MPS Quarantine & Isolation Guidelines

*NEW* MPS Quarantine and Isolation Guidelines March 2022

Please see DESE/DPH document for FULL OUTLINE OF 2021-2022 Protocols:

DESE/DPH Protocols for Responding to COVID-19 Scenarios - SY 2021-22

Section 1: Key definitions

This section outlines the list of COVID-19 symptoms, provides the definition of a close contact, and outlines situations where close contacts are exempt from COVID-19 testing and quarantine response protocols including isolation, quarantine, and Test and Stay.

COVID-19 symptoms

Below is the full list of symptoms for which caregivers should monitor their children, and staff should monitor themselves.¹

At this time, based on the advice of public health officials and medical experts, DESE and DPH are revising the symptoms list to align with DPH statewide guidance. While previous guidance provided a differentiated symptoms list for vaccinated and unvaccinated individuals, the new symptoms list below applies to all individuals, regardless of vaccination status. Individuals who experience any symptoms on the list below should follow the testing and quarantine response protocol for symptomatic individuals (Protocol C) as outlined in Section 2 of this document. Please note that, consistent with the DPH Public Health Advisory Regarding COVID-19 Testing, these protocols have been adjusted to recommend, but not require, a COVID-19 test to return to school.

COVID-19 symptoms list:

• Fever (100.0° Fahrenheit or higher), chills, or shaking chills

• Difficulty breathing or shortness of breath

• New loss of taste or smell

• Muscle aches or body aches

• Cough (not due to other known cause, such as chronic cough)

• Sore throat, when in combination with other symptoms

• Nausea, vomiting, or diarrhea when in combination with other symptoms

• Headache when in combination with other symptoms

• Fatigue, when in combination with other symptoms

• Nasal congestion or runny nose (not due to other known causes, such as allergies) when in combination with other symptoms

Definition of a close contact

Close contacts are defined as individuals who have been within 6 feet of a COVID-19 positive individual while indoors, for at least 15 minutes during a 24-hour period.^{2 3} Please note that the at-risk exposure time begins 48 hours prior to symptom onset (or time of positive test if asymptomatic) and continues until the time the COVID-19 positive individual is isolated. In general, close contacts should follow the testing and quarantine response protocols in Section 2 of this document. However, certain close contacts are exempted from testing and quarantine response protocols as noted below.

Close contacts who are exempt from testing and quarantine response protocols

The following close contacts are exempt from testing and quarantine response protocols:

• Asymptomatic, fully vaccinated⁴ close contacts: Individuals who are asymptomatic and fully vaccinated are exempt from testing and quarantine response protocols.

• Masked close contacts in classrooms and on buses: An individual who is exposed to a COVID-19 positive individual in the classroom, so long as the individuals were spaced at least 3 feet apart, or on the bus, while both individuals were masked, is exempt from testing and quarantine response protocols.

• Close contacts who have had COVID-19 within the past 90 days: An individual who has been previously diagnosed with COVID-19 and then becomes a close contact of someone with COVID-19 is exempt from testing and quarantine response protocols if:

  • The exposure occurred within 90 days of the onset of their own illness AND

  • The exposed individual is recovered and remains without COVID-19 symptoms.

Section 2: Recommended testing and quarantine response protocols

This section outlines testing and quarantine response protocols for individuals – students and staff – who test positive for COVID-19, close contacts who are not exempt from testing and quarantine response protocols, and symptomatic individuals. Each scenario outlines the duration of any recommended quarantine or isolation, the conditions to be met for the individual to return to school, and any additional considerations.

Overview of Protocol Categories:

• Protocol A: For individuals who test positive for COVID-19

• Protocol B: Protocol for asymptomatic close contacts

• Protocol C: Protocol for symptomatic individuals

Protocol A: For individuals who test positive for COVID-19

Protocol A for individuals who test positive

• Duration: Self-isolation for COVID-19 positive cases is a minimum of 5 days after symptom onset or after positive PCR or antigen test, if asymptomatic.

• Return to school: After 5 days⁵ and once they have:

o Been without fever for 24 hours (and without taking fever-reducing medications)

o Experienced improvement in other symptoms.

o Following the 5-day isolation period, wear a mask for 5 additional days when around others, other than when eating, drinking, or outside.

• Note: Return to school should be based on time and symptom resolution. Testing during isolation to return to school is not required.

Protocol B: Protocol for asymptomatic close contacts

Protocol B* (New Version) for Districts and Schools that Selected the New Testing Option to Provide At-home Rapid Antigen Tests

Updated testing guidance from DESE and DPH recommend that districts select the new option within the statewide testing program to offer weekly rapid at-home antigen tests to students and staff and discontinue contact tracing and Test and Stay programs. As such, for districts selecting this new option, individuals will no longer be identified as close contacts by school health professionals.

However, individuals may still be identified as close contacts outside of school settings (e.g. as a close contact of someone who tests positive for COVID-19 in their household). Individuals who test positive are encouraged to notify their close contacts. In these cases:

• While in school settings (including for sports and extracurriculars), asymptomatic vaccinated⁶ individuals remain exempt from testing and quarantine protocols. If an asymptomatic, vaccinated individual is identified as a close contact outside of school, they may return to school. Individuals should closely monitor for symptoms and follow Protocol C if they experience symptoms listed in Section 1.

• Unvaccinated individuals who are identified as close contacts outside of school settings should stay home and follow Protocol B* below prior to returning to school:

Protocol B* (New Version): Protocol for asymptomatic, unvaccinated individuals identified as close contacts outside of school settings

• Duration: Quarantine is at least 5 days from the date of exposure.

• Return to School: After 5 days, returning on day 6, provided that they:

• Remain asymptomatic,

• Wear a mask, other than when eating, drinking, or outside, and conduct active monitoring for symptoms through day 10; and,

• Self-isolate if symptoms develop.

• Note: If an individual has symptoms at the time they are designated as a close contact or within the 5 days following initial exposure, they should follow the protocol for symptomatic individuals (Protocol C). If an individual tests positive at any time, they follow the protocol for individuals who test positive for COVID-19 (Protocol A).

• For all those exposed, best practice would also include a viral test (antigen or PCR) for COVID-19 at day 5 after exposure. An antigen test may be self-administered and does not need to be proctored or performed by a healthcare professional.

Protocol C: Protocol for symptomatic individuals

Protocol C applies to vaccinated and unvaccinated individuals who experience the COVID-19 symptoms listed in Section 1 and who have not tested positive for COVID-19.

Protocol C for symptomatic individuals: Return to school post-symptoms with optional test⁸

• Duration: Dependent on improvement in symptoms

• Return to School: Individuals may return to school after they:

o Have improvement in symptoms.

o Have been without fever for at least 24 hours without the use of fever-reducing medications.

o It is also recommended that individuals receive a negative PCR or antigen test result for COVID-19. An antigen test may be self-administered and does not need to be proctored or performed by a healthcare professional. For districts

participating in the at-home testing option, individuals may use their district provided test for this purpose. Note: So long as the individual is not a close contact, if a medical professional makes an alternative diagnosis for the COVID-19-like symptoms, the individual may use this recommendation (e.g., for influenza or strep pharyngitis) in lieu of a PCR test or antigen test.

o Best practice would also include wearing a mask until symptoms are fully

resolved.

• Please note: If an individual has mild symptoms, the individual may be considered for

testing using BinaxNOW, if available.

o If the result is positive, they should be sent home & follow Protocol A.

o If the result is negative, they should remain in school.

• If symptom(s) persist after a negative test, the individual may retest within

the subsequent 1-2 days.

• If symptoms worsen, the individual should seek medical care and be

evaluated for the need for PCR testing.

¹ https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

² Note: To be in close contact, the 15 minutes must occur within a 24-hour period. Multiple brief or transitory interactions (less than a minute) throughout the day are unlikely to result in 15 minutes of cumulative contact and do not meet the definition of close contact.

³ CDC definition of Close Contact. Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/schools childcare/operation-strategy.html.

⁴ At this time, fully vaccinated is defined as two-weeks following the completion of the Pfizer or Moderna series or two-weeks following a single dose of Johnson & Johnson’s Janssen vaccine.

⁵ Please note that, consistent with the DPH Public Health Advisory Regarding COVID-19 Testing, these protocols have been adjusted to recommend, but not require, a COVID-19 test to return to school

MPS Quarantine and Isolation Guidelines Updated February 1, 2022

Please refer to the DESE/DPH Protocols for Responding to COVID-19 Scenarios - SY 2021-22 for the Complete Outline of Protocols

Section 1: Key definitions

This section outlines the list of COVID-19 symptoms, provides the definition of a close contact, and outlines situations where close contacts are exempt from COVID-19 testing and quarantine response protocols including isolation, quarantine, and Test and Stay.

COVID-19 symptoms

Below is the full list of symptoms for which caregivers should monitor their children, and staff should monitor themselves. ¹

At this time, based on the advice of public health officials and medical experts, DESE and DPH are revising the symptoms list to align with DPH statewide guidance. While previous guidance provided a differentiated symptoms list for vaccinated and unvaccinated individuals, the new symptoms list below applies to all individuals, regardless of vaccination status. Individuals who experience any symptoms on the list below should follow the testing and quarantine response protocol for symptomatic individuals (Protocol C) as outlined in Section 2 of this document. Please note that, consistent with the DPH Public Health Advisory Regarding COVID-19 Testing, these protocols have been adjusted to recommend, but not require, a COVID-19 test to return to school.

COVID-19 symptoms list:

• Fever (100.0° Fahrenheit or higher), chills, or shaking chills

• Difficulty breathing or shortness of breath

• New loss of taste or smell

• Muscle aches or body aches

• Cough (not due to other known cause, such as chronic cough)

• Sore throat, when in combination with other symptoms

• Nausea, vomiting, or diarrhea when in combination with other symptoms

• Headache when in combination with other symptoms

• Fatigue, when in combination with other symptoms

• Nasal congestion or runny nose (not due to other known causes, such as allergies) when in combination with other symptoms

Definition of a close contact

Close contacts are defined as individuals who have been within 6 feet of a COVID-19 positive individual while indoors, for at least 15 minutes during a 24-hour period.^{2 3} Please note that the at-risk exposure time begins 48 hours prior to symptom onset (or time of positive test if asymptomatic) and continues until the time the COVID-19 positive individual is isolated.

In general, close contacts should follow the testing and quarantine response protocols in Section 2 of this document. However, certain close contacts are exempted from testing and quarantine response protocols as noted below.

Close contacts who are exempt from testing and quarantine response protocols

The following close contacts are exempt from testing and quarantine response protocols:

• Asymptomatic, fully vaccinated⁴ close contacts: Individuals who are asymptomatic and fully vaccinated are exempt from testing and quarantine response protocols. • Classroom close contacts: An individual who is exposed to a COVID-19 positive individual in the classroom while both individuals were masked, so long as the individuals were spaced at least 3 feet apart, is exempt from testing and quarantine response protocols.

• Bus close contacts: Individuals on buses must be masked according to federal requirements. As such, individuals who are masked on buses when windows are open are exempt from testing and quarantine response protocols.

• Close contacts who have had COVID-19 within the past 90 days: An individual who has been previously diagnosed with COVID-19 and then becomes a close contact of someone with COVID-19 is exempt from testing and quarantine response protocols if:

o The exposure occurred within 90 days of the onset of their own illness AND

o The exposed individual is recovered and remains without COVID-19 symptoms.

Section 2: Recommended testing and quarantine response protocols

This section outlines testing and quarantine response protocols for individuals – students and staff – who test positive for COVID-19, close contacts who are not exempt from testing and quarantine response protocols, and symptomatic individuals. Each scenario outlines the duration of any recommended quarantine or isolation, the conditions to be met in order for the individual to return to school, and any additional considerations.

4

Overview of Protocol Categories:

• Protocol A: For individuals who test positive for COVID-19

• Protocol B: Protocol for asymptomatic close contacts

• Protocol C: Protocol for symptomatic individuals

Protocol A: For individuals who test positive for COVID-19

Protocol A for individuals who test positive

• Duration: Self-isolation for COVID-19 positive cases is a minimum of 5 days after symptom onset or after positive PCR for antigen test, if asymptomatic.

• Return to school: After 5 days and once they have:

o Been without fever for 24 hours (and without taking fever-reducing medications) o Experienced improvement in other symptoms.

o Following the 5-day isolation period, individuals must mask for 5 additional days when around others, other than when eating, drinking, or outside.

• Note: Return to school should be based on time and symptom resolution. Testing during isolation to return to school is not required.

Protocol B: Protocol for asymptomatic close contacts

Protocol B* (New Version) for Districts and Schools that Selected the New Testing Option to Provide At-home Rapid Antigen Tests

Updated testing guidance from DESE and DPH recommend that districts select the new option within the statewide testing program to offer weekly rapid at-home antigen tests to students and staff and discontinue contact tracing and Test and Stay programs. As such, for districts selecting this new option, individuals will no longer be identified as close contacts by school health professionals.

However, individuals may still be identified as close contacts outside of school settings (e.g. as a close contact of someone who tests positive for COVID-19 in their household).

In these cases:

While in school settings (including for sports and extracurriculars),

• Asymptomatic vaccinated 6 individuals remain exempt from testing and quarantine protocols. If an asymptomatic, vaccinated individual is identified as a close contact outside of school, they may return to school. Individuals should closely monitor for symptoms and follow Protocol C if they experience symptoms listed in Section 1.

• Unvaccinated individuals who are identified as close contacts outside of school settings should stay home and follow Protocol B* below prior to returning to school:

Protocol B* (New Version): Protocol for asymptomatic, unvaccinated individuals identified as close contacts outside of school settings

• Duration: Quarantine is at least 5 days from the date of exposure

• Return to School: After 5 days, returning on day 6, provided that they: o Remain asymptomatic,

o Adhere to strict mask use, other than when eating, drinking, or outside, and conduct active monitoring for symptoms through day 10; and,

o Self-isolate if symptoms develop.

• Note: If an individual has symptoms at the time they are designated as a close contact or within the 5 days following initial exposure, they should follow the protocol for symptomatic individuals (Protocol C). If an individual tests positive at any time, they follow the protocol for individuals who test positive for COVID-19 (Protocol A). For all those exposed, best practice would also include a viral test (antigen or PCR) for COVID 19 at day 5 after exposure. An antigen test may be self-administered and does not need to be proctored or performed by a healthcare professional.

Protocol C: Protocol for symptomatic individuals

Protocol C applies to vaccinated and unvaccinated individuals who experience the COVID-19 symptoms listed in Section 1 and who have not tested positive for COVID-19.

Protocol C for symptomatic individuals: Return to school post-symptoms with optional test⁵

• Duration: Dependent on symptom resolution

• Return to School: Individuals may return to school after they:

o Have improvement in symptoms

o Have been without fever for at least 24 hours without the use of fever-reducing medications.

o It is also recommended that individuals receive a negative PCR or antigen test result for COVID-19. An antigen test may be self-administered and does not need to be proctored or performed by a healthcare professional. Note: So long as the individual is not a close contact, if a medical professional makes an alternative diagnosis for the COVID-19-like symptoms, the individual may use this recommendation (e.g., for influenza or strep pharyngitis) in lieu of a PCR test or antigen test.

• Please note: If an individual has mild symptoms, the individual may be considered for testing using BinaxNOW, if available.

o If the result is positive, they should be sent home and follow Protocol A. If the result is negative, they should remain in school.

o If the minimal symptom(s) persist, the individual may be re-tested within the subsequent 3 days. If symptoms worsen, the individual should seek

medical care and be evaluated for the need for PCR testing.

¹ https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

² Note: To be in close contact, the 15 minutes must occur within a 24-hour period. Multiple brief or transitory interactions (less than a minute) throughout the day are unlikely to result in 15 minutes of cumulative contact and do not meet the definition of close contact.

³ CDC definition of Close Contact. Available at: https://www.cdc.gov/coronavirus/2019-ncov/community/schools childcare/operation-strategy.html.

⁴ At this time, fully vaccinated is defined as two-weeks following the completion of the Pfizer or Moderna series or two-weeks following a single dose of Johnson & Johnson’s Janssen vaccine.

⁵ Please note that, consistent with the DPH Public Health Advisory Regarding COVID-19 Testing, these protocols have been adjusted to recommend, but not require, a COVID-19 test to return to school