Dallas County School Decision-Making Protocol for Responses to Multiple Cases PREVENTION MEASURES EXPECTED in ALL SITUATIONS: Cloth face coverings a positive case of COVID-19 is identified within a school community. The RRT will collaborate with DCHHS to ensure coordinated response and communication efforts. Has individual been in the BUILDING or at school activities since 48h prior to the onset of symptoms? YES YES Can all contacts be easily traced? *When case has been in multiple locations, each location will need to close for 24H for cleaning and disinfecting † Wait at least 24H before cleaning and disinfecting. If 24H is not feasible, wait the time needed to remove airborne contaminants based on efficiency as referenced in Table 2 on slide 4 Page 1 SPECIFIC STEPS if community spread is: Low Adapted from TN DOH and TN DOE (8/2020) Moderate High Close classroom(s)* 24h† Close classroom(s)* 24h† Close classroom(s)* 24h† Reopen classroom(s) Reopen classroom(s) Reopen classroom(s) • • • • for cleaning and until school has identified close contacts 1. Exclude contacts from the building for 14d 2. Reinforce prevention measures above Restrict events & gatherings Close building 24h for NO NO Hand hygiene Cohort students & staff into small groups that remain together over time as much as possible. District/school representatives should contact DCHHS for guidance, as needed. The school’s designated rapid response team (RT) should serve as the initial response command unit, when For EVERY identified case Social distancing for cleaning and until school has identified close contacts 1. Exclude contacts from the building for 14d 2. Reinforce prevention measures above Restrict events & gatherings Close building 24h for for cleaning and until school has identified close contacts 1. Exclude contacts from the building for 14d 2. Reinforce prevention measures above NO events or gatherings Reduce students/staff present at the same time Close building 24h for cleaning and until school has identified close contacts 1. Exclude contacts from the building for 14d 2. Reinforce prevention measures above cleaning and until school has identified close contacts 1. Exclude contacts from the building for 14d 2. Reinforce prevention measures above cleaning and until school has identified close contacts 1. Exclude contacts from the building for 14d 2. Reinforce prevention measures above Reopen building, including classroom Reopen building, including classroom Reopen building, including classroom • • • Restrict events & gatherings Restrict events & gatherings • Restrict events & gatherings Consider reducing numbers of students/staff present at the same time District contacts local health department to assist with tracing contacts. Ensure contacts do not return to the building for 14 days from the last exposure. Dallas County School Decision-Making Protocol for Responses to Multiple Cases PREVENTION MEASURES EXPECTED in ALL SITUATIONS: Cloth face coverings Social distancing Hand hygiene Cohort students & staff into small groups that remain together over time as much as possible. District representatives should contact local health department for guidance, as needed. School & District Action Teams should be formed to serve as the initial response command unit should a positive case of COVID-19 be identified within a school community. The action teams will collaborate with local health authorities to ensure coordinated response and communication efforts. For two or more unlinked cases May need to consider 14 day CLOSURE YES Can all contacts be easily traced? NO of a section of hallway, grade or the entire building depending upon degree of involvement. May need to consider 14 day CLOSURE of a section of hallway, grade or the entire building depending upon degree of involvement. Seriously consider 14 day CLOSURE of a section of hallway, grade or the entire building depending upon degree of involvement. Refer to “For Every Identified Case.” (prior algorithm) If exposure is widespread, consider partial or complete building closure for 14 days. YES Confident contacts have been identified? Increasing number of cases identified within 14 days? Page 2 High Refer to “For Every Identified Case.” Continue with current plan. (prior algorithm) Common classmates, friend group, teammates, etc. (excludes siblings) NO Moderate See section for management of increasing number of cases in 14 days Two or more linked cases within 14 days YES Low Refer to “For Every Identified Case.” (prior algorithm) No common classes, close friends, teammates Are cases within a physical single CLASSROOM space or relatively confined area? SPECIFIC STEPS if community spread is: Adapted from TN DOH and TN DOE (8/2020) Seriously consider 14-day BUILDING closure if extensive exposure NO Seriously consider 14day BUILDING closure unless circumstances dictate otherwise Seriously consider 14day BUILDING closure unless circumstances dictate otherwise Minimum 14-day BUILDING closure unless circumstances dictate otherwise Table 1: Considerations for Different Steps in the Algorithm Step Consideration “Can contacts be easily traced?” No = No cohorting of students and/or no assigned seating, extracurricular gatherings with large number unknown contacts Yes = Assigned seating in class, on bus, and at lunch and/or cohorts employed “Classroom closure” • There may be consequences of closing a physical space used by multiple groups of students throughout the day. There may need to be backup spaces available in the case of classroom closures. Otherwise all other students meant to utilize that space will need to transition to distance learning. • Wait at least 24h before cleaning and disinfecting. If 24 hrs is not feasible, wait the time needed to remove airborne contaminants based on efficiency as referenced in Table 2 on slide 4. “Level of Community • Definitions for high, medium, and low transmission levels are Spread” determined by Dallas County public health committee “Increasing number of cases in 14 days” Page 3 • Each situation will be determined on a case by case basis Table 2: Air changes per hour (ACH) and time required for airborne-contaminant removal by efficiency ACH Time (mins.) required for removal 99% efficiency Time (mins.) required for removal 99.9% efficiency 2 138 207 4 69 104 6 46 69 8 35 52 10 28 41 12 23 35 15 18 28 20 14 21 50 6 8 https://www.cdc.gov/infectioncontrol/guidelines/environmental/appendix/air.html Page 4