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Reopening Schools: Health Guidance by COVID-19 Phase

Introduction

CDPHE, CDE and the Governor’s Office worked together to develop this guidance for Local Public Health agencies (LPHAs) and districts as they develop school plans.

The guidance has been drafted in light of evolving scientific knowledge about the spread of COVID-19 among children and in schools, as well as real-world disease control knowledge acquired through months of experience at the state and local level. Input has been solicited from both internal and external stakeholders, and their invaluable comments and suggestions have been instrumental in developing practical, broadly applicable guidance.

The guidance is organized by the level of COVID-19 incidence in the community: Stay at Home (high level of COVID-19), Safer at Home (mid-level of COVID-19), and Protect Our Neighbors (lower level of COVID-19).

Safe at Home

Safer at Home

Protect Our Neighbors


Goals

  1. Support in-person learning in as a safe and healthy way as possible.
  2. Ensure a reasonable level of safety for students and staff for in-person learning.
  3. Minimize disruptions to education by facilitating timely responses to COVID-19 through cohorting students and staff when possible, screening for symptomatic individuals, and coordinating closely with local and state public health agencies.
  4. Ensure equity in educational opportunity by considering learning and health needs of all students, including those with varying health conditions, economic backgrounds, language skills, or educational needs.
  5. Encourage flexibility, adaptation, and innovation as schools develop novel approaches to disease control appropriate to local contexts and as scientific knowledge about COVID-19 transmission and control develops.

Guidance Rationale

  • Global COVID-19 evidence suggests that younger children play a smaller role in onward transmission of COVID-19 1. The risk of transmission between young children and from young children to adults is lower, than the risk of transmission between or from older children and adults. The risk to children is likely lower than that of yearly influenza, accounting for both primary disease and Multisystem Inflammatory Disease in Children (MIS-C). This is why kindergarten and elementary schools should have different guidelines than secondary schools.
  • The risk of transmission between children and from children to adults is low, and the risk of transmission to adults is greater from other adults with either symptomatic or asymptomatic infection. Therefore, the most important limit to classroom size for adults is the number of adults required to be in close proximity.
  • Given the limited role young children likely play in transmission, there likely is minimal benefit relative to the great difficulty of physical distancing young children within a class to prevent COVID-19 spread. (American Academy of Pediatrics) Moreover, physical distancing has the potential to negatively impact appropriate child development in this age group. Therefore, focus should be placed on other risk mitigation strategies that better complement the learning and socialization goals of children up through 5th grade. In secondary schools there is likely a greater impact of physical distancing on risk reduction of COVID-19.
  • Cohorting significantly reduces the number of students and staff who will need to be excluded in the event of a case of COVID-19 in a school by limiting the number of close contacts of each individual (all of whom will need to be quarantined up to 14 days if they have close contact with a case). Considerations about the number of close contacts should be included in decisions about transportation and activities as well.
  • For COVID-19, a close contact is defined as any individual who was within 6 feet of an infected person for at least 15 minutes, starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to positive specimen collection) until the time the patient is isolated. However, members of the same classroom cohort may be considered "close contacts,", even if desk spacing is greater than 6-foot.
  • Protection efforts applied collectively (for example social distancing AND masking AND cohorting) will provide stronger protection than any one effort in isolation as it will reduce the transmission of disease and minimize the disruption to in-person learning.

Frequently Asked Questions

Who has the authority to declare the phase in a county?

Local public health agencies (LPHAs) may declare the phase for their county/area using the Stay, Safer, and Protect Complete Framework (PDF) metrics.

Note: The Protect Our Neighbors phase requires a request for certification to the Colorado Department of Public Health and Environment for approval. A county may seek to qualify for Protect Our Neighbors by themselves, or voluntarily form a "region" with neighboring counties who choose to submit for a certification together. To enter Protect Our Neighbors, counties must qualify by meeting scientifically established metrics. If a county that has entered Protect Our Neighbors falls out of compliance with any one of the metrics, they have three weeks to implement their containment plan and reestablish compliance.

What does "require" mean in these phases?

Executive Orders, issued by the Governor’s Office and State Public Health Orders, issued by the state or local government, are legal requirements that apply to all Coloradans. Local public health agencies and local governments can choose to enact stricter guidance than the state. In some cases, local governments may seek and be granted a variance from the state’s orders that may allow for looser restrictions. Public health guidance, such as this document, and the CDE Toolkit provide many examples and strategies for schools to comply with orders. At the local school level, districts, BOCES, and charters may also adopt policies related to COVID-19 that include tighter restrictions.

Do local public health agencies approve district or school fall opening plans?

No, unless required by the LPHA.

Who has the authority to intervene if a district or school is not following requirements or guidance within Executive Orders issued by the Governor’s Office and/or Public Health Orders issued by the state or local government?

The LPHA has the authority to enforce requirements in Executive Orders and Public Health Orders. Likewise, the Colorado Department of Public Health and Environment has the authority to enforce requirements in Executive Orders and Public Health Orders.

 If school districts have questions about the legal implications of their local planning decisions, those districts should contact their legal counsel.

With public health orders changing often, CDE has continued to work to update what is identified as required, guidance or considerations within the CDE Framework and Toolkit. There is a legend throughout the toolkit that provides these definitions. If an item is labeled as “required” it lives within a current public health order or executive order for K-12 Education.  If the item is identified as “guidance” this is a recommendation for “how to” implement a statute or rule. They are based on best practice and provide direction for how to operationalize the requirements set forth in various orders. All efforts should be made to follow the recommendations when feasible.  At the same time, we acknowledge that all of these guidelines may not be met with 100% consistency at all times.  And, last, if an item is identified as a “consideration”, this is an idea to think about as schools/districts make their own decisions.

How do the executive and public health orders, this guidance and the CDE toolkit all fit together?

The Executive Orders and Public Health Orders set the policies we all need to follow. This “phased” guidance is designed to help LPHAs and districts make local decisions about school on health and safety precautions that meet the requirements of the Executive and Public Health Orders. The CDE toolkit is a broader set of ideas, resources and guidance on a myriad of other topics concerning school in the era of COVID-19. If provided, LPHA guidance is specific health guidance or orders for your local community, and ultimately they all help districts plan for operating safely this school year.