Alabama just released new guidance for school officials as they encounter the inevitable question: What to do when students or teachers catch COVID-19?
Just days before some schools reopen, the Alabama Department of Public Health released an 85-page toolkit that outlines everything from what to do when a student or teacher has symptoms to how to use the county risk dashboard to make decisions to which forms to use to tell health officials about an outbreak.
The document was posted online a day ahead of a statewide training session ADPH is holding to walk school officials through the toolkit.
State Superintendent Eric Mackey said he is ready to help superintendents with any changes they need to make based on ADPH's guidance.
"For instance, if they need to delay the start of school or change their schedule to an A/B hybrid schedule," Mackey said, "then we'll work with superintendents to make those things happen."
Mackey said ADPH made some revisions last week based on input he shared, but not all of the changes he wanted were made. "They're public health, and it's a medical document."
The guidance is clear: anyone with symptoms needs to be sent home and anyone in “close contact” with the symptomatic person needs to be sent home. Clean and disinfect the areas where the symptomatic person was. If the person with symptoms tests positive for COVID-19, everybody waits two weeks before returning to school.
The state guidance does not set any parameters for when a classroom or a school should be closed.
"ADPH does not routinely mandate school closure for outbreaks of infectious diseases," the document states. "The decision to close a school is a local administrative decision and one that may be made after consultation with public health officials."
The guidance defines an outbreak as two people in one classroom positively diagnosed with COVID-19.
What this all could mean for schools is an ongoing rotation of students and staff in and out of the classroom, as the guidelines call for those showing symptoms and all of those in close contact—defined as within six feet for 15 minutes or more—with the symptomatic person, including those who are wearing masks, to be sent home.
Symptoms include coughing, fever, muscle aches, headaches, new loss of taste or smell among others.
How long everyone has to stay away from school depends on whether the symptomatic person tests positive for COVID-19.
A positive test means everyone who has been in close contact with the person testing positive must quarantine for 14 days from the date of the contact with the person who tested positive according to the guidance.
Related: Thousands of children in Alabama could lose access to school meals as waivers expire
School officials are required to file an online report within four hours once school officials are notified that someone has tested positive, and the report must include the names of all students in the classroom, teacher and staff names, guardians for students and their telephone numbers.
Among the key principles for schools to consider is to use seating charts in classrooms and on buses "to help identify which students were in close contact to other students who test positive for COVID-19."
Those seating charts can then be used in contact tracing, uploaded to ADPH when schools report confirmed and suspected cases.
If a student or staff member tests positive for COVID-19, they should quarantine for 10 days and be without fever or fever-reducing medicine for 24 hours before returning to school.
The document doesn't clearly say what happens to everyone if the symptomatic person tests negative, but presumably everyone except the symptomatic person would be cleared to return to school.
ADPH gives schools the choice of whether to require a healthcare provider's release for the symptomatic person to return to school.
As to how families and others in the school will be notified, the document states that school officials should use their existing school communication methods to notify parents and families that an exposure has occurred. "Confidentiality and privacy must be maintained," according to the document.
School nurses will play a key role, serving as contact tracers within the school itself, identifying symptomatic students, tracing those in close contact, reporting those contacts to ADPH for further investigation, and contacting families of those children to let them know of the possible exposure.
Not every school in Alabama has a school nurse, so it's unclear who will be responsible for the school nurse's duties.
ADPH contact tracers will work with the sick person to identify close contacts made outside of the school community.
The document opens with a statement of purpose, saying it is a roadmap to "support the goal of all students returning to school safely during the COVID-19 pandemic" and includes pages of preventative suggestions
Those suggestions are similar to ones already released by the Centers for Disease Control and Protection, and include encouraging everyone to wear masks at school, set up rooms where students can be six feet apart, make sure students have access to soap and water for frequent 20-second handwashing, and reminding students to avoid touching their eyes, nose, or mouth with unwashed hands.
- All students and school employees are required to wear masks under Gov. Kay Ivey’s order, which expires Aug. 31.
- Frequently touched surfaces within the school and on school buses should be cleaned and disinfected at least daily, the guidance states, or between use as much as possible. Shared objects should be limited and cleaned between uses.
- Cleaning and disinfecting products should not be used near children, and adequate ventilation must be used to prevent inhaling toxic fumes.
- Limiting movement of students in the school, having the teacher change classrooms instead of students in hallways, and minimizing or eliminating large group activities should be considered.
- Lunchrooms need to be at reduced capacity, and students should be encouraged to bring their own meals to school. Disposable utensils are recommended, too.
- Soap and water hand washing is preferred for younger students, but hand sanitizer is acceptable for older students and staff.
Mackey said he’s waiting to comment further until after the statewide training on Tuesday.
For all of AL.com’s back to school coverage, click here.
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Alabama releases plan for when a student or teacher appears sick at school - AL.com
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