The Indiana Department of Education has updated its guidelines to help school officials and parents decide how schools can reopen safely during the coronavirus pandemic.
As schools near the midway point in the fall semester, the number of students and school employees who’ve tested positive for COVID-19 continues to grow.
Nearly 2,000 students and school employees have tested positive for COVID-19 since the school year started this fall, according to new data from the Indiana State Department of Health released Wednesday.
Health officials have repeatedly said that isolating those who test positive and quarantining their close contacts who are possibly infected is key to stopping the spread of the coronavirus. In schools, the number of people told to stay home can add up in some instances.
Around the state, multiple schools have closed buildings and moved classes temporarily online, due to the number of people who must quarantine.
For example, last month in Muncie, Delta High School and Middle School closed their buildings for 14 days after more than 200 students were in quarantine.
The number of employees quarantining has also closed school buildings, even when students were attending virtually — like at Hamilton Southeastern Intermediate/Junior High — and impacted school bus transportation before the start of school — like at Westfield Washington Schools.
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Dr. Kristina Box, the state health commissioner, acknowledged earlier this month that quarantining can be frustrating for schools and families.
“What we know is individuals are at highest risk,” she said, “when someone they live with is infected.”
Box stressed that close contacts of a positive person need to quarantine because they could infect the people they live with as well as others they are around.
But knowing which students should stay home when isn’t always easy to know or figure out as guidance from health experts is updated.
Here’s what families need to know:
Harper Williams waves from the bus as she prepares for her first day of first grade at Sycamore Elementary School in Avon, Ind., on Wednesday, July 29, 2020. (Photo: Mykal McEldowney/IndyStar)
Where does the guidance about who needs to quarantine when come from?
The state department of health follows guidance from the Centers for Disease Control and Prevention when it comes to how children and their families should quarantine, Megan Wade-Taxter, a spokesperson for the department, told IndyStar.
And the state has largely directed school leaders to work with their local health departments to stay up-to-date on guidance.
Michael Aviah, the public health education specialist at the Hendricks County Health Department, said that anytime state or CDC recommendations change, the county health department contacts all school nurses and coordinators to update them.
In Boone County, Lisa Younts, health administrator for the Boone County Health Department, said the department shares any updates with school contacts including superintendents, building principals and school nurses. She said schools also receive information directly from the CDC and state departments of health and education.
Marion County Public Health Director Dr. Virginia Caine meets with school leaders regularly to answer questions and clarify any recommendations from the health department, said Curt Brantingham, a department spokesperson.
While Aviah and Younts stressed that their respective county health departments aim to stay consistent with state and CDC guidelines, Brantingham added that there are times when the Marion County Health Department has been more restrictive than the state, such as determining when schools can have in-person learning.
When should students stay home from school and how should they quarantine if needed?
Students should stay home if they tested positive for COVID-19, are waiting on test results or have symptoms of COVID-19, per guidance from the state health department.
Additionally, students should stay home if they are identified as a close contact of someone who tested positive or if someone they live with is a close contact and has symptoms or tests positive.
If a student has tested positive, they are isolating, which keeps someone who is sick away from others who are healthy. If a student might be sick, then they are quarantining, or staying away from others to stop from spreading the virus before they know they are sick.
Because those quarantining or isolating run the risk of infecting those they live with, they should stay away from others in the household as much as possible and that includes not sharing utensils or bathrooms if possible and wearing masks, the state advised.
What symptoms should keep a student home from school?
Here are the symptoms that families should screen their students for on a daily bases, according to the state department of health:
- fever or chills
- sore throat
- cough or shortness of breath (for those with allergic/asthmatic cough, a change from the baseline)
- diarrhea, nausea, vomiting or stomach pain
- new loss of taste or smell
However, the state health department points out that this is not a full list of COVID-19 symptoms. And the list of symptoms for the daily screener has changed since the start of school, due to changes from the Centers for Disease Control and Prevention, the state health department said.
State guidance acknowledges that the list of symptoms is a broad one, but added that if students have any of these symptoms, schools should respond as if it could be COVID-19 unless a healthcare provider determines otherwise and provides a note.
Even one symptom from the list is worth “further evaluation and conversation,” per the state.
A student with symptoms but no test should stay home for at least 10 days since the symptoms started and be fever-free without the use of fever-reducing medicines for 24 hours as well as have symptoms improve before returning to school. However, if a student is diagnosed with something else that explains the symptoms, they would just need a doctor’s note to return to school.
What happens if a student is tested for COVID-19? What should they do?
Once a student is tested, the guidance on when they can return to school depends on two things: the outcome of the test and if they have symptoms or not.
As they are waiting for test results, they should quarantine at home. Here are the state guidelines when test results return:
- Positive test and symptomatic: Isolate at home for at least 10 days since symptoms began and be fever-free without fever-reducing medications for 24 hours and have symptoms improve before returning to school.
- Positive test and no symptoms: Isolate for 10 days after the day the test was done before returning to school.
- Negative test and symptoms: Be fever-free for 24 hours without the use of fever-reducing medications and have symptoms improve, unless a healthcare provider advises otherwise. Also, provide proof of a negative test. If there’s an alternative diagnosis, the student should base any additional days home on that diagnosis.
- Negative test and no symptoms: Return to school.
What should siblings do if a student has symptoms or tests positive?
If a student has symptoms but hasn’t been tested, their siblings don’t have to stay home from school. However, the state guidance says that if the student is symptomatic and there’s a “significant concern for COVID-19,” quarantine can be considered for siblings and others in the house.
But if a student is a close contact of someone who tested positive and develops symptoms, then others in their household should follow the instructions for a close contact, per the state.
If a student tests positive — whether they were a close contact of someone else or not — anyone in their house is considered a close contact and should follow the guidelines for those deemed close contacts.
If a student is a close contact, what should they do?
Once a student is determined to be a close contact of someone who tested positive for COVID-19, how long they stay home again depends on if they are tested and if so, the test’s outcome and if they have symptoms.
The guidance is in part based on the close contact’s last day of contact with the sick person. So if the person who tested positive is someone who lives in the same house and can’t properly isolate, then the last day of contact is the sick person’s last day of isolation.
Here’s the state guidance for close contacts on returning to school:
- No test and symptomatic: Quarantine for at least 14 days after the last contact with the person who is sick. Since symptoms mean that close contact could be positive, they also need to stay home for at least 10 days since symptoms began and be fever-free without fever-reducing medicine for 24 house and have symptoms improve. That 10 day period could end after the 14-day quarantine.
- No test and no symptoms: Quarantine for 14 days from the day of the last contact with the sick person. If symptoms develop, refer to guidance for close contacts with symptoms.
- Positive test and symptomatic: Isolate for at least 10 days since symptoms started and are fever-free without the use of fever-reducing medicine for 24 hours and improvement in symptoms. The close contact should also be still quarantining for 14 days from the last contact with the person who tested positive and that quarantine may end before or after isolation.
- Positive test and no symptoms: Isolate at home for 10 days after the same was collected.
- Negative test and symptoms: Quarantine for 14 days after contact with a positive person even if the close contact has an alternative diagnosis for symptoms. If symptoms are still there after 14 days, don’t return to school until fever-free for 24 hours without the use of the fever-reducing medicine and improvement of symptoms.
- Negative test and no symptoms: Quarantine for 14 days from last exposure to the positive person. If symptoms develop, refer to guidance for close contacts with symptoms.
What should siblings do if a student is a close contact?
This advice has changed as health officials determine what is the best approach.
Current state guidance boils down to if the student who is a close contact has symptoms. If they don’t, siblings don’t need to quarantine. But if the close contact does develop symptoms and hasn’t been tested, others in the house should start following the state’s advice for being a close contact.
Both Boone and Hendricks counties echo that in their advice to schools and health officials said they have had that advice all school year.
In Marion County, Brantingham said the health department doesn’t recommend that close contacts of close contacts quarantine.
However, it’s likely that if a close contact does test positive, regardless of having symptoms, those in their household would qualify as close contacts. And that’s why the state recommends that if a close contact tests positive, their family members that they live with are now close contacts and are advised to follow that advice.
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