Bureau of Infectious Disease Control Considerations for Transitioning Between School Instructional Models Based on Level of Community COVID-19 Transmission and Impact on Local Schools September 1, 2020 Background: The spread of Coronavirus Disease 2019 (COVID-19) in New Hampshire in March 2020 resulted in schools transitioning to full-time remote learning for the remainder of the 2019-2020 academic year. In July, the New Hampshire Department of Education (NH DOE) released Grades K-12 Back-to-School Guidance for the return to school in the fall. Because of continued COVID-19 community transmission and the unpredictability of the pandemic, schools were asked to plan for different instructional scenarios (in-person, remote, and hybrid) and maintain flexibility to adapt school learning to the constantly changing pandemic. Purpose: The purpose of this document is to provide considerations for when schools can consider transitioning between the different instructional models in response to the changing community and school-based COVID-19 epidemiology. This guidance suggests an instructional model based on the COVID-19 level of: 1.) Community transmission within the county in which the school resides (or within the cities of Manchester and Nashua for those school districts) 2.) Impact on individual school facilities These two factors are incorporated into a decision matrix below that specifies the least restrictive method of instruction suggested by the New Hampshire Department of Health and Human Services, Division of Public Health Services (DPHS). Data related to these metrics will be displayed on the “School” tab on the analytics data dashboard available at: https://www.nh.gov/covid19/dashboard/overview.htm. Each school and school district, however, operates in a unique context and with different facility and space capacity, so school districts can choose to take a more or less restrictive approach, as deemed necessary based on the local situation. NH DPHS will also work with schools and SAUs to implement public health protective measures based on specific situations. Determining the Level of COVID-19 Community Transmission: NH DPHS proposes three different criteria outlined in the table below for determining county COVID-19 transmission level; Manchester and Nashua will continue to have city-level data separated for local decision making. The overall community transmission level should be assigned based the highest level identified by any one of the following criteria. School districts should utilize the appropriate county/city-level data in which their schools primarily reside for the criteria below. Criteria COVID-19 PCR test positivity as a 7 day average Number of new infections per 100,000 population over prior 14 days Number of new hospitalizations per 100,000 people over the prior 14 days NH Department of Health and Human Services Division of Public Health Services Bureau of Infectious Disease Control Level of Community Transmission Minimal Moderate Substantial < 5% 5 – 10% >10% <50 50-100 >100 <10 10-20 >20 -1- Transitioning Between Instructional Models COVID-19 September 1, 2020 Determining the Level of COVID-19 School Impact (defined at the educational facility level): To determine the school-specific COVID-19 impact level, NH DPHS suggests three criteria outlined in the table below. The overall level of school impact should be assigned based the highest level identified by any one of the following criteria. These criteria and impact levels may change during the school year as we better understand how COVID-19 impacts schools. Level of School Impact Criteria Transmission within the school facility Low Medium Zero or sporadic cases with no evidence of transmission within the school setting One cluster* in the school <15% 15-30% >30% Normal Strained Critical Student absenteeism due to illness Staff capacity to conduct classes and school operations† High Two or more unrelated clusters* in the school with onset (based on source case symptom onset dates) within 14 days of each other * A cluster is defined as 3 or more individuals confirmed with COVID-19 who are part of a related group of individuals (e.g., classroom) who had the potential to transmit infection to each other through close contact. † This subjective assessment should factor in a school’s ability to maintain adequate staff for facility operations, transportation, teaching, and administrative functions. Decision Matrix for Transitioning Between Methods of Instruction: Using the assigned community transmission and school impact levels, schools can use the table below to identify the least restrictive method of instruction suggested by NH DPHS. Level of Community Transmission Level of School Impact Minimal Moderate Substantial Low In-Person In-Person Hybrid Medium In-Person Hybrid Remote Hybrid* Remote Remote High * Depending on the level of COVID-19 transmission in the school and outbreak status, public health may recommend temporary closure of school and remote learning for a short period of time to control transmission before re-opening in a hybrid instructional model. This matrix should serve as a guide for schools to consider when planning and making decisions around when to move between methods of instruction, regardless of which instructional model was chosen for initial school re-opening. NH DPHS will work with schools and districts to implement public health prevention measures and conduct contact tracing in the school setting for any person identified with COVID-19, and the State will work with local schools and communities to ensure adequate testing capacity and contact tracing resources. In some circumstances, schools may want to take a more restrictive approach than what is suggested in the table above. For example, in situations with a “high” level of school impact but “minimal” community transmission, schools could consider a temporary short-term period of remote instruction before moving to a hybrid model of instruction, especially if the school is already conducting operations in a hybrid model of learning. For schools that go to remote learning, that decision can be a short-term period (e.g., at least 2 weeks) of remote learning, or potentially longer, especially in situations with “high” community transmission. When relaxing restrictions and increasing in-person learning, schools should transition back to the next most restrictive option allowed by their level of community transmission. For example, if a school is in remote instruction, they should transition back to a hybrid instructional model; if a school is in hybrid they can transition back to full in-person instruction, if suggested at their level of community transmission. Schools should monitor their local situation for at least 2-4 weeks before continuing to relax restrictions. NH Department of Health and Human Services Division of Public Health Services Bureau of Infectious Disease Control -2- Transitioning Between Instructional Models COVID-19 September 1, 2020