Information for School Nurses and Other Healthcare Personnel (HCP) Working in Schools and Child Care Settings
School nurses and other healthcare personnel (HCP) play an important role in safely keeping schools and child care programs open for in-person learning, in addition to supporting other in-person activities, during the COVID-19 pandemic. School nurses and other HCP routinely evaluate students for symptoms or exposures. They also assist administrators and teachers in implementing mitigation strategies; contact tracing; maintaining school-based clinics; implementing school-based testing strategies; and supporting students, families, and staff. The information and resources below can help in performing these new roles and responsibilities during the COVID-19 pandemic. Resources for self-care are also included.
COVID-19 and Children
While fewer children had been reported to have COVID-19 compared with adults in the United States, the number of children and adolescents with COVID-19 has been increasing since early in the pandemic. Children can be infected with SARS-CoV-2, the virus that causes COVID-19, can get sick with COVID-19, and can spread the virus to others. Most infected children have mild symptoms and some have no symptoms at all. Some children can get severely ill from COVID-19, which means they might require hospitalization, intensive care, a ventilator, or might even die. Among those who do experience COVID-19 symptoms, the symptoms are typically similar in adults and children and can look like other common illnessespdf icon, such as the common cold, strep throat, influenza, asthma or seasonal allergies. For more information about influenza, visit Influenza Information for Health Professionals and Similarities and Difference between Flu and COVID-19.
Children with underlying medical conditions are at increased risk for severe illness from COVID-19. Additionally, some children may develop the rare but serious condition associated with COVID-19 called Multisystem Inflammatory Syndrome in Children (MIS-C). For more information on COVID-19 in children, visit Information for Pediatric Healthcare Providers.
Mitigation Strategies for Schools and Child Care Settings
Mitigation strategies should be layered, using many at the same time, to prevent the spread of the virus that causes COVID-19. The key mitigation strategies for schools are:
- Consistent and correct use of masks
- Physical distancing (staying at least 6 feet apart)
- Hand hygiene and respiratory etiquette
- Cleaning and disinfection
- Proper ventilation
- Contact tracing in collaboration with the state or local health department
- Additional mitigation strategies
For information on protecting school staff, visit Protecting K-12 School Staff from COVID-19.
Quarantine, Isolation, Symptom Screening, and Testing for Children
Quarantine and isolation are public health practices used to prevent exposure to people who have or may have a contagious disease, such as COVID-19. Quarantine keeps someone who might have been exposed to the virus away from others, and isolation keeps someone who is infected with the virus away from others. Check your local health department’s website for information about quarantine requirements for your area.
CDC does not currently recommend that schools conduct symptom screenings for students, but parents, guardians, and caregivers are strongly encouraged to monitor their children for signs and symptoms of infectious illness every day. Students who are sick should not attend school in-person. For more information on symptom screening, what to do if a student has symptoms of COVID-19, and when that student can return to in-person school, visit Screening K-12 Students for Symptoms of COVID-19: Limitations and Considerations.
CDC recommends testing for people with any signs or symptoms of COVID-19 and for all close contacts of persons with COVID-19. For more information, visit Overview of Testing for SARS-CoV-2, Information for Pediatric Healthcare Providers, and Considerations for Testing in K-12 Schools.
Additionally, CDC’s Coronavirus Self-Checker is an interactive clinical assessment tool that can be used by school nurses and other HCPs, as well as parents, guardians, and caregivers, to help make decisions on when to seek testing or medical care for persons presenting with COVID-19 symptoms or with a potential exposure to someone with COVID-19.
Contact Tracing in Schools
Contact tracing is essential to prevent the spread of the virus that causes COVID-19. Contact tracing is the process of notifying people (close contacts) of their potential exposure to the virus that causes COVID-19, providing information about the virus, providing instructions for quarantine and monitoring for symptoms, and referring to testing, clinical services, and other services as needed. School nurses and other HCP in schools and child care settings may be asked to help administrators and public health officials with contact tracing. For more information, visit Case Investigation and Contact Tracing in K-12 Schools and discuss with your public health officials.
Infection Prevention Recommendations for School Nurses and Other HCP Providing Care
School nurses and other HCP in schools and child care settings should follow the Infection Prevention and Control Recommendations for Healthcare Personnel when providing direct care.
- Nurses and other HCP should use all recommended personal protective equipment (PPE) when providing direct care to someone with suspected or confirmed COVID-19, including use of N95 or equivalent respirator (or facemask if unavailable), gown, gloves, and eye protection.
- Nurses and other HCP should use a facemask and eye protection when caring for students who are not suspected to have COVID-19 when there is moderate or substantial community transmission. Facemasks are preferred over cloth masks for all HCP.
- If there are shortages of PPE, nurses and other HCP should review CDC’s guidance for Optimizing Personal Protective Equipment (PPE) Supplies and can consider using the same respirator or facemask throughout the entire shift.
- Additional PPE information is available:
- For information on what to do if a nurse or other HCP is exposed to a person with the virus that caused COVID-19, visit Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19.
- For information on nurses and other HCP returning to work with SARS-CoV-2 infection, visit the Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection.
- Nurses and other HCPs should discuss with administrators considerations for increasing ventilation in schools (e.g., protective “clean-to-less-clean” airflows, use of portable high-efficiency particulate air (HEPA) fan/filtration systems).
Clinical Services Provided by Schools
Many important clinical services (e.g., immunizations, behavioral health, reproductive health) are provided in schools. Information for providing in-person services (Get your Clinic Ready for COVID-19) and telehealth services (Using Telehealth during the COVID-19 Pandemic) is available. Please also see information on COVID-19 specific considerations:
- Asthma management, including bronchodilator treatments
- Considerations for School Sealant Programs During the COVID-19 Pandemic
- Vision screening during the COVID-19 pandemic (visit the American Association for Pediatric Ophthalmology websiteexternal icon)
- Promoting Hearing Health in Schools
The infection prevention and control practices, described above, should be followed when providing in-person clinical services. All equipment should be cleaned and disinfected between uses. Environmental infection control recommendations should be followed after caring for someone with suspected or confirmed COVID-19. General information on cleaning, disinfecting, and ventilation in schools is also available, as well as information on maintaining health environments in schools. Additional guidelines provided by school districts and local health authorities should be followed.
Supporting Students and Staff
School staff and other trusted adults can play an important role in helping children make sense of what they hear in a way that is honest, accurate, and reduces anxiety or fear. Resources to help children and young adults:
- Talking with Children about COVID-19
- Helping Children Cope
- Support for Teens and Young Adults
- Asking the local school district about plans to continue meal services
The pandemic has also been stressful for adults. Resources to help adults manage stress and promote resilience include:
- Stress and Coping
- How Right Nowexternal icon
- Cope with Job Stress and Build Resilience During the COVID-19 Pandemic
- Manage Workplace Fatigue During COVID-19
Self-Care for Nurses and other Healthcare Personnel
Providing care to others during the COVID-19 pandemic can lead to stress, anxiety, fear, and other strong emotions. How nurses and other HCP cope with these emotions can affect their well-being, the care they give to others while doing their job, and the well-being of the people they care about outside of work. Resources to help are available:
- HCP and First Responders: How to Cope with Stress and Build Resilience
- National Crisis Support Hotlines and Directoriespdf iconexternal icon for HCP experiencing stress and burnout
- Self-Care for Healthcare Workers Modulespdf iconexternal icon
CDC is learning more about how COVID-19 spreads and affects people and communities. Visit CDC’s COVID-19 website for the latest information and guidance.