Here's How The Coronavirus Could Close Any NJ School

NEW JERSEY — It could take just two coronavirus cases — even if they were detected in separate classrooms — to shut down a school building in September.

That's what the state Department of Health is suggesting now that the agency has issued its own guidelines for keeping schools open in the fall (see list below).

The DOH on Thursday released its own recommended health and safety protocols for parents, teachers and school nurses to follow if schools that have in-person instruction experience even one case of the coronavirus.

Murphy is expected to address the issue further during a 1 p.m. news conference Friday. Read more: WATCH LIVE: Gov. Murphy's NJ Coronavirus, School Reopen Update

Districts could avoid all this by opting out of in-person instruction and going fully remote before they even consider opening their school doors.

Indeed, each community needs to comply to a long list of rules — and get approval from the state — if it chooses to open up its classrooms at all. Read more: NJ Issues Rules For In-Person Education In Schools Amid COVID-19

Once those doors open, however, the schools should comply with yet another list of standards that could prove to be daunting for districts that are already struggling to find the right amount of staffing and supplies for in-person instruction.

One of those was Toms River, which decided Thursday to start the year fully remote. Read more: Toms River Schools Starting 2020-2021 With Remote Learning

The following districts already have announced they plan to start the school year remote:

• Bayonne
• Elizabeth
• Freehold Township
• Jersey City
• Montclair
• New Brunswick
• Plainfield
• Toms River
• Willingboro

Here is how each school should deal with coronavirus cases:

School Closure Scenarios

The state Department of Health outlined various scenarios that could close a school — or, if the illness is limited in scope and contained, keep it open — once cases are detected.

Scenario — One confirmed case in the school:

• Outcome: School remains open; students and staff in close contact with the positive case are excluded from school for 14 days.

Scenario — Two or more cases in the same classroom (outbreak limited to one cohort):

• Outcome: School remains open; students and staff in close contact with a positive case are excluded from school for 14 days. But a public health investigation of the entire classroom would be considered.

Scenario — Two or more cases within 14 days, but they're linked to a clear alternative exposure that is unrelated to the school setting:

• Outcome: School remains open; students and staff in close contact with positive cases are excluded from school for 14 days. The case is unlikely to be a source of exposure for the larger school community (meaning that the case originated in the same household, or the student was exposed at the same event outside of school).

Scenario — Two or more cases within 14 days, linked together by some activity in school, but are detected in different classrooms (outbreak involving multiple cohorts):

• Outcome: Recommendations for possible school closure will be based on an investigation by the local health department.

Scenario — A significant community outbreak is occurring or has recently occurred (such as a large event or large local employer) and is impacting multiple staff, students and families served by the school community:

• Outcome: Consider closing school for 14 days, based on investigation by local health department.

Scenario — Two or more cases are identified within 14 days that occur across multiple classrooms:

• Outcome: Close school for 14 days. There would have to be a clear connection between cases or to a suspected or confirmed case of coronavirus that cannot be easily identified (an outbreak involving multiple cohorts).

Scenario — Very high risk of community transmission:

• Outcome: Close school until coronavirus transmission decreases.

The state Department of Health also outlined how the districts and schools should deal with and treat individual cases and outbreaks once they're discovered.

Risk Assessment

The state Department of Health identified levels of "risk" for students and staff, and if they're confronted or test positive:

The green, yellow and orange levels are for in-person learning, which:

• Require staff and students to stay home when sick or if they have been in close contact with someone with COVID-19 within the past 14 days. Parents/guardians, students and staff should notify school administrators of illness.
• Require districts to have a policy for daily symptom screening for students and staff, and have plans for students and staff to report symptoms that develop during the day.
• In conjunction with local health department, require schools to identify COVID-19 rapid testing resources (viral testing) for when staff and students develop COVID-19 compatible symptoms.
• Require staff to clean and disinfect frequently touched surfaces at least daily.
• Require staff to ensure adequate hand hygiene supplies are readily available.
• Require schools to implement physical distancing measures (such as, reducing occupancy, staggered schedules, use of alternate spaces, installation of partitions/physical barriers, canceling large gatherings/events and maintaining defined cohorts).
• Require schools to implement source control through wearing face coverings.

Each district should inform staff, students and their families about when they should stay home and when they should return to school, the DOH says.

Students and staff should stay home if they have:

• Tested positive (viral test) for COVID-19
• COVID-19 symptoms
• Potential exposure to COVID-19
• Recent close contact (being within 6 feet for at least 10 minutes) with a person with COVID-19 in the past 14 days.
• Traveled to an area with high levels of COVID-19 transmission in the past 14 days

Hand hygiene

For hand hygiene and respiratory etiquette, schools should:

• Teach and reinforce hand-washing with soap and water for at least 20 seconds and increase monitoring of students and staff.
• If soap and water are not readily available, hand sanitizer that contains at least 60 percent alcohol can be used (for staff and older children who can safely use hand sanitizer).
• Encourage students and staff to cover coughs and sneezes with a tissue if not wearing a face covering/mask.
• Ensure used tissues are thrown in the trash.
• Have adequate supplies including soap, hand sanitizer with at least 60 percent alcohol (for staff and older children who can safely use hand sanitizer), paper towels, tissues, and no-touch trash cans.
• Assist/observe young children to ensure proper hand-washing.

Hand hygiene should take place:

• Upon arrival at school.
• Before and after meals and snacks.
• After going to the bathroom.
• Before leaving for the day.
• After blowing nose, sneezing or coughing into tissue.
• When hands are visibly soiled.

Mask Wearing

The DOH also says wearing face coverings is an important step to help slow the spread of COVID-19 when combined with everyday preventive actions and social distancing in public settings.

Face coverings must be worn by staff, students and visitors unless it's health risk for them, the DOH says. This includes prior to boarding the school bus, while on the bus and until they are completely off the bus.

Also:

• Schools should teach and reinforce the use of face coverings and should be worn by staff and students.
• Face coverings are not a substitute for social distancing. Information should be provided to staff and students on proper use, removal and washing of cloth face coverings and face masks.
• Cloth face coverings should be washed after everyday of use and/or before being used again, or if visibly soiled or damp/wet.
• Disposable face masks should be changed daily or when visibly soiled, damp or damaged.
• Students and schools should have additional disposable masks or cloth face coverings available for students, teachers, and staff in case a back-up face covering is needed (such as, the face covering is soiled or lost during the day).

Appropriate and consistent use of face coverings may be challenging for some students, teachers, and staff, including:

• Students, teachers and staff with severe asthma or other breathing difficulties.
• Students, teachers and staff with special educational or health care needs, including intellectual and developmental disabilities, mental health conditions and sensory concerns or tactile sensitivity.

Schools may consider assigning any staff with health issues other duties or locations to limit interaction or allow teleworking, the DOH says.

Cleaning and Disinfection

Schools should follow standard procedures for routine cleaning and disinfecting with an EPA-registered product for use against SARS-CoV-2, the DOH says.

This means daily sanitizing surfaces and objects that are touched often, such as desks, countertops, doorknobs, computer keyboards, hands-on learning items, faucet handles, phones and toys.

Increasing the frequency of cleaning when there is an increase in respiratory or other seasonal illnesses is a recommended prevention and control measure.

Also:

• As long as routine cleaning and disinfecting have been done regularly (at least daily), additional cleaning measures are not necessary unless the COVID-19 positive person is in school on the day school officials are notified of the positive test.
• Depending on when the person with COVID-19 was last on site, it may be difficult to know what areas they were in and what objects or surfaces they may have touched after they became sick.
• If routine cleaning and disinfection have not been performed at least daily, or if the COVID-19 positive person is in school the day school officials are notified, close off areas used by the person who tested positive for COVID-19 (such as offices, bathrooms, classrooms, and common areas), open outside doors and windows to increase air circulation in the area and wait 24 hours after the COVID-19 positive person was last in school before cleaning and disinfection.
• If it has been more than 7 days since the person who tested positive for COVID-19 was at school, additional cleaning and disinfection is not necessary.
• Cleaning staff should clean and disinfect all areas used by the ill person such as offices, classrooms, bathrooms, common areas, and shared electronic equipment (like tablets, touch screens, keyboards, remote controls), focusing especially on frequently touched surfaces.
• Once area has been appropriately disinfected, it can be opened for use.

If an individual becomes ill with COVID symptoms:

• Immediately close off areas used by the person who is sick with COVID-19 symptoms (such as offices, bathrooms, classrooms, and common areas), open outside doors and windows to increase air circulation in the area and wait 24 hours before cleaning and disinfection.
• Cleaning staff should clean and disinfect all areas used by the ill person such as offices, classrooms, bathrooms, common areas, and shared electronic equipment (like tablets, touch screens, keyboards, remote controls), focusing especially on frequently touched surfaces.
• Once area has been appropriately disinfected, it can be opened for use.

Symptom Screening

Although the Centers for Disease Control and Prevention does not recommend universal symptom screening (screening all students grades K-12) be conducted by schools, NJDOH does recommend that schools have a policy for daily symptom screening for students and staff.

Parents/caregivers should be strongly encouraged to monitor their children for signs of illness every day as they are the front line for assessing illness in their children, the DOH says.

Students who are sick should not attend school in-person. Schools are encouraged to strictly enforce exclusion criteria for both students and staff, the DOH says.

Schools should consider:

• Providing parent education about the importance of monitoring symptoms and staying home while ill through school or district messaging.
• Having a plan to screen students if not screened by parents prior to arrival.
• Using existing outreach systems to provide reminders to staff and families to check for symptoms before leaving for school.
• Schools should provide clear and accessible directions to parents/caregivers and students for reporting symptoms and reasons for absences.
• Schools should implement a plan to screen teachers and staff before or upon arrival at school.

Preparing for Illness

Schools should ensure that procedures are in place to identify and respond to when a student or staff member becomes ill with COVID-19 symptoms.

• Closely monitor daily reports of staff and student attendance/absence and identify when persons are out with COVID-19 symptoms.
• Establish procedures for safely transporting anyone who is sick to their home or to a healthcare facility.
• If you are calling an ambulance or bringing someone to the hospital, try to call first to alert them that the person may have COVID-19.
• Designate an area or room away from others to isolate individuals who become ill with COVID-19 symptoms while at school.
• An area separate from the nurse’s office would be ideal for the isolation area so the nurse’s office can be used for routine visits such as medication administration, injuries and non COVID-19 related visits.
• Ensure there is enough space for multiple people placed at least 6 feet apart.
• Ensure that hygiene supplies are available, including additional cloth masks, facial tissues, and alcohol-based hand sanitizer.
• Staff assigned to supervise students waiting to be picked up do not need to be health care personnel and should follow social distancing guidelines.

COVID-19 Symptoms

While some children and infants have been sick with COVID-19, adults make up most of the known cases to date, the DOH says. Early research suggests that fewer children than adults with COVID-19 get a fever, cough, or shortness of breath. Few children with COVID-19 have had to be hospitalized.

However, severe illness has been reported in children, most often in infants less than a year, the DOH says.

Some children have developed multi-system inflammatory syndrome. Currently, information about this syndrome is limited, the DOH says.

According to the CDC, children do not seem to be at higher risk for getting COVID-19. However, some people, including children with special health care needs, may be at higher risk.

Those at increased risk include:

• Older adults
• People who have serious chronic medical conditions such as cancer; chronic kidney disease; COPD; immunocompromised state from solid organ transplant; obesity (body mass index of 30 or higher;) serious heart conditions, such as heart failure, coronary artery disease, or cardiomyopathies; sickle cell disease; or type 2 diabetes

Signs and symptoms of COVID-19 in children may be similar to those of common viral respiratory infections or other childhood illnesses. The overlap between COVID-19 symptoms and other common illnesses means that many people with symptoms of COVID-19 may actually be ill with something else, the DOH says.

This is even more likely in young children, who typically have multiple viral illnesses each year.

Individuals with COVID-19 have had a wide range of symptoms reported – ranging from mild to severe illness. There is not a single symptom that is uniquely predictive of a COVID-19 diagnosis, the DOH says.

A COVID-19 viral test is needed to confirm if someone has a current infection. Symptoms may appear 2-14 days after exposure to the virus and include the following:

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

Parents should not send students to school when sick. School staff should have plans to isolate students with overt symptoms of any infectious disease that develop during the school day.

When Illness Occurs Within the School Setting

Children and staff with COVID-19 symptoms should be placed away from others and asked to wear a face covering/mask until they can be sent home. Per state policy, all students' (age 2 and older) noses and mouths should be covered with a mask or cloth face covering, the DOH says.

If a mask is not tolerated by the ill student or staff member due to their illness, other staff should be sure to adhere to the universal face covering policy and follow social distancing guidelines (6 feet away).

Staff should ask the ill student (or parent) and staff about potential exposure to COVID-19 in the past 14 days and determine if they:

• Had lose contact (within 6 feet of an infected person for at least 10 minutes) with a person with confirmed COVID-19
• Traveled to an area with a high level of COVID-19 transmission.

Also:

• Individuals should be sent home and referred to a healthcare provider for evaluation on whether testing is needed. Testing for COVID-19 is recommended for persons with COVID-19 symptoms.
• Schools should notify local health departments when students or staff are ill and have potential COVID-19 exposure, are ill when COVID-19 risk level is high, or when they see an increase in the number of persons with compatible symptoms.

Schools should be prepared to provide the following information when consulting with the local health department:

• Contact information for the ill persons;
• The date the ill person developed symptoms, tested positive for COVID-19 (if known),
• and was last in the building;
• Types of interactions (close contacts, length of contact) the person may have had with other persons in the building or in other locations;
• Names, addresses, and telephone numbers for ill person’s close contacts in the school;
• Any other information to assist with the determination of next steps.

Schools should immediately close off areas used by the person who is sick, open outside doors and windows to increase air circulation in the area and wait 24 hours before you clean or disinfect.

The schools should clean and disinfect all areas used by the person who is sick, including the isolation area. Once area has been appropriately disinfected, it can be opened for use.

If the number of ill students exceeds the number of isolation areas and the areas cannot be closed for 24 hours, clean and disinfect between ill persons.

When Someone Tests Positive for COVID-19

Schools should ensure that parents and staff notify school authorities if they test positive for COVID-19, the DOH says.

Schools should notify the local health department and provide the following information, where available:

• Contact information for the person(s) who tested positive for COVID-19;
• The date the COVID-19 positive person developed symptoms (if applicable), tested positive for COVID-19 (if known), and was last in the building;
• Types of interactions (close contacts, length of contact) the person may have had with other persons in the building or in other locations;
• Names, addresses, and telephone numbers for ill person’s close contacts in the school;
• Any other information to assist with the determination of next steps. As long as routine cleaning and disinfecting have been done regularly (at least daily), additional cleaning measures are not necessary unless the COVID-19 positive person is in school on the day school officials are notified of the positive test.
• Notify the school community as per school protocol.

Music

Due to potential increased risk of droplet transmission, physical distancing should be prioritized for wind instruments and singing.

If it’s safe and weather permits, schools should consider moving music class outdoors where air circulation is better than indoors and maintain at least 6 feet distance between students.

When students are not playing an instrument that requires the use of their mouths, they should wear a face covering in music class (unless class is outdoors, and distance can be maintained).

Read the rest of the DOH guidelines here.