Practical guide for operationalizing CDC’s school guidance

Updated March 22, 2022.

Effective August 1, 2021.

Languages available: Español

Summary of most recent changes

Updates as of February 11, 2022

Updates as of February 01, 2022

  • Added Test to Stay guidance as an additional alternative to quarantine for students and staff who are not up to date with COVID-19 vaccinations, but have been identified as school-associated close contacts to an individual with COVID-19.
  • Included a Test to Stay decision tree for staff and parents in the tools section of the guidance.

Updates as of January 20, 2022

  • Aligned with CDC’s  updated definition of “up to date” on COVID-19 vaccinations. When CDC released updated school guidance on January 6, 2022, the definition of “up to date” included 12-17 year old children who completed their primary series, regardless of third (booster) dose status. Now, the definition only considers children who are 12-17 years old as “up to date” if they have received a third (booster) dose. Children younger than 12 years of age are not yet eligible for third (booster) doses and are considered up to date after completion of the primary series. Up to date status is used to determine whether quarantine is needed after an exposure.
  • Clarified that eligible Colorado students, in addition to educators, have until February 1, 2022 to receive third (booster) doses if they have not done so already. Until that date, students and staff who have completed their primary vaccine series, but have not yet received a third dose, may return to school or work following exposure if they obtain a negative test and wear a well-fitting mask around others for 10 days after exposure. They should get tested again on day five after exposure. Additionally, students and staff will be considered up to date with COVID-19 vaccinations immediately after they have received their third dose; they do not have to wait 14 days after vaccination.

Updates as of January 7, 2022 

  • Aligned with CDC’s new recommendations for five-day isolation and quarantine and new Guidance for COVID-19 Prevention in K-12 Schools.
  • Clarified that Colorado students and educators have until February 1, 2022 to receive third (booster) doses if they have not done so already. Until that date, staff who have completed their primary vaccine series but have not yet received a third dose may return to work following exposure if they obtain a negative test and wear a well-fitting mask around others for 10 days after exposure. They should get tested again on day five after exposure. Additionally, staff will be considered up to date with COVID-19 vaccinations immediately after they have received their third dose; they do not have to wait 14 days after vaccination.
  • Clarified the definition of and special considerations for Early Care Education.
  • Added a definition of the Test to Stay program, which will be operationalized February 1, 2022.
     

Colorado is following CDC’s recommendations for schools. This guide is designed to help schools operationalize and clarify CDC’s recommendations.

Executive Summary

Colorado has made tremendous strides in mitigating the worst outcomes from COVID-19. More than 81% of Coloradans age 5 and older have received at least one dose of the COVID-19 vaccine statewide. An additional 54.5% of adults over the age of 18 have received their third (booster) dose. Yet unvaccinated Coloradans remain vulnerable to new variants, including the omicron variant.

Because many students have yet to be vaccinated and students under 5 are not yet eligible, we must continue to remain vigilant, take important mitigation steps that can reduce transmission of COVID-19, and address outbreaks in a safe and thoughtful manner. Colorado Department of Public Health and Environment (CDPHE) will adopt and elaborate upon CDC school guidance, which was originally released on July 9, 2021. This includes new recommendations for isolation and quarantine released by CDC in January of 2022 and guidance and support for Test to Stay beginning in February of 2022. Beginning with implementation on February 28, 2022, this guidance now also outlines a framework for school and local jurisdictions to transition from an individual case-investigation response to a more routine disease control model for COVID-19. This new model closely aligns COVID-19 efforts with public health response strategies used for other infectious diseases in schools. CDPHE is providing this practical guide for schools, parents, and students on how to operationalize CDC guidance in our education settings. 

This guide to operationalizing CDC guidance is aimed at disease control and minimizing the risk of exposure in education settings. But we know students’ wellness extends well beyond just disease control. Schools, educators, parents, and students must balance all of the needs of our students in order to achieve wellness and create a productive learning environment. With this in mind, the state has let all statewide school-based health orders and mandates expire and instead has adopted a guidance model designed to empower local public health and local leaders to protect their communities using the mitigation strategies most appropriate to local conditions. The guidance provides practical tools to assess the risks of COVID-19 and minimize those risks. The guidance does not constitute statewide requirements, but instead outlines evidence-based best practices for local governments and schools to implement together to manage the current stage of the pandemic. 

The state continues to recommend a layered approach of best practices to COVID-19 prevention. This outline of best practices is described in detail in the Back to School Roadmap, including ventilation, maximization of outdoor activities, mask-wearing, testing, spacing, cohorting, symptom screening, cleaning and disinfecting, and handwashing. It also includes information for local public health agencies, schools, and parents about community transmission and layered precautions.

This guidance strongly recommends local leaders and school leaders take a layered approach to prevention as described above. Communities with higher rates of transmission and low vaccination rates should continue to take heightened COVID-19 precautions. Local public health still has the authority to enforce local public health orders, which may include quarantine requirements. 

When schools have low vaccination rates (defined as a vaccination rate under 80% among staff and students age 12 and older) and their communities are experiencing high rates of community transmission (defined  as 35 cases per 100,000 people over seven days), the local public health agency should work with schools and school districts to institute higher precautionary measures, such as: 

  • Universal masking (if not already implemented as recommended at all transmission levels).
  • Increased physical distancing. 
  • Serial COVID-19 testing, Test to Stay, and other screening programs.
  • Contact tracing. 
  • Targeted quarantining.
  • Limiting high-risk activities. 

In addition to communities facing higher risk factors, certain student groups may be at greater risk of COVID-19 due to the nature of their activities. Riskier activities include indoor sports, contact sports, and other activities involving forced exhalation such as band or orchestra. In these higher risk settings, local public health and school districts should consider precautionary measures to prevent the spread of COVID-19, such as universal masking, serial testing and screening programs, contact tracing, targeted quarantining, vaccine outreach, and educational efforts. During the spring 2021 semester, outbreaks of COVID-19 often originated with these groups of students and then spread to the larger school community, disrupting learning.

Similar to adults, students with underlying health conditions such as obesity, diabetes, asthma, down syndrome, and heart disease are more likely to experience severe health impacts, hospitalization, and death from COVID-19. Students and staff with these underlying health conditions are strongly advised to get vaccinated, including third doses if they are eligible. If they cannot get vaccinated, they should continue practicing a layered approach to prevent COVID-19. 

Regardless of transmission and vaccination rates, all education settings should create the safest environment possible for their students through tried-and -true disease prevention measures. These include promoting hand washing, ensuring good ventilation, encouraging activities outside, social distancing, and asking sick students to stay home following CDPHE’s guidance. In addition, CDC and CDPHE recommend universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Universal masking is an especially critical strategy when a community is at higher risk of transmission, such as when vaccination rates are low and in settings where children are not yet eligible for vaccination. Schools should create an accepting environment for parents and students who choose to use masks even when they are not required. 

Not only is COVID-19 vaccination Colorado’s best defense against the pandemic, vaccination also prevents disruptions to in-person learning. Staff and students who are up to date on recommended COVID-19 vaccinations are less likely to miss school due to exposures. The COVID-19 vaccines have been highly successful at reducing transmission, infections, hospitalizations, and deaths. CDPHE looks forward to continuing to partner with schools and districts to host vaccination clinics and increase our defense against this virus. Vaccines, including third doses for those eligible, are essential for students and caretakers alike. Children’s risk of contracting COVID-19 is greatly reduced when they live in a household where all eligible individuals are up to date on recommended COVID-19 vaccines, even if the children are not yet eligible for vaccination. Any school or school district interested in hosting a vaccination clinic can complete the online Vaccination Event Request Form. Throughout the school year, CDPHE will monitor disease transmission, severity, and vaccine effectiveness trends as well as community feedback. We will update our guidance and disease control strategies as the COVID-19 landscape changes with a continued focus on the essential nature of in-person learning.

Both local and state public health have statutory, legal and regulatory authority to investigate and control disease transmission, including isolation of cases and quarantine of close contacts, closing public places and prohibiting gathering to control the spread of disease. Statutory citations include but are not limited to 25-1.5-102(1), 25-1-506(3)(b)(V), 25-1-122(2), 25-1.5-101(1)(a),(h),(k) and (l), C.R.S.. Regulatory authority includes, 6 CCR 1009-1, 6 CCR 1010-6 and 6 CCR 1010-7.

Applicability

This guidance applies to all circumstances where a teacher or caregiver cares for multiple children outside the usual home of the children. These circumstances include, but are not limited to:

  • K-12 schools, both public and private.

  • Licensed child care settings.

  • Home-based family child care settings.

  • License-exempt child care programs such as single skill building and 72-hour camps.

  • Guest child care facilities at ski resorts and courthouses.

  • “Pods” and other home learning/homeschooling groups.

See Special considerations for early childhood education below.

This guide also applies to extracurricular activities, including sports, where the participants are in grades P-12. Additional guidance for sports can be found on the Organized sports page. 

 

Special considerations for early childhood education

Child care and pre-K settings are different from K-12 settings in important ways. The particular facilities, curriculum, and modes of supervision in child care facilities require modifications to guidance developed for K-12 settings. For example, Early ChildhoodEducation (ECE) settings, facilities that care for children age 0-8 years old, are not always appropriate settings for remaining seated and distanced throughout the day or recalling who a child interacted with. Furthermore, CDPHE and CDC do not recommend children under the age of 2 wear masks, and children under the age of 5 are not yet eligible for vaccination. New CDC guidance that pairs shorter isolation and quarantine durations (days 0-5) with mask use (days 6-10) may not be applicable in some early childhood educational settings where mask use is not possible. Additionally, young children are more likely to need feeding, diapering, and holding, and are more likely to nap and sing in their classrooms. 

Additionally, funding for the testing supplies that support Test to Stay (TTS) can only be allocated for K-12 schools, therefore TTS cannot be used in child care settings at this time. 

For these reasons, we ask that you take note of special recommendations for pre-K and child care settings throughout this guidance. In the guidance and tools, the term “schools” includes K-12 schools and child care providers, including in-home providers; however, determining close contacts will likely be more similar to higher risk settings where targeted contact tracing is not possible. Keeping young children in small, stable cohorts or pods, universal masking for anyone 2 years old and up, and encouraging up-to-date vaccination for all staff and children as soon as they are eligible will reduce the number of close contacts and impacts from isolation and quarantine. People who cannot wear a mask, including children < 2 years of age and people of any age with certain disabilities, should isolate (if infected) and quarantine (if exposed) for 10 days.

Residential settings, including overnight camps and group homes, have different transmission characteristics and abilities to isolate and quarantine compared to K-12 schools and other child care settings. These settings should follow the outbreak guidance relevant to their particular circumstances. 

 

Definitions

School outbreak-associated case: a case among students, teachers, or staff that meets the outbreak definition. Family members or others outside the school who get sick should not be classified as outbreak-associated.

Outbreak: Outbreaks are defined in Colorado’s COVID-19 case and outbreak definitions.

COVID-like symptoms: loss of taste or smell, fever (100.4°F or higher), chills, new or worsening cough, shortness of breath or difficulty breathing, headache, sore throat, muscle or body aches, congestion or runny nose, fatigue, nausea or vomiting, diarrhea. A person is assumed to be contagious two days before they start having symptoms and for 10 days after symptoms start. In children too young or unable to reliably report their symptoms, caregivers and teachers should monitor for symptoms and other age-appropriate signs of disease, including decreased appetite or activity. All symptomatic individuals should seek clinical evaluation, including testing, as soon as possible after symptoms develop.

Isolation: staying home from work, school, and activities when a person is sick or diagnosed with COVID-19. Most people who do not have symptoms or who have mild symptoms that are improving may return to school and school-associated activities after five full days of isolation. For the five days after isolation, a well-fitting mask must be worn over the mouth and nose while around others. During meals when masking is not possible, extra emphasis should be placed on ventilation and distancing to avoid exposing others. Testing is not required to end isolation. If testing is available, the best approach is to use an antigen test at the end of the five-day isolation period. If the test is positive, isolation should continue through day 10. Individuals who are unable to wear a mask around others should isolate for a full 10 days. In rare circumstances in consultation with a medical provider, people who are severely ill or immunocompromised may require additional testing to determine when they are no longer infectious. Find more information about how to isolate.

Quarantine: staying home from work, school, and activities after a person was in close contact with someone with COVID-19. Find guidance on who needs to quarantine, how to quarantine, and how long quarantine lasts. A person should not attend work, school, or out of school activities if they are under quarantine following an exposure. If a person develops symptoms of COVID-19 or tests positive during their quarantine period, they should begin isolation. After returning to school following a five-day quarantine, a well-fitting mask must be worn over the mouth and nose while around others. During meals when masking is not possible, extra emphasis should be placed on ventilation and distancing to avoid exposing others. Individuals who are unable to wear a mask around others should quarantine for a full 10 days.

Close contact: a person who was close enough to a person with COVID-19 or symptoms of COVID-19 to be at risk of becoming ill. 

Diagnostic COVID-19 test: a test that detects a current COVID-19 infection. These tests include PCR, rapid molecular, and antigen tests. Serology tests can check for evidence of past infection or vaccination, but cannot reliably tell if a person currently has COVID-19 so are not considered diagnostic tests. Learn more about different types of COVID-19 tests.

 

Prioritizing in-person learning

We must support and prioritize uninterrupted, full-time, in-person learning in all communities. While we must remain vigilant, particularly when it comes to new COVID-19 variants, children under the age of 12 are less likely to experience severe disease, hospitalization, and death from COVID-19. We also know that vaccinations, including third doses for those eligible, are our best defense against COVID-19. Therefore, Colorado has moved from an individual case-based response strategy to a transmission mitigation strategy, where instead of quarantining students and staff after individual exposures, the risk of the whole school community, including the risk of interruptions to learning, is considered. Colorado has also added a Test to Stay program as an alternative to quarantine for both students and staff in K-12 settings. Because in-person learning is essential for communities and students to thrive, CDPHE is recommending reduced incidents of quarantine in schools and child care specifically. Reduced quarantine and Test to Stay are not recommended in other settings at this time. 

 

Preventive measures

The state continues to recommend a layered approach of best practices to COVID-19 prevention. These best practices are described in detail in the Colorado Department of Education’s Toolkit and Resources for 2021 School Guidance, and include ventilation, maximization of outdoor activities, sick leave policies, mask-wearing, testing, spacing, cohorting, symptom screening, cleaning and disinfecting, and handwashing. These policies will continue to be important for preventing the transmission of all diseases in schools.

 

Mask wearing

CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status and at all transmission levels. CDPHE recommends local public health agencies and school districts implement universal mask requirements for all individuals entering K-12 schools in Colorado. This is especially important in settings where vaccination rates are low and where children are not yet eligible for vaccination. Mask use is also essential in the setting of new CDC guidance that pairs shorter isolation and quarantine durations (days 0-5) with mask use (days 6-10). It is also an essential component of a successful Test to Stay program. If staff or students are unable to wear a mask on days 6-10 following quarantine or isolation, then quarantine and isolation should continue for a full 10 days. These staff and students should not participate in Test to Stay programs.

Those who cannot medically tolerate a mask should work with their school administration to assess the need for a reasonable accommodation in accordance with the Americans with Disabilities Act (ADA). Additional information regarding reasonable accommodations can also be found in the State’s Civil Rights Guidance. Both state and local public health have the authority to issue public health orders requiring masks, and include within those orders any allowable exceptions to the mask requirement. For settings in which masks are required by the State, exceptions include temporary removal of a mask to participate in a life rite or religious service where such temporary removal is necessary for participation; there is no broader general exemption from wearing a mask for religious or personal belief in the state public health orders. In addition, even when not required by local public health or a school district, staff and students may choose to wear masks. Schools and school districts should ensure that every classroom is a welcome environment for students and staff who choose to protect themselves in this manner. 

 

Improving ventilation 

COVID-19 and other respiratory illnesses are spread through respiratory droplets that are produced when we breathe, talk, sneeze, or cough. Improving ventilation by increasing air exchanges and filtration assists with the dilution of contaminants that might be present, including respiratory droplets. Schools can improve ventilation in a number of ways. 

Existing HVAC systems should be maintained in good working order, and should run for at least 30 minutes before and after the building is occupied. 

Schools without existing HVAC systems or inadequate systems can open windows during the school day to increase ventilation and air flow. 

Additionally HEPA filters can be added to an existing HVAC system and portable HEPA filters can be added to areas to filter out contaminants from the air. 

Outdoor activities are strongly encouraged, especially for higher risk activities and meal times. 

Additional resources on improving ventilation

 

Isolation of positive cases

Ensuring sick people stay home (and people with COVID-19 follow isolation requirements, regardless of vaccination status) is critical to preventing the spread of COVID-19. Under state law, isolation of positive cases is required and must be enforced by local public health and school districts. Test to Stay cannot be used in lieu of isolation for individuals who have symptoms or have tested positive for COVID-19.

 

Monitoring and communication

While students and staff who are up to date with all recommended vaccine doses, including third doses if eligible, are not required to quarantine if they are exposed to someone with COVID-19, they should wear a well-fitting mask around others and monitor themselves for symptoms for 10 days. They should also get tested at least five days after exposure or if symptoms develop.

We continue to recommend alerting students, staff, and parents of known classroom exposures so all individuals are appropriately informed, will monitor closely for symptoms, and may choose to increase personal mitigation measures as necessary when living or working with vulnerable individuals (e.g. a high school student who volunteers in a nursing home or who lives with an immunosuppressed relative). 

Parent letter templates can be used to notify parents of COVID-19 cases and exposures in schools:

 

Quarantine for routine classroom exposures

The state recommends counties, schools, and individuals that meet any of the below metrics shift to a transmission control strategy, with quarantine not required following routine classroom exposures. Large outbreaks or important circulating variants may necessitate more stringent disease control strategies at the discretion of the local public health agency (LPHA).

 

Table: Criteria for Reduced Quarantine

 

County population protections

School community protections

Individual protections

Low community transmission

High rates of school community COVID-19 vaccination

  • ≥80% of staff and students 12 and older with at least one COVID-19 vaccination


OR

High rates of weekly school screening testing

  • ≥70% of unvaccinated staff and students participating in weekly testing

Up to date with COVID-19 vaccinations*

OR 

Previously confirmed positive viral test in the 90 days before exposure

OR

Participating in weekly screening testing

OR

Both parties wearing a mask at the time of exposure**

OR

Participating in Test to Stay, including testing twice, remaining negative and asymptomatic and wearing a well-fitting mask for 10 full days following last exposure

*Students and staff who have completed their primary vaccine series and are due for a third dose but have not received one will be exempt from quarantining until February 1, 2022.

Quarantine of close contacts does not need to be required by local public health authorities following routine classroom exposures if any of the above are met by the county, school, or individual considered a close contact (**and the ill individual for mask use)

 

Quarantine in counties with low vaccination and high case rates

Even in schools with low vaccination rates or in counties with high case rates, the state recommends multiple ways schools can avoid quarantine for lower-risk typical classroom exposures at the discretion of the local public health authority. Schools must work with their local public health agency when cases of COVID-19 are identified to determine quarantine requirements. 
 
Vaccinated individuals: Students, teachers, and staff who are up to date on COVID-19 vaccinations, including third doses (boosters) and additional primary shots for some immunocompromised people, are not required to quarantine if exposed to a case.. These quarantine exemptions apply even in low vaccination, high case settings. However, these individuals should wear a well-fitting mask around others, monitor for symptoms for ten days after exposure, and seek testing at least five days after exposure or if symptoms develop. 

To provide time for Colorado students and educators to get up to date with COVID-19 vaccinations, students and staff who have completed their primary vaccination series  but have not yet received their third (booster) doses may return to school following an exposure until February 1, 2022. They must obtain a negative test result before returning to school and wear a well-fitting mask around others for 10 days after exposure. Testing should be repeated on day five. Additionally, students and staff will be considered up to date with COVID-19 vaccinations immediately upon receiving a third dose; a 14-day window after vaccination is not necessary. 

School-level vaccination rate: If at least 80% of individuals age 12 and older within a school community have received at least one dose of COVID-19 vaccine, no one, including unvaccinated individuals, needs to quarantine following a typical classroom exposure to a case. 

Weekly serial testing: Schools can also implement weekly serial testing in their schools. Students of all ages who are actively participating in at least weekly serial testing should not be required to quarantine following typical classroom exposures to a positive case of COVID-19. School districts may opt into a free and voluntary statewide serial testing program. If a school or school district is interested in enrolling in this program, please contact cdphe_schooltesting@state.co.us

If schools have at least 70% of their students and staff who are not up to date with vaccinations actively participating in serial testing, students and staff should not be required to quarantine following a typical classroom exposure to a case of COVID-19. 


Test to Stay: Test to Stay (TTS) is a voluntary program that combines close contact determinations and testing to allow some students, teachers, and staff who would otherwise need to quarantine to continue in-person learning. This includes people who are a school-associated close contact*, are not up to date on their COVID-19 vaccines, do not test positive for SARS-CoV-2, and have no symptoms. Detailed information about Colorado’s Test to Stay Program can be found on the test to stay program webpage.

*Principals or superintendents may choose to also allow staff and students with non-household community exposures to participate in Test to Stay.

Masking: CDPHE recommends that students not be required to quarantine following a typical classroom exposure if both the infected individual and the exposed student(s) were wearing well-fitting masks correctly and consistently over the mouth and nose during the exposure. 

In classroom settings, CDPHE recommends quarantine or participation in Test to Stay for students, teachers, and staff who don't meet vaccination requirements for quarantine exemption and were within six feet for 15 minutes or more of an infected individual if either the infected individual or the contact were unmasked during the exposure. Note that this guidance differs slightly from current CDC guidance. CDC’s definition of a close contact and need for quarantine in a typical classroom only excludes students who were within three to six feet of an infected individual if both parties were wearing masks. CDPHE does not specify a minimum of three feet when excluding exposed students from quarantine, if both the infected individual and the exposed student(s) were wearing masks and no direct physical contact occurred. CDPHE’s “Who Needs to Quarantine?” tool is updated to provide additional clarification. 

Additionally, students and staff who return to school on days 6-10 following isolation or quarantine as well as participants of Test to Stay must wear a well-fitting mask over the mouth and nose while at school or around others. Anyone unable to wear a well-fitting mask over the mouth and nose should complete 10 full days of isolation or quarantine. 
 

Higher risk exposures

Several close contact situations would be considered higher risk exposures to COVID-19. The state recommends local public health take a heightened risk approach to these higher risk exposures, which should include quarantine or Test to Stay of exposed individuals who are unvaccinated or not up to date on COVID-19 vaccinations. These exposures are significantly higher risk than typical activities within a classroom. Examples include: 

  • Indoor or high contact athletic competitions.
  • Evaluating or assessing ill students or staff.
  • Performing an aerosol-generating procedure.
  • Caring for a young child (feeding, holding, or diapering).
  • Interactions between young children where it is not age appropriate to remain seated or physically distanced. 
  • Indoor forced exhalation activities such as singing, exercising, or playing a wind or brass instrument. 

This is not an exhaustive list, and public health authorities can assist with determining whether or not quarantine or Test to Stay is necessary after a particular exposure. Schools should discuss these more complex cases with their local public health agency.

Staff and students who are not up to date with recommended  COVID-19 vaccinations  and are exposed to a case of COVID-19 outside of the school classroom, including social settings, athletics, workplaces, and household exposures, will likely be required to quarantine, pursuant to statutory and regulatory public health authority. Students participating in high-risk activities (such as unmasked indoor athletic competitions) and individuals who are at higher risk for severe infection are strongly encouraged to get all recommended vaccine doses for their own protection. 

 

Individuals at higher risk for severe disease

Individuals should discuss their personal risk factors with their health care providers. Individuals determined to be at higher risk for severe disease should get vaccinated and receive recommended third doses (and additional primary doses for some immunocompromised individuals) as soon as they are eligible in consultation with their health care provider. If individuals are not eligible for vaccination, or vaccination is not medically advised, serial testing and masking indoors is strongly recommended. Schools may consider universal masking requirements, ventilation improvements, and other protective measures when they serve or employ large numbers of high-risk or vulnerable individuals.

 

Positive cases and outbreaks

As described above, all positive cases will be required to isolate and stay home for at least five days to protect others, pursuant to statutory and regulatory public health authority. Once a school has an outbreak that impacts multiple classrooms, school leadership should work with their local public health authority to determine what additional mitigation strategies may be necessary. Additional mitigation strategies may include: universal masking indoors, distancing, testing and contact tracing, and quarantine or Test to Stay for close contacts. Persons returning to school on days 6-10 following isolation or quarantine and those participating in Test to Stay must wear a well-fitting mask over the mouth and nose while at school or around others. Anyone unable to wear a well-fitting mask over their mouth and nose should complete a full 10 days of isolation or quarantine. 

Caveat: Variants of Concern circulating in communities could impact population-based strategies to reduce spread. 

 

Variants of COVID-19

CDC and CDPHE are actively monitoring the impact that variants of the COVID-19 virus may have on communities and individuals. The state is closely evaluating  variants that may cause more severe disease, could be more contagious, or may have a greater potential to infect those who are vaccinated or who have recently been infected with COVID-19. 

All variants of COVID-19 spread through exhaled viral particles generated by sick people, and the same protective measures that have helped keep students safe in schools throughout the past year will continue to be effective. These key strategies also help protect students and staff from other diseases, such as influenza and RSV, and include: 

  • Getting COVID-19 vaccines and recommended third doses as soon as possible.
  • Encouraging students and staff to stay home when sick or potentially contagious.
  • Encourage testing if symptomatic or exposed and participation in serial COVID-19 testing and Test to Stay.
  • Universal masking indoors.
  • Improving indoor ventilation.
  • Practicing good hand and respiratory hygiene.
  • Appropriate cleaning of shared spaces and objects. 

More information about COVID-19 variants is available from CDC.

 

Encouraging vaccinations in schools

Vaccines are our best defense against COVID-19 and many other diseases. Schools are encouraged to educate their communities about the safety and efficacy of COVID-19 vaccines. 

 

Resources for schools to educate their communities about the COVID-19 vaccine

CDPHE has developed many vaccination resources to support this effort and added information about COVID-19 vaccines to our online vaccine education module

CDPHE is prepared to support schools who wish to host a vaccination event for their students, faculty, and staff. For more information or to request event support, see the Event Based Vaccination Request Form

Additional resource are available, including testimonials, talking points, social media graphics, and more, to help schools communicate effectively with their communities about the safety and effectiveness of the COVID-19 vaccines: 

 

The CDC and the American Academy of Pediatrics (AAP) have additional resources about the COVID-19 vaccines:

 

Verifying vaccination status 

Schools can verify the vaccination status of their students using the Colorado Immunization Information System (CIIS) without written consent. Per FERPA, written consent must be obtained if a school wants to enter vaccination data for a student into CIIS. Statute does not permit schools to use CIIS to verify the vaccination status of employees or staff.

 

Acceptable proof of COVID-19 vaccination

Acceptable proof of COVID-19 vaccination will be the same as all other school-required vaccines. A student or staff member may provide the vaccination card that includes the name of the provider, name of the patient, date, type of vaccine, and lot number. For students who received their vaccine in Colorado, the school may verify proof of vaccination with CIIS. Schools do not need written consent to look up vaccination records in CIIS. Students who receive their vaccination outside of Colorado may provide both their vaccination cards and/or IIS records from the state where they received their shots.

Additionally, CDPHE has added COVID-19 vaccines to the “recommended vaccines” section of the official Colorado Certificate of Immunization to better enable incoming students to share records of their immunizations with their school. 

Colorado public school COVID-19 vaccination rates dashboard

Colorado’s public school COVID-19 vaccination data dashboard is a resource for families, schools, local public health agencies, health care providers, and other partners. COVID-19 vaccination rates at the district, school, and grade levels can help parents/guardians/caregivers, educators, and school staff make informed decisions about mitigation practices they may want to consider for their children and/or themselves. This is especially important for parents of children with weakened immune systems and educators/school staff with immunocompromising conditions.

Reporting

Per 6 CCR 1009-1 and Public Health Order 20-33, clinical labs and/or health care providers are required to report all COVID-19 test results, both positive and negative, to public health. If school personnel perform and interpret rapid testing on-site, they are functioning as a clinical lab and are required to report all results. Per 6 CCR 1009-1 schools and child care facilities are also required to report single cases of which they become aware to public health, even if testing was performed elsewhere. Additionally, participants of Test to Stay are required to report their results immediately upon completing testing as instructed using the Abbott BinaxNOW NAVICA Connect application. 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. 

Public health may interview the people who have COVID-19 and conduct contact tracing to determine who might be close contacts of the case, to make recommendations about isolation and quarantine. 

Schools and child care providers are required to report all outbreaks to their local public health agency or CDPHE within four hours per 6 CCR 1009-1.

Schools and child care providers must report both suspected and confirmed outbreaks.
Schools and child care providers can report outbreaks by:

  • Filling out the CDPHE COVID-19 outbreak report form and sending it to the local public health agency (via web form or emailing the PDF form).
  • Calling their local public health agency.
  • Calling CDPHE at 303-692-2700.

 

Other respiratory infections

COVID-19 spreads via the same mechanisms as influenza, RSV, and other important respiratory illnesses. Therefore, the same strategies that schools have used to protect students and staff from COVID-19 also slow the spread of these other diseases. These include:

  • Getting a COVID-19 and influenza vaccine as soon as possible.
  • Encouraging students and staff to stay home when sick or potentially contagious.
  • Improving indoor ventilation through increased air exchanges and filtration.
  • Wearing a mask indoors.
  • Practicing good hand and respiratory hygiene.
  • Cleaning shared spaces and objects appropriately. 

Additionally, these diseases share many symptoms and it is not always possible to distinguish these illnesses from one another based on symptoms alone, even for experienced medical providers. Therefore, testing is important for anyone with symptoms of a respiratory infection to help guide an appropriate disease response. 

 

Consideration for travel and school breaks

Travel may put individuals at increased risk of contracting COVID-19, especially those that are not up to date with COVID-19 vaccinations. Travel may involve crowded public vehicles and spaces, where close contact with a high number of unique contacts with unknown vaccination status may occur.

The same layered mitigation strategies used in schools are recommended when traveling, especially those who are not yet up to date with COVID-19 vaccinations. Masking is recommended for anyone two years old and older in crowded indoor spaces, and is required on public transportation and in transportation hubs by federal order.
Families and staff should be encouraged to get all recommended COVID-19 vaccine doses before traveling and to use layered mitigation strategies to stay safe. After returning, students and staff should monitor for symptoms and get tested if symptoms develop. 

 

Transitioning to a routine disease control model for COVID-19 in K-12 settings

Background: As the youngest Coloradans become eligible for vaccines and COVID-19 surveillance indicators such as case rates, percent positivity, and hospitalization rates decrease and stabilize at low levels, schools may choose to transition away from a case-investigation response model to a more typical routine disease control model for disease control in schools. Such a model focuses more on response to clusters of cases, outbreaks, and evidence of ongoing transmission in schools, and less on individual case investigation, contact tracing, and quarantining of staff and students following school exposures. A routine disease control model for COVID-19 more closely aligns COVID-19 efforts with public health response strategies used for other infectious diseases in schools. CDPHE’s suggested implementation date for this transition is February 28, 2022.

To avoid an increase in outbreaks and greater disruption to schools, transitioning to a routine disease control model should ideally occur once local transmission risk falls below a high or medium level and stabilizes. Schools that are implementing current CDPHE and CDC school guidance for mitigating transmission, including new implementation of Test to Stay, are encouraged to continue doing so. Test to Stay and other strategies outlined in the CDPHE guidance are more likely to prevent outbreaks that result in disruption in learning from occurring, especially while community transmission rates are high. Schools that are currently experiencing outbreaks should continue current mitigation strategies and wait for outbreak resolution before transitioning to this new response model. Additionally, school administrators should be prepared for the emergence of new variants or substantial waning immunity that could once again lead to greater morbidity, mortality, and disruption, and require returning to an individual case investigation approach in schools.

Elements of a routine disease control model for COVID-19 in K-12 settings

Routine disease control strategies:

  • Continue to encourage vaccination of staff and students.
  • Follow isolation requirements for students and staff who are ill or have tested positive for COVID-19.
  • Continue to recommend transmission prevention strategies, including testing and masking for staff and students following illness and exposures.
  • Continue to support regular mask use by staff and students, even when not required by local public health orders. CDC continues to recommend universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status and at all transmission levels.
  • Respond to clusters of cases (including increases in respiratory illness) and confirmed outbreaks as described below.
  • Continue to report identified cases and outbreaks to public health as required by Colorado Statute and Regulation (6 CCR 1009-1). 
  • In lieu of individual case investigation and contact tracing, implement new cluster or outbreak detection strategies including public health reporting of school absenteeism data and participation in wastewater surveillance. CDPHE is exploring funding mechanisms to support this work.

Strategies not continued in routine disease control model (unless a cluster or outbreak is detected):

  • Individual case investigation and contact tracing.
  • Quarantine of students and staff with school-associated exposures.* Given the much greater risk of household exposures compared to non-household exposures, schools should continue to follow quarantine guidance for students and staff who report household exposures.

*In consultation with their LPHA, principals or superintendents may also choose to discontinue quarantine for staff and students with non-household community exposures.

Without routine case investigation and contact tracing in place, outbreaks may be difficult to identify and outbreak thresholds challenging to implement. If schools identify increases in absenteeism, especially due to respiratory illness, or an increase in reported cases of COVID-19, they should contact their LPHA. LPHAs will work closely with schools to determine if an outbreak is suspected and if outbreak response strategies are needed to control transmission.

Recommended COVID-19 school outbreak response strategies:

  • Limit mixing of impacted grades, classrooms, or other groups during meals, recess, and other gatherings to limit spread while a school is experiencing an outbreak.
  • Universal masking of staff and students on a temporary basis. Implementation of masking can be done at the classroom, grade, or school level depending on the extent of transmission and structure of the school. 
  • Temporary universal testing of staff and students. Implementation of testing can be done at the classroom, grade, or school level depending on the extent of transmission and structure of the school. Schools can use tests available through CDPHE’s Test to Stay Program and apply this algorithm to determine which staff/students can remain in school.
    • A first round of testing should be implemented as soon as possible, ideally within one week of detection of the suspected outbreak.
    • Two rounds of testing are recommended for outbreak control but school administrators and LPHAs should consider the extent of transmission and the number of new cases identified through initial testing when determining the duration of outbreak response activities, including testing.
    • Based on capacity and local circumstances, school administrators and LPHAs may choose to implement testing for all staff and students regardless of vaccination and recent infection status.

Tools

For more information or questions regarding school guidance,
please contact CDPHE_COVID_School_Childcare@state.co.us or scan the QR code below.

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