Jun 30, 2020 — In order to secure the safety and protection of children and their families across the state, Governor Cooper, in collaboration with the NC
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 2020; Updated January 10, 2022 2 What™s Inside CURRENT PUBLIC HEALTH GUIDANCE 3 WHAT DO WE KNOW ABOUT COVID -19 AND SCHOOL SETTINGS? .. 6 PREVENTION STRATEGIES 7 PROMOTING VACCINATION .. 7 FACE COVERINGS . 9 PHYSICAL DISTANCING AND MINIMIZING EXPOSURE 10 TESTING .. 11 HANDLING POSSIBLE , SUSPECTED , PRESUMPTIVE , OR CONFIRMED POSITIVE CASES OF COVID -19 . 13 CLEANI NG AND HYGIENE 18 TRANSPORTATION . 19 WATER AND VENTILATION SYSTEMS 20 PROTECTING VULNERABLE POPULATIONS 21 ADDITIONAL CONSIDERATIONS 22 GLOSSARY 23 Available Online: CDC Guidance for COVID -19 Prevention in K -12 Schools Science Brief: Transmission of SARS -CoV -2 in K -12 Schools and Early Care and Education Programs Œ Updated K-12 COVID -19 Testing Program Contact Tracing Procedures for K -12 Scho ols Vaccine Operational Guidance for Schools
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 3 Current Public Health Guidance This Toolkit was last updated on January 7h, 2022 . Key updates are noted in red. The Centers for Disease Control (CDC ) continues to update Guidance for COVID -19 Prevention in K -12 Schools . Key takeaways include: Studen ts benefit from in -person learning, and safely returning to in -person instruction in the fall 2021 is a priority. Vaccination , including getting a booster if eligible , is currently the leading public health prevention strategy to end the COVID -19 pandemic. Promoting vaccination can help schools safely return to in-person learning as well as extracurricular activities and sports. Masks should be worn indoors by all individuals (age 2 and older) who are not fully vaccinated. Consistent and correct ma sk use by people who are not fully vaccinated is especially important indoors and in crowded settings, when physical distancing cannot be maintained. Many schools serve children under the age of 12 who recently became eligible to be vaccinated . Therefore, this guidance emphasizes implementing layered prevention strategies , (e.g., using multiple prevention strategies together consistently) to protect people who are not fully vaccinated, including students, teachers, staff, and other members of the ir households. Localities should monitor community transmission, vaccination coverage, screening testing, and occurrence of outbreaks to guide decisions on the level of layered prevention strategies. Over the summer of 2021, w ith rapidly accelerating viral transmission and the increased contagiousness of the Delta variant, CDC updated the guidance to include recommendations for universal indoor masking for all teachers, staff, students, and visitors to K -12 schools, regardless of vaccination status. The Omicron variant, currently circulating in North Carolina, is even more t ransmissible than the Delta variant and makes the layered prevention strategies even more important . CDC updated the recommended quarantine and isolation p eriods for those exposed to COV ID-19 on December 27, 2021. These updated recommendations have been incorporated in this Toolkit in the Handling Possible, Suspected, Presumptive, or Confirmed Positive Cases of COVID -19 section. Additionally , an option for Test to Stay was included in the January 7, 2022 update. The CDC™s revised school guidance is supported by an accompanying Science Brief , which summarizes the research of COVID -19 among children and adolescents and transmission in schools and among students, familie s, teachers, and school staff used to shape the updated school guidance. The CDC also has released an updated Science Brief on the Community Use of Masks to Control the Spread of COVID -19. This Science Brief summarizes the research available on masks, including studies on mask wearing among children . Additionally, o n November 2 , 2021, the American Academy of Pediatrics (AAP) released updated guidance for schools that recommends the implementation of a multi -pronged layered approach to reduce viral transmission , including universal masking . The AAP recommendations include : All eligible individuals should receive the COVID -19 vaccine. o It ma y become necessary for schools to collect COVID -19 vaccine information of staff and students (as done for other immunizations against other highly infectious diseases ). o Adequate and timely COVID -19 vaccination resources for the whole school community must be available and accessible.
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 4 All students older than 2 years and all school staff should wear face masks at school (unless medical or developmental conditions prohibit use). o The AAP recommends universal masking in school at this time for the following reasons: a significant portion of the student population is not eligible for vaccination protection of unvaccinated students from COVID -19 and to reduce transmission Œ lack of a system to monitor vaccine status among students, teachers and staff potential difficulty in monitoring or enforcing mask policies for those who are not vacci nated; in the absence of schools being able to conduct this monitoring, universal masking is the best and most effective strategy to create consis tent messages, expectations, enforcement, and compliance without the added burden of needing to monitor vaccination status possibility of low vaccination uptake within the surrounding school community continued concerns for variants that are more easily spread among children, adolescents, and adults An added benefit of universal masking is protec tion of students and staff against other respiratory illnesses that would take time away from school. Summary of major updates for 2020 -2021 School Year The StrongSchoolsNC Public Health Toolkit has been updated to align with updated CDC Guidance for COVID -19 Prevention in K -12 Schools . Below is a summary of the major updates to the Toolkit from the previous version: Each section of the Toolkit ha s been organized into categories that prioritize implementation of the strategies that have been shown to be most effective in lowering the risk of COVID -19 exposure and spread in school sessions and school activities : o Strategies that SHOULD be implemented by all school s. These are strategies that, if not implemented, create conditions of high risk for COVID -19 exposure and spread. NCDHHS strongly advises that school leaders adopt all the strategies in the SHOULD sections. o Strategies that school leaders COULD CONSIDER adopting . These are strategies to provide additional layers of prevention and that, if implemented, will further reduce the risk of COVID -19 exposure and spread. o Strategies that are required. These are activities relating to control measures and exclusion from school. Added information on offering and promoting COVID -19 vaccination. Revised to emphasize the COVID -19 prevention strategies most important for in -person learning for K -12 schools – most importantly, promoting vaccinations and proper and consistent use of face coverings . Added language on the importance of offering in -person learning, regardless of whether all the prevention strategies can be implemented at the school. For example, students should not be excluded from full -time , in-person learning to accommodate physical distancing. Instead, other prevention strategi es, in particular consistent and proper masking , should be used. Updated to align with guidance for fully vaccinated people. Added additional guidance on tes ting strategies Added modified quarantine guidance for people after a close contact in which both people were wearing masks . Removed references to options for Plans A, B, and C. Removed reference to remote learning requirement.
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 5 Additionally , the following actions were removed that are not supported by current evidence or are no longer needed due to the lower rates of community transmission and increased rates of vaccination including: o Limit nonessential visitors o Discontinue activities that bring a large group together, such as field trips or assemblies o Keep students in small cohorts o Direct the flow of traffic b y designating hallways as one way or designating certain doors for entrance or exit o Recommend that everyone wear a face covering outdoors o Keep students™ personal items separate o Conduct daily symptom screening o Enforce social distancing on transportation o Provide remote learning options for students unable to be at school due to illness or exposure Operational Flexibility and Planning for Different Scenarios The Toolkit has been updated to provide school leaders with greater flexibility in implementing the layered prevention strategies based on current COVID -19 trend s and updated CDC guidance . School leaders should continue to consult with local public health officials for input on communit y transmission and vaccine uptake to make local decisions . School leaders should continue to maintain plans for different potential scenarios depending on what restrictions are deemed necessary by state or local public health leaders at any time in the school year to control the spread of the disease.
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 6 What Do We K now About COVID -19 and School Settings ? Schools are an important part of the infrastructure of communities. They provide safe and supportive learning environments for students that support social and emotional development, provide access to critical services, and improve life outcomes. Protection against exposure to COVID -19 is essential to ensure that schools can continue to serve these critical functions and that the risk to students, staff and visitors is the lowest possible in school sett ings . Throughout the COVID -19 pandemic, we have continued to learn about how to reduce the risk of viral spread while keeping our children, teachers, and staff in an in -person learning environment . Key to decreasing spread in a school environment is a mu lti -layered approach to prevention, that includes universal face coverings. With North Carolina experiencing a high rate of COVID -19 cases due to the highly contagious Delta and Omicron variant, multi -layered COVID -19 prevention efforts and protection against exposure are more critical than ever within our schools. Any scenario in which people who are not vaccinated gather together poses a risk for COVID -19 transmission. Though studies conducted early in the pandemic suggested children and teens appeared less likely to acquire and spread COVID -19 than adults, the Centers for Disease Control indicates that more recent studies have found their rates of infection to be compar able to, and in some settings higher than, the rates of infection in adults. As camps, sports events, and schools have resumed in -person operations, outbreaks in such settings indicate children and teens can also transmit COVID -19 to others. Compared to a dults, children and teens who contract COVID -19 are more commonly asymptomatic or likely to have mild symptoms and less likely to experience severe outcomes such as hospitalization or de ath. However, while less likely, some children can experience severe illness, hospitalization, and death for children with underlying health conditions and children from minority groups being at increased risk of hospitalizations. In addition, younger peo ple can still spread COVID -19 to people of higher risk of severe illness, even if they are asymptomatic or have mild symptoms. The most recently emerging data is described in CDC™s Science Brief: Transmission of SARS -CoV -2 in K -12 Schools and Early Care and Education Programs – www.cdc.gov/coronavirus/2019 -ncov/science/science -briefs/transmission_k_12_schools.html Fortunately, there are many actions that school and district administrators can take to help lower the risk of COVID -19 exposure and spread during school sessions and activities as outlined in this Toolkit.
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 8 Encourage teachers, staff, students, and families, including extended family members that have frequent contact with students , to get vaccinated as soon as they can. Consider partnering with state or local health departments to serve as COVID -19 vaccination sites and work with loca l healthcare providers and organizations, including school -based health centers. Offering vaccines on -site before, during, and after the school day and during summer months can potentially decrease barriers to getting vaccinated against COVID -19. Identify other potential barriers that may be unique to the local community and implement policies and practices to address them. Find ways to adapt key messages to help families, teachers, and staff become more confident about the vaccine by using the language, tone, and format that fits the needs of the community and is responsive to concerns. Host information sessions to connect parents and guardians with information about the COVID -19 vaccine. Offer flexible, supportive sick leave options (e.g., paid sick leave) for employees to get vaccinated or who have side effects after vaccination. See CDC™s Post -vaccination Consideratio ns for Workplaces . Promote vaccination information for parents and guardians and other household members as part of kindergarten transition and enrollment in summer activities for families entering the school system. Provide students and families flexible options for excused absence s to receive a COVID -19 vaccination and for possible side effects after vaccination. Work with local partners to offer COVID -19 vaccination for eligible students and eligible family members during sport s or extracurricular activity summer physicals. Local communities should determine how best to address school staff with COVID -like symptoms or exposure before they are fully immuniz ed, which is two weeks after they received the last dose of their vaccine series. Due to individual responses to COVID -19 vaccines and timing of possible exposures, it may be difficult to determine when someone who is in process of vaccination is exhibitin g symptoms of COVID -19 infection versus vaccine side effects. In these situations, isolation and quarantine procedures should be based on consultation with the school nurse, local health department and/or health care provider. Existing laws and regulation s require certain vaccinations for children attending school. K -12 administrators regularly maintain documentation of people™s immunization records. Since recommended prevention strategies vary by COVID -19 vaccination status, K -12 administrators who maint ain documentation of students™ and workers™ COVID -19 vaccination status can use this information, consistent with applicable laws and regulations, including those related to privacy, to inform prevention practices. Schools that plan to request voluntary submission of documentation of COVID -19 vaccination status should use the same standard protocols that are used to collect and secure other immunization or health status information from students. The protocol to collect, secure, use, and further disclose this information should comply with relevant statutory and regulatory requirements, including the Family Educational Rights and Privacy Act (FERPA) and its regulatory requirements. More information may be found at Frequently Asked Questions about COVID -19 Vaccinations and NCDHHS Interim Guidance for Individuals Who Have Been Vaccinated Against COVID -19. Recommendations for prevention strategies differ based on vaccination status , for example, participat ion in screening testing programs or quarantine after a close contact with someone with a confirmed case of COVID -19. All schools should: Require teachers and staff to report vaccination status . Require teachers and staff who are unvaccinated , or do not dis close vaccine status, participate in screening/testing programs.
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 9 Face Coverings The following guidance reflects the CDC recommendations on masks , which is informed by the recently updated Science Brief on the Community Use of Masks to Control the Spread of COVID -19. When teachers, staff, and students consistently and correctly wear a mask, they protect others as well as themselves . Consistent and correct mask use is especially important indoors and in crowded settings when physical distancing cannot be maintained. Indoors : Mask use is recommended for all people including students, teachers, and staff in K -12 settings . Children under 2 years of age should not wear a mask. Outdoors : In general, people do not need to wear masks when outdoors. However, particularly in areas of substantial to high transmission , CDC recommends that people who are not fully vaccinated wear a mask in crowded outdoor settings or during activities that involve sustained close contact with other people who are not fully vaccinated. During school transportation: CDC™s Order applies to all public transportation conveyances , including school buses. Regardless of the mask policy at school, all passengers and drivers should wear a mask on school buses, including on buses operated by school systems, subject to the exclusions and exemptions in CDC™s Order. All schools should: Require all children and staff in schools K -12th grade to wear fac e coverings consistently when indoors. Because students cannot mask consistently during mealtimes, students should maintain physical distancing of a minimum of 3 feet to the fullest extent possible when actively eating . Consider having meals outside where risk of virus transmission is low. Per CDC™s Order , require passengers and staff to wear a face covering on buses, vans, and other group school transportati on. Share guidance and information with teachers, staff, students, and families on the proper use, wearing, removal, and cleaning of cloth face coverings, such as CDC™s guidance on wearing and removing cloth face masks and CDC™s use of cloth face coverings . Visit NCDHHS ™ COVID -19 response site for more information about face co verings, a nd to access sign templates that are a vailable i n English and Spanish. Provide masks to those students who need them (including on buses), such as students who forgot to bring their mask or whose families are unable to afford them. No disciplinary action should be taken against a student who does not have a mask as described in the U.S. Department of Education COVID -19 Handbook, Volume 1 . Exceptions to face coverings are people who: Should not wear a face covering due to any medical or behavioral condition or disability (including, but not limited to, any person who has trouble breathing, or is unconscious or incapacitated, or is otherwise unable to put on or remove the face covering without assistance); Is under two (2) years of age; Is actively eating or drinking; Is seeking to communicate with someone who is Deaf, Hard of Hearing, and DeafBlind in a way that requires the mouth to be visible; Is giving a speech for a broadcast or to an audience;
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 10 Is working at home or is in a personal vehicle; Is temporaril y removing his or her face covering to secure government or medical services or for identification purposes; Would be at risk from wearing a face covering at work, as determined by local, state, or federal regulations or workplace safety guidelines; Has found that his or her face covering is impeding visibility to operate equipment or a vehicle; or Is a child whose parent, guardian, or responsible person has been unable to place the Face Covering safely on the child™s face . If a school does not require all individuals to wear a mask , they should ensure a layered mitigation strategy, including physical distancing, ventilation, hand hygiene, adequate access to diagnostic and screening testing and closely monitor for increases i n COVID -19 cases. Physical Distancing and Minimizing Exposure Physical distancing means keeping space between yourself and other people outside of your household . It is a key tool to decrease the spread of COVID -19. Below is the latest CDC recommendations on physical distancing Because of the importance of in -person learning, schools where not everyone is f ully vaccinated should implement physical distancing to the extent possible within their structures, but not exclude students from in -person learning to keep a minimum distance requirement. Based on studies from 2020-2021 school year, CDC recommends school s maintain at least 3 feet of physical distance between students within classrooms, combined with indoor mask wearing by people in areas of high or substantial transmission , according to the CDC., to reduce transmission risk. When it is not possible to maintain a physical distance of at least 3 feet, such as when schools cannot fully re -open while maintaining these distances, it is especially important to layer multiple other prevention strategies , such as indoor masking, screening testing, improved ventilation, handwashing and covering coughs and sneezes, staying home when sick with symptoms of infectious illness including COVID -19, and regular cleaning to help reduce transmission risk. Mask use by people who are not fully vaccinated is particularly important when physical distance cannot be maintained. A distance of at least 6 feet is recommended between students and teachers/staff, and between teachers/staff who are not fully vaccinated. Note: T he CDC removed recommendations for physical barriers (e.g., plexiglass), as of 3/19/2021. All schools should: Maintain a minimum of three (3) feet of distance between K -12 students who are not fully vaccinated within indoor school settings to the greatest extent possible without excluding students from full -time, in -person learning . Maintain a minimum of six (6) feet between adults (teachers/staff/visitors) and students and between adults (teachers/staff/visitors) who are not fully vaccinated withi n indoor school settings to the greatest extent possible. Follow the recommendations outlined in Interim Guidance for A dministrators and Participants of Youth, College & Amateur Sports Programs
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StrongSchoolsNC: Public Health Toolkit (K -12) Interim Guidance Ł Published June 8, 2020; Updated January 10, 2022 11 Instruction that includes singing, shouting, playing wind instr uments, rigorous dance , or exercise, should be held outside if possible . If held indoors, ensure consistent mask use and 6-feet physical distancing between students . All schools could consider : Providing indoor physical distancing floor/seating markings . Marking 3 feet of spacing indoors to remind students to stay 3 feet apart in lines and at other times when they may congregate. Marking 6 feet of spacing indoors to remind teachers and staff to stay 6 feet apart at times when they may congregate, such as during staff meetings, planning periods, lunch, food preparation and distribution, recess, in teacher lounges, and break rooms . Minimize opportunities for close c ontact resulting from sustained exposure (15 minutes or more , cumulative over a 24 hour period, within 6 feet distance) between teachers and staff during staff meetings, planning periods, lunch, recess, in teacher lounges, and break rooms and other areas t eachers and staff may congregate. Allowing visitors and volunteers to resume normal activities if they follow the same protocols as staff and students. Choosing physical education activities that limit frequent and close contact between students. Testing Testing for COVID -19 can help quickly identify those who are infected and those who have been exposed , but have yet to develop symptoms. Viral testing strategies in partnership with schools should be part of a comprehensive approach. Testing shou ld not be used alone, but in combination with other prevention to reduce risk of transmission in schools. When schools implement testing combined with prevention strategies, they can detect new cases to prevent outbreaks, reduce the risk of further transmi ssion, and protect students, teachers, and staff from COVID -19. School testing programs can increase family confidence in school attendance and reduce barriers to testing access in a community. The StrongSchoolsNC K -12 COVID -19 Testing Program provides an ability for schools to implement a testing plan at no cost to the school or the district (funded by DHHS) that includes both screening and diagnostic testing . Learn more about this free test ing at NC DHHS COVID -19 Testing Program for K -12 Schools . Testing Scenarios Diagnostic testing refers to testing done on someone who has symptoms consistent with COVID -19 or has had a close contact with someone with a confirmed case of COVID -19. The ability to do rapid testing on -site can facilitate COVID -19 diagnosis and inform the need for quaran tine of close contacts and isolation. Rapid antigen testing works to prevent in -school transmission while minimizing in -person learning time lost. Screening testing refers to testing done on someone without symptoms or known close contact with someone wit h COVID -19. CDC guidance provides that people who are fully vaccinated do not need to participate in screening testing. Screening testing may be mo st valuable in areas with substantial or high community transmission levels, in areas with low vaccination coverage, and in schools where other prevention strategies are not implemented. More frequent screening testing can increase effectiveness, but feasi bility of increased testing in schools needs to be considered. Screening testing should be done in a way that ensures the ability to maintain confidentiality of results and protect student,
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