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 opening schools and child care programs for in-person learning and other in-person activities and keeping them open during the COVID-19 pandemic.  School nurses and other HCP will likely be evaluating children for symptoms or exposures, assisting administrators and teachers in implementing mitigation strategies, assisting with contact tracing, maintaining school-based clinics, assisting in 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 during the pandemic, the number of children and adolescents with COVID-19 has been increasing since early in the pandemic. Children can be infected with the virus that causes COVID-19 (SARS-CoV-2), can get sick with COVID-19, and can spread the virus to others. Most children infected with the virus that causes COVID-19 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. The symptoms of COVID-19 are similar in adults and children and can look like other common illnesses, like colds, strep throat, influenza, or allergies.  For more information about influenza, visit Influenza Information for Health Professionals and The 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, visit 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
• Social distancing (at least 6 feet)
• Hand hygiene and respiratory etiquette
• Cleaning and disinfection
• Contact tracing in collaboration with the state or local health department

For information on protecting school staff, visit Protecting 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. Quarantine keeps someone who was exposed to the virus away from others for the duration of the incubation period (14 days), and isolation keeps someone who is infected with the virus away from others for the duration the infectious period (10 days). The best way to protect yourself and others is to stay home for 14 days if you think you’ve been exposed to someone who has COVID-19. Check your local health department’s website for information about options in your area to possibly shorten this quarantine period.

CDC does not currently recommend that schools conduct symptom screenings for students, but parents or caregivers should be strongly encouraged to monitor their children for signs 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 Symptom Screening in Schools.

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 HCP, information for Pediatric Healthcare Providers, and  Considerations for Testing in K-12 Schools.

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 (contacts) of their potential exposure to the virus that causes COVID-19, providing information about the virus, providing instructions for quarantine and symptom monitoring, 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 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 patient care.

• Nurses and other HCP should use all recommended personal protective equipment (PPE) when providing direct care to someone with confirmed or suspected COVID-19, including use of N95, or equivalent respirator (or face mask if unavailable), gown, gloves, and eye protection.
• In addition to following standard precautions like hand hygiene and disinfection, nurses and other HCP should use a facemask and eye protection when caring for students who are not suspected to be 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 PPE Supplies and can consider using the same respirator or facemask throughout the entire shift.
• For information on how to safely put on and take off PPE, visit Using PPE.
  • For more information, visit Facemaskspdf icon and Respiratorspdf icon.
  • For information about respirator fit testing, visit Respiratory Protectionpdf icon.
• For information on what to do if a nurse or other HCP is exposed to a person with the virus that causes COVID-19, visit Guidance for Risk Assessment and Work Restrictions for HCP. For information on when a nurse or HCP can return to work after having COVID-19, visit Return to Work for HCP.
• For information on providing nebulizer treatments in schools and other considerations for asthma treatments in schools, visit FAQs for Schools.

Providing Services in Clinic and Through Telehealth

For nurses and other HCP working in clinics that provide in-person services, visit Get your Clinic Ready for COVID-19. For nurses and HCP providing telehealth services, visit Using Telehealth during the COVID-19 Pandemic.

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 minimizes anxiety or fear. For tips and discussion topics, visit Talking to Children about COVID-19. CDC has additional resources like Helping Children Cope and Support for Teens.

The pandemic has been stressful for many people. For toolkits and more resources for adults, visit Stress and Coping and How Right Nowexternal icon. For information about coping with stress for staff in the workplace, visit Coping with Stress for Employees and Managing 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 you cope with these emotions can affect your well-being, the care you give to others while doing your job, and the well-being of the people you care about outside of work. For information on coping with stress during the pandemic, visit HCP and First Responders: How to Cope with Stress. For nurses and other HCP who are experiencing stress and burnout, the National Crisis Support Hotlines and Directoriespdf iconexternal icon has resources that can help. For more information on self-care, view the Self-Care for Healthcare Workers Modulespdf iconexternal icon.

For considerations on maintaining daily life during the pandemic, visit Daily Activities.

For the latest information on COVID-19 from CDC, visit CDC’s COVID-19 Website.