After a lot of media coverage of the new Biden administration’s focus on safely opening K-12 schools, the CDC released updated school guidelines last Friday (02/12/21). This new guidance doesn’t contradict previous CDC releases, and largely builds off of the Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19). The new Operational Strategy for K-12 Schools through Phased Mitigation expands on the prior recommendations, tailoring them specifically towards schools, and includes a K-12 Schools COVID-19 Mitigation Toolkit that acts as a checklist for school pandemic planning. The new guidance includes “essential” and “preferred” measures, which I will elaborate on.

While vaccinating teachers is a top priority, the guidance points to research showing that with proper mitigation, schools can be opened safely without vaccinations. The document emphasizes the importance of learning benefits and support services of in-person schooling. Property taxes typically pay for most public school funding, so lack of school resources in impoverished neighborhoods creates major obstacles in some of the communities hardest hit by the pandemic and most in need of in-person school services.

The CDC suggests a mitigation strategy that integrates 3 essential elements, and 2 more that schools should aspire to incorporate. These elements are:

Essential: 

1) Consistently using multiple layers of strategies that mitigate risk of SARS-CoV-2 transmission in schools

2) Monitoring community transmission

3) Adjusting mitigation layers used in schools (1) according to community transmission levels (2)

Preferred: 

4) Testing and associated isolation, quarantining, and contact tracing

5) Vaccination of teachers, staff, and communities

The CDC recommendations on layers of mitigation strategies are most dramatically changed when the community spread of coronavirus reaches the orange ‘Substantial Transmission’ level. This happens when in the previous 7 days a community (usually a county) has either 50+ new cases per 100,000 people, or at least 8% positive SARS-CoV-2 genetic test results. A school in the orange level of community spread should not go to full in-person learning unless they can use testing to screen their population. Instead, they should use some level of hybrid or virtual learning, and should keep students 6 feet or more apart at all times.

Below this level of community spread, in-person learning should be relatively safe as long as 5 essential layers are implemented:

1) Universal & correct use of masks (mask use was >90% in studies showing schools were safe)

2) Physical distancing (at least 6 feet to the greatest extent possible, and use of cohorts/pods is recommended)

3) Handwashing and proper etiquette for covering and cleaning up after coughs, sneezes, etc.

4) Cleaning & maintaining healthy facilities

5) Contact tracing through the health department, with associated isolation and quarantine

All of the above essential mitigation strategy layers are fairly self-explanatory except for #4. The CDC goes into more detail, but basically, a healthy facility requires the use of some administrative controls and some engineering controls. Good administrative controls include protocols for things like increased sanitation and testing, the facilitation of physical distance, and the reduced touching of shared surfaces. Good engineering controls include thoughtful furniture placement, physical barriers, and increased ventilation.

Send me your questions on this topic. I’m happy to discuss options for building a robust set of mitigation layers for healthy school facilities.

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