorting 16 https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/reopening-schools-faqs.html 74 Drop off and pick up: • Create drop off and pick up procedures that promote physical distancing and hygiene practices. Let parents know what to do when they drop off and pick up students and how to keep their families healthy and the school safe. - Place markers 6 feet apart at the entrance and exits of the school. - Students should not get closer than 6 feet to the person in front of them as they enter or exit the school. - Place markers where students should be dropped off and picked up. After they exit their vehicle, students should stand on their marker and wait until the person in front of them has moved to the next spot. • Place markers 6 feet apart where students who ride the bus will enter and exit the school. - Bus drivers should place markers in the bus 6 feet apart for students to stand when they enter or exit the bus. - Students should stay seated until the row in front of them has moved to the next marker. - Students, teachers, and employees should put on their face covering or mask before they enter the bus and should wear it any time they are on the bus. • Place markers at least 6 feet apart for teachers or employees who oversee drop off and pick up areas to stand. - It is a good idea to also place another marker 6 feet from where the teacher or employee will stand. - It is common for students or parents to take the opportunity to talk to a teacher in drop off and pick-up areas. - People are more likely to practice health behaviors when they are easy to do. Having a spot marked off by the teacher will remind students and parents to physical distance and keep teachers and employees safe. • Consider having different drop off and pick up times for each grade level. • In areas of higher community spread, have a designated drop off and pick up time and area for each class. Consider having classroom teachers meet students outside at the designated time and location outside the school and take students directly to the classroom or to the playground, if time and scheduling permits. This way, when students are at school, they are only in close contact with the other students in their class. - This recommendation would be challenging for students who need to eat breakfast at school. - It would also be challenging for parents who need to drop their children off earlier because of work schedules. If you consider using this approach, you will need to plan to accommodate situations such as these. • Have a designated location on the playground for teachers to meet their class when the bell rings in the morning. This will help prevent students from being in close contact with students from other classes when they go back into the building. If you do not have automatic hand sanitizer stations at entrance and exits, consider having teachers provide students with hand sanitizer before they go back into the school. • For secondary students, consider having students’ 1st period teachers meet them at a designated location outside the school. If you do not have automatic hand sanitizer stations at entrance and exits, consider having teachers provide students with hand sanitizer before they go back into the school. 75 Face coverings: • Students, teachers, and employees should put on their face covering before they exit their vehicle and enter the school. No one should enter the school without wearing a face covering. • All visitors and non-regular staff should wear a face covering. • Include cloth face coverings on school supply lists and provide cloth face coverings as needed to students, teachers, employees, or visitors who do not have them. • Consider clear face coverings for teachers and staff who interact with students who are deaf or hard of hearing, students learning to read, students with disabilities, and those who rely on lip reading as a part of learning, such as students who are English Language Learners. • Make sure students, teachers, and employees know how to use face coverings correctly. Face coverings should be worn over the nose and mouth, and fit securely around the face. You may consider having teachers include this instruction as they teach classroom procedures. • Wash your hands before you put on a face covering. • Encourage students, teachers, and employees to try not to touch their faces when they wear a face covering. If they touch their face, they should wash their hands or use hand sanitizer right away. • Teachers and employees should wash or sanitize their hands before and after they help students put on or adjust a face covering. Consider having a designated employee for this task. • Do not wear face coverings if they are wet. A wet face covering may make it hard to breathe. • Students, teachers, and employees should never share face coverings. • Write students’ names or initials on face coverings to keep them from wearing someone else’s. • Students may need you to label their face coverings to show them the top, bottom, front, and back. • Store student face coverings separately. • Wash face coverings every day, or if they look dirty. • Have extra face coverings for students, teachers, and employees in case a back-up is needed during the day. Does everyone need to wear a face covering? There is clear scientific evidence that wearing a face covering prevents the spread of COVID-1917. The CDC recommends all people 2 years of age and older wear a cloth face covering in public settings and when around people who don’t live in your household, especially when it is hard to physical distance18. While cloth face coverings are strongly encouraged to reduce the spread of COVID-19, it may not be possible in every situation or for some people to wear a face covering. In some situations, a cloth face covering could make a physical or mental condition worse or be a safety concern. Consider adaptations and alternatives whenever possible to help someone wear a face covering or to reduce the risk of COVID-19 spread if it is not possible for someone to wear one. 17 https://pws.byu.edu/covid-19-and-masks 18 https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html 76 Examples of times people may need adaptations and alternatives to cloth face coverings19: eople who rely on lipreading to communicate may not be able to wear a cloth face P covering (such as someone who is deaf or hard of hearing, or someone who cares for or interacts with a person who is hearing impaired). • Consider using a clear face covering. • If a clear face covering isn’t available, consider whether you can: - Use written communication - Use closed captioning, or - Decrease background noise to make it possible to communicate if you are wearing a cloth face covering that blocks your lips. • Consider using a plexiglass barrier. • If you choose to wear a face shield, be sure it wraps around your face and goes below your chin. It may be hard for some people with intellectual and developmental disabilities, mental health conditions, or other sensory sensitivities to wear a cloth face covering. They should talk to their doctor or healthcare provider for advice about wearing a cloth face covering. It may be hard for young children (preschool or early elementary aged children) to wear a cloth face covering correctly, especially for a long time. • Make sure face coverings fit correctly. Face coverings should be the right size and fit. • Teach children how important it is to wear a face covering, and remind them often. • I f young children have a hard time wearing a face covering for long periods of time, choose the most important times they should wear them. These are times when it is hard to stay 6 feet from others (drop off and pickup, standing in line at school). Students, teachers, and employees should not wear cloth face coverings during activities that may cause the cloth face covering to get wet, like swimming. A wet cloth face covering may make it hard to breathe. For activities like swimming, it is very important to physical distance from others when you are in the water. 19 https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html#feasibility-adaptations 77 Students may not be able to wear a face covering during high intensity activities, like running, if it makes it hard for them to breathe. • Consider doing the activity in a location with more ventilation and air exchange (for example, outdoors versus indoors) and where they can physical distance from others. Some students, teachers, or employees may have classes or work in areas where cloth face coverings may increase the risk of heat-related illness or cause safety hazards (for example, straps could get caught in machinery). • In these situations, students, teachers, and employees should talk to an occupational safety and health professional to find the right face covering for their setting. • You may consider allowing students, teachers, and employees who have classes or work outdoors to wear a face covering when in close contact with other people, like during group travel or shift meetings, but take off the face covering when they are able to physical distance. Cloth face coverings Cloth face coverings are an important safety precaution, and are most important when you can’t physical distance. If cloth face coverings can’t be used, make sure to take other safety precautions to reduce the risk of COVID-19 spread (such as physical distance, wash hands often, clean and disinfect high-touch surfaces). Remember, even when you wear a cloth face covering, you still need to physical distance. Face shields It is not known if face shields provide any benefit to protect others from the spray of respiratory particles. The CDC does not recommend use of face shields instead of a cloth face covering, or for normal everyday activities. • If you wear a face shield without a cloth face covering, make sure it wraps around your face and goes below your chin. • Only wear a disposable face shield one time. • Clean and disinfect reusable face shields after each use. • DO NOT use a plastic face shield for a newborn or infant. Surgical masks Cloth face coverings are not surgical masks or respirators. Right now, surgical masks and respirators are critical supplies that should be reserved for healthcare workers and other medical first responders. 78 What are some strategies I can use to help students wear a cloth face covering in school? Try to always be positive when you talk about ways to prevent the spread of COVID-19 and wearing face coverings. This is a scary time for students. Students are likely to practice health behaviors to help others. Try to frame prevention as something positive we can do to reduce everyone’s risk, without letting students be scared. • Consider asking parents, caregivers, and guardians to practice wearing cloth face coverings with students at home before the first day of school. If they show students how to use face coverings correctly and help them get used to wearing one before they have to in school, students may be more comfortable using one on the first day. • Make sure there is someone to help students put on and adjust face coverings if students need help. Teachers and employees should wash or sanitize their hands before and after they help students with face coverings. Teachers and employees should ALWAYS wear a face covering when they are in close contact with students. • Post signs in classrooms and in the hall to remind students how to wear a face covering correctly. You may want to use pictures of popular influencers or characters your students are interested in to promote or model how to use a cloth face covering. • Remind students about face coverings during daily announcements, in the school newspaper, and any other medium students are likely to engage with. Make sure communication is written in plain language and available in different languages. • You may want to include how to correctly use, take off, and wash a face covering in back-to-school materials. Elementary school • Play games or do fun activities to teach students how to wear a face covering. • Use some art materials or other creative ways to help students understand how face coverings help reduce the spread of COVID-19. • Read or share stories so students know what changes to expect at school. Middle and high school • Show short videos or use short lessons (less than 2 minutes) to teach students how to wear a face covering.You may want to use videos with celebrities, musicians, athletes or other influencers popular among these age groups. • Show students how to wear a face covering correctly. • Have the class come up with a class project about how your class can help reduce the spread of COVID-19 in your community. • Use science lessons to show students how respiratory droplets spread infectious disease. • Create a schoolwide competition to see which class can create the best health communication strategy about how important it is to wear a cloth face covering and use prevention strategies to middle and high school students. 79 Students with special healthcare needs • Ask parents, caregivers, and guardians to practice wearing face coverings at home before students return to school. • Read or share stories so students know what changes to expect at school. • You may want to have students with sensory concerns or tactile sensitivities try face coverings made of different materials, prints, and textures. Allow students to choose the most comfortable face covering. Hygiene practices and symptom checking • Check students, teachers, and employees for symptoms of COVID-19 before they enter the school. You should also take temperatures if you can. If someone is sick, he or she should not enter the school. • Have a designated isolation room if students get sick at school. This helps the student stay away from other people while they wait for his or her parents to come pick them up. • Check visitors and non-regular staff for symptoms of COVID-19. You should take their temperature if you can. All visitors and non-regular staff should wear a face covering. • Provide education to students and families about hygiene practices. • Students, teachers, and employees should wash their hands often for 20 seconds with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer that is at least 60% alcohol. - If students’ hands look dirty, they need to wash them with soap and water. Washing your hands is best, but if students’ hands do not look dirty and they do not have soap and water, they can use hand sanitizer. Children younger than 6 years old should be supervised by an adult when they use hand sanitizer. • Provide tissues and no-touch trash cans in the classroom. • Students should eat or drink only in designated areas. Students should not exit their vehicle while eating. • Ask parents to have students wash their hands before they leave home or use hand sanitizer before they exit their vehicle. • Consider having automatic hand sanitizer stations at entrances and exits. You may consider posting a video on your school’s website of hygiene practices people should use before they enter the school. • Consider having teachers or employees who oversee drop off and pick up areas provide students with hand sanitizer before they enter the school, or have a designated employee at entrance and exits to provide students with hand sanitizer. • Clean high-touch surfaces more often, such as door knobs and handles Fever (temperature of 100.4°F or 38°C or higher or feeling feverish) Fever Fever (temperature of 100.4°F or 38°C or higher or feeling feverish) (temperature of 100.4°F or 38°C or higher or feeling feverish) Decrease in sense of smell or taste Cough Cough Sore throat Shortness of breath Shortness of breath Decrease in sense of smell or taste Decrease in sense of smell or taste Cough Sore throat Sore throat Shortness of breath Muscle aches and pains Muscle aches and pains Muscle aches and pains 80 Large group gatherings (such as assemblies and performances): • Record attendance and seating location for large gatherings to support contact tracing. • At special events, consider screening adults who will be direct participants and will have direct contact with students for symptoms of COVID-19. You should also take temperatures if possible. • Make sure group gatherings are organized with health and safety principles and requirements in place. You should consult with the local health department on how to hold the event safely if needed. • You may want to consider limiting or canceling nonessential assemblies, recitals, dances, and other school gatherings or reschedule them as virtual gatherings. Gatherings that are held outside, where students and others who attend can practice physical distancing, are also an option to reduce the risk of exposure. • Broadcast assemblies to classrooms or hold multiple sessions of the assembly, with smaller group sizes. • Try to avoid in-person meetings as much as possible. Consider having virtual meetings and gatherings. Recess and playground: • Have assigned, staggered times for each class for recess, playground, and outdoor spaces. It is best if the same students can stay together all day, including on the playground. • Teach children how to physical distance when they play. Students are more likely to practice physical distancing at recess and when they play with other children in their personal lives, if teachers provide explicit instruction about how to physical distance when they play and provide them with ideas of how they can stay safe and have fun at the same time. • Students are not required to use face coverings at recess20. It is less likely students will be exposed outside, especially if they are practicing physical distancing when they play or participate in activities. However, there is still a risk of students being exposed if they have a close contact exposure when they are outside. This is why it is important for students to stay with the same students as much as possible. • Have a designated location on the playground for teachers to meet their class when the bell rings after lunch and recess. This will help prevent students from being in close contact with students from other classes when they go back into the building. If you do not have automatic hand sanitizer stations at entrance and exits, consider having teachers provide students with hand sanitizer before they go back into the school. • Make sure recess and playgrounds are managed with health and safety principles and requirements in place. Work with the local health department if needed. 20 https://coronavirus.utah.gov/special-orders/ 81 Restrooms: SCHEDULE • Try to have the same groups of students use the same bathroom as much as possible. If students are grouped by the same hallway, floor, or grade level, designate a restroom for each cohort. - Tell younger students what to do in the case of a bathroom emergency. Younger students may think they can only use their designated restroom, even in an emergency. • You may want to consider asking secondary students to use the restroom during class periods and reduce the number of students going to the restroom at one time. • It may be effective in elementary classrooms to build in additional, scheduled times for restroom visits to reduce the number of students going to the restroom at once. • Use strategies to minimize the number of individuals in a restroom, such as: - Increase barriers between stalls/urinals. - Block off every-other stall. • Place floor markers to remind students to physical distance when waiting to use restrooms. • Post signs to remind people to practice proper hand hygiene. • Create a schedule for cleaning high-touch areas often (faucets, paper towel dispensers, door handles, etc.). • Make sure employees who provide support in restrooms, including custodians, have the necessary PPE (gloves, masks). • Provide training for proper cleaning protocols for COVID-19. • Set a schedule to monitor to make sure soap is always available. School courses that may increase the risk of exposure: • School administrators should identify courses that would put students and teachers at an increased risk of exposure. Work with the local health department to make a plan to reduce the risk for these classes. • Choir is an inherently high-risk of exposure because people are more likely to be exposed to someone else’s respiratory droplets. Consider using several strategies, such as: - Hold choir courses or practice in outdoor spaces. - Students should be spaced 6 feet apart. - Limit the amount of time students are face-to-face. - Use barriers in between students. - Increase the airflow and ventilation. • You may want to consider limiting or canceling nonessential assemblies, recitals, dances, and other school gatherings or reschedule them as virtual gatherings. Gatherings that are held outside, where students and others who attend can practice physical distancing, are also an option to reduce the risk of exposure. • Build in time to clean and sanitize between classes or when students use the area. 82 Special education, related services, or school counseling (school psychologist, speech language pathologist, etc.): • Make accommodations for circumstances where a student or parent will be in close contact with someone else like a school counselor or speech language specialist for more than 15 minutes. • Provide plexiglass, face shields, or auxiliary aids for one-on-one close contact to provide students with disabilities equal access to information. • Allow accommodations for students who are exempt from wearing a face covering or mask as described in the State Public Health Order available at https://coronavirusdownload.utah.gov/Governor/UPHO-2020-10-State-Public-Health-Order-Masks-inSchools.pdf. Transitions: • Keep the same students together as much as possible when they are at school. • Post signs or use floor markers to show people which door they should use to enter or exit. This will reduce the chance people will have face-to-face contact if they are trying to use a door, but are going opposite directions. • Post signs to remind people to physical distance. • Let people enter and exit through all doors. This will help reduce the number of students who gather in groups while they wait to get into the building. • Develop a plan for how you will maintain physical distancing during safety drills (fire, lockdown, earthquake) Transportation: • Assign seats on the bus to support contact tracing. • Place markers in the bus 6 feet apart for students to stand when they enter or exit the bus. • Students should stay seated until the row in front of them has moved to the next marker. • Students, teachers, and employees should put on their face covering or mask before they enter the bus and should wear it any time they are on the bus. • Consider seating children one student per row, facing forward and skip rows between students, if possible. Students who live in the same home can sit together if they need to. • Clean and disinfect seats and other high-touch surfaces often. • Try to physical distance as much as you can on the bus. If students can’t stay 6 feet apart on the bus, try to keep them as far apart as possible. • Make a plan to keep drivers safe, such as installing plexiglass around the driver. • Consider staggered pick up and drop off times for students who ride the bus. • Have clean, spare cloth face coverings for students who forget theirs. • Open bus windows to increase circulation of outdoor air. Make sure windows do not open far enough to be a safety hazard. 83 Visitors, volunteers, and non-regular employees: • Limit nonessential visitors and volunteers to schools, campuses, and programs. Your school should determine essential versus nonessential. • Check visitors and non-regular staff for symptoms of COVID-19. You should take their temperature if you can. If someone is sick, he or she should not enter the school. • All visitors and non-regular staff should wear a face covering or mask when inside the building. • Consider protocols for visitors, including sign-in and sign-out, locations being visited, screening, calling front office before entering, etc. 84 Cleaning The guidance in this section is for regular cleaning of your school or workplace. We still have much to learn about COVID-19. From what we know right now about the virus and about similar coronaviruses, COVID-19 is most easily spread from close contact (within about 6 feet or 2 meters for 15 minutes or more). The virus is spread by respiratory droplets. We don’t know yet if, or how easily, it spreads with infectious aerosols (droplets in the air that another person inhales). It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the main way the virus spreads. From what we know, COVID-19 can live on surfaces for hours to days. We are still learning many things about COVID-19 and how it spreads. Clean visibly dirty and high-touch surfaces. Disinfect them after you clean. This will help prevent the spread of COVID-19 and other viral respiratory illnesses. These guidelines are meant for community, non-healthcare facilities such as: • Schools • Institutions of higher education • Offices • Childcare centers • Businesses • Community centers that do, and do not, house persons overnight These guidelines are not meant for cleaning staff in healthcare facilities or repatriation sites, households, or for others who have specific cleaning guidance. You should train all cleaning staff on-site before they begin cleaning tasks. 85 Cleaning products Cleaning staff and others should clean hands often. Employees should wash their hands with soap and water right away after they take off gloves or have contact with someone who is sick. If you do not have soap and water and your hands do not look dirty, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. If your hands look dirty, you need to wash them with soap and water. • To disinfect surfaces, use products that meet EPA criteria for use against SARS-CoV-2, the virus that causes COVID-19, and are the right ones for the surface. • Employers must follow OSHA standards on Bloodborne Pathogens (29 CFR 1910.1030), Call the Utah Poison including proper disposal of regulated waste, and PPE (29 CFR 1910.132). Control Center if • Most common EPA-registered household disinfectants can be used to fight COVID-19. you have questions • A list of EPA-approved products for use against the virus that causes COVID-19 is available about exposures to at https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2. cleaning products. Always follow the manufacturer’s instructions for all cleaning and disinfection products for concentration, application method, and contact time, etc. • Always read and follow the directions on the label to make sure you are safe and using the products correctly. • Wear gloves and consider wearing eye protection in case chemicals splash. • Make sure there is enough ventilation in the room when you are using chemicals. • Only use the amount recommended on the label. • If you are diluting chemicals, use water that is room temperature (unless it says something different on the label). • Do not mix chemicals. • Put a label on diluted cleaning solutions. • Store and use chemicals out of the reach of children and pets. • You should never eat, drink, breathe, or inject these products into your body or put them directly on your skin. They can cause serious harm. Do not wipe or bathe pets with these, or any other products that are not approved for animal use. You can also use diluted household bleach solutions (at least 1000ppm sodium hypochlorite, or concentration of 5%–6%) to fight COVID-19. • Check to make sure bleach can be used on the surface before you use it. • Follow the manufacturer’s instructions to apply a bleach solution. • Make sure it stays on the surface for at least 1 minute. • Always make sure there is enough ventilation during and after using bleach solutions. • Check to make sure the product is not past its expiration date. • Never mix household bleach with ammonia or any other cleanser. This can cause fumes that could be very dangerous to breathe in. • Household bleach that is not expired will be effective against coronaviruses when it is properly diluted. Bleach solutions will be effective for disinfection up to 24 hours. You can make a bleach solution by mixing: • 5 tablespoons (1/3 cup) bleach per gallon of room temperature water or • 4 teaspoons bleach per quart of room temperature water. 86 How to clean hard surfaces • Increase how often you clean surfaces and shared objects that are touched often (such as workstations, keyboards, telephones, handrails, and doorknobs). This will reduce the risk of cross contamination. For example, clean before and after shifts or before and after employees use shared objects. • Clean dirty surfaces with soap and water before you disinfect them. • Always wear gloves and gowns recommended for the type of chemicals you use. • You may need to wear extra PPE to clean and disinfect. This will depend on the product you are using and if there is enough ventilation in the place you are cleaning. Always follow the manufacturer’s instructions for each product you use. • Give employees disposable disinfecting wipes so they can wipe down surfaces that are touched often before they use them (doorknobs, keyboards, remote controls, desks, or other work tools and equipment). How to clean soft (porous) surfaces When you clean soft (porous) surfaces like carpeted floor, rugs, and drapes, remove anything you can see that is dirty or might contaminate it. Vacuum before you use any type of cleaner. You can then use a cleaner meant for this type of surface. After you clean: • If the items can be washed in a washing machine, follow the manufacturer’s instructions to wash them. Use the warmest water setting you can for the items. Dry the items all the way. • If items can’t be washed in a washing machine, use products made for porous surfaces that are EPA-approved for use against the virus that causes COVID-19. 87 How to clean electronics When you clean electronics like tablets, touch screens, keyboards, remote controls, and ATM machines, remove anything you can see that is dirty or might contaminate it. • Follow the manufacturer’s instructions for all cleaning and disinfection products. • You may want to use wipeable covers for electronics. • If you don’t have the manufacturer’s instructions, you may want to use alcoholbased wipes or sprays that have at least 70% alcohol to disinfect touch screens. Make sure you dry surfaces very well so liquids don’t pool. Cleaning linens, clothes, or other items that go in the laundry • Do not shake dirty laundry. You do not want to spread the virus in the air. • Use the manufacturer’s instructions when you wash items. Wash items on the warmest water setting you can use for the items. Dry them all the way. You can wash dirty laundry from someone who was sick with other people’s items. • Clean and disinfect hampers or other carts used to carry laundry. Follow the manufacturer’s instructions. How to clean outdoor areas, like playgrounds Do your regular cleaning on these areas. You do not need to disinfect them. • Do not spray disinfectant on outdoor playgrounds. This is not a good use of your supplies because disinfecting outdoor equipment is not proven to reduce the risk of COVID-19. • Clean high-touch surfaces made of plastic or metal often (grab bars, railings). • You do not need to clean and disinfect wooden surfaces (play structures, benches, tables) or ground covers (mulch, sand). • You should not disinfect sidewalks and roads. Spread of COVID-19 from these surfaces is very low. 88 Personal protective equipment (PPE) for cleaning staff The risk of exposure to COVID-19 for cleaning staff is low. • Cleaning employees should wear disposable gloves and gowns for all of their tasks in the cleaning process. This includes when they handle trash. • You should have gloves and gowns that can be used with the disinfectant products you are using. • You may need to have extra PPE, depending on the type of cleaning or disinfectant products you use. For example, you may need eye protection if there is a risk of cleaning products splashing into your eyes. • Be careful when you take off gloves and gowns. You don’t want to come into contact with any germs or spread them into the air. Wash your hands right away with soap and water for 20 seconds after you take off your gloves. • If you don’t have a gown, you can wear coveralls, an apron, or a work uniform when you clean and disinfect. If you are wearing reusable (washable) clothes, wash it after you wear it. Wash your hands after you touch dirty laundry. • Take off your gloves after you clean a room or an area where sick people have been. Wash your hands right away after you take off your gloves. • Tell your supervisor right away if something happens to your PPE, like a tear in your gloves or something else that could expose you to COVID-19. • Wash your hands often for 20 seconds with soap and water. If you don’t have soap and water and your hands don’t look dirty, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. If your hands look dirty, you need to wash them with soap and water. • Use good hygiene at work and home. Wash your hands often. Try not to touch your eyes, nose, or mouth with unwashed hands. Personal protective equipment (PPE) for all employees Use the Phased Guidelines to see the PPE recommended for your industry. The state has a list of Utah vendors who offer personal protective equipment (PPE) like masks, sanitizer, and disinfectant. If you need PPE for your workforce or on-site visitors, please reach out to other Utah companies that can provide those products. You can see a list of the vendors at https://coronavirus.utah.gov/business/workplace-resources/. You may want to give your employees the PPE they need to do their jobs. It is a good business practice and lets you control the look and quality of cloth face masks. 89 Cleaning after a positive case of COVID-1921 You should wait 24 hours before you clean and disinfect. This reduces the chance for other students, teachers, and employees to be exposed to respiratory droplets. If you can’t wait 24 hours, wait as long as possible. Open outside doors and windows to increase air circulation in these areas during this waiting period. Wait 24 Hours Clean visibly dirty and high-touch surfaces. Disinfect them after you clean. This will help prevent the spread of COVID-19 and other viral respiratory illnesses. We don’t know how long the air inside a room could be infectious after someone with COVID-19 was there. When you decide how long to close off rooms or areas used by people who were sick before you start disinfecting them, think about: • The size of the room • The ventilation system design. You should know where the supply and exhaust vents are. It is also important to know the flow rate (air changes per hour). • You can shorten the time it takes respiratory droplets to be out of the air, if you increase the ventilation in the area or room. 21 https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility.html 90 Number of days since the person who was sick or tested positive was at the school What to do Fewer than 7 days Close off all areas used for long periods of time by the person who is sick. Wait 24 hours before you start to clean and disinfect. 7 days or more You do not need to do extra cleaning and disinfection. Just do your regular cleaning and disinfecting of all high-touch surfaces at the school. At a school, childcare center, office, or other facility that does not house people overnight: • Close off areas visited by the person who was sick. • Open outside doors and windows and use ventilating fans to increase air circulation in the area. • Do not vacuum a room or space that has people in it. Wait until the room or space is empty to vacuum, such as at night for common spaces, or during the day for private rooms. • Cleaning staff should clean and disinfect all areas, such as classrooms, offices, bathrooms, common areas, shared electronic equipment (like tablets, touch screens, keyboards, and remote controls) used by the person who is sick, focusing on frequently touched surfaces. DO NOT ENTER At a facility that does house people overnight: • You should work with state and local health officials to isolate people who are sick and provide temporary housing as needed. Follow the Interim Guidance for US Institutions of Higher Education. • Close off areas visited by the person who is sick. • Open outside doors and windows and use ventilating fans to increase air circulation in the area. • Do not vacuum a room or space that has people in it. Wait to vacuum until the room or space is empty, such as at night for common spaces, or during the day for private rooms. • In areas where people who are sick are being housed in isolation, follow the CDC Interim Guidance for Environmental Cleaning and Disinfection for U.S. Households with Suspected or Confirmed Coronavirus Disease 2019. - Focus on cleaning and disinfecting common areas where staff or other people who provide services may come into contact with people who are sick. - You should reduce how often you clean and disinfect the bedrooms and bathrooms used by people who are sick. Only clean and disinfect these spaces as-needed. - Clean and disinfect as normal in areas people who are sick have visited or used. You do not need to do any extra cleaning and disinfection if it has been more than 7 days since the person with COVID-19 visited or used the area. 91 Considerations for schools as employers Sick leave The easiest way to protect your school is to ask sick employees to stay home. Many employees are scared to take time off if they are sick for fear of losing their job or income while they get better. Employees may also be scared to tell their employer if someone in their home has tested positive for COVID-19 or if they have come in close contact with someone who has tested positive. Most people who test positive for COVID-19 will have symptoms of the disease. However, COVID-19 may also be spread by people who have very mild symptoms or no symptoms at all. This means a person can have the virus and not even know it. This is why it is very important during the pandemic for employers to have sick leave policies that make employees feel safe to take time off if they are sick or should be quarantined. You should not ask employees who are sick for a COVID-19 test result, a doctor’s note, or a note from the health department to prove they are ill, qualify for sick leave, or to come back to work. This places a burden on the healthcare and public health systems. You do not need a doctor’s note from the employee to get the tax credits. The Families First Coronavirus Response Act (FFCRA) requires certain employers to give employees emergency paid sick leave or expanded family and medical leave for reasons related to COVID-19. Private employers with fewer than 500 employees get tax credits for the cost to give employees paid leave for reasons related to COVID-19. Keep in mind this emergency leave is in addition to any paid sick leave your company already offers. You can’t reduce the benefits in the policy you have because of the law. You may want to create a form or template for employees to fill out if they need to isolate or quarantine for COVID-19. This form should include all of the information you will need to get the FFCRA tax credits for your business. Symptoms of COVID-19 Fever Fever (temperature of 100.4°F or 38°C or higher or feeling feverish) (temperature of 100.4°F or 38°C or higher or feeling feverish) Cough Cough Fever (temperature of 100.4°F or 38°C or higher or feeling feverish) Shortness of breath Shortness of breath Decrease in sense of smell or taste Decrease in sense of smell or taste Cough Sore throat Sore throat Shortness of breath Muscle aches and pains Muscle aches and pains 92 Decrease in sense of smell or taste Sore throat Muscle aches and pains Generally, the FFCRA says employees of covered employers are eligible for: Reason for paid sick leave The employee is unable to work because the employee is quarantined or isolated due to COVID-19. Covered hours of paid sick leave Up to 80 hours Covered rate of pay Employee’s regular rate of pay Documentation needed for FFCRA tax credit A statement from the employee that says he or she has symptoms of COVID-19 and will get medical treatment. The statement should include: • Employee’s full name • Date of birth • Social security or work residency number • Rate of pay The employee is unable to work because he or she has to care for someone who is quarantined for COVID-19. Up to 80 hours of paid sick leave Two-thirds (2/3) the employee’s regular rate of pay The statement must include: • Employee’s full name • Employee’s date of birth • Employee’s social security number or work residency number • Full name of the person the employee is taking care of • The date of birth of the person the employee is taking care of • The employee’s relationship to the person he or she is taking care of • Name of the government entity or healthcare provider that required the quarantine. Or The employee has to care for a child (under 18 years of age) whose school or childcare provider is closed or unavailable for reasons related to COVID-19. An employee, who has been employed for at least 30 calendar days, is unable to work because he or she has to care for a child whose school or childcare provider is closed or unavailable for reasons related to COVID-19. A statement from the employee that says he or she is unable to work because he or she must provide care for someone who is quarantined. Up to an additional 10 weeks of paid expanded family and medical leave Two-thirds (2/3) the employee’s regular rate of pay A statement from the employee that says he or she is unable to work because he or she must provide care for children whose school or childcare center is closed due to COVID-19 related reasons. The statement must say that no other person will be providing care for the period the employee is receiving EFMLEA. If the child is over the age of 14, the employee must also state there are special circumstances requiring the employee to provide care. The statement must include: • Employee’s full name • Employee’s date of birth • Employee’s social security number or work residency number • Full name of the children the employee is taking care of • The dates of birth of the children the employee is taking care of • The employee’s relationship to the children he or she is taking care of • The name of the school, care center, or childcare provider that is unavailable for COVID-19 reasons. 93 If you offer sick leave During the pandemic, make sure you have sick leave policies in place to protect all of your employees. If someone comes to work sick, he or she could spread illness to other employees. Make employees stay home when they are sick to prevent the spread of COVID-19 to others. • Review your sick leave and human resource policies. It is a good idea to add in a section about sick leave for reasons related to COVID-19. • It is important to make sure employees understand sick leave policies so they don’t come to work sick. • Your policies should give employees the leave they need to quarantine or isolate. • Sick leave policies should let employees stay home to care for a sick family member or take care of children if school or childcare is closed. • During the pandemic, you may want to give advances on future sick leave and allow employees to donate sick leave to each other. If you do not offer sick leave to some or all of your employees If you do not offer sick leave to some or all of your employees, you may want to make a non-punitive “emergency sick leave” policy. This means your policy should not punish employees for taking leave for reasons related to COVID-19. If you use other companies for contract or temporary employees, talk to them about how important it is for sick employees to stay home. You may want to ask them to use non-punitive leave policies. A good example of a non-punitive emergency sick leave policy An employer does not offer sick leave, but employees earn a certain amount of paid time off each pay period. The amount of paid time off is based on the hours they work each pay period. An employee tests positive for COVID-19 and must isolate at home. The employer lets the employee keep earning paid time off while the employee is on isolation, even though the employee is not working. A policy like this makes it more likely employees will stay home when they are sick, and not spread the virus to other employees. 94 Plan for teachers and employees to be sick. If many teachers and employees get sick at one time, this can make it hard to keep your school open. • Have a process or system for teachers and employees to report if they are sick. You can use this same process to let teachers and employees know about exposures to COVID-19 or transition to remote or hybrid learning. • Cross-train employees to do essential functions. You need your workplace to operate even if key employees are absent. • Plan to track and respond to absenteeism in the workplace. If many teachers and employees get sick, you may need to change your plan to make sure your school stays open. • Plan for how you will operate if many teachers and employees are sick at one time or have sick family members to care for at home. If an employee tests positive for COVID-19, do I have to keep the employee on the payroll? The Families First Coronavirus Response Act requires certain employers to give employees paid sick leave or expanded family and medical leave for reasons related to COVID-19. Private employers with fewer than 500 employees get tax credits for the cost to give employees paid leave for reasons related to COVID-19. 95 Travel Travel increases the chance you may get infected or spread COVID-19. Try to limit non-essential travel during the COVID-19 pandemic as much as you can. For up-to-date travel recommendations, visit the CDC website at https://www.cdc. gov/coronavirus/2019-ncov/travelers/index.html. Right now, there are no COVID-19 travel restrictions in Utah. This means students, teachers, or employees who travel outside the state of Utah do not need to quarantine when they get back. However, there may be mandatory quarantines in other cities or states across the U.S. Before traveling, visit the state website of the area you are traveling to for more information. If students, teachers, or employees travel outside the U.S., the CDC recommends he or she quarantine for 14 days after getting back. You can find the CDC’s recommendations for what to do after you return from international travel at https://www.cdc.gov/coronavirus/2019-ncov/travelers/after- travel-precautions.html. The CDC recommends you avoid all nonessential travel to certain areas of the world where COVID-19 is widespread. There may also be restrictions entering the U.S. if you travel to these areas. These travel health alerts can be found at https://www.cdc.gov/ coronavirus/2019-ncov/travelers/map-and-travel-notices.html. Consider these questions before you travel: Is COVID-19 spreading where you are going? You can get infected when you travel. I s COVID-19 spreading in your community? Even if you don’t have symptoms, you can spread COVID-19 to others while traveling. ill you, or people you travel with, be within 6 feet or 2 meters of other people during or after your trip? W COVID-19 is mainly spread by close contact with someone who is sick. If you are within 6 feet or 2 meters (about 2 arm lengths) of other people you are more likely to get the virus. re you or people you are traveling with at high-risk of getting very sick from COVID-19? Older adults and A people of any age who have a serious underlying medical condition are at higher risk for severe illness from COVID-19. o you live with someone who is at high-risk of getting very sick from COVID-19? If you get infected while D you travel you can spread COVID-19 to loved ones when you return, even if you don’t have symptoms. oes the state or local government where you live or at your destination require you to stay home for D 14 days after traveling? Some state and local governments may require people who have recently traveled to stay home for 14 days. I f you get sick with COVID-19, will you have to miss work or school? People with COVID-19 disease need to isolate at home until the health department says they will no longer spread the virus to other people. 96 Help your students, teachers, and employees. This is a stressful time for everyone. Students, teachers, and employees may not always feel comfortable telling someone they need help. Talk to your students, teachers, and employees about stress related to COVID-19 and ways to cope with that stress. Employee concerns You may want to have a hotline or another way employees can voice any concerns anonymously. Worksite wellness resources for teachers, employees, students, and families The Utah Department of Health and your local health department have many other resources for your school to help you keep students, their families, teachers, and employees healthy. If you are interested in other ways we can help, such as bringing health screenings right to your worksite at no cost to you, contact the Utah Department of Health or your local health department. Resources Help connect employees to employee assistance program (EAP) resources and community resources if they need help. Employees can call 2-1-1 or visit https://211utah.org/ for a list of resources. Your students, teachers, and employees may need extra help from a professional. You can help them by making sure they know where to find resources. To help students, teachers, and employees understand the signs of stress, ways to feel better, and find mental health resources, visit https://coronavirus.utah.gov/Mental-health/. • Emotional health relief hotline: 1-833-442-2211. Caregivers are available 7 days a week. • The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress. • The Disaster Distress Helpline provides crisis counseling to people affected by the COVID-19 pandemic. • The SafeUT app is a free youth crisis text and tip line. 97 Helpful resources Schools and the education sector are not just places of learning for students, but also places of employment. Your school’s plan should address the health and safety of students, teachers, and employees. Make sure your school’s COVID-19 reopening plan follows public health guidance, as well as state and federal labor laws. These resources may be helpful to you as you write your school reopening plan. Utah State Board of Education School Reopening Planning Handbook https://www.schools.utah.gov/file/5997f53e-85ca-418683fe-932385ea760a Utah State Board of Education Planning Requirements and Recommendations for K-12 School Reopening Addendum to Utah Leads Together Color-coded Guidelines https://www.schools.utah.gov/file/a5eba09a-42b8-45c0b8fa-9adeea879fcd Utah State Board of Education Resource Hub for Educators www.schools.utah.gov/coronavirus Utah Color-Coded Health Guidelines (Phased Guidelines) The Phased Guidelines help you understand the guidelines for in-person or virtual learning based on what level of risk or color your community is in. You can find the guidelines at https://coronavirus.utah.gov/utahs-health-guidancesystem/. Utah Leads Together The state of Utah has a plan for health and economic recovery. This plan can be found at https://coronavirus.utah. gov/utah-leads-together/. Utah High School Activities Association https://uhsaa.org/ Utah Guidelines for School Re-entry COVID-19 Response Plan from the Utah School Nurses Association https://www.utahschoolnurses.org/resources CDC school guidance https://www.cdc.gov/coronavirus/2019-ncov/community/ schools-childcare/index.html Student privacy The U.S. Department of Education website answers questions about how to protect student privacy and federal privacy laws such as FERPA apply to COVID-19. https:// studentprivacy.ed.gov/ Leavitt Partners “Understanding the Coronavirus & Situational Characteristics: A Framework for Individuals and Businesses for Mitigating Risk” This framework has guidelines to help reduce the spread of COVID-19. https://leavittpartners.com/whitepaper/understanding-thecoronavirus-situational-characteristics-a-framework-forindividuals-and-businesses-for-mitigating-risk/ Anti-discrimination laws and COVID-19 The U.S. Equal Employment Opportunity Commission website answers questions about how COVID-19 impacts anti-discrimination laws. https://www.eeoc.gov/coronavirus Wage and hour issues, FLSA, FMLA, OSHA, unemployment The U.S. Department of Labor website answers questions about how COVID-19 impacts: • Wage and hour issues • Fair Labor Standards Act (FLSA) • Family Medical Leave Act (FMLA) • Occupational Safety and Health Administration requirements (OSHA) • Unemployment compensation • Families First Coronavirus Response Act (FFCRA) https:// www.dol.gov/coronavirus - Answers to common questions about the FFCRA. This resource is for both employers and employees. https:// www.dol.gov/agencies/whd/pandemic/ffcra-questions - This is a tool to help employees find out if they may qualify for paid sick leave if they need to be on isolation or quarantine for COVID-19. https://www.dol.gov/ agencies/whd/ffcra/benefits-eligibility-webtool 98 COVID-19 outbreaks in schools The Utah Department of Health and Utah’s 13 local health departments provide guidelines to help school administrators understand when a group of students, teachers, or employees at the school may need to be dismissed from in-person learning because there is spread of COVID-19 in the school. These guidelines may change as we learn more about COVID-19. Schools and public health need to be willing to adapt to these changes as we learn more about the best ways to keep students, teachers, and employees safe and schools open for in-person learning. What is an outbreak of COVID-19 in a school? An outbreak is when a disease happens in higher numbers than expected. An outbreak can happen in one area (like a classroom) or extend more widely (like a school or even a school district). The Utah Department of Health and Utah’s 13 local health departments do not consider a single case of COVID-19 (meaning only one person tested positive for COVID-19) in a school or classroom to be an outbreak. However, it is important to know what the public health recommendations are for this situation and how these recommendations change as more people test positive for COVID-19 in the school. At this time, these guidelines only apply to the classroom or school setting. This is at the discretion of the school district and the health department when this may happen. The decision of when to consider an outbreak in extracurricular activities, like a sports team, will be made by the local health department in collaboration with the school on a case-by-case basis. Where is the outbreak happening? How many people tested positive for COVID-19? What are some examples of this type of outbreak? What are the recommendations to protect students, teachers, and employees at the school? Individual 1 A student tests positive. This is not considered an outbreak if only one person tests positive for COVID-19 in a classroom or school. A teacher tests positive. The person who tested positive should isolate until they have been fever-free for 24 hours and it has been at least 10 days since they first got sick or tested positive. A bus driver tests positive. The school should follow the cleaning guidelines on page 85. 99 Where is the outbreak happening? How many people tested positive for COVID-19? What are some examples of this type of outbreak? What are the recommendations to protect students, teachers, and employees at the school? Classroom 3 people who are connected by the same setting and time period is considered a classroom outbreak. A teacher tests positive and within 2 weeks, two of the students in his or her class also test positive. People living in the same home are not considered an outbreak. Three students in the same class test positive within 2 weeks of each other. The people who tested positive should isolate until they have been fever-free for 24 hours and it has been at least 10 days since they first got sick or tested positive. The people who were exposed should quarantine for 14 days from the last date of exposure. No one in the whole class can go to school for 14 days from the last date of exposure. Modified quarantine is not allowed if there is an outbreak in the classroom. The school will provide virtual learning for the whole class. The school should clean the classroom using the cleaning guidelines on page 85. School 15 people tested positive for COVID-19 across multiple settings in the school (more than one classroom) and are connected by the same time period or 10% of the student population, whichever is lower, is considered a school outbreak. 15 students and teachers in different classes in the school test positive within 2 weeks of each other. A charter school has 100 students and 10 of the students (10% of the total student population) have tested positive. The people who tested positive should isolate until they have been fever-free for 24 hours and it has been at least 10 days since they first got sick or tested positive. The people who were exposed should quarantine for 14 days from the last date of exposure. No students can go to school for 14 days from the last date of exposure. Modified quarantine is not allowed if there is an outbreak in the school. The school will provide virtual learning for all students. They should clean the whole school using the cleaning guidelines on page 85. School district An outbreak that affects more than one school in a school district. This will be decided on a case-by-case basis by the local health department in collaboration with the local school district. 100 Who will decide if schools will transition from in-person learning to hybrid or remote learning? The decision to transition from in-person learning to hybrid or remote learning will be made by school administrators in collaboration with the local school board and the health department. If a school needs to transition from in-person learning to hybrid or remote learning, it may be for a short period of time, such as 2 weeks, or for the rest of the school year. The Governor, state health department, and local health department each have legal authority to close schools in response to a public health emergency22. Many things will be considered in this situation including the: • Importance of in-person learning to the social, emotional, economic, and academic growth and well-being of students. • Number of people in the community who are testing positive for COVID-19 (called community spread or community transmission). • Number of students, teachers, and employees who are testing positive for COVID-19 or who are on quarantine due to an exposure. • Growth rate of new cases (people who tested positive) in the area. • Statewide capacity for testing, hospital beds, and ICUs. • The color coded risk phase the city or county is currently in23. • Interaction of students, teachers, and employees among other schools in the district. • Ability to provide virtual learning to students. • Economic and social hardships on families and students. 22 https://schools.utah.gov/coronavirus?mid=4985&aid=1 23 https://coronavirus.utah.gov/utahs-health-guidance-system/ 101