Important update: Healthcare facilities
CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more
UPDATE
Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.
UPDATE
The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.
UPDATE
Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available here.

Responding to COVID-19 Cases in K-12 Schools: Resources for School Administrators

Responding to COVID-19 Cases in K-12 Schools: Resources for School Administrators
Updated June 9, 2022

As K-12 schools resume in-person learning, school administrators must be prepared to respond quickly when someone with COVID-19 has been in the school or at a school event. In these instances, case investigation and contact tracing serve as important strategies for reducing the transmission of SARS-CoV-2, the virus that causes COVID-19.  Case investigation is the process that helps a person who has COVID-19 recall everyone they have had close contact with during the timeframe they may have been able to spread the virus to other people. Contact tracing is the process of notifying the identified exposed individuals (close contacts) of their potential exposure. They are most effective when implemented in combination with other prevention strategies.

Contact tracing is used to provide instructions and support to people who have COVID-19 and their close contacts. Timely and complete contact tracing can help to quickly isolate people who have COVID-19, and to identify their close contacts so that those contacts can quickly take actions (such as quarantine, testing, and wearing a mask) to prevent any further spread of the virus. This can slow spread in schools (and in the community) and help prevent school closures due to large-scale outbreaks. For contact tracing to be effective, schools need protocols to quickly identify people with COVID-19 and determine their close contacts. The process requires timely action and cooperation by everyone involved in the confidential investigation of cases of COVID-19 and notification of their close contacts.

Core principles of case investigation and contact tracing

  • Case investigation is part of the process to support people with suspected or confirmed COVID-19 (cases).
  • People who have COVID-19 are given information and support to know what to do if they are sick, how to safely isolate and separate themselves from others who are not infected, when to seek emergency medical attention, and how to avoid spreading the virus to others.
  • In case investigation for K-12 settings, designated staff (e.g., from a public health agency, school, or district) work with a person who has COVID-19 to help them recall everyone with whom they have had close contact during the timeframe while they may have been infectious.
  • Designated staff then begin contact tracing by confidentially notifying the exposed individuals (close contacts) of their potential exposure as rapidly as possible.
  • To protect privacy, close contacts are only informed that they may have been exposed to a person with COVID-19. They are not told the identity of the person with COVID-19 who identified them as a close contact.
  • Close contacts are provided with information and support to understand their risk, how to monitor themselves for symptoms, and what steps they need to take, such as quarantine, or testing and wearing a mask, depending on their vaccination and booster status or history of prior infection in the past 90 days.
  • It also is important to help them understand that they could spread the virus to others even if they are not experiencing symptoms of COVID-19.

Process for responding to COVID-19 cases in K-12 schools

This step-by-step process is intended to serve as a guide for a school administrator’s response to a COVID-19 case in their school or at a school event. It includes links to resources and tools that can be tailored for local use and, in some cases, can be shared directly with students, their families, and staff.

This process starts when a school becomes aware of someone within the school community who has COVID-19.  Schools may find out about people having COVID-19 in a number of ways, including through parent reports to the school, self-reports from students or staff, or screening testing conducted by the school.  To ensure that schools know about COVID-19 cases, it is important to encourage staff, students, and their families to report to the school anytime staff, students, or others who have been in the school or at a school event test positive for COVID-19.  Once a school is aware of a COVID-19 case within the school or at a school event, the school should take the following steps in response:

Step 1: Find out the date the person with COVID-19 started showing symptoms (if they have symptoms) or if they don’t have symptoms, the date the person tested positive for COVID-19 (use the date the test was collected). This will help with providing guidance for how long the person should isolate and who to identify as close contacts during contact tracing (see steps below). If applicable, notify your school district officials or other governing body officials according to your district or governing body’s plan for such notifications.  In addition, notify your local health department according to your district or governing body’s plan for such notifications.

Step 1: Find out the date the person with COVID-19 started showing symptoms (if they have symptoms) or if they don’t have symptoms, the date the person tested positive for COVID-19 (use the date the test was collected). This will help with providing guidance for how long the person should isolate and who to identify as close contacts during contact tracing (see steps below). If applicable, notify your school district officials or other governing body officials according to your district or governing body’s plan for such notifications.  In addition, notify your local health department according to your district or governing body’s plan for such notifications.

Step 2: Provide isolation guidance for the person who tested positive for COVID-19.  You can tailor this letter template for individuals with COVID-19 for use by your school, and you can share this overview of isolation.

Step 2: Provide isolation guidance for the person who tested positive for COVID-19.  You can tailor this letter template for individuals with COVID-19 for use by your school, and you can share this overview of isolation.

Step 3: Immediately identify close contacts of the person who has COVID-19. Use the Steps for Determining Close Contact and Quarantine in K–12 Schools infographic to aid with this task. Consider close contacts in all settings within the school (e.g., classroom, cafeteria, after school activities) and school-sponsored events (e.g., club meetings, athletic practices and events, extra-curricular activities). Close contacts that are outside the school setting should be elicited and notified by the local health department or by the person with COVID-19.

If the person with COVID-19 has symptoms, identify contacts from 2 days prior to the beginning of the person’s symptoms.  If the person with COVID-19 does not have symptoms, identify contacts from the 2 days prior to their positive test result (use the date the test was collected).  Contacts should be identified up until the last date the person with COVID-19 was in school or at a school event.  For example, if a person tested positive or developed symptoms on Saturday, August 7th, and was last at a school event on Saturday morning, you would identify all close contacts from the school setting or school events that happened on Thursday (August 5th), Friday (August 6th), and Saturday (August 7th).

Step 3: Immediately identify close contacts of the person who has COVID-19. Use the Steps for Determining Close Contact and Quarantine in K–12 Schools infographic to aid with this task. Consider close contacts in all settings within the school (e.g., classroom, cafeteria, after school activities) and school-sponsored events (e.g., club meetings, athletic practices and events, extra-curricular activities). Close contacts that are outside the school setting should be elicited and notified by the local health department or by the person with COVID-19.

If the person with COVID-19 has symptoms, identify contacts from 2 days prior to the beginning of the person’s symptoms.  If the person with COVID-19 does not have symptoms, identify contacts from the 2 days prior to their positive test result (use the date the test was collected).  Contacts should be identified up until the last date the person with COVID-19 was in school or at a school event.  For example, if a person tested positive or developed symptoms on Saturday, August 7th, and was last at a school event on Saturday morning, you would identify all close contacts from the school setting or school events that happened on Thursday (August 5th), Friday (August 6th), and Saturday (August 7th).

Step 4: Notify all close contacts of their “close contact” status.

People who had close contact with someone with COVID-19 should follow CDC recommendations to protect themselves and others. Recommendations for close contacts to quarantine and get tested will vary depending on vaccination status and prior COVID-19 diagnosis within the past 90 days. People who have come into close contact with someone diagnosed with COVID-19 should follow the recommendations outlined on the COVID-19 Quarantine and Isolation webpage.

Everyone who is a close contact should wear a well-fitting mask around others and watch for COVID-19 symptoms for 10 days from the date of their last close contact with someone with COVID-19 (the date of last close contact is considered day 0). They should also get tested at least 5 days after having close contact with someone with COVID-19 unless they had confirmed COVID-19 in the last 90 days and subsequently recovered. Those who test positive or develop COVID-19 symptoms should follow recommendations for isolation.

CDC continues to recommend indoor masking in K-12 schools for all individuals ages 2 years and older, including students, teachers, staff, and visitors, regardless of vaccination status. The school should ensure there is a plan for people identified as close contacts to stay masked at all times indoors if they are not required to quarantine. During times in the school day when students or staff members may typically remove masks indoors (such as during lunches, snacks, band practice, etc.), have a plan for them to adequately distance from others and ensure they wear their masks when not actively participating in these activities (such as when they are not actively eating).

Step 4: Notify all close contacts of their “close contact” status.

People who had close contact with someone with COVID-19 should follow CDC recommendations to protect themselves and others. Recommendations for close contacts to quarantine and get tested will vary depending on vaccination status and prior COVID-19 diagnosis within the past 90 days. People who have come into close contact with someone diagnosed with COVID-19 should follow the recommendations outlined on the COVID-19 Quarantine and Isolation webpage.

Everyone who is a close contact should wear a well-fitting mask around others and watch for COVID-19 symptoms for 10 days from the date of their last close contact with someone with COVID-19 (the date of last close contact is considered day 0). They should also get tested at least 5 days after having close contact with someone with COVID-19 unless they had confirmed COVID-19 in the last 90 days and subsequently recovered. Those who test positive or develop COVID-19 symptoms should follow recommendations for isolation.

CDC continues to recommend indoor masking in K-12 schools for all individuals ages 2 years and older, including students, teachers, staff, and visitors, regardless of vaccination status. The school should ensure there is a plan for people identified as close contacts to stay masked at all times indoors if they are not required to quarantine. During times in the school day when students or staff members may typically remove masks indoors (such as during lunches, snacks, band practice, etc.), have a plan for them to adequately distance from others and ensure they wear their masks when not actively participating in these activities (such as when they are not actively eating).

Step 5: Notify the school community of the presence of COVID-19 within the school setting and that all people determined to be close contacts have been notified.  Frequency of notification can be tailored to the volume of cases identified within your school and should be determined based on local protocols. You can tailor this letter template for general notification of a COVID-19 case for use by your school.

Step 5: Notify the school community of the presence of COVID-19 within the school setting and that all people determined to be close contacts have been notified.  Frequency of notification can be tailored to the volume of cases identified within your school and should be determined based on local protocols. You can tailor this letter template for general notification of a COVID-19 case for use by your school.

Step 6: For each person with COVID-19 and each close contact, document the earliest possible date for the person to return to school or school activities, and ensure that students do not rejoin in-person class participation until their isolation or quarantine period is over.  Maintain communication with close contacts to document any changes from quarantine to isolation status if they develop symptoms or test positive for COVID-19.  Determine a new return to school date and document this.  Use these records to ensure that individuals do not return to the school setting prior to the end of their isolation or quarantine periods. If a close contact develops symptoms or tests positive for COVID-19, they should be interviewed to determine their close contacts, and you should repeat this process until all close contacts of all positive cases are identified and notified.

Step 6: For each person with COVID-19 and each close contact, document the earliest possible date for the person to return to school or school activities, and ensure that students do not rejoin in-person class participation until their isolation or quarantine period is over.  Maintain communication with close contacts to document any changes from quarantine to isolation status if they develop symptoms or test positive for COVID-19.  Determine a new return to school date and document this.  Use these records to ensure that individuals do not return to the school setting prior to the end of their isolation or quarantine periods. If a close contact develops symptoms or tests positive for COVID-19, they should be interviewed to determine their close contacts, and you should repeat this process until all close contacts of all positive cases are identified and notified.