COVID-19 guidance: higher education

Last updated November 20, 2020.

College students in lecture distance and wear masks

IF THERE IS A CONFIRMED CASE OF COVID-19 AMONG STUDENTS OR EMPLOYEES

Institutions of higher education should adhere to all applicable public health and executive orders. Public Health Order 20-35 contains specific language which applies to institutions of higher education. This guidance provides additional information about the responsibilities of institutions of higher education and how these institutions can protect their campus communities. 

This guidance is for:
  • Post-secondary institutions, both public and private. 
  • Private religious institutions authorized by the Colorado Department of Higher Education.
  • Private occupational schools.

On this page:
  • Planning and preparation
    • Emergency operations
    • Situational awareness
    • Deciding about remote vs. in-person operations
  • Testing
    • Testing during quarantine
    • Retesting and quarantine in individuals who have recovered
    • Routine testing
    • Reporting test results
    • Wastewater testing
  • Questions and answers
  • Decreasing transmission risk
    • Considerations applicable to all contexts
    • Considerations applicable to specific contexts
  • Illness on campus
    • Case identification
    • Isolation
    • Quarantine
    • Supporting students during isolation and quarantine
    • Tech solutions to support contact tracing
    • Cooperation with case investigation and contact tracing
  • Additional resources

Institutions of higher education have a responsibility to protect the safety of the entire campus community, including students, faculty, staff, third-party businesses operating on campus, campus visitors, and the surrounding community. 

Emergency operations

Institutions of higher education should follow their established emergency operations procedures. Adherence to these practices will facilitate timely and coordinated response both to COVID-19 as well as to other emergencies that may arise on campus. These organizations have further guidance to support emergency response activities:

The core planning team for emergency response should include members from across the institution of higher education. These members may include: 

Academic affairs. Information technology.
Business office. International student services office.
Central administration. Legal counsel.
Counseling and mental health services. Local and state public health agencies.
Emergency medical services. Public information office.
Environmental health and safety. Public safety operations.
Facilities and operations. Residential life.
Food services. Student services.
Health services. Transportation.
Human resources.  

Situational awareness

Awareness of community levels of COVID-19 transmission, both within the institution and in the wider community, are integral to facilitating a timely, proportionate response to disease. Additionally, restrictions may apply to various industry sectors based on a county’s dial level. Institutions of higher education should develop a process to review transmission data on a regular basis. 

CDPHE has many publicly available tools available to support awareness of COVID-19 transmission levels. Relevant data should be reviewed both for county and state level. Resources include:

 

Deciding about remote vs. in-person operations

The decision about whether to operate in person or remotely can be difficult. There are many considerations, and no single metric can dictate the appropriate decision for every context. When choosing to operate in person, it is important to ensure members of the campus community are aware that isolation or quarantine will be required at their local residence. This is an especially important consideration for students whose permanent residence may be in another state as they decide whether or not to return to campus.

Institutions should offer remote learning and work options for students and staff, as appropriate, including but not limited to those at higher risk of severe illness from COVID-19. Institutions should also consider that individuals living with or caring for individuals at higher risk of severe illness may choose to learn or work remotely, even if their personal risk of severe illness is low. Additionally, institutions should encourage remote work and learning in circumstances where in-person attendance is not necessary. 

It is imperative to review sick-leave policies for staff and ensure there are no penalties for students or staff who miss class or work due to illness or symptoms of COVID-19. Punitive sick leave policies discourage accurate reporting of symptoms and exposures and increase the risk of transmission in the community.

Sick leave policies should be in line with the Healthy Families and Workplaces Act (HFWA). Under this act, employers must provide paid leave to an employee under certain conditions, including having COVID-19 symptoms and seeking a medical diagnosis.

The decision to move between remote and in-person operations should take into consideration the following non-exhaustive list of factors:

  • County and state disease transmission metrics, including case rate and percent positivity.

  • County dial level.

  • Disease transmission metrics on campus (where available).

  • Outbreaks on campus.

  • Capacity for testing and contact tracing, both on- and off-campus.

  • Ability for individuals to isolate or quarantine on campus, including availability of suitable lodging, meal delivery, and other necessary services.

  • Availability of staff to support in-person operations.

  • Makeup of student population, including higher-risk groups.

  • Input from campus and surrounding community stakeholders, including the local public health agency.

COVID-19 has required unprecedented innovation and adaptation at all levels of society. Institutions of higher education are uniquely positioned to take proactive steps to ensure the safety of the campus community. Guidance is divided below into considerations that apply across contexts and those that apply to specific contexts. These considerations should not be considered exhaustive, and institutions should also consult guidance available from other organizations.

Considerations applicable to all contexts

LIMIT THE NUMBER OF PEOPLE ON CAMPUS

One of the simplest ways for an institution of higher education to reduce the risk to the campus community is to limit the number of students, teaching staff, administrative support personnel, visitors, and other individuals who are physically present on campus. Remote work and learning is inherently lower risk than in-person activities.

  • Encourage all employees not critical to in-person operations or not classified as essential employees to continue working remotely.

  • Consider limitations on visitors to campus facilities.

  • Supervise visitors and follow all health policies while on campus, including symptom screening and mask-wearing policies.

  • Support students and faculty who choose to participate in remote education.

  • Encourage and facilitate remote working arrangements for administrative and support staff.

  • Avoid in-person meetings for administrative and support staff, even for staff who choose to work onsite.

  • Stagger shifts and work schedules to limit the number of individuals on campus at any one time.

 

LIMIT THE UNNECESSARY EXPOSURES FOR MEMBERS OF THE CAMPUS COMMUNITY

Institutions of higher education should ensure that individuals who choose to be on campus are not exposing the in-person campus community to excess risk through behaviors that increase the risk of disease transmission.

  • For students who require on-campus housing, limit to one student per room, if possible.

  • Ensure physical distancing in common areas and enforce capacity restrictions.

  • Encourage individuals traveling to/from campus to use personal vehicles rather than public transportation.

  • Limit group gatherings outside of classes, social or otherwise. On-campus and school sanctioned gatherings must be pre-approved and conducted in adherence with CDPHE’s guidance for indoor and outdoor events. Institutions may require campus community members who attend large gatherings to quarantine following return to campus. 

  • Discourage individuals from undertaking unnecessary travel during campus holidays and weekends. See further guidance on off-campus travel below.

  • Proactively identify and discourage attendance at potential high-risk exposures off campus, including parties, festivals, and other large gatherings or public events.

  • Following high-risk travel or other high-risk activity, even in the absence of a known COVID-19 exposure, consider enforcing a 14-day self-quarantine or transition period. 

 

ENSURE THE SAFETY OF LEARNING AND WORK SPACES

  • Require all students, faculty, and staff to wear masks in learning and work spaces.

  • Ensure 6-foot distancing or greater between all students, faculty, and staff. Ensure classes allow for appropriate physical distancing.

  • For activities in which 6-foot distancing is not possible (e.g. physical therapy training), limit both duration of exposure and number of unique contacts to the degree possible.

  • Adhere to capacity restrictions for spaces and activities.

  • Limit, wherever possible, the sharing of equipment and other resources.

  • Conduct increased cleaning of campus spaces in accordance with CDPHE cleaning guidance.

  • Maximize effectiveness of ventilation of indoor spaces. (Ventilation guidance)

  • Close or restrict access to high-risk contexts, including gymnasia and recreational services.

  • Ensure ancillary student services including bookstores, other retail and food, maintenance, etc. follow relevant industry guidelines.

  • Maintain neat and detailed attendance records and visitor logs to enable contact tracing.

  • Students, faculty, and staff who choose to participate in higher-risk activities for COVID-19 transmission should consider staying out of the workplace/classroom, even if they are not known to have COVID-19.

    • These activities may include group athletics, large social gatherings, and frequent travel, among other activities.

 

CREATE A CULTURE OF SAFETY AND SUPPORT

  • Provide clear communications about COVID-19 and campus policies, using easy-to-understand illustrations and text in multiple languages.

  • Use signs to remind individuals of proper hygiene techniques and other safety measures such as physical distancing and mask use.

  • Use existing student communication channels and consider peer leadership programs to educate and reinforce responsible behaviors. 

  • Update student codes of conduct to promote responsible on- and off-campus behavior and cooperation with state and local health officials, including case investigation and contact tracing.

  • Consider creating social contracts or campus pledges for students to acknowledge that they agree to abide by campus codes of conduct and COVID-19 policies, and will follow state and local public health orders for isolation and quarantine.

  • Create anonymous reporting mechanisms (such as hotlines or online surveys) for students and staff to report infection prevention and safety concerns.

  • Refer students not complying with required risk reduction strategies to student disciplinary processes.

 

SUPPORT MASK WEARING

Faculty, staff, and students who are not engaged in industrial or health care activities should wear a mask that covers both the nose and mouth. These can either be purchased or made by individuals for their own use. Instructions are available on the CDC website.

  • Require masks to be worn in all public indoor spaces, as well as outdoors, especially if 6-foot distancing cannot be maintained.

    • Masks should not be worn by:

      • Children under 2 years old.

      • Anyone who is having trouble breathing or is unconscious.

      • Anyone who is unable to remove their mask without assistance.

    • Alternatives to masks (including clear face shields) may be considered for:

      • Individuals who are deaf or hard of hearing if the face covering interferes with wearing hearing aids (although alternate mask styles should be considered first).

      • Individuals who are interacting with people who rely on lip-reading for communication.

  • Ensure masks are worn properly, with both nose and mouth covered.

  • Consider restricting activities where masks must be removed (e.g. eating, vigorous exertion) to outdoor and non-public indoor spaces with group size limitations and restrictions.

  • Additional mask guidance

 

REQUIRE DAILY SYMPTOM SCREENING FOR ALL MEMBERS OF THE CAMPUS COMMUNITY

  • Require daily symptom screening and encourage daily temperature checks for all members of the campus community.

    • For individuals residing on campus, screening should be completed prior to leaving their room or entering common spaces.

    • For individuals not residing on campus, screening should be completed prior to arrival on campus.

  • Campus officials may consider using a cell phone application or other mechanism for all members of the campus community to demonstrate completion of symptom screening.

  • Create clear guidelines for individuals who screen positive for symptoms to follow, including not attending class or other in-person activities without further evaluation.

  • Refer symptomatic individuals to a medical provider for testing and evaluation, as well as to the Colorado COVID Symptom Support tool.

  • Develop protocols for how to manage symptomatic members of the campus community (see below for more information).

  • If temperature screening will be required prior to accessing certain facilities or services, place screening tables outside the entrance and facilitate physical distancing in people waiting to be screened. 

  • Create signage and reminders for students, faculty, and staff to perform symptom screening at least daily and prior to attending on-campus activities.

 

SUPPORT HYGIENE AND CLEANING PRACTICES THAT REDUCE THE RISK OF DISEASE TRANSMISSION

  • Require frequent handwashing upon arrival, departure, and throughout the day, and have hand sanitizer available in public areas.

  • Post signage for staff and students on hygiene and safety measures.

  • Discourage use of shared objects, and clean and disinfect shared objects between use.

  • Develop procedures to maintain cleanliness of any on-campus housing and to stagger access to shared areas.

  • Regularly schedule cleaning and disinfection of all shared and common spaces, focusing on high-touch areas.

 

ENSURE APPROPRIATE VACCINATION OF MEMBERS OF THE CAMPUS COMMUNITY

While there is currently no vaccine approved to protect against COVID-19, many other vaccinations are both safe and effective in reducing the risk of disease on campus. Reducing the risk of influenza, measles, meningitis, and other preventable diseases (both common and serious) is an effective way to keep the campus community safe and healthy. 

  • Consider requiring or encouraging an influenza vaccine for all people on campus.

  • Consider holding a flu clinic on campus or promote fluvaxcolorado.org for more information and locations where people can get an influenza vaccination.

  • Actively disseminate information encouraging influenza vaccination (additional resources). 

  • Ensure that vaccine documentation for required and recommended immunizations is current and complete for all members of the campus community.

    • Meningococcal (MenACWY and MenB).

    • Human papillomavirus (HPV).

    • Tetanus, diphtheria, pertussis (Tdap or Td).

    • Measles, mumps, rubella (MMR).

    • Varicella (VAR).

    • Pneumococcal (PCV13 and PPSV23).

    • Hepatitis (HepA and HepB).

    • Haemophilus influenzae type b (Hib).

 

SUPPORT COPING AND RESILIENCE

The risk mitigation strategies implemented in response to the COVID-19 pandemic may lead to feelings of social isolation and may strain usual coping mechanisms. Institutions of higher education should take an active role in supporting the mental and emotional health of the campus community. These steps may include:

  • Increase the availability of counseling services, including virtual counseling.

  • Encourage and support behaviors that positively impact mental and emotional health, including connecting with peers, exercise, and sleep.

  • Actively discourage and intervene on stigmatization of individuals who test positive or have been exposed to COVID-19. 

  • Actively disseminate information about crisis mental health services, including the National Suicide Prevention Lifeline (1-800-273-8255 for English, 1-888-628-9454 for Spanish), Lifeline Crisis Chat, or 911. 

  • Additional information related to supporting mental and emotional health in the context of COVID-19

 

Considerations applicable to specific contexts

CLASSROOM SETTING

Smaller classes and classes in spaces less conducive to disease transmission (e.g. outside) are lower risk than larger classes and those held in spaces with high-risk transmission potential (e.g. poorly ventilated, crowded).

  • Ensure students and faculty have completed symptom screening before arriving to class.

  • To the degree possible, support online or remote learning for individuals who choose not to participate in in-person classes, those with medical conditions that place them at higher risk of severe complications of COVID-19, and individuals following isolation or quarantine precautions. 

  • Have a plan in place to facilitate switching an entire class to remote learning if cases of COVID-19 occur among attendees or if the instructor is in isolation or quarantine.

  • Consider curricular changes that facilitate small group gatherings for interactive discussion rather than large lecture activities (e.g. “flipped classroom”), or only have in-person attendance for activities that cannot be completed remotely (e.g. laboratory sessions).

  • Maintain 6-foot spacing among attendees and consider using larger classrooms to host smaller class sizes.

  • Maintain an accurate attendance record/seating chart to facilitate contact tracing.

 

RESIDENCE HALLS, OFF-CAMPUS HOUSING, GREEK LIFE HOUSING, AND OTHER CONGREGATE LIVING SITUATIONS

Congregate living settings which involve numerous individuals sharing indoor common spaces (including bathrooms, kitchens, hallways, and other areas) have higher risk of disease transmission than individual housing units where each individual (or family unit) has their own facilities without sharing common spaces. 

The risk of congregate living settings may be increased in situations where campus officials have less influence over building operations, such as Greek housing and other off-campus housing complexes that cater to students. Campus officials should encourage operators of such facilities to follow disease control practices consistent with those practiced in on-campus residences.

Congregate living settings can pose additional challenges when cases of COVID-19 are identified. Campus officials and congregate living settings should work with state and local public health officials when determining close contacts and when providing housing conducive to effective isolation and quarantine. 

Settings where social activities are focused around a congregate living setting (e.g. Greek life housing) also pose increased risk. Institutions of higher education should be proactive in developing and communicating policies surrounding gatherings of students in such settings. These policies may include exclusion from on-campus activities for 14 days or longer for attendees of such events as well as for occupants of locations where these events take place. 

 

FOOD SERVICE, RESTAURANTS, AND DINING HALLS 

Institutions of higher education should support restaurants and dining halls in adapting operations to decrease the risk of disease transmission while continuing to provide nutritious and appetizing meal options. These adaptations may include facilitating order-ahead and to-go-only arrangements, outside-only dining, and delivery options.

Special accommodations to facilitate delivery from off-campus food vendors may be considered. These can include allowing delivery vehicles to use short-term parking on campus and providing space near the entrances to residential halls for no-contact delivery of meals.

In addition, consider the following modification to reduce the risk of transmission in dining and food service contexts:

  • Avoid the use of communal appliances.

  • Avoid self-service food and drink options.

  • Provide grab-and-go options.

  • Ensure food and utensils are not shared between patrons, including serving utensils.

  • Provide no-touch (foot pedal or automatic) waste disposal containers.

  • Install touchless payment methods where practical.

  • Provide hand hygiene stations for patrons.

  • Guidance for restaurants and food service.

 

RETAIL AND OTHER BUSINESSES

As with other contexts, institutions of higher education should support businesses in adapting their services to reduce the risk of disease transmission. This may include supporting outdoor retail and delivery options, facilitating employee health screening policies, and eliminating barriers to delivery.

Retail and other businesses that serve the campus community should follow sector-specific requirements and best practices available both on the CDPHE and CDC website: 

 

DISABILITY RESOURCE CENTERS

Disability resource centers may be an important resource in connecting students and staff to necessary accommodations, modifications, and assistance related to their risk of severe outcomes from COVID-19.

  • Consider establishing disability resource centers as the primary point of contact for individuals requesting accommodations, modifications, and assistance.

  • Create standardized policies to support fair and equitable evaluation for accomodations, including policies around:

    • Required documentation, if any.

    • Scope of available accommodations.

    • Communication and disclosure practices.

  • Facilitate access to resources and equipment to support remote learning and work practices, including:

    • Individuals who are deaf or hard of hearing.

    • Individuals with limited visual ability.

    • Individuals requiring other specialized human interface or input devices.

  • CDC: People at Increased Risk.

 

CAMPUS HEALTH SERVICES

Campus health services will face special challenges in providing usual care services while supporting efforts to reduce the spread of COVID-19 and other respiratory diseases on campus. Institutions of higher education may consider partnering with outside providers to ensure access to immunization services, testing, and routine care. 

Campus health services should consider refocusing limited staffing and space resources on services that are best provided in an in-person context, or that benefit from a practice within the campus community. These services may include:

  • Facilitating testing and evaluation of diseases of public health significance, including COVID-19 and other communicable viral diseases (e.g. varicella, measles).

  • Routine and acute reproductive health services, including STIs and family planning.

  • Evaluation and treatment of other mild- to moderate-severity acute illnesses.

  • Influenza vaccination.

Services that may be best provided by outside partners include:

  • Annual visits.

  • Other routine vaccinations (available in many pharmacies).

  • Management of chronic conditions.

Campus health providers should follow all guidance relevant to health care providers in other contexts, including:

 

Considerations for travel

Travel puts individuals at additional risk of contracting COVID-19 via a number of mechanisms. Travel may involve crowded public vehicles, where close contact with a high number of unique contacts may occur. Risk reduction practices may be less consistent during travel, and travelers may unknowingly travel to or through high-incidence areas. Even with all appropriate precautions in place, travel exposes individuals to a new group of contacts.

Institutions of higher education should discourage unnecessary travel away from campus during weekends and short breaks, and take steps to protect the campus community and ensure continuity of academic operations during longer breaks. 

 

TRAVEL DURING HOLIDAYS AND SEMESTER BREAKS
 
Many individuals may wish to travel home, or visit relatives or friends during holidays and scheduled breaks. Holidays are a time of increased COVID-19 spread. Institutions should advise members of the campus community that protecting themselves, their friends, and their loved ones requires careful planning and consideration of the risks involved.
 

  • Encourage members of the campus community to reconsider holiday/break travel plans, supporting individuals in choosing the safest arrangements for themselves and their family members. This may include supporting remote holiday celebrations while keeping dorms open during the holiday season. For individuals who must leave campus, support travel plans which minimize the risk to members of the campus community, their families, and the wider community. Safer modes of travel include traveling in a private vehicle with the minimum number of stops between departure and arrival.

  • When possible, members of the campus community should have the opportunity to learn remotely for 14 days prior to a scheduled break, allowing them to limit close contact prior to interacting with persons who are not a member of the campus community. This will reduce the risk of exposing family members who may be at higher risk of severe outcomes of COVID-19. 

  • Testing may be offered to members of the campus community near the end of a 14-day transition period, with results ideally available prior to planned travel. Anyone with a positive test must postpone travel while they are in isolation. This prevents someone with an asymptomatic COVID-19 infection from infecting others during travel.

  • Individuals should be educated that a negative test only provides a “snapshot” of their COVID-19 status, and that they could still become ill at a later date. Therefore, they should continue to monitor for symptoms of COVID-19 and seek testing and evaluation if they later develop symptoms. 

  • Advise students to prepare for a range of possible scenarios following a scheduled break, including the need for isolation or quarantine if they become ill or are exposed while away from campus. They should also be prepared for changes in state or local public health orders, or an institution’s decision to move to remote learning. If traveling, students should pack with them all materials that are needed for remote learning.

  • Prior to returning to campus, students and staff should self-evaluate for symptoms or any contact with symptomatic individuals or known exposures to COVID-19. Individuals with symptoms or exposures should be instructed to complete isolation or quarantine prior to traveling.

 
TRAVELING OFF CAMPUS DURING THE SEMESTER
 
Students may wish to travel during the semester. These trips present increased risk of exposure to COVID-19 for both the campus community and individuals at the travel destination. The short duration of these trips may make quarantine prior to departure and after return more difficult.

Unnecessary travel should be discouraged during the semester, especially for students who are participating in in-person learning. Institutions may choose to require individuals who chose to travel away from campus during the semester to quarantine for 14 days prior to resumption of in-person learning and other activities. These requirements may be applied universally, or only during times of heightened community or on-campus transmission of COVID-19. 

 

SPECIAL PRECAUTIONS FOR HIGH-RISK TRAVEL

Institutions of higher education may consider requiring a 14-day quarantine period and/or testing for all individuals arriving from countries or regions with high rates of COVID-19 transmission, or for individuals participating in high risk activities during breaks. Individuals should be informed of the necessity of quarantine on return as soon as is practicable to facilitate advanced planning.

It is important to note that quarantine or testing prior to arrival to campus does not ensure that an individual will not become infected during either on-campus or off-campus activities, during travel, or after arrival. Therefore, quarantine after arrival to campus is likely to be most protective for the campus community.

Tests for COVID-19 are a critical tool for disease control that should be employed alongside other tools, rather than relied upon alone. See detailed information about testing from CDPHE

Additional considerations specific for institutions of higher education are below.

Testing during quarantine

It is recommended that individuals who are quarantining receive a RT-PCR test for COVID-19 about seven days following their last exposure to someone with COVID-19. Testing at this interval may facilitate detection of asymptomatic infections. Testing should be obtained immediately if an individual develops symptoms of COVID-19, even if a previous test has been negative. 

An individual who has been exposed to COVID-19 must continue to quarantine for the full 14 days even if they have one or more negative tests. A negative test result cannot “clear” someone from quarantine following an exposure to someone with COVID-19 or symptoms of COVID-19. 

Individuals who have been exposed to someone with COVID-19 may test negative initially, but later develop symptoms and be contagious. With ongoing community spread in Colorado and elsewhere in the United States, an individual who tests negative initially could also later become infected with the virus from exposure to another source.

Retesting and quarantine in individuals who have recovered from a previous COVID-19 infection

CDPHE does not recommend retesting people who have already been confirmed to have COVID-19 for at least 90 days, except in rare circumstances in discussion with public health or a provider. 

These individuals may not be required to quarantine during this 90-day period if they are identified as having been exposed to someone with COVID-19, as long as they themselves do not develop symptoms. Decisions about quarantine for these individuals should be made in discussion with public health or a health care provider.

Routine testing

Many institutions of higher education have adopted routine testing as part of an overall strategy of protecting their campus community from COVID-19. 

In general, testing individuals only on entry to campus is insufficient, as individuals may become infected with COVID-19 during on- and off-campus activities or might be pre-symptomatic when arriving on campus. In-person participation in the campus community may be a higher risk context than prior-to-arrival activities.

The most effective testing strategies involve routine testing of all members of the campus community. More frequent targeted testing may be appropriate when increased transmission risk is present, either due to higher rates of community spread, membership of high-transmission groups, or participation in higher risk activity. These institutions should consider the CDC guidance.

 

Reporting test results

Clinical labs and health care providers are required to report cases to public health. Public health then interviews the people who have COVID-19 and conducts contact tracing to determine who might be close contacts of the case, and makes recommendations about isolation and quarantine. However, institutions of higher education also are encouraged to report single cases of COVID-19 to their local public health agency. Schools are able to disclose this information to public health without prior written consent under FERPA’s health or safety emergency exception, because a person with COVID-19 represents a potential threat to the health and safety of others at the school. This is true even if there is not an outbreak. 

Institutions of higher education are required to report all outbreaks to their local public health agency or CDPHE within 24 hours per statute. Institutions must report both suspected and confirmed outbreaks.

Campus officials can report outbreaks by:

  • Completing the CDPHE Outbreak Report Form and emailing it to cdphe_covid_outbreak@state.co.us

  • Calling their local public health agency.

  • Calling CDPHE at 303-692-2700.

 

Wastewater testing

Institutions of higher education may consider monitoring for COVID-19 virus particles in wastewater as one part of a strategy to detect infections on campus. Research has shown that people can shed the virus before showing symptoms, or even in the absence of symptoms. Wastewater testing may allow the early identification of such cases allowing institutions to begin targeted testing of individuals.

However, wastewater testing, if pursued, should only be one part of a comprehensive COVID-19 monitoring strategy. There are also important limitations to wastewater monitoring. Some individuals who are contagious with COVID-19 may never shed viral particles in waste, and other substances in the wastewater may inhibit detection of viral particles (including detergents in cleaning and hygiene products).

Institutions interested in pursuing wastewater monitoring for COVID-19 are encouraged to partner with outside organizations, including CDPHE and the CDC’s National Wastewater Surveillance System, to learn about and develop best practices.
 

Keep in mind that individuals will be required to isolate and quarantine at their local residence. Be sure to inform campus members of this requirement prior to their arrival on campus. This is an especially important consideration for students whose permanent residence may be in another state as they decide whether or not to return to campus.

Case identification

Anyone who has symptoms of COVID-19 should be tested immediately and follow isolation precautions while awaiting test results. Individuals who have been exposed to someone with COVID-19 but do not have symptoms should get tested about seven days after their last exposure to the infected individual. 

Symptoms of COVID-19
 

Fever or chills. New loss of taste or smell.
Cough. Sore throat.
Shortness of breath or difficulty breathing. Congestion or runny nose.
Fatigue. Nausea or vomiting.
Muscle or body aches. Diarrhea.
Headache.  


Local public health should be notified within 24 hours of any cases detected on campus.

Individuals who are suspected of having COVID-19 and those who test positive may have infected others two days prior to symptom onset or a positive test. To determine who may have been exposed and should get tested, close contacts must be identified as soon as possible. 

Confirmed case: a person who has tested positive for the COVID-19 virus using certain laboratory tests (usually PCR). Public health professionals will assign the case a definition using the Colorado COVID-19 case and outbreak definitions

Probable case: a person who either has developed COVID-19 symptoms after exposure to someone with COVID-19 who has not tested negative by PCR test; OR a person who has tested positive using a point-of-care antigen test. Details are available using the Colorado COVID-19 case and outbreak definitions

“Exposure” consists of having had “close contact” with someone who has confirmed or probable COVID-19 during the period when that person is likely to be contagious. 

Individuals with COVID-19 and symptoms are considered contagious for two days before symptoms start until 10 days after symptoms started. 

Individuals who test positive for COVID-19, but have not had symptoms, are considered contagious for two days before the test was collected and for 10 days afterward, unless they develop symptoms later. Individuals who are suffering from severe symptoms or who are immunocompromised should consult their medical provider to determine if they may be contagious for longer. 

“Close contact” is typically defined as one of the following:

  • Being in close proximity (for example, within 6 feet) of someone who has a COVID-19 infection for at least 15 minutes total, even if that time is made up of numerous shorter intervals.

  • Providing care for someone who has a COVID-19 infection without appropriate personal protective equipment (PPE). 

  • Having direct physical contact with someone who has a COVID-19 infection.

  • Sharing eating or drinking utensils with someone who has a COVID-19 infection.

  • Being exposed to the respiratory droplets of someone who is sick with COVID-19 (through sneezing, coughing, shouting, etc.).

Whether students in the same classroom with someone who has COVID-19 infection are considered to be “exposed” is determined based on a number of factors, including the classroom environment, the physical distancing protocols in the classroom, the size and ventilation of the classroom, and the sanitation protocols used in the classroom. 

Because class sessions typically last much longer than 15 minutes and may involve different activities and configurations, prolonged contact even at distances greater than 6 feet may make someone a “close contact.” Local public health agencies, in concert with institutions, will conduct a case investigation to determine what information and directions individuals in the impacted class should be provided. In addition, contact tracing will be initiated by the appropriate local health department. 

Depending on the environment and types of person-to-person interactions, high-risk "close contact" exposures can occur in fewer than 15 minutes and distances greater than 6 feet; for example, with activities like coughing, sneezing, singing, or vigorous indoor exertion which are known to increase the risk of disease spread.

 

Isolation

Isolation means staying home from work, school, and activities when a person is sick or diagnosed with COVID-19. Isolation lasts for at least 10 days after the onset of symptoms — and for 24 hours after being fever-free without the aid of fever-reducing medication and if the person shows an improvement of symptoms. 

For people who have not had symptoms, isolation lasts 10 days from the day they had their first positive test. In rare instances (for example, if a person was very sick or has certain medical problems), isolation may last 20 days. Public health experts do not recommend repeat testing to decide when to end the period of isolation except in rare circumstances in consultation with a medical provider.

Ill students, faculty, and staff should be instructed not to return to in-person classes, campus activities, or group settings until they have met CDC’s criteria to discontinue home isolation. Require individuals to notify campus officials if they become ill with COVID-19 symptoms, test positive for COVID-19, or are exposed to someone with COVID-19 symptoms or a confirmed or suspected case. 

It is important that individuals who are under isolation do not undertake long distance or interstate travel to isolate in another location. If an individual will not be isolating in their usual on- or off-campus residence, they should only relocate to a private residence they can reach in a single trip in a private vehicle without stopping. For example, they may choose to remain in a family residence in the same city as their institution of higher education where they can more easily separate themselves from other individuals (including family members).

Students, faculty, and staff with COVID-19 symptoms should immediately be separated from other members of the campus community. Individuals who are ill should return to their local residence, unless urgent medical care is necessary depending on the severity of symptoms, and follow CDC Guidance for caring for oneself and others who are sick. 

Campus healthcare providers should use standard and transmission-based precautions when caring for people with symptoms or positive tests for COVID-19. Establish procedures for safely transporting anyone who is sick to a place where they can be isolated from well students, faculty, and staff, or to a health care provider. If you are calling an ambulance or bringing someone to the hospital, call first to alert them that the person may have COVID-19. Also see What Healthcare Personnel Should Know About Caring for Patients with Confirmed or Possible COVID-19

 

Quarantine

Quarantine means staying home from work, school, and/or activities after a person was in close contact with someone with COVID-19. Quarantine lasts for 14 days from the last exposure to a person who may be contagious. If a person who is quarantining develops symptoms or has a positive test result, they should be put in isolation and their contacts will have to quarantine. Negative tests cannot be used to release a person from quarantine. 

As with individuals who are isolating, individuals under quarantine should not undertake long distance or interstate travel to quarantine in another location. 

An individual must follow quarantine instructions for subsequent exposures, even after an initial quarantine period is completed.

 

Supporting students during isolation and quarantine

Campus administrators should prepare in advance to immediately separate people who need to isolate or quarantine by providing options for distance learning and access to single-occupancy rooms with separate restrooms, if possible, in dormitories or other housing facilities. Unoccupied student housing may be designated for this purpose. 

Institutions should consider ways to manage and support students, staff, and faculty who are required to isolate or quarantine, both physically and emotionally. Students living on campus may need additional support to ensure they are able to safely complete their isolation or quarantine. Students living in off-campus congregate settings may need assistance with alternate housing while under isolation or quarantine. Consider facilitating meal delivery, separate restrooms, and virtual wellness checks for students. 

Institutions may follow CDC’s Guidance for Shared or Congregate Housing for those living in shared on- or off-campus housing. More resources for students, faculty, and staff.

 

Outbreaks

All possible outbreaks of COVID-19 must be reported to public health in the county of the campus within 24 hours of detection. 

An outbreak in a postsecondary institution is defined as two or more laboratory-confirmed COVID-19 cases among students or staff from separate households in contact with one another, with either onset of symptoms or a positive test date (if asymptomatic) within a 14-day period. 

Note that a residence hall or Greek life house is not considered a single household for outbreak definitions. The determination of close contacts in congregate living settings can be complex and therefore should be determined in cooperation with public health officials. Roommates and suitemates will be considered close contacts. Public health will determine which other people in the congregate setting are also close contacts and must quarantine. 

When there is an outbreak, the main goal is to minimize further spread of the virus. The primary strategy is to isolate individuals who are sick or contagious, quarantine people exposed to sick or contagious individuals, and determine if additional testing in that setting is appropriate.

  • Students, faculty, and staff with either a positive test or symptoms of COVID-19 should immediately be isolated (isolation instructions) either at home (if local), in their dorm room, or in a designated isolation room for a 10-day isolation period. Travel during isolation is not permitted apart from a short drive alone in a personal vehicle that does not require any stops and does not cross state lines. 

  • Individuals who have been exposed and in close contact to someone who has symptoms of COVID-19 or a positive COVID-19 test should quarantine and monitor for symptoms of COVID-19 and seek testing if symptoms develop. Contacts who remain asymptomatic may consider getting tested approximately seven days after exposure to assist in the detection of asymptomatic or early secondary infections. However, a negative test does not shorten the quarantine period (14 days after last exposure). 

 

Tech solutions to support contact identification

The Exposure Notifications application is available for iOS and Android devices. This application anonymously alerts participating individuals if they have been in close contact to a participating person with COVID-19. The identity of the infected person will not be disclosed.

These applications, and other similar technologies, may provide an important additional mechanism for institutions of higher education to ensure the safety of the campus community. Institutions of higher education should consider strongly encouraging use of these applications for individuals participating in on-campus activities.

These tools should be employed in conjunction with other contact tracing strategies, and are not a replacement for full and active cooperation with local public health agencies in identifying persons who may have been exposed to COVID-19.

 

Cooperation with case investigation and contact tracing

Case investigations require the full cooperation of students, faculty, and staff with contact tracers and public health officials. Full cooperation with this process allows for a more rapid public health response and more effective infection prevention. 

In the event information necessary for case investigation is withheld or deemed unreliable or untrustworthy, broader (and potentially more disruptive) public health measures may be necessary. For example, all members of a dorm may be required to quarantine if within-dorm contacts of a case cannot be reliably ascertained through case and contact interviews.

If one person in a classroom is positive, does everyone in that classroom quarantine — or have they not necessarily been “exposed?”

In some cases the whole classroom may have to quarantine, but not in all cases. Each case will be evaluated individually by local health officials, who will advise institutions as to the appropriate course of action. Local public health agencies, in concert with institutions, will conduct case investigations to aid in defining the appropriate response. 

 

What if a student, teacher, or staff member is in contact with a person who has confirmed COVID-19 outside of school?

Anyone who has close contact with someone with confirmed COVID-19 or new symptoms of COVID-19 should quarantine for 14 days from the date they were last with that person. People required to quarantine will be contacted by public health in collaboration with the higher education institution. Contacts of close contacts do not need to quarantine. 

 

Can a school disclose the name(s) of students, teachers, or staff members who have COVID-19?

Schools are required to disclose names of people with COVID-19 to public health authorities. Schools should not disclose the name(s) of students, faculty, or staff members with COVID-19 to other faculty, staff, students, parents, the media, or anyone outside public health. 

 

Does the federal Family Educational Rights and Privacy Act (FERPA) limit the information that schools can share with public health during COVID-19 investigations? 

Regarding student confidentiality and privacy, the federal Family Educational Rights and Privacy Act (FERPA) prohibits sharing of health-related information except in certain well-defined circumstances, including, but not limited to, sharing information with specified officials for audit or evaluation purposes and appropriate officials in health and safety emergencies. Notifying the state or local public health agency of a reportable disease in a student or an outbreak in a school does not breach FERPA confidentiality laws. In these situations, schools may disclose personally identifiable information to public health officials without prior parent consent.

 

Are people fully protected if they wear a mask and stay 6 feet apart?

Masking and maintaining physical distancing reduces the risk of the disease spreading. However, because no single measure is 100% protective from disease spread, people can still get COVID-19 even if they are 6 feet apart and wearing a mask. Therefore, adherence to these guidelines does not eliminate the need to quarantine based on other factors. The local public health agency will work with the institution to determine the most appropriate course of action based on the setting. Close contacts of people with COVID-19 still must quarantine for 14 days.

 

What type of mask should faculty, staff, and students wear?

Faculty, staff, and students who are not engaged in industrial or health care activities should wear a cloth face covering or mask that covers both the nose and mouth, and fits snugly but comfortably against the side of the face. Masks should be made of multiple layers of fabric and allow for breathing without difficulty. These can either be purchased or made by individuals for their own use. Instructions are available on the CDC website. CDC does not recommend the use of gaiters or face shields.

 

When should an institution implement online or remote learning, either for an individual class or the entire campus?

Institutions should work closely with local public health agencies to determine the best course of action if one or more cases of COVID-19 are detected on campus. Institutions may be advised to temporarily move to online learning if an outbreak is detected and may elect to implement online learning if a large number of students or instructors are unable to attend in-person classes.

 

Would a closure apply to a classroom, a dormitory, or an entire campus?

The extent of a closure will depend on numerous factors. Work with the local public health agency to determine the best course of action. 

 

Can a negative test release someone from quarantine?

No, the 14-day quarantine period is based on the incubation period of COVID-19. We recommend a PCR test for asymptomatic contacts on day seven of quarantine. This allows people who test positive to isolate, and allows public health to conduct additional contact tracing. However, a negative test does not mean the individual will not develop COVID-19 later on during the quarantine period. Serology (antibody) testing cannot be used to make decisions about quarantining, returning to school, or cohorting. 

 

When is an outbreak considered over? 

An outbreak is over when 28 days have passed since the last person started having symptoms and no new cases have occurred. If the last person did not have symptoms, use the day the person was tested.

 

What is the difference between “isolation” and “quarantine?” 

Isolation separates sick people with a contagious disease (i.e., someone who has COVID-19 symptoms or a positive test) from others while they could spread the disease. Quarantine separates and restricts people who were exposed to COVID-19, but have not developed disease or evidence of infection. Quarantine helps prevent the spread of disease from people who become infectious after exposure. This is very important for COVID-19 because people can spread the disease even when they do not have symptoms.

 

Do students, faculty, or staff identified as a case need a negative test to return to campus? 

People do not need a negative test to return to campus, and a negative test before the end of their full isolation period does not mean they can return sooner. CDC and CDPHE do not recommend repeat testing to end the isolation period of a person who has confirmed COVID-19, except in very rare circumstances when recommended by a medical provider.