The health subcommittee reviewed the ever-evolving updates from those experts at the CDC, DOH and NYSED as well as meritorious publications and various professional organizations including the American Academy of Pediatrics (AAP), the NYS Center for School Health and the National Association for School Nurses (NASN) for the safe return of students and staff.

We value the framework of the AAP position statement. Our collective opinion is that the AAP guidance is both medically and administratively feasible. We also appreciate the AAP’s guidance between higher- and lower-priority strategies.

“The purpose of this guidance is to support education, public health, local leadership, and pediatricians collaborating with schools in creating policies for school re-entry that foster the overall health of children, adolescents, staff, and communities and are based on available evidence. Schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits. Beyond supporting the educational development of children and adolescents, schools play a critical role in addressing racial and social inequity. As such, it is critical to reflect on the differential impact SARS-CoV-2 and the associated school closures have had on different races, ethnic and vulnerable populations. These recommendations are provided acknowledging that our understanding of the SARS-CoV-2 pandemic is changing rapidly.

Any school re-entry policies should consider the following key principles:

• School policies must be flexible and nimble in responding to new information, and administrators must be willing to refine approaches when specific policies are not working.

• It is critically important to develop strategies that can be revised and adapted depending on the level of viral transmission in the school and throughout the community and done with close communication with state and/or local public health authorities and recognizing the differences between school districts, including urban, suburban, and rural districts.

• Policies should be practical, feasible, and appropriate for child and adolescent's developmental stage.

• Special considerations and accommodations to account for the diversity of youth should be made, especially for our vulnerable populations, including those who are medically fragile, live in poverty, have developmental challenges, or have special health care needs or disabilities, with the goal of safe return to school.

• No child or adolescents should be excluded from school unless required in order to adhere to local public health mandates or because of unique medical needs. Pediatricians, families, and schools should partner together to collaboratively identify and develop accommodations, when needed.

• School policies should be guided by supporting the overall health and well-being of all children, adolescents, their families, and their communities. These policies should be consistently communicated in languages other than English, if needed, based on the languages spoken in the community, to avoid marginalization of parents/guardians who are of limited English proficiency or do not speak English at all.

With the above principles in mind, the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.”

The district will proceed with the understanding that planning for schools to reopen is not a one-time event. We will continuously monitor the situation and provide updated guidance, policies, and regulatory changes as the situation requires.

Please follow this link to Suffolk County DOH Daily Case Update and Local Hospital Capacity.

• Health Checks - schools must instruct staff to recognize signs and symptoms of illness in students and staff, and health screenings per DOH guidance.

• Physical Distancing - schools must develop plans to maximize physical distancing whenever possible.

• Management of ill persons - requires persons with signs and symptoms of COVID-19 to be isolated until they can be sent home.

• Health Hygiene - schools must instruct students and staff in proper hand and respiratory hygiene and provide necessary supplies.

• Face Coverings and PPE - requires students and staff to wear face coverings (or PPE based on job functions), per DOH guidance.

• Cleaning and Disinfecting - reviews cleaning and disinfecting procedures for the school in accordance with CDC recommendations.

District Health Protocols

• Health screenings, including daily temperature checks and completion of a screening questionnaire, are required for all students, staff, contractors, vendors, and visitors.

• Staff and parents/guardians must perform temperature checks prior to the arrival at school. Periodic temperature checks will be conducted by the district on site.

• Students and staff are required to notify the school when they develop symptoms or if their answers to the questionnaire change during or outside school hours.

• The district is developing a staff and family screening tool for completion of the required temperature check and survey questionnaire.

Healthy Hygiene Practices

Healthy hygiene practices will be taught and re-taught in school for both students and staff. Videos will be created to demonstrate to the school community best practices in hand and respiratory hygiene. Additionally, signs will be posted throughout the school. Signage will remind individuals to:

• stay home if they feel sick.

• cover their nose and mouth with an acceptable face covering.

• properly store and, when necessary, discard PPE.

• adhere to physical distancing instructions.

• report symptoms of, or exposure to, COVID-19.

• follow hand hygiene, and cleaning and disinfection guidelines.

• follow respiratory hygiene and cough etiquette.

Per NYSDOH, schools are prohibited from keeping records of student, faculty, staff, and visitor health data (e.g., the specific temperature data of an individual), but are permitted to maintain records that confirm individuals were screened and the result of such screening (e.g., pass/fail, cleared/not cleared).

School nurses will review the incoming reports of screening by staff and parents/guardians and attest that they are complete. The nurses will also be the contact for staff or students if they later experience COVID-19 symptoms.

Recognizing the interdependence of all members of our community, the district is recommending that all parents, students, and staff sign an oath - Community Compact - promising to abide by district and public health policy and to promote the health and safety of all community members.

Dr. Howard Sussman, Chief Medical Officer, and Mr. Jack Blaum, Coordinator of School Safety and Security, have been designated as COVID-19 Safety Coordinators whose responsibilities include continuous compliance with all aspects of the schools re-opening plan, as well as any phased in re-opening activities necessary to allow for operational issues to be resolved before activities return to normal or new normal levels. Dr. Dawn Mason, Executive Director of Pupil Personnel Services, is designated as the District DOH Liaison.

School Attendance

Students should not be sent to school, admitted or re-admitted to school or allowed to remain in school if they exhibit fever of 100.0 degrees F or greater and/or signs or symptoms of possible coronavirus infection as per District screening protocols in accordance with CDC and DOH guidelines. [See Screening Questionnaire]

Students and staff with symptoms of illness must be sent to the health office. The school nurse will assess individuals with chronic conditions, such as asthma and allergies or chronic gastrointestinal conditions may present the same symptoms as COVID-19 but are neither contagious nor pose a public health threat.

If Students or Staff become Ill with Symptoms of COVID-19 at School

We will follow Education Law § 906, which provides whenever…a student in the public schools shows symptoms of any communicable or infectious disease reportable under the public health law that imposes a significant risk of infection of others in the school, he or she shall be excluded from the school and sent home immediately, in a safe and proper conveyance. The director of school health services shall immediately notify a local public health agency of any disease reportable under the public health law [which now includes COVID-19]. The director of school health services, or other health professionals acting upon direction or referral of such director, may make such evaluations of teachers and any other school employees, school buildings and premises as, in their discretion, they may deem necessary to protect the health of the students and staff. School staff must immediately report any illness of students or staff to the school nurse or other designated school staff. Such reports should be made in compliance with FERPA, and Education Law 2-d. If nurses choose to go to classrooms to make assessments of students, this also should be done in a manner that protects the student’s confidentiality. If there are several students waiting to see the school nurse, arrangements should be made to have students wait at least 6 feet apart. We will have two rooms for school health personnel - one room for healthy students who have injuries or need their medications or nursing treatments, and another room for assessing and caring for ill students and staff. Both rooms require a supervising adult to be present and should have easy access to a bathroom and sink with hand hygiene supplies. School nurses and other school health professionals assessing or providing care to ill students and staff should follow transmission- based precautions which includes the use of appropriate PPE. Students suspected of having COVID-19 awaiting transport home by the parent/guardian must be isolated in a room or area separate from others, with a supervising adult present utilizing appropriate PPE. Multiple students suspected of COVID-19 may be in this isolation room, if they can be separated by at least 6 feet. We will follow the guidance of the CDC and NYSDOH who recommend:

• Closing off areas used by a sick person and not using these areas until after cleaning and disinfection has occurred.

• Opening outside doors and windows to increase air circulation in the area.

• Waiting at least 24 hours before cleaning and disinfection. If waiting 24 hours is not feasible, wait as long as possible.

• Clean and disinfect all areas used by the person suspected or confirmed to have COVID-19, such as offices, classrooms, bathrooms, lockers, and common areas.

• Once the area has been appropriately cleaned and disinfected it can be reopened for use.

• Individuals without close or proximate contact with the person suspected or confirmed to have COVID-19 can return to the area and resume school activities immediately after cleaning and disinfection.

• Refer to DOH’s “Interim Guidance for Public and Private Employees Returning to Work Following COVID-19 Infection or Exposure” for information on “close and proximate” contacts.

• If more than seven days have passed since the person who is suspected or confirmed to have COVID-19 visited or used the facility, additional cleaning and disinfection is not necessary, but routine cleaning and disinfection should continue.

If a separate room is not available, keep at least a 6-foot distance between ill students and other persons. If they cannot be isolated in a separate room from others, a facemask (e.g., cloth or surgical mask) should be provided to the student if the ill person can tolerate wearing it and does not have difficulty breathing, to prevent the possible transmission of the virus to others while waiting for transportation home. We will follow the recommendations that:

• Students should be escorted from isolation area to the parent/guardian.

• The parent or guardian be instructed to call their health care provider, or if they do not have a health care provider, to follow up with a local clinic or urgent care center.

• Symptomatic students or staff members follow CDC’s “Stay Home When You Are Sick” guidance unless otherwise directed by a healthcare provider or the local department of health. If the student or staff member has emergency warning signs such as trouble breathing, persistent pain or pressure in the chest, new confusion, inability to arouse, bluish lips or face, call 911 and notify the operator that the person may have COVID-19.

• School staff be aware of the symptoms of Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 which is a serious condition associated with COVID-19, in children and youth. Schools should notify the parent/guardian if their child shows any of the following symptoms and recommend the child be referred for immediate follow up with a healthcare provider:

  • fever

  • abdominal pain

  • vomiting

  • diarrhea

  • neck pain

  • rash

  • bloodshot eyes

  • feeling extra tired

Schools must call for emergency transport (911) following district policies, for any student showing any of these emergency warning signs of MIS-C or other concerning signs:

• trouble breathing

• pain or pressure in the chest that does not go away

• new confusion

• inability to wake or stay awake

• bluish lips or face

• severe abdominal pain

Return to School after Illness

Schools must follow CDC guidance for allowing a student or staff member to return to school after exhibiting symptoms of COVID-19:

If a person is not diagnosed by a healthcare provider (physician, nurse practitioner, or physician assistant) with COVID-19 they can return to school:

• Once there is no fever, without the use of fever reducing medicines, and they have felt well for 24 hours.

• If they have been diagnosed with another condition and has a healthcare provider written note stating they are clear to return to school.

If a person is diagnosed with COVID-19 by a healthcare provider based on a test or their symptoms or does not get a COVID-19 test but has had symptoms, they should not be at school and should stay at home until:

• It has been at least ten days since the individual first had symptoms.

• It has been at least three days since the individual has had a fever (without using fever reducing medicine); and

• It has been at least three days since the individual’s symptoms improved, including cough and shortness of breath.

• Return to school will be coordinated with the local health department.

The CDC provides specific guidance for individuals who are on home isolation regarding when the isolation may end. [n.b., CDC recommendations for discontinuing isolation in persons known to be infected with COVID-19 could, in some circumstances, appear to conflict with recommendations on when to discontinue quarantine for persons known to have been exposed to COVID-19.] CDC recommends 14 days of quarantine after exposure based on the time it may take to develop illness if infected. Thus, it is possible that a person known to be infected could leave isolation earlier than a person who is quarantined because of the possibility they are infected.

Students who screened positive for COVID-19 symptoms and were sent home from school, or those who reported symptoms on the Daily Health Assessment must provide the following in order to return to the in-person learning environment:

• Documentation from a health care provider following evaluation.

• Negative COVID-19 diagnostic test result.

• Symptom resolution or if COVID-19 positive, release from isolation by Suffolk County Department of Health.