Now that Connecticut’s schools are reopening, the million-dollar question is what happens when there is the (unfortunate) inevitable brush with COVID-19. Schools must balance the competing need to safeguard the health and safety of students and staff with providing robust learning opportunities. Schools do not want to cancel classes at the drop of a hat, but they also do not want to be responsible for illnesses (or worse).
There is no scientific formula to be followed. Indeed, the Centers for Disease Control and Prevention backed off its prior guidance that suggested that schools be closed two to five days for a single instance of COVID-19. That being said, Connecticut’s State Department of Education (SDE) has issued guidance that might help schools make these difficult decisions.
In its “Interim Guidance for Responding to COVID-19 Scenarios” (Addendum 5 to its “Adapt, Advance, Achieve” reopening guidance), the SDE poses several scenarios and provides differing school responses to individuals who may have (or have been exposed to) COVID-19, based upon whether an individual has 1) COVID-19 symptoms, 2) had “close contact” with a person diagnosed with COVID-19, and/or 3) tested positive or negative (or has not been tested at all) for COVID-19. For purposes of this guidance, the SDE defines “close contact” as spending at least 15 minutes within six feet of a person with confirmed COVID-19, or a direct exposure to possibly infected droplets of saliva or nasal mucus (e.g., begin sneezed or coughed on in the face).
If a person (whether a student or staff member) has COVID-19 symptoms but no such “close contact” and has received a negative COVID-19 test result, the person can return to school once he or she has no symptoms for 24 hours. If such person has not been tested, he or she can return to school after obtaining a note from a health care provider with alternate diagnoses.
If a person does not have COVID-19 symptoms, but has had such “close contact”, the person should remain in self-quarantine at home for 14 days from the last exposure if the person has tested negative or has not been tested; however, if the person has a positive test, he or she should stay home for 10 days after the test.
In all other scenarios (i.e., all other combinations of symptom, contact, and test result status), the person should stay in self-isolation for at least 10 days since the onset of symptoms and until at least 24 hours have passed with no fever (without medications) and with improvement of other symptoms. In addition, under all scenarios where there is a positive test result, the person should notify the school, notify close personal contacts, and assist public health and school officials in contact tracing.
Addendum 5 and its scenarios provide assistance on how to respond to the specific person who may have (or may have been exposed to) COVID-19. However, the question remains as to what the school/school district as whole must do to respond. Do you close a program (e.g., based upon a “cohort”), the affected school/building, or the entire school district? Or do you just exclude certain persons?
In its “Contact Tracing Scenarios” guidance (Addendum 5), the SDE poses several scenarios to assist a school’s response at large to a confirmed case (i.e., a positive test result for COVID-19). As the SDE warns, the response in all of these scenarios should be informed by many factors (including local circumstances), with the “first and most important step is to understand the timing of symptom onset of the affected person to be able to determine if exposure occurred in the school setting.”
INCIDENTAL: In scenarios where there is 1) one confirmed case in the school, 2) two or more cases in the same classroom (with the outbreak limited to one cohort), or 3) two or more cases within 14 days, but that are linked to an exposure outside the school setting (e.g., in same household, exposed at the same event outside of school), the responses could include the following:
-Students and staff who are determined to be close contacts to a case are excluded from school for 14 days, and /or
-All students/staff in any cohort(s) where the case spent time (at least 15 minutes on any one day) are excluded from school for 14 days.
The SDE states that an assessment of mitigation measures in a school, including social distancing, interaction between cohorts, mask wearing, disinfection and cleaning, school building ventilation, and hand hygiene might “allow for some students inside an affected cohort, and staff to not be considered close contacts.” This assessment will guide the decision as to whether quarantining the entire cohort can be avoided.
MORE: In a scenario where there two or more cases within 14 days, but that are linked together by some activity in school, and who are in different classrooms (i.e., an outbreak involving multiple cohorts), the school should consider not only the above mitigation factors, but also assess whether “activities/events with additional interactions outside of school might result in other individuals outside of the affected cohort being considered close contacts.” In addition to the possible responses listed above, the school will need to consider as a response the closure of school for 14 days.
WIDER: In scenarios where 1) “multiple cases” are identified within 14 days that occur across multiple cohorts with no clear connection between cases, or 2) significant community outbreak is occurring or has recently occurred (e.g., large event or large local employer) and is impacting multiple staff, students, and families served by the school community, the school will not only have to assess the factors listed above, but also assess community case rates and transmission. The school may consider all of the above responses, but the school closure option may be more warranted.
EVEN WIDER: As we noted in this recent blog post, and as was noted in the SDE’s “Interim Guidance for Decision-Making Regarding the Use of In-Person, Hybrid (Blended), or Remote Learning Models in Connecticut Schools during COVID-19” (Addendum 4), the levels of community transmission as determined by the State’s “metrices” may be above certain thresholds so as to cause the school to change its actual learning model. If there is a moderate level of community spread, then the school may switch from full time in person learning (if it is in that model) to a hybrid model, with reduced capacity and programs. If there is a “high” community spread, then school may need to move a 100% remote learning model.
SO, WHAT SHOULD OUR SCHOOL DO? I wish that I had an easy answer. Despite these above tools and suggested/possible responses, there is no “one size fits all” approach or “correct” answer. The SDE notes in Addendum 9 that all decisions about possible exclusions or closures of school will be based on the considerations and the individual circumstances of the case, and such decisions should be made in consultation with local public health officials. The SDE tools provide some logical starting points, but the schools must still make these very difficult calls. At the very least, reliance upon state and federal guidance will serve to minimize a school’s exposure to legal liability.
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