COVID-19 school screening protocol Universal face covering remains a cornerstone in controlling the spread of COVID-19. However, it is hard to quantify the impact of this intervention given the variables of types and care of masks in a school setting, so this protocol is framed accordingly. For those districts with the ability to provide surgical masks to their staff and students, we have an adjusted protocol we would be happy to share. protocol for front-line school screening screening: screen all students and staff for potential or exposure start here If screening in Dem?, wear proper quarantine at home exposure: within the last 14 days, yes within the last 14 daysl yes i4 mtg? to; sghooltaftter i haveyou been In contact with a were you within 5 feet ful- EYE as 3'0? all: un ess person who I: diagnosed longer than 15 minutes Wm? ?ms EVE Up with onion-1s? 1llIllrith this person? If developI lsola te at home and seek evaluation by no no a health care provider the last 48 hours, have you had any of the following signs and of illness? newoough {or change in baseline} vomitingfdiarrhea fever abdominal pain return to newonsetsevere headache loss oftasteysmeil class sure ?'roat yes for any PmPPE-indsxiu care prov er Ind W?imt Main:5epinteas&moonlaginos MESEElas-amormi: maeonn?nnsi?nasmseeif?ey diagnosis of CCWID-IEI become sid: alternative no dlagnosls diagnosis of covIo-19 return to school after: - 24 hours afebriie. without fever reducing medicines isolate at home {notify school district and health department of positive) Isolate at home - AND i0 days since first return to school after: AND improving . 24 hours afebriie. without fever reducing medicines - AND improving a on Return may depend on your diagnosis children?s 3310033 0:2 2033' Dayton All Rights Reserved The Wh Logo Mark and all trade marks are owned by Dayton ?s Hosprtal - rensdaybonorg scenarios • 12 different scenarios identified • Variations of well and sick classmates/staff/bus driver/others o Who is evaluated by a health care provider for possible testing o Who should quarantine* for each scenario o When to return to class • In general, exposure is defined as contact within 6 feet for 15 minutes in the prior 14 days. Exposure may vary depending on degree of contact. • Contact of a contact – exposure to someone who was exposed to a person diagnosed with COVID-19 is not an exposure. *Isolate and quarantine are used throughout this document. The definitions are: • Isolate – Separate a sick or contagious person from others who are not sick • Quarantine – Separate or restrict movement of people who were exposed to a contagious illness to see if they become sick scenarios table of contents • • • • • Scenarios 1-2: Scenario 3: Scenarios 4-6: Scenarios 7-8: Scenarios 9-12: Riding the bus In the classroom In school, outside the classroom Extracurricular activities/sports Home scenario 1 Child rides school bus Monday-Friday to school only, wears face covering about half of the time they’re on the bus (bus ride is 10 minutes). Begins to feels ill Sunday, diagnosed with COVID-19 Monday afternoon. Child is isolated at home. Who is quarantined at home? a) b) c) d) e) Bus driver? Classmates sitting with him/near him? Classmates/teacher in class? Parents/family? Parents/family of the classmates? Who is evaluated by a health care provider for possible testing? a) b) c) d) e) Bus driver? Classmates sitting with him/near him? Classmates/teacher in class? Parents/family? Parents/family of the classmates? scenario 1 - answers Child rides school bus Monday-Friday to school only, wears face covering about half of the time they’re on the bus (bus ride is 10 minutes). Begins to feel ill Sunday, diagnosed with COVID-19 Monday afternoon. Child is isolated at home. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) d) e) Bus driver? No, because the duration of exposure was less than 15 minutes. Classmates sitting with him/near him? No, because the duration of exposure was less than 15 minutes. Classmates/teacher in class? If classmates/teacher in class had contact within 6 feet for more than 15 minutes with the ill classmate, they should quarantine at home. Parents/family? Yes. Parents and family members of the child with COVID-19 likely had contact within 6 feet for more than 15 minutes. Parents/family of the classmates? No, they do not need to quarantine at home. b) c) d) e) Bus driver? If the bus driver develops symptoms, they should be evaluated. Classmates sitting with him/near him? If the classmate develops symptoms, they should be evaluated. Classmates/Teacher in class? If the classmates/teacher develop symptoms, they should be evaluated. Parents/family? Parents and family members of the child with COVID-19 should be evaluated by a health care provider if they exhibit symptoms. Parents/family of the classmates? No, it is not necessary to evaluate the family members of classmates at this time. scenario 2 Bus driver drives Monday-Friday, sits behind plexiglass shield and does not wear face covering except when kids are entering or exiting the bus. Feels ill Saturday, isolates at home. Diagnosed with COVID-19 Tuesday. Who is quarantined at home? a) b) c) d) All students on the bus? Students in the front of the bus? Parents/family members of students? Family member of the bus driver? Who is evaluated by a health care provider for possible testing? a) b) c) d) All students on the bus? Students in the front of the bus? Parents/family members of students? Family member of the bus driver? scenario 2 - answers Bus driver drives Monday-Friday, sits behind plexiglass shield and does not wear face covering except when kids are entering or exiting the bus. Feels ill Saturday, isolates at home. Diagnosed with COVID-19 Tuesday. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) d) All students on the bus? Not all students need to quarantine, but some may need to. Students who were within 6 feet of the bus driver on rides longer than 15 minutes should quarantine at home. Students in the front of the bus? Yes. Those students within 6 feet of the bus driver on rides longer than 15 minutes should quarantine at home. Parents/family members of students? No, unless the parents or family member had exposure to the bus driver within 6 feet and longer than 15 minutes. Family member of the bus driver? Yes, it is likely the family member had contact within 6 feet for more than 15 minutes. b) c) d) All students on the bus? If the student develops symptoms, they should be evaluated. Students in the front of the bus? If the student develops symptoms, they should be evaluated. Parents/family members of students? It is not necessary to evaluate the family members of students at this time. Family member of the bus driver? If the family member develops symptoms, they should be evaluated. scenario 3 A classroom has desks in rows closer than 6 feet. A student develops symptoms and is diagnosed with COVID-19. Students and teacher have consistently worn face coverings. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) b) c) d) a) b) c) d) Classmates/teacher? Family members of the positive student? Family members of the other classmates and teachers? Students and teachers in other rooms? Classmates/teacher? Family members of the positive student? Family members of the other classmates and teachers? Students and teachers in other rooms? scenario 3 answers A classroom has desks in rows closer than 6 feet. A student develops symptoms and is diagnosed with COVID-19. Students and teacher have consistently worn face coverings. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) d) Classmates/teacher? Yes, anyone who had contact within 6 feet for more than 15 minutes should quarantine at home. Family members of the positive student? It is likely the family of the positive student had contact for more than 15 minutes within 6 feet and should quarantine at home. Family members of the other classmates and teachers? No, they do not need to quarantine at home. Students and teachers in other rooms? No, they do not need to quarantine at home. b) c) d) Classmates/teacher? If the classmate/teacher develops symptoms, they should be evaluated. Family members of the positive student? If the family member of the child with COVID-19 develops symptoms, they should be evaluated. Family members of the other classmates and teachers? It is not necessary to be evaluated at this time. Students and teachers in other rooms? It is not necessary to be evaluated at this time. scenario 4 Student eats lunch every day in the lunchroom. Feels ill at the end of the day Thursday. Rode bus home from school. Wore face covering the whole time on the bus. No one in his immediate social circle is ill. Student is diagnosed with COVID-19. Who is quarantined at home? a) b) c) d) e) f) Classmates at lunch? Classmates/teacher in classroom? Classmates on bus? Bus driver? Parents/family members of the COVID positive student? Parents and family members of other exposed classmates/teacher? Who is evaluated by a health care provider for possible testing? a) b) c) d) e) f) Classmates at lunch? Classmates/teacher in classroom? Classmates on bus? Bus driver? Parents/family members of the COVID positive student? Parents and family members of other exposed classmates/teacher? scenario 4 – answers (1 of 2) A student eats lunch every day in the lunchroom. Feels ill at the end of the day Thursday. Rode bus home from school. Wore face covering the whole time on the bus. No one in his immediate social circle is ill. Student is diagnosed with COVID-19. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) Classmates at lunch? Classmates within 6 feet for more than 15 minutes on Tuesday, Wednesday, or Thursday at lunch should quarantine at home. Classmates/teacher in classroom? Classmates within 6 feet for more than 15 minutes Tuesday, Wednesday, or Thursday should quarantine at home. Students on bus? Students within 6 feet for more than 15 minutes Tuesday, Wednesday, or Thursday should quarantine at home. b) c) Classmates at lunch? Classmates within 6 feet for more than 15 minutes at lunch should be evaluated if symptoms develop. Classmates/teacher in classroom? Classmates/teacher within 6 feet for more than 15 minutes should be evaluated if symptoms develop. Students on bus? Students within 6 feet for more than 15 minutes on bus should be evaluated if symptoms develop. scenario 4 – answers (2 of 2) A student eats lunch every day in the lunchroom. Feels ill at the end of the day Thursday. Rode bus home from school. Wore face covering the whole time on the bus. No one in his immediate social circle is ill. Student is diagnosed with COVID-19. Who is quarantined at home? d) e) f) Who is evaluated by a health care provider for possible testing? Bus driver? If the student sat within 6 feet of the bus d) driver for more than a total combined time of 15 minutes on Tuesday, Wednesday, or Thursday, the driver should e) quarantine at home. Parents/family members of the COVID-19 positive student? Yes. Parents and family members likely had contact f) within 6 feet for more than 15 minutes. Parents and family members of exposed classmates/teacher? No, they do not need to quarantine at home. Bus driver? A driver within 6 feet for more than 15 minutes on bus should be evaluated if symptoms develop. Parents/family members of the COVID-19 positive student? Parents and family members of the COVID-19 positive student should be evaluated if they develop symptoms Parents and family members of other exposed classmates/teacher? It is not necessary to be evaluated at this time. scenario 5 Teacher’s spouse is COVID-19 tested Monday and has positive result Wednesday. Teacher is feeling well. Wore face covering at all times in classroom. Ate lunch with other teachers in teachers’ lounge area with face covering off for 25 minutes. Teacher stays home from Wednesday afternoon on. Teacher is diagnosed with COVID-19 on Friday. Who is quarantined at home? a) b) Coworkers? Students in classroom? Who is evaluated by a health care provider for possible testing? a) b) Coworkers? Students in classroom? scenario 5 - answers Teacher’s spouse is COVID-19 tested Monday and has positive result Wednesday. Teacher is feeling well. Wore face covering at all times in classroom. Ate lunch with other teachers in teachers’ lounge area with face covering off for 25 minutes. Teacher stays home from Wednesday afternoon on. Teacher is diagnosed with COVID-19 on Friday. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) Coworkers? Yes, if contact on Wednesday was greater than 15 minutes within 6 feet. Students in classroom? Yes, if contact on Wednesday was greater than 15 minutes within 6 feet. b) Coworkers? If the coworker develops symptoms, they should be evaluated. Students in classroom? If the student develops symptoms, they should be evaluated. scenario 6 School nurse has been screening all students daily. Nurse wears face covering at all times. Nurse has minimal/significant* contact, closer than 6 feet, to students as they enter the building. Nurse has minimal/significant contact, closer than 6 feet, with teachers as they enter the building. School nurse is diagnosed with COVID19 on Wednesday. Who is quarantined at home? a) b) c) Students? Teachers? Family members of the school nurse? Who is evaluated by a health care provider for possible testing? a) b) c) Students? Teachers? Family members of the school nurse? *Scenario 6 provides 2 answer slides including: minimal contact and significant contact, using PPE as distinction. scenario 6 – answers (minimal contact) School nurse has been screening all students daily. Nurse wears face covering at all times. Nurse has minimal contact, closer than 6 feet, to students as they enter the building. Nurse has minimal contact, closer than 6 feet, with teachers as they enter the building. School nurse is diagnosed with COVID-19 on Wednesday. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) Students? No, less than 15 minutes exposure within six feet for each person during screening. Teachers? No, less than 15 minutes exposure within six feet for each person during screening. Family members of the school nurse? Yes. Family members of the person with COVID-19 likely had contact within 6 feet for more than 15 minutes. b) c) Students? Unless there are symptoms, there is not a need for evaluation at this time. Teachers? Unless there are symptoms, there is not a need for evaluation at this time. Family members of the school nurse? If the family member develops symptoms, they should be evaluated. Minimal contact example: School nurse has either mild cold-like symptoms or no symptoms, asks students/teachers quick screening questions, and sends to class. scenario 6 – answers (significant contact) School nurse has been screening all students daily. Nurse wears face covering at all times. Nurse has significant contact, closer than 6 feet, to students as they enter the building. Nurse has significant contact, closer than 6 feet, with teachers as they enter the building. School nurse is diagnosed with COVID-19 on Wednesday. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) Students? Yes, significant contact may be less than a combined 15 minutes of exposure within six feet for each person during screening. Teachers? Yes, significant contact may be less than a combined 15 minutes of exposure within six feet for each person during screening. Family members of the school nurse? Yes. Family members of the person with COVID-19 likely had contact within 6 feet for more than 15 minutes. b) c) Students? Unless there are symptoms, there is not a need for evaluation at this time. Teachers? Unless there are symptoms, there is not a need for evaluation at this time. Family members of the school nurse? If the family member develops symptoms, they should be evaluated. Significant contact example: School nurse has severe cough, asks students/teachers detailed screening questions, takes temperature, then sends to class. scenario 7 Student participates in volleyball*. Teammates have closer than 6 feet contact for more than 15 minutes regularly during practice. Student has symptoms consistent with COVID-19, alerts team and is diagnosed with COVID-19. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) b) c) d) e) a) b) c) d) e) Teammates/coach? Classmates of the well students on the volleyball team? Classmates of the positive player? Family members of the positive player? Family members of the teammates? Teammates/coach? Classmates of the well students on the volleyball team? Classmates of the positive player? Family members of the positive player? Family members of the teammates? *In general, team and contact sports participants have a presumed unprotected contact within 6 feet for at least 15 minutes. scenario 7 - answers Student participates in volleyball*. Teammates have closer than 6 feet contact for more than 15 minutes regularly during practice. Student has symptoms consistent with COVID-19, alerts team and is diagnosed with COVID-19. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) b) a) c) d) e) Teammates/coach? Yes, teammates/coach needs to quarantine. Classmates of the well students on the volleyball team? No. Even if the test results are positive, secondary contacts (i.e. contacts of contacts) do not need to quarantine. Classmates of the positive player? Yes, anyone who had contact within 6 feet for more than 15 minutes should quarantine at home. Family members of the positive player? Yes. Family members of the person with COVID-19 likely had contact within 6 feet for more than 15 minutes. Family members of the teammates: If the teammates are without symptoms, family members do not need to quarantine at home. If teammates are positive, families of teammates should quarantine at home. b) c) d) e) *In general, team and contact sports participants have a presumed unprotected contact within 6 feet for at least 15 minutes. Teammates/coach? If the teammates/coach develops symptoms, they should be evaluated. Classmates of the well students on the volleyball team? No, no direct exposure to the COVID-19 positive student. Classmates of the positive player? If the classmate develops symptoms, they should be evaluated. Family members of the positive player? If the family members of the positive player develop symptoms, they should be evaluated. Family members of the teammates? Unless there are symptoms, there is not a need for evaluation at this time. scenario 8 Soccer players A & B participate in 2-hour practices with face uncovered. Player A does not wear his face covering consistently while in class. There are no symptoms. A fellow soccer player, Player B, is positive for COVID-19. Unlike his teammate, Player B wears his face covering consistently while in class. Who is quarantined at home? a) b) c) d) e) Teammates/coach? Classmates of Player A, the classmate who does not wear his face covering consistently? Classmates of Player B, the classmate who was positive? Family members of Player A? Family members of Player B? Who is evaluated by a health care provider for possible testing? a) b) c) d) e) Teammates/coach? Classmates of Player A, the classmate who does not wear his face covering consistently? Classmates of Player B, the classmate who was positive? Family members of Player A? Family members of Player B? *In general, team and contact sports participants have a presumed unprotected contact within 6 feet for at least 15 minutes. scenario 8 - answers Soccer players A & B participate in 2-hour practices with face uncovered. Player A does not wear his face covering consistently while in class. There are no symptoms. A fellow soccer player, Player B, is positive for COVID-19. Unlike his teammate, Player B wears his face covering consistently while in class. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) d) e) Teammates/coach? Yes, teammates, including player A and coach likely had exposure longer than 15 minutes within 6 feet. Classmates of Player A, the student who does not wear his face covering consistently? No. Secondary contacts (i.e. contacts of contacts) do not need to be quarantined. Classmates of Player B, the classmate who was positive? Yes, anyone who was within 6 feet for longer than 15 minutes should quarantine at home. Family members of Player A? Family members of the well player do not need to quarantine at this time because he does not have a positive test. Family members of Player B? Yes, family members of Player B, the player with COVID-19, likely had contact within 6 for more than 15 minutes. b) c) d) e) Teammates/coach? If the teammates/coach develop symptoms they should be evaluated. Classmates of Player A, the student who does not wear his face covering consistently? No, no direct exposure to the COVID-19 positive classmate. Classmates of Player B, the classmate who was positive? If the classmates develop symptoms, they should be evaluated. Family members of Player A? Family members of the well player do not require evaluation. Family members of Player B? If the family member(s) of Player B develop symptoms they should be evaluated. *In general, team and contact sports participants have a presumed unprotected contact within 6 feet for at least 15 minutes. scenario 9 Student with fever of 101 degrees for 24 hours on a Saturday. No fever since that time, but has been given fever-reducing medications. No other symptoms. No exposure history. Student has not been evaluated by a health care provider. Who is quarantined at home? a) b) c) Student? Classmates/teacher? Family? Who is evaluated by a health care provider for possible testing? a) b) c) Student? Classmates/teacher? Family? scenario 9 – answers Student with fever of 101 degrees for 24 hours on a Saturday. No fever since that time, but has been given fever-reducing medications. No other symptoms. No exposure history. Student has not been evaluated by a health care provider. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) Student? Student should be evaluated by a health care provider. If no evaluation, isolate at home for 10 days. Classmates/teacher? If student is diagnosed with COVID-19 or no diagnosis, quarantine at home for 14 days. Family? If student is diagnosed with COVID-19 or no diagnosis, quarantine at home for 14 days. b) c) Student? Although there are no other minor symptoms, this student is using fever-reducing medications. To be safe, this child should be evaluated by a medical provider. Classmates/teacher? If the classmate/teacher develops symptoms, they should be evaluated. Family? If the family member develops symptoms, they should be evaluated. Isolate and quarantine are used in this scenario. For clarification, the definitions are: •Isolate – Separate a sick or contagious person from others who are not sick •Quarantine – Separate or restrict movement of people who were exposed to a contagious illness to see if they become sick scenario 10 Student with fever, cough and loss of smell on Friday evening. Attended school all week. Fever resolved Saturday afternoon. Cough resolved Sunday. Still loss of smell. No known COVID-19 exposures. Who is quarantined at home? a) b) c) Student? Classmates/teacher? Family members? Who is evaluated by a health care provider for possible testing? a) b) c) Student? Classmates/teacher? Family members? scenario 10 - answers Student with fever, cough and loss of smell on Friday evening. Attended school all week. Fever resolved Saturday afternoon. Cough resolved Sunday. Still loss of smell. No known COVID-19 exposures. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) Student? This student needs to be evaluated by a health care provider. If no evaluation, the student should isolate at home for 10 days. Classmates/teacher? If diagnosed with COVID-19 or no diagnosis, quarantine at home for 14 days. Family members? If diagnosed with COVID-19 or no diagnosis, quarantine at home for 14 days. b) c) Student? This student with symptoms should be evaluated by a health care provider. Classmates/teacher? If the classmates/teacher develop symptoms they should be evaluated. Family members? If the family members develop symptoms they should be evaluated. Isolate and quarantine are used in this scenario. For clarification, the definitions are: •Isolate – Separate a sick or contagious person from others who are not sick •Quarantine – Separate or restrict movement of people who were exposed to a contagious illness to see if they become sick scenario 11 Student with fever, diarrhea and vomiting for 24 hours at home. No fever or vomiting for the last 24 hours but continues with diarrhea. Who is quarantined at home? a) b) c) Student? Classmates/teacher? Family members? Who is evaluated by a health care provider for possible testing? a) b) c) Student? Classmates/teacher? Family members? scenario 11 - answers Student with fever, diarrhea and vomiting for 24 hours at home. No fever or vomiting for the last 24 hours but continues with diarrhea. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) Student? This student needs to be evaluated by a health care provider. If no evaluation, the student should isolate at home for 10 days. Classmates/teacher? If diagnosed with COVID-19 or no diagnosis, quarantine at home for 14 days. Family members? If diagnosed with COVID-19 or no diagnosis, quarantine at home for 14 days. b) c) Student? This student should be evaluated by a health care provider to determine if COVID-19 testing is needed. If tested for COVID, return to school will depend on testing results. Classmates/teacher? If a classmate/teacher develops symptoms, they should be evaluated. Family members? If a family member develops symptoms, they should be evaluated. Isolate and quarantine are used in this scenario. For clarification, the definitions are: •Isolate – Separate a sick or contagious person from others who are not sick •Quarantine – Separate or restrict movement of people who were exposed to a contagious illness to see if they become sick scenario 12 Student’s parents both test positive for COVID-19. Student is asymptomatic for COVID-19 symptoms. The local health department recommends student quarantine. On day 7 of quarantine, the family has student tested for COVID-19. Test is negative. Who is quarantined at home? a) b) c) 29 Student? Classmates/teacher? Family members? Who is evaluated by a health care provider for possible testing? a) b) c) Student? Classmates/teacher? Family members? scenario 12 - answers Student’s parents both test positive for COVID. Student is asymptomatic for COVID-19 symptoms. The local health department recommends student quarantine. On day 7 of quarantine, the family has student tested for COVID-19. Test is negative. Who is quarantined at home? Who is evaluated by a health care provider for possible testing? a) a) b) c) Student? Yes. Student must quarantine for 17 more days* even with a negative test. If both parents isolate away from student, quarantine will be 14 days from last day of exposure. Classmates/teacher? No, secondary contacts (i.e. contacts of contacts) do not need to be quarantined. Family members? This depends. Other exposed family members should quarantine. Positive family members should isolate from remaining family members. *Quarantine = 14 days from the last day of exposure. COVID isolation = 10 days. 10 (isolation) + 14 (quarantine) = 24 total days. (24-7=17 more days) 30 b) c) Student? If the student develops symptoms, they should be evaluated. Classmates/teacher? If the classmates/teacher develop symptoms they should be evaluated. Family members? Other exposed family members should be evaluated if they develop symptoms. Isolate and quarantine are used in this scenario. For clarification, the definitions are: •Isolate – Separate a sick or contagious person from others who are not sick •Quarantine – Separate or restrict movement of people who were exposed to a contagious illness to see if they become sick