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Protocols for responding to COVID-19 scenarios in school, on the bus, or in community settings

July 17, 2020

 

Introduction and overview

 

As a supplement to DESE’s Initial Fall School Reopening Guidance, we are providing districts and schools with additional information on protocols for responding to specific COVID-19 scenarios this fall. Protocols from the Centers for Disease Control (CDC) related to this topic may be released in the coming weeks and this guidance may be updated accordingly. We will also be providing additional clarifying information through our FAQ process.

 

This guidance provides more information and protocols to answer the following questions:

·      What should a district do if there is a symptomatic individual – at home, on the bus, or at school?

·      What should a district do if someone in the school community tests positive for COVID-19 – be it a student, teacher, staff, or bus driver, or one of their household members or close contacts?

·      Who should get tested for COVID-19 and when?

·      In what circumstances would someone need to quarantine (when they have been exposed but are not sick) or isolate (when they are sick)?

·      What should school districts do to monitor COVID-19 spread in their communities?

 

In our Initial Fall School Reopening Guidance, we put forth the goal of the safe return of as many students as possible to in-person learning. At the same time, we asked districts to plan for all contingencies by asking for three reopening models.

 

A safe return to in-person school environments will require a culture of health and safety every step of the way. Specifically:

·      It is not one mitigation strategy but a combination of all these strategies taken together that will substantially reduce the risk of transmission. No single strategy can ever be perfect, but all strategies together will reduce risk. In addition, although we are currently in Phase 3 of Reopening Massachusetts, it will take collective continued vigilance towards health and safety measures to continue to contain COVID-19.

·      Staff must monitor themselves for symptoms daily and students, with the assistance of families, must also be monitored daily for symptoms. Staff and students must stay home if feeling unwell. Everyone must do their part to protect others and not come to school if they are exhibiting any COVID-19 symptoms or are feeling sick.

·      Masks are among the most important single measures to contain the spread of COVID-19. We require students second grade and above and all staff to wear masks that adequately cover both their nose and mouth. Younger children are strongly encouraged to wear masks. Exceptions must be made for students with medical, behavioral, or other challenges who are unable to wear masks/face coverings.

·      Hand hygiene is critical. Students and staff are required to exercise hand hygiene (handwashing or sanitizing) upon arrival to school, before eating, before putting on and taking off masks, and before dismissal.

·      Physical distance greatly reduces the risk of transmission. As COVID-19 is transmitted through respiratory droplets, putting distance between yourself and others reduces risk. In classroom settings, when all parties are wearing masks, a minimum of 3 feet of separation is needed; if one or both parties are not wearing masks, 6 feet is needed. (Kindergarten and first grade students without masks may be 3 feet apart, but no less, which is permissible given the lower susceptibility of the age group).

·      Cohorts/assigned seating. Students organized in groups/classrooms and other cohorts help mitigate transmission of the virus. Assigned seating is important because it effectively creates even smaller groups within cohorts which minimize transmission. Assigned seats can also assist with contact tracing. Wherever possible, seats should be assigned (including classroom, bus, meals).

 

To support a culture of health and safety, schools must have robust and reliable ways to communicate with all families, students, teachers, and staff in order to send and receive key messages related to COVID-19.

 

Preparing to respond to COVID-19 scenarios

Even as we remain vigilant, and public health metrics in Massachusetts remain positive, the risk of exposure to COVID-19 in school will not be zero. As we prepare to reopen schools, we must also prepare to respond to potential COVID-19 scenarios, whether in school, on the bus, or in our communities. Depending on the circumstances, a positive COVID-19 test, a potentially symptomatic student, or exposure to someone in the outside community who has COVID-19 can each have health, safety, and operational implications.

 

Be prepared to provide remote learning

When students must stay home for quarantine or isolation, teaching and learning should not stop. It is the school’s duty to provide remote learning for students who cannot be in school for any extended period of time.

 

Testing, tracing, and isolation

It is important to note that testing, combined with contact tracing and isolation, helps control the spread of COVID-19 in Massachusetts. All test results, both positive and negative, are reported to the Massachusetts Department of Public Health (DPH). When a person has a positive COVID-19 test, it is the local board of health or the Massachusetts Community Tracing Collaborative that will reach out to provide support so that these individuals can remain safely in medical isolation. They will also ask for help to identify close contacts. These organizations will then reach out to the individual’s close contacts to provide important information that is aimed to stop the spread of the virus, including how to safely isolate/quarantine. While these organizations will provide support, to further assist with contact tracing the student/family and staff are asked to reach out to their personal contacts and notify the school.

 

 

 

Self-isolation for COVID-19 positive cases is a minimum of 10 days

Most people who test positive and have a relatively mild illness will need to stay in self-isolation for at least 10 days. People who test positive can resume public activities after 10 days and once they have:

a.   gone for 3 days without a fever (and without taking fever-reducing medications like Tylenol); and

b.  experienced improvement in other symptoms (for example, their cough has gotten much better); and

c.   received clearance from public health authority contact tracers (the local board of health or Community Tracing Collaborative).

 

Repeat testing prior to return is not recommended. Return to school should be based on time and symptom resolution.

 

Close contacts of a positive COVID-19 case should be tested. For general guidance, DPH defines close contact as:[1]

·    Being within less than 6 feet of COVID-19 case for at least 10-15 minutes. Close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case while the case was symptomatic or within the 48 hours before symptom onset, OR

·    Having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on) while not wearing recommended personal protective equipment.

 

In school settings, close contacts include other students and staff who were within 6 feet of the student or staff for at least 10-15 minutes in a classroom, in other school spaces, on the bus, or at an extracurricular activity. In elementary and other school situations where the students are in self-contained classrooms for an extended period, all students/staff within this “cohort” are considered close contacts as they may have been within 6 feet of the person with a positive test result. Possible close contacts should not come back to school until they have been tested (or elected instead to self-quarantine for 14 days). If an individual tests positive for COVID-19, then self-isolation is for a minimum of 10 days and until at least three days have passed with no fever and improvement in other symptoms as noted. If the test is negative, the student/staff can return to school if asymptomatic and wearing a mask.

 

Most common symptoms of COVID-19 and testing requirements

 

The single most important thing to do if any of the following symptoms are present is to STAY HOME. Our collective health relies, in part, on individual attention and responsibility. Note that some symptoms of COVID-19 are the same as the flu or a bad cold; please do not assume it is another condition. When in doubt, stay home.    

 

Please STAY HOME if you have any of the symptoms listed.

 

Below is the full list of symptoms for which caregivers should monitor their children, and staff should monitor themselves:[2] [3]

    Fever (100.4° Fahrenheit or higher), chills, or shaking chills

    Cough (not due to other known cause, such as chronic cough)

    Difficulty breathing or shortness of breath

    New loss of taste or smell

    Sore throat

    Headache when in combination with other symptoms

    Muscle aches or body aches

    Nausea, vomiting, or diarrhea

    Fatigue, when in combination with other symptoms

    Nasal congestion or runny nose (not due to other known causes, such as allergies) when in combination with other symptoms

 

If staff or students have any of these symptoms, they must get a test for active COVID-19 infection prior to returning to school.

 

Every school should have a list of available test sites.[4] A list of test sites is available here, and Massachusetts also has an interactive testing map. Staff and students who have symptoms should also contact their primary care physician for further instructions. More information related to the availability of testing will be provided later this summer.

 

 

Please turn to the next page for information on protocols for possible COVID-19 scenarios.

Protocols for possible COVID-19 scenarios

 

While specific protocols vary, there are some common elements for each possible COVID-19 scenario:

ü  Evaluate symptoms

ü  Separate from others

ü  Clean and disinfect spaces visited by the person

ü  Test for COVID-19 and stay at home while awaiting results

ü  If test is positive:

-       Remain at home at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms

-       Monitor symptoms

-       Notify the school and personal close contacts

-       Answer the call from local board of health or Massachusetts Community Tracing Collaborative to help identify close contacts to help them prevent transmission

-       Secure release from contact tracers (local board of health or Community Tracing Collaborative) for return to school

 

The following pages outline protocols for the scenarios below.

 

Section 1: Protocols for individual exposure or individual positive test

 

·      Protocol: Student or staff tests positive for COVID-19

·      Protocol: Close contact of student or staff tests positive for COVID-19

·      Protocol: Student is symptomatic on the bus

·      Protocol: Student is symptomatic at school

·      Protocol: Staff is symptomatic at home

·      Protocol: Staff is symptomatic at school

 

Section 2: Protocols for potential school closure (partial or full) or district closure

 

·      Protocol: Presence of multiple cases in the school or district

·      Protocol: Presence of significant number of new cases in a municipality

·      Protocol: Statewide regression to a previous reopening phase

 

 

 


 

   Quick reference sheet: Key actions for individual COVID-19 events

 

Event

Location of Event

Testing Result

Quarantine

Individual is symptomatic

If an individual is symptomatic at home, they should stay home and get tested.

 

If an individual student is symptomatic on the bus or at school, they should remain masked and adhere to strict physical distancing. Students will then be met by the nurse and stay in the medical waiting room until they can go home. They should not be sent home on the bus.

If an individual staff member is symptomatic at school, they should find coverage for their duties and then go home and get tested.

Individual tests negative

Return to school once asymptomatic for 24 hours

Individual tests positive

Remain home (except to get medical care), monitor symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or MA Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms.

Individual is not tested

Remain home in self-isolation for 14 days from symptom onset

 

 

 

 

Individual is exposed to COVID-19 positive individual

If an individual is at home when they learn they were in close contact with an individual who tested positive for COVID-19, they should stay at home and be tested 4 or 5 days after their last exposure.

 

If an individual is at school when they learn they were in close contact with an individual who tested positive for COVID-19, they should be masked for the remainder of the day (including K-1 students) and adhere to strict physical distancing. At the end of the day, they should go home and should not take the bus home. They should stay at home and be tested 4 or 5 days after their last exposure.

Individual tests negative

Return to school, if asymptomatic or once asymptomatic for 24 hours

Individual tests positive

Remain home (except to get medical care), monitor symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or MA Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms.

Individual is not tested

Remain home in self-quarantine for 14 days from exposure

Section 1: Protocols for individual exposure or individual positive test

 

Protocol: Student or staff tests positive for COVID-19

 

1.     The student or staff member must remain at home (except to get medical care), monitor their symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or Massachusetts Community Tracing Collaborative. For most people who have relatively mild illness, they will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms.

 

2.     The student’s parent/caregiver or the staff member informs the proper school official (e.g.  a designated person that is the COVID-19 school lead) that the individual has tested positive for COVID-19. The designated COVID-19 school lead in turn notifies others as pre-determined by the school (e.g., school leadership, school nurse or school medical point of contact, building management, maintenance).

 

3.     Determine whether the student or staff member was on the premises during the time frame that started two days prior to symptom onset (or testing positive if not symptomatic) until the time of isolation.

    1. If so, promptly close off areas visited by the COVID-19 positive individual until such areas can be cleaned and disinfected, if they have not been cleaned and disinfected already.
    2. Promptly clean and disinfect the student’s or staff member’s classroom and any other facilities (e.g., extracurricular facilities) visited by the individual, if that has not been done already.
    3. Promptly clean and disinfect the bus(es) the student or staff member was on, if any, and if not already done.

 

4.     ELEMENTARY SCHOOL (e.g., student has self-contained classroom throughout the day):

    1. Send a communication to the other families in the student’s class (e.g., cohort) that there has been a positive test without naming the individual student or staff member who tested positive.
    2. Communications sent to families/staff should:
      1. Inform them there was a positive test (not the specific individual) in the self-contained classroom.
      2. Explain that since they were within this cohort and may have been within 6 feet of the person with a positive test, they are considered a “close contact” and therefore should be tested. (In cases where the student may have been in close contact with others outside their cohort, having assigned seating and keeping up-to-date seating charts will help identify who should be instructed to be tested: specifically, those who were sitting next to the student, plus any others who also had close contact with the student.)
      3. Instruct those designated as close contacts to isolate prior to their test and while waiting for the results. In general, as the highest yield test will be a few days after the exposure, ideally, the test should occur no sooner than day 4 or 5 after the last exposure. (In other words, if an exposure lasted several days, the best time to test is 4 or 5 days after the end of the exposure period.)
      4. Explain that if close contacts choose not to be tested, the student or staff member should remain home in self-quarantine for 14 days.[5]
      5. Remind families and/or staff of the importance of not having contact with higher-risk individuals (e.g., grandparents and those with underlying medical conditions).
      6. Remind families and/or staff of the list of COVID-19 symptoms for which to monitor.
    3. If the school finds out about the original COVID-19 positive test in the middle of a school day when the rest of the cohort is in class:
      1. Make sure these students are wearing masks, including in kindergarten and first grade. Extra masks as may be needed should be provided by the school. Enforce strict physical distancing. Require students to wash their hands.
      2. The school should quickly identify the individuals who may be “close contacts” of the student and notify students and their families.
      3. Caregivers of students in the class or other close contacts may pick students up prior to the end of the day. Caregivers must wear a mask/face covering when picking up their student. Students who are close contacts and students with any symptoms should not ride the school bus to get home. Caregivers and students, as well as staff, should wash their hands upon arriving at home and change their clothes as a precaution. 
      4. Close contacts should not come back to school until they have received the results of testing (or elected to instead quarantine for 14 days[6]) and are asked to communicate their test results to the school.
    4. As feasible, to assist with contact tracing, make a list including phone number and email of any other close contacts the student or staff member had, beginning two days before the onset of symptoms (or positive test if asymptomatic) until individual was isolated. Instruct those students and/or staff members to get tested according to the same protocol as the student’s cohort above.

 

  1. MIDDLE AND HIGH SCHOOL (e.g., no single self-contained classroom):
    1. The school should identify the student’s or staff member’s possible “close contacts” based on the assigned seating charts. The lookback period should begin two days before symptoms appeared (or two days prior to the date of the positive test if there were no symptoms) and include up until the time the student was isolated. Consider students and staff members who were within 6 feet of the individual for 10-15 minutes in class, on the school bus, or at extracurricular activities.
    2. Follow the communication and other relevant Elementary School protocols above.
    3. Close contacts should be tested for COVID-19 at one of Massachusetts’s test sites.[7] Sites may require pre-screening, a referral, and/or an appointment.
    4. Instruct the student or staff member to isolate while waiting for the results of their test.
    5. An individual who does not wish to be tested should instead quarantine for 14 days[8] and until asymptomatic.

 

6. IF OTHERS IN THE SCHOOL TEST POSITIVE: Perform all steps under this protocol for that person. ALSO FOLLOW: “Protocol: Presence of multiple cases in the school.”

 

7. IF NO OTHERS IN THE SCHOOL TEST POSITIVE: Close contacts can return to school immediately if they test negative and do not have symptoms; however, strict mask wearing covering the nose and mouth must be maintained at all times. The wearing of masks includes K-1 students for this 14-day period. If they have symptoms but test negative regardless, they should wait until they are asymptomatic for 24 hours before returning to school.

 

Any area of the school visited by the COVID-19 positive individual must be closed off and/or cleaned and disinfected. The area can be used 12 hours after cleaning/disinfecting has occurred.

 

 


 

Protocol: Close contact of student or staff tests positive for COVID-19

 

  1. Current Massachusetts DPH guidance is that all close contacts of someone who has tested positive for COVID-19 should be tested.[9]

 

  1. The student or staff member who was in close contact with someone who tested positive for COVID-19 should be tested at one of Massachusetts’s test sites.[10] Sites may require pre-screening, a referral, and/or an appointment. An individual who does not wish to be tested should instead quarantine for 14 days[11] and until asymptomatic.

 

3.     Close contacts should isolate at home prior to testing and while awaiting test results. Ability to mask is critical, so if the close contact cannot mask or is in K-1 and not masking they should not return for 14 days. 

 

  1. In order to return to school, close contacts need to have one negative test result and not be showing any COVID-19 symptoms, or if they do not wish to be tested, quarantine at home for 14 days. Because tests performed too early can be falsely negative, ideally the test should be performed no sooner than 4 or 5 days after the last contact with the person who tested positive.

 

  1. IF POSITIVE TEST: The student or staff member should remain at home (except to get medical care), monitor their symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or Massachusetts Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms. FOLLOW STEPS UNDER: “Protocol: Student / staff tests positive for COVID-19.”

 

 


 

Protocol: Student is symptomatic at home

 

  1. Family should monitor students at home each morning for the most common symptoms of COVID-19 (see list above).
    1. IF NO SYMPTOMS:
      1. Send student to school.
    2. IF ANY SYMPTOM:
      1. Do not send the student to school.
      2. Call the school’s COVID-19 point of contact and inform them student is staying home due to symptoms.
      3. Current Massachusetts DPH guidance is that all symptomatic individuals in Massachusetts, even those with mild symptoms, should be tested.[12] An individual who does not wish to be tested should instead isolate for 14 days[13] and until asymptomatic.
      4. The student should get tested at one of Massachusetts’s test sites.[14] Sites may require pre-screening, a referral, and/or an appointment.
      5. Isolate at home until test results are returned.
      6. Proceed as follows according to test results:
        1. IF NEGATIVE: Student stays home until asymptomatic for 24 hours.
        2. IF POSITIVE: Student should remain at home (except to get medical care), monitor their symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or Massachusetts Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms. [15] FOLLOW STEPS UNDER: “Protocol: Student / staff tests positive for COVID-19.”

 

Protocol: Student is symptomatic on the bus

 

  1. Although families are the most important first line of defense for monitoring symptoms, bus drivers and bus monitors also play an important role in flagging possible symptomatic students. Note: This will require training for bus drivers (and bus monitors, if applicable).

 

  1. If symptoms are noticed as the student is getting on the bus and if there is a caregiver present, do not allow student to board the bus. Caregiver should then FOLLOW: “Protocol: Student is symptomatic at home.”

 

  1. If student is already on the bus, ensure student is masked and keeps mask on. Ensure other students keep their masks on. Ensure student keeps required physical distance from other students.

 

  1. Bus driver/monitor should call ahead to the bus service dispatch. The bus service dispatch should be equipped with appropriate cell phone numbers for school and district personnel (nurse or other medical personnel). The dispatch should contact the school to inform the school nurse (or school medical point of contact) of a possible symptomatic child.

 

  1. School nurse (or school medical point of contact) should meet the bus as it arrives, wearing a mask. As practical, student with possible symptoms should exit the bus first.

 

  1. Bus should be cleaned / disinfected.

 

  1. Nurse (or school medical point of contact) should evaluate the student for symptoms (see list above: “Most common symptoms of COVID-19”).
    1. IF ANY SYMPTOM:
      1. Place the student in the designated medical waiting room. There is no specific capacity limit for the medical waiting room, but all students in the medical waiting room must be as far apart as possible, and no less than 6 feet. Strict mask wearing covering the nose and mouth at all times for every person in the room must be enforced. Students can work on individual schoolwork or other activities while in the medical waiting room.
      2. Contact caregiver for pick-up.
        1. IF CAREGIVER CAN PICK UP DURING THE DAY: Student waits to be picked up in the medical waiting room. Caregivers must wear a mask/face covering when picking up their student. Students should not ride the school bus to get home. Caregivers and students should wash their hands upon arriving at home and change their clothes, as a precaution.
        2. IF CAREGIVER CANNOT PICK UP DURING THE DAY: The student should wait in the medical waiting room until the end of the day to be picked up by caregiver. The student should not go home on a school bus with other students.

                                       iii.         Current Massachusetts DPH guidance is that all symptomatic individuals in Massachusetts, even those with mild symptoms, should be tested.[16] An individual who does not wish to be tested should instead isolate for 14 days[17] and until asymptomatic.

      1. Student should get tested at one of Massachusetts’s test sites.[18] Sites may require pre-screening, a referral, and/or an appointment.
      2. Isolate at home until test results are returned.
      3. Proceed as follows according to test results:
        1. IF NEGATIVE: If the student does not have COVID-19, the student may return to school based upon guidance from their clinician and necessary management of another diagnosis. Student stays home until asymptomatic for 24 hours.
        2. IF POSITIVE: Student should remain at home (except to get medical care), monitor their symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or Massachusetts Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms. [19] FOLLOW STEPS UNDER: “Protocol: Student/staff tests positive for COVID-19.”
    1. IF NO SYMPTOMS:
      1. If the evaluation shows the student does not have symptoms, send the student to class.

 

 


 

Protocol: Student is symptomatic at school

 

  1. Although families are the most important first line of defense for monitoring symptoms, teachers will play an important role in referring possible symptomatic students to the school nurse or other medical point of contact. (Note: This will require training for teachers.)

 

  1. Teacher ensures the student is wearing a mask that fully covers nose and mouth at all times.

 

  1. Teacher calls the nurse or school medical point of contact to inform them that they have a possible case. Nurse or school medical point of contact comes to get the student from class.

 

4.     Nurse (or school medical point of contact) should evaluate the student for symptoms (see list above: “Most common symptoms of COVID-19”).

    1. IF ANY SYMPTOM:
      1. Place the student in the designated medical waiting room. There is no specific capacity limit for the medical waiting room, but all students in the COVID-19 waiting room must be as far apart as possible, and no less than 6 feet. Strict mask wearing covering the nose and mouth at all times for every person in the room must be enforced. Students can work on individual schoolwork or other activities while in the medical waiting room
      2. Contact caregiver for pick-up.
        1. IF CAREGIVER CAN PICK UP DURING THE DAY: Student waits to be picked up in the medical waiting room. Caregivers must wear a mask/face covering when picking up their student. Students should not ride the school bus to get home. Caregivers and students should wash their hands upon arriving at home and change their clothes as a precaution.
        2. IF CAREGIVER CANNOT PICK UP DURING THE DAY: The student should wait in the medical waiting room until the end of the day to be picked up by caregiver. The student should not go home on a school bus with other students.
      3. Current Massachusetts DPH guidance is that all symptomatic individuals in Massachusetts, even those with mild symptoms, should be tested.[20] An individual who does not wish to be tested should instead isolate for 14 days[21] and until asymptomatic.
      4. Student should get tested at one of Massachusetts’s test sites.[22] Sites may require pre-screening, a referral, and/or appointment.
      5. Isolate at home until test results are returned.
      6. Proceed as follows according to test results:
        1. IF NEGATIVE: If the student does not have COVID-19, the student may return to school based upon guidance from their clinician and necessary management of another diagnosis. Student stays home until asymptomatic for 24 hours.
        2. IF POSITIVE: Student remain at home (except to get medical care), monitor their symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or Massachusetts Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms. [23] FOLLOW STEPS UNDER: “Protocol: Student or staff tests positive for COVID-19.”
    2. IF NO SYMPTOMS:
      1. If the evaluation shows the student does not have symptoms, send the student back to class.

 

 


 

Protocol: Staff is symptomatic at home

 

  1. Staff should monitor themselves at home each morning for the most common symptoms of COVID-19 (see list above: “Most common symptoms of COVID-19”).
    1. IF NO SYMPTOMS:
      1. Come to work.
    2. IF ANY SYMPTOM:
      1. Do not come to work.
      2. Contact the COVID-19 point of contact and/or other absence reporting mechanism established by the school.
      3. Current Massachusetts DPH guidance is that all symptomatic individuals in Massachusetts, even those with mild symptoms, should be tested.[24] An individual who does not wish to be tested should instead isolate for 14 days[25] and until asymptomatic.
      4. The staff member should get tested at one of Massachusetts’ test sites.[26] Sites may require pre-screening, a referral, and/or an appointment.
      5. Isolate at home until test results are returned.
      6. Proceed as follows according to test results:
        1. IF NEGATIVE: If the staff member does not have COVID-19, they may return to school based upon guidance from their clinician and necessary management of another diagnosis. Staff member stays home until asymptomatic for 24 hours.
        2. IF POSITIVE: Staff member should remain at home (except to get medical care), monitor their symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or Massachusetts Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms. [27] FOLLOW STEPS UNDER: “Protocol: Student/staff tests positive for COVID-19”.

 

Protocol: Staff is symptomatic at school

 

  1. As noted above, staff should be encouraged not to come to school if they are experiencing any symptoms of COVID-19.

 

  1. If a staff member suspects any symptoms during the day, they should follow the school’s protocols for getting another adult to cover their class mid-day, if needed, and see the school nurse (or school medical point of contact) to be evaluated for symptoms.
    1. IF NO SYMPTOMS: The staff member should follow the school’s standard protocols for being excused due to illness.
    2. IF ANY SYMPTOM:
      1. Current Massachusetts DPH guidance is that all symptomatic individuals in Massachusetts, even those with mild symptoms, should be tested.[28] An individual who does not wish to be tested should instead isolate for 14 days[29] and until asymptomatic.
      2. The staff member should get tested at one of Massachusetts’s test sites.[30] Sites may require pre-screening, a referral, and/or appointment.
      3. Isolate at home until test results are returned.
      4. Proceed as follows according to test results:
        1. IF NEGATIVE: Staff member stays home until asymptomatic for 24 hours.
        2. IF POSITIVE: Staff member should remain at home (except to get medical care), monitor their symptoms, notify the school, notify personal close contacts, assist the school in contact tracing efforts, and answer the call from local board of health or Massachusetts Community Tracing Collaborative. Most people who have relatively mild illness will need to stay in self-isolation for at least 10 days and until at least 3 days have passed with no fever and improvement in other symptoms. [31] FOLLOW STEPS UNDER: “Protocol: Student/staff tests positive for COVID-19”.

 

Section 2: Protocols for potential school closure (partial or full) or district closure

 

Protocol: Presence of multiple cases in the school or district

 

  1. If there is more than one confirmed COVID-19 case (students or staff) in the school at one time, or if there is a series of single cases in a short time span, school leaders and the superintendent should work with the local board of health to determine if it is likely that there is transmission happening in school.

 

  1. For each individual case, FOLLOW STEPS UNDER: “Protocol: Student or staff tests positive for COVID-19.” Note that when there is one isolated case, the student’s close contacts will need to stay home and be tested, not the whole school.

 

3.     When there is suspected in-school transmission beyond one cohort or a small number of cohorts, school and district leaders must consult with the local board of health as to proposed next steps. These steps could include, for example, making a decision to a) close part of the school or the entire school for a short time (e.g. 1-3 days) for an extensive cleaning or other facility mitigation, or b) close the school partially or fully for the longer duration of a 14-day quarantine period.

 

4.     Should there be circumstances where there are multiple cases in multiple schools, school and district leaders must consult with the local board of health as to proposed next steps.  These steps could include, for example, making a decision to a) shut down the district for a short time (e.g. 1-3 days) for an extensive cleaning or other facility mitigation, or b) shut down the district for the longer duration of a 14-day quarantine period.

 

5.     Before a final decision is made on a school or district closure, the superintendent must consult with DESE for further guidance.

 

Contacts:

Russell Johnston, Senior Associate Commissioner, Russell.Johnston@mass.gov, 781-605-4958.

Erin McMahon, Senior Advisor to the Commissioner - Fall Reopening Implementation Lead, Erin.K.Mcmahon@mass.gov, 781-873-9023.

 

  1. If the decision is made to close for some number of days, the school and/or district should send clear information and instructions to families and staff:
    1. Informing them that it is possible COVID-19 is being transmitted in the school and/or district
    2. Noting that there may be more potential cases that are not yet symptomatic
    3. Recommending students quarantine and not have contact with others
    4. Reminding families of the importance of not having contact with higher-risk individuals (e.g., grandparents)
    5. Reminding families of the list of COVID-19 symptoms for which to monitor
    6. Ensuring that remote learning is immediately provided to all students

 

  1. Before bringing students back to school:
    1. Check inventory levels of needed supplies (e.g., disposable masks, soap, hand sanitizer, cleaning products); re-order replacement inventory
    2. Consider a school-wide refresher training on the importance of correct hygiene procedures (masks, physical distance, handwashing)
    3. Reiterate the critical nature of masks, physical distancing, and hand hygiene when students return to school

 

Protocol: Presence of significant number of new cases in a municipality

 

  1. In the case of significant municipal outbreak, as determined by the local board of health or DPH, the superintendent and school leaders must consult with the local board of health to determine whether it is appropriate to close a specific school, schools, or an entire district.

 

  1. Before a final decision is made on a school or district closure, the superintendent must consult with DESE for further guidance.

 

Contacts:

Russell Johnston, Senior Associate Commissioner, Russell.Johnston@mass.gov, 781-605-4958.

Erin McMahon, Senior Advisor to the Commissioner - Fall Reopening Implementation Lead, Erin.K.Mcmahon@mass.gov, 781-873-9023.

 

Protocol: State-wide regression to a previous reopening phase

 

  1. Massachusetts is tracking its overall statewide reopening in phases according to the Reopening Massachusetts plan. Currently, Massachusetts is in Phase 3 of reopening, where even more businesses can resume operations with specific guidance.

 

  1. If Massachusetts moves back into a prior phase, DESE (in consultation with the Massachusetts COVID-19 Command Center) will communicate with school districts and schools to determine whether in-person school should continue.