The Centers for Disease Control and Prevention on July 9 released updated “Guidance for COVID-19 Prevention in Kindergarten (K)-12 Schools” that emphasizes the benefits of in-person learning to students and the importance of implementing layered prevention strategies as determined by local circumstances, including levels of community transmission and local vaccine coverage. The new CDC guidance says that fully vaccinated individuals, including students, need not wear a mask indoors, and, in general, people do not need to wear a mask outdoors, with some exceptions noted below. CSBA will be watching closely to see how this federal guidance aligns with or differs from upcoming guidance the State of California is expected to release next week. According to the CDC’s guidance, “This CDC guidance is meant to supplement — not replace — any federal, state, local, territorial, or tribal health and safety laws, rules and regulations with which schools must comply.”
The California Department of Public Health followed the CDC announcement with a preliminary statement of its own, largely reinforcing the CDC guidelines but also emphasizing that masking will continue indoors in California schools and that every school has access to free testing through a state-run program. This is a significant point given that CDPH’s guidance, not the CDC’s, will be operative in California.
“We applaud the CDC’s commitment to ensuring that schools are fully, safely opened for in-person instruction. Given California’s science-based approach and the fact that the state’s school facilities can’t accommodate physical distancing, we will align with the CDC by implementing multiple layers of mitigation strategies, including continued masking and robust testing capacity,” said California Health & Human Services Agency Secretary Dr. Mark Ghaly in a July 9 press release. “Masking is a simple and effective intervention that does not interfere with offering full in-person instruction. At the outset of the new year, students should be able to walk into school without worrying about whether they will feel different or singled out for being vaccinated or unvaccinated — treating all kids the same will support a calm and supportive school environment.”
CDPH will be releasing its guidance as early as Monday, July 12.
Because schools will have a mixed population of people who are fully vaccinated and who are not, K-12 administrators will need to make decisions about the use of layered COVID-19 mitigation strategies in schools to protect everyone. Working with local public health offices, school administrators should consider multiple factors when deciding which layered prevention strategies work best based on the school population, families and students served, and their communities. According to the CDC guidance, the primary factors to consider include:
- Level of community transmission of COVID-19.
- COVID-19 vaccination coverage in the community and among students, teachers and staff.
- Use of a frequent SARS-CoV-2 screening testing program for students, teachers and staff who are not fully vaccinated. Testing provides an important layer of prevention, particularly in areas with substantial to high community transmission levels.
- COVID-19 outbreaks or increasing trends in the school or surrounding community.
- Ages of children served by K-12 schools and the associated social and behavioral factors that may affect risk of transmission and the feasibility of different prevention strategies.
CDC PREVENTION STRATEGIES
“Achieving high levels of COVID-19 vaccination among eligible students as well as teachers, staff and household members is one of the most critical strategies to help schools safely resume full operations,” according to the guidance. Schools can be key messengers in promoting vaccinations among teachers, staff, families and eligible students by providing information, encouraging vaccine trust and confidence, and establishing supportive policies and practices that make getting vaccinated as easy and convenient as possible. When promoting COVID-19 vaccination, it is important to keep in mind that certain communities and groups have been disproportionately affected by COVID-19, and some communities might have experiences that affect their trust and confidence in the healthcare system. The full guidance gives a lengthy list of resources to increase vaccination trust in the community.
Consistent and correct mask use among teachers, students and staff who are not fully vaccinated is necessary and especially important indoors and in crowded settings when physical distancing cannot be maintained.
- Indoors: Mask use is recommended for people who are not fully vaccinated including students, teachers and staff. Children under 2 years of age should not wear a mask.
- Outdoors: In general, people do not need to wear masks when outdoors. However, particularly in areas of substantial to high transmission, CDC recommends that people who are not fully vaccinated wear a mask in crowded outdoor settings or during activities that involve sustained close contact with other people who are not fully vaccinated.
Based on the needs of the community, school administrators may opt to require mask use by all people on school campuses, regardless of vaccination status. Some reasons the CDC lists for this include: having a student population that is not yet eligible for vaccination (e.g., schools with grades preK-6); increasing, substantial or high COVID-19 transmission within the school or surrounding community; increasing community transmission of a variant that is spread more easily among children and adolescents or is resulting in more severe illness from COVID-19 among children and adolescents; lacking a system to monitor the vaccine status of students and/or teachers and staff; and difficulty monitoring or enforcing mask policies that are not universal. Exceptions to masking for people under the age of 2 or who have special needs are still in effect.
Based on studies from the 2020–21 school year, CDC recommends schools maintain at least 3 feet of physical distance between students within classrooms, combined with indoor mask wearing by people who are not fully vaccinated. However, the guidance states that an inability to provide physical distancing should not exclude students from in-person learning, and other layered mitigation strategies should be considered, such as indoor masking, screening testing, cohorting, improved ventilation, handwashing and covering coughs and sneezes, staying home when sick with symptoms of infectious illness including COVID-19, and regular cleaning to help reduce transmission risk.
CDC guidance provides that people who are fully vaccinated do not need to participate in screening testing and do not need to quarantine if they do not have any symptoms. Screening testing may be most valuable in areas with substantial or high community transmission levels, in areas with low vaccination coverage, and in schools where other prevention strategies are not implemented. Screening 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 testing should be offered to students who have not been fully vaccinated when community transmission is at moderate, substantial, or high levels; at any level of community transmission, screening testing should be offered to all teachers and staff who have not been fully vaccinated. To be effective, the screening program should test at least once per week, and rapidly (within 24 hours) report results.
The guidance also recommends strategies around proper ventilation, handwashing and respiratory etiquette, staying home when sick and getting tested, contract tracing in combination with isolation and quarantine, and cleaning and disinfection.
CSBA will produce an additional update on COVID-19 related school safety procedures when the CDPH releases its own guidance.