Responding to COVID-19 Case(s) in Schools

Last Updated January 14, 2022

Requirements for Schools | Key Terms | Guide for Responding to a Positive COVID-19 Case in Schools | Responding to a COVID-19 Outbreak in Schools

When a case of COVID-19 is identified in a school setting, schools should work with the Pennsylvania Department of Health (DOH) or their county or municipal health department (CMHD) to report aggregate case information and complete contact tracing for individuals diagnosed with or exposed to COVID-19.

Schools within a CMHD jurisdiction should work with their local health department when responding to cases of COVID-19 in a school setting.

School officials have the authority to restrict people who are at risk of spreading COVID-19 from entering the school building. Schools do not need, and should not require, a quarantine order to take this action to protect the health and safety of students and staff.

The following is a Pennsylvania-specific guide for responding to COVID-19 cases in K-12 schools. The Centers for Disease Prevention and Control (CDC) also published a Toolkit for Responding to COVID-19 Cases to assist schools across the country in responding to COVID-19. Schools are encouraged to utilize both resources for assistance responding to cases of COVID-19.

Requirements for Schools

In alignment with requirements in Title 28 Pa. Code Chapter 27 (relating to communicable and noncommunicable diseases), schools must:

• Report positive cases of COVID-19 to DOH for case investigation, contact tracing, and issuance of quarantine and/or isolation orders; and
• Exclude school children and staff from having contact with other school children or staff showing symptoms of a communicable disease.

School officials have the authority to restrict people who are at risk of spreading COVID-19 from entering the school building. Schools do not need, and should not require, a quarantine order to take this action to protect the health and safety of students and staff.

Key Terms

Case: A person who either tests positive for COVID-19 or who has been exposed to someone with COVID-19 and developed clinically compatible symptoms.

Close Contact: A person who was within six feet of an infected person for 15 consecutive minutes starting from two days before illness onset (or for asymptomatic infected people, two days prior to positive test collection) until the time the infected person is isolated. (See definition of "isolation" below.) Although the "close contact" definition is generally 15 consecutive minutes, there are circumstances where 15 cumulative minutes, or less than 15 minutes, may be used.

In the K–12 indoor classroom setting or a structured outdoor setting where mask use can be observed (i.e., holding class outdoors with educator supervision), the "close contact" definition excludes students who were within three to six feet of an infected student (laboratory-confirmed or a clinically compatible illness) if both the infected student and exposed student(s) correctly and consistently wore well-fitting masks the entire time. This exception does not apply to teachers, staff, or other adults in the indoor classroom setting.

For additional information on determining close contacts, please access PA-HAN 533. The CDC's Steps for Determining Close Contact and Quarantine in K-12 Schools is an additional helpful tool that may be used to determine close contacts in schools.

Isolation: Separates an individual who is sick with a contagious disease from people who are not sick. Access additional isolation information or refer to CDC's Overview of COVID-19 Isolation for K-12 Schools. Please note, isolation and quarantine are official public health terms and directives issued by DOH or CMHDs. School officials have the authority to restrict people who are at risk of spreading COVID-19 from entering school building. Schools do not need, and should not require, a quarantine order to take this action to protect the health and safety of students and staff.

Who needs to isolate? Any individual, regardless of vaccination status, who experiences symptoms consistent with COVID-19 should isolate and be evaluated for COVID-19 by a health care provider. Any individual who tests positive for COVID-19 should isolate.

How long does a person with COVID-19 need to isolate?

• Individual with symptoms: the isolation period can end when at least 5 days have passed since symptom onset and 24 hours have passed without fever and other symptoms have improved. Symptom onset should be counted as day zero.
• Individual without symptoms: the isolation period for an individual without symptoms is at least 5 days since positive test result. Test date should be counted as day zero.

Access PA-HAN 619 for additional information on isolation periods.

Quarantine: Separates and restricts the movement of an individual who was exposed to a contagious disease to see if they become sick. The CDC's Overview of COVID-19 Quarantine for K-12 Schools offers additional information on quarantine. For additional information on quarantine, please access PA-HAN 619 . Please note, isolation and quarantine are official public health terms and directives issued by DOH or CMHDs. School officials have the authority to restrict people who are at risk of spreading COVID-19 from entering school building. Schools do not need, and should not require, a quarantine order to take this action to protect the health and safety of students and staff.

Who needs to quarantine?

• People aged 18 or older and completed the primary series of recommended vaccine but have not received a recommended booster shot when eligible.
• People who received the single-dose Johnson & Johnson vaccine (completing the primary series) over 2 months ago and have not received a recommended booster shot.
• People who are not vaccinated or have not completed a primary vaccine series.

Persons who meet the following criteria do NOT need to quarantine:

• People who are 18 or older and have received ALL recommended vaccine doses, including boosters and additional primary shots for some immunocompromised individuals.
• People who are 5-17 and have completed the primary series of COVID-19 vaccines.
• People who had confirmed COVID-19 within the last 90 days as diagnosed by a viral test.

How long does a close contact need to quarantine?

People who are quarantining should stay home and away from other people for at least 5 days after the last contact with a person who has COVID-19 and wear a well-fitting mask around others at home where possible.

For people who share a household with someone who has COVID-19, the close contact's quarantine period starts from the last time they were exposed to the person with COVID-19. If the person with COVID-19 cannot fully isolate, the household contacts who are either unvaccinated or have not received all the recommended doses should quarantine for an additional 5 days AFTER the person with COVID-19 is released from isolation. Access PA-HAN 619 for additional information on quarantine periods.

Case Investigation: The identification and investigation of individuals who are classified as being a confirmed or probable case of COVID-19. This includes learning when the case was infectious and identifying the people and places they were around while infectious.

Contact Tracing: The subsequent verification, monitoring, and support of contacts who have been exposed to, and possibly infected with, COVID-19.

Outbreak: Two or more cases among students/staff without other identified epidemiological linkages, with onset within 14 days in a single classroom or core group (e.g., teams, band).

Epidemiological link: Characteristic that links two cases, such as close contact between two people or a common exposure. Epidemiological links between cases are considered in the process of determining outbreaks. For example, if two cases occur on a soccer team but the cases are siblings, this would not be considered an outbreak because the transmission can be explained by their linkage as siblings. Alternatively, if there are two cases on a soccer team and the soccer team is the only source of exposure to one another, then this would be considered an outbreak with transmission occurring on the team.

Guide for Responding to a Positive COVID-19 Case in Schools

Schools within a CMHD jurisdiction should work with their local health department when responding to cases of COVID-19 in a school setting.

1. Identify the positive case of COVID-19. Schools may be notified of a positive case by the individual or individual's family, by DOH or CMHD, or through their school-based testing program.
2. Separate the positive case from other students and staff if the person is present in school at the time of identification. Exclude the positive case from school for the duration of their isolation period (as defined above).
3. Identify close contacts of the case. DOH or CMHD staff can assist schools in identifying close contacts and provide additional guidance as needed.
   Remember: A close contact is an individual who has been within six feet of a case for 15 consecutive minutes. In the K–12 indoor classroom setting or a structured outdoor setting where mask use can be observed (i.e., holding class outdoors with educator supervision), the close contact definition excludes students who were within three to six feet of an infected student (laboratory-confirmed or a clinically compatible illness) if both the infected student and exposed student(s) correctly and consistently wore well-fitting masks the entire time. This exception does not apply to teachers, staff, or other adults in the indoor classroom setting.
4. Exclude close contacts from school and notify the families of close contacts of possible exposure.
5. Notify the school community of the presence of COVID-19 within the school setting and that all people determined to be close contacts have been notified.
6. Use the COVID Return Date Calculator (Excel) to determine when the positive case and close contacts may return to school.
7. Report cases and close contacts to DOH
1. Use survey tool to report aggregate cases and close contacts to DOH on a weekly basis.

In addition to this guide, schools may refer to CDC's Responding to COVID-19 Cases in K-12 Schools: Resources for School Administrators for more information.

Responding to a COVID-19 Outbreak in Schools

If a school is experiencing an outbreak or a rise in cases, the school can contact DOH or their local CMHD if additional guidance on outbreak response is needed. To preserve safe in-person learning to the greatest extent possible, DOH staff will work with schools to determine if a closure is necessary and if so, the appropriate closure length, with a maximum 14-day recommendation for full incubation period.

A maximum 14-day suspension of in-person learning may be recommended by DOH if the following criteria are met:

• 5% of students/staff confirmed cases in a 14-day window:
• Small school (<500 staff & students): 25 case threshold
• Medium school (500-900 staff & students): 25-45 case threshold
• Large school (900+ staff & students): 45+ case threshold

OR

• Three simultaneous classroom and/or core group outbreaks when:
• Contact tracing cannot adequately identify close contacts or be completed in a timely manner; and
• Other mitigation strategies such as physical distancing or universal masking are not being implemented or adhered to.

The criteria outlined above will be used by DOH to determine if a recommendation for a maximum 14-day suspension of in-person learning is appropriate. DOH and PDE support continuation of in-person learning and will limit closure recommendations when possible. Recommendations for 1 to 2-day closures may be provided when schools need additional time to identify, notify, and exclude close contacts. Longer closures may be recommended for an entire school or specific cohort (e.g., an entire grade) when the large numbers of cases or close contacts present logistical and safety concerns. The decision to close for any length of time remains a local decision. Schools may use other criteria to determine if a suspension of in-person learning is necessary for their local school community.