Public Health Guidelines for Returning to School

It is important for children and adolescents to continue to receive their routine immunizations. This will help avoid outbreaks of other illnesses while the COVID-19 pandemic continues. In addition, the AAP and CDC highly encourage everyone to get the flu vaccine this year if they are medically eligible. It will be important to help reduce the spread of flu this year.

The Pfizer vaccine for COVID-19 has been granted emergency use authorization for children ages 5 and up. The COVID-19 vaccine offers the best protection against COVID-19 infection, severe illness, hospitalization and death. Learn more about the vaccine.

Physical distancing needs to be encouraged to the extent possible within the school system, but not at the expense of in-person learning. Studies suggest three feet should be adequate distance to reduce spread, particularly when combined with face coverings. When maintaining a physical distance of three feet is not possible, it is especially important to add additional prevention strategies, but again this should not limit in-person learning. For younger students, reducing group size and keeping groups together (cohorting or pods) will help reduce the risk of spread to more individuals. For older students, spacing desks and having them face the same direction will help improve the effectiveness of physical distancing.

Students or staff who become sick during the school year, either at school or home, should be encouraged to connect with their medical provider to determine if they need testing.

Schools should determine how they are going to screen staff and students for symptoms. Many remote reporting tools have been developed and implemented to assist with this.  

Screening and testing can be used to help evaluate and adjust prevention strategies and provide added protection for schools that are not able to provide optimal physical distance between students. Screening and testing should be offered to students who have not been fully vaccinated when community transmission is at increased levels and offered to all teachers and staff who have not been fully vaccinated. Testing in low-prevalence settings might produce false positive results, but testing can provide an important prevention strategy and safety net to support in-person education.

To facilitate safe participation in sports, extracurricular activities and other activities with elevated risk of transmission (such as activities with singing, shouting, band and exercise), schools may consider implementing screening and testing for participants who are not fully vaccinated. Schools can implement screening and testing of participants who are not fully vaccinated up to 24 hours before sporting, competition or extracurricular events. High-risk sports and extracurricular activities should be virtual or canceled in areas of high community transmission unless all participants are fully vaccinated.

Improving ventilation is an important COVID-19 prevention strategy that can reduce the number of virus particles in the air. During student transportation, open or crack windows in buses and other forms of transportation, if doing so does not pose a safety risk. Funds provided through the Elementary and Secondary Schools Emergency Relief Programs and the Governor’s Emergency Education Relief Programs can support improvements to ventilation.

• Teach and reinforce handwashing with soap and water for at least 20 seconds.
  
• Remind everyone in the facility to wash hands frequently and assist young children with handwashing.
  
• If handwashing is not possible, use hand sanitizer containing at least 60% alcohol (for teachers, staff and older students who can safely use hand sanitizer). Hand sanitizers should be stored up, away and out of sight of young children and should be used only with adult supervision for children under 6 years of age.
  
• Schools also need to have cleaning plans to ensure high touch areas (such as doors, railings, lockers, desks) are cleaned at least daily. The plans also need to include external spaces.

COVID-19 has been very stressful for students, parents and caregivers, teachers, school staff and others. Children and adolescents have been impacted by being disconnected from their friends, classmates and teachers, as well as all the strain and stress of COVID-19 on their families. It means schools can expect to see students with decreased attention spans, increased anxiety and other symptoms related to stress and trauma. Schools also need to make sure staff and teachers are getting support for their mental health needs during this period.

Longer quarantine duration is associated with worse mental health outcomes, and extended periods of virtual learning place students at further risk for social isolation. In communities where virtual learning will continue, it is critical that the education and health sectors employ active outreach to students and families, that educators and health care providers are trained in trauma-informed practices, and that telehealth opportunities for mental health care are maximized.

Historical and structural racism have led to chronic underfunding of schools that serve higher populations of students of color. Research during the pandemic shows that Black, Latinx and Native American students have less access to electronic devices, internet connectivity and quality virtual learning programs. Due to these inequities, Black and Latinx students may experience an additional three months of learning loss compared to other students. Black, Latinx and Native American communities also experience a disproportionate burden of disease and death due to COVID-19, as a result of longstanding health and social inequities. It is important that historically underfunded schools and communities have access to the resources needed to open schools safely and provide academic supports to address learning loss during the pandemic.