A growing body of evidences suggest that the risk for transmission of COVID to children is significantly lower than the risk to adolescents and adults. Additionally, Governor Parson announced changing school guidance from Missouri’s departments of health and education (DHSS, DESE) to take into consideration mask use in quarantine. In response to this information, and the negative educational impacts of quarantine for students, the Springfield-Greene County Health Department is implementing a modified quarantine approach that applies only to K-12 schools in Greene County.
Modified quarantine is solely an effort to keep children in the learning environment, while managing the risk for the spread of COVID-19. The local educational system has proactively demonstrated the ability to develop and implement mitigation strategies to slow the spread of COVID-19 and serve as a key partner in contact tracing. This, in combination with the reduced risk of transmission to children, create the only scenario the Springfield-Greene County Health Department is examining this modified approach. Future research and evidence will be taken into consideration for its ongoing implementation. Effective immediately, the following may be applied in Greene County.
Criteria for Modified Quarantine
Criteria for modified quarantine must be met, before being applied to a situation.
- Modified quarantine may only be applied in K-12 schools.
- Modified quarantine does not apply to all contacts to positive cases of COVID-19. It applies for transmission from a child to a child and adult to a child in a school setting. It does not apply in any situation of potential transmission to an adult; whether by a child or an adult (19 years or older). A growing body of evidence, including the guidance from the state of Missouri, suggest that adults are more likely to transmit and acquire the virus. Keeping adults who have had exposure in school increases the likelihood of disease transmission to others. Modified quarantine does not apply to children younger than in Kindergarten, regardless if the children are in a K-12 facility or in another facility.
- The school environment must have significant mitigation strategies in place. Masking must be required for everyone (ages two and older without a medical exemption). Classrooms must be designed to limit spread and maximize physical distancing. Increased hand hygiene activities, including before eating and before moving throughout the facility must be in place. Screening for COVID-19 and immediate isolation of anyone with symptoms of COVID-19 must be in place.
- Masks must be worn at all times. Any time without appropriate mask use by either the infectious individual or others nearby, will result in standard quarantine practices. This includes during lunch, recess, and all classes. Face shields are not an acceptable alternative and if worn around the infectious individual will result in standard quarantine practices. Individuals who are not able to wear a mask due to a medical exemption will be required to follow standard quarantine practices.
- Individuals that are in direct physical contact for a cumulative of more than 15 minutes will be required to follow standard quarantine practices. While masks reduce the chances of transmission, having prolonged, direct physical contact with someone who is infectious is a greater risk than can be substantially mitigated by mask use. Other high-risk behaviors may require standard quarantine practices and should be evaluated on a case-by-case basis with the Springfield-Greene County Health Department.
- Modified quarantine only pertains to the educational environment at a school. Exposures outside of the normal school day, including extracurricular activities, are not considered for modified quarantine. Exposures occurring outside of the normal school day do not have the same level of assurances of mitigating factors in place, increasing the risk, and will follow standard quarantine practices. Exposures on a bus, when transporting children to and from the normal school day are included in the consideration for modified quarantine, but buses must meet all other criteria outlined herein.
- Modified quarantine consideration begins when there is an infectious individual exposure to others in the classroom. Modified quarantine can be used in the classroom, unless additional cases occur within the same classroom that are likely due to transmission in the classroom. If additional cases occur within the classroom that are likely linked to the classroom, standard quarantine practices will be used. Once standard quarantine practices apply to a situation, they will be used in the classroom until there is a minimum of 14 days without additional cases. After this criterion is met, modified quarantine practices may resume. The Springfield-Greene County Health Department should be consulted in making this determination.
- Modified quarantine will be suspended in facilities that are experiencing multiple clusters of disease resulting from school-based transmission. If two more classrooms have had to shift to standard quarantine practices, modified quarantine will be suspended for the facility. This suspension will continue until there is no more than one class in standard quarantine practices.
When an individual is identified as positive for COVID-19, close contacts are identified. This includes anyone who has been within 6 feet for a cumulative 15 minutes or more within a 24-hour period during the infectious period. When the above criteria are met, modified quarantine may be used. Modified quarantine allows for a student to continue to attend school. During the period in which a student would be in quarantine, the following must occur:
- Outside of regular school day educational activities, the child must quarantine at home (they may not participate in extracurricular activities).
- Mask is worn at all times, except while eating or drinking.
- When the mask is removed, the student must be a minimum of 6 feet from others.
- Children are not to participate in any activity in which a mask cannot be worn.
- Monitoring for symptoms must occur daily within the school.
- A screening PCR test for COVID-19 is encouraged between 5-10 days from the most recent exposure.
If the individual develops any symptoms of COVID-19, they should immediately be isolated and excluded from school, isolate at home, and be tested for COVID-19. If the circumstances of the individual’s symptoms meet the criteria for antigen testing, it can serve as an acceptable alternative to a PCR test. The individual should remain at home for a minimum of 10 days unless a current negative test result is provided.