Guidance for COVID-19 Prevention in K-12 Schools

Key Takeaways

• Students benefit from in-person learning, and safely returning to in-person instruction in the fall 2021 is a priority.
• Vaccination is currently the leading public health prevention strategy to end the COVID-19 pandemic.  Promoting vaccination can help schools safely return to in-person learning as well as extracurricular activities and sports.
• Masks should be worn indoors by all individuals (age 2 and older) who are not fully vaccinated. Consistent and correct mask use by people who are not fully vaccinated is especially important indoors and in crowded settings, when physical distancing cannot be maintained.
• CDC recommends schools maintain at least 3 feet of physical distance between students within classrooms, combined with indoor mask wearing by people who are not fully vaccinated, to reduce transmission risk. When it is not possible to maintain a physical distance of at least 3 feet, such as when schools cannot fully re-open while maintaining these distances, it is especially important to layer multiple other prevention strategies, such as indoor masking.
• Screening testing, ventilation, handwashing and respiratory etiquette, staying home when sick and getting tested, contact tracing in combination with quarantine and isolation, and cleaning and disinfection are also important layers of prevention to keep schools safe.
• Students, teachers, and staff should stay home when they have signs of any infectious illness and be referred to their healthcare provider for testing and care.
• Many schools serve children under the age of 12 who are not eligible for vaccination at this time. Therefore, this guidance emphasizes implementing layered prevention strategies (e.g., using multiple prevention strategies together consistently) to protect people who are not fully vaccinated, including students, teachers, staff, and other members of their households.
• COVID-19 prevention strategies remain critical to protect people, including students, teachers, and staff, who are not fully vaccinated, especially in areas of moderate-to-high community transmission levels.
• Localities should monitor community transmission, vaccination coverage, screening testing, and occurrence of outbreaks to guide decisions on the level of layered prevention strategies (e.g., physical distancing, screening testing).

Summary of Recent Changes

This updated version of COVID-19 guidance for school administrators outlines strategies for K-12 schools to reduce the spread of COVID-19 and maintain safe operations.

Many schools serve children under the age of 12 who are not eligible for vaccination at this time. Therefore, this guidance emphasizes implementing layered prevention strategies (e.g., using multiple prevention strategies together) to protect people who are not fully vaccinated, including students, teachers, staff, and other members of their households. The guidance is intended to help administrators and local health officials select appropriate, layered prevention strategies and understand how to safely transition learning environments out of COVID-19 pandemic precautions as community transmission of COVID-19 reaches low levels or stops. This guidance is based on current scientific evidence and lessons learned from schools implementing COVID-19 prevention strategies.

This CDC guidance is meant to supplement—not replace—any federal, state, local, territorial, or tribal health and safety laws, rules, and regulations with which schools must comply. The adoption and implementation of this guidance should be done in collaboration with regulatory agencies and state, local, territorial, and tribal public health departments, and in compliance with state and local policies and practices.

COVID-19 Prevention Strategies Most Important for Safe In-Person Learning in K-12 Schools

Schools are an important part of the infrastructure of communities. They provide safe and supportive learning environments for students that support social and emotional development, provide access to critical services, and improve life outcomes. They also employ people, and enable parents, guardians, and caregivers to work. Though COVID-19 outbreaks have occurred in school settings, multiple studies have shown that transmission rates within school settings, when multiple prevention strategies are in place, are typically lower than – or similar to – community transmission levels. CDC’s science brief on Transmission of SARS-CoV-2 in K-12 Schools and Early Care and Education Programs  summarizes evidence on COVID-19 among children and adolescents and what is known about preventing transmission in schools and Early Care and Education programs.

Schools should work with local public health officials, consistent with applicable laws and regulations, including those related to privacy, to determine the prevention strategies needed in their area by monitoring levels of community transmission (i.e., low, moderate, substantial, or high) and local vaccine coverage, and use of screening testing to detect cases in K-12 schools. For example, a school in a community with substantial (50-99 new cases per 100,000 population in the last 7 days) or high transmission ( ≥100 new cases per 100,000 population in the last 7 days), with low teacher, staff, or student vaccination coverage, and with a screening testing program in place might decide that they will no longer require physical distancing (to ensure all students can access in-person learning), but will continue masking requirements until the levels of community transmission are lower or vaccination coverage increases.

As another example, a school in a community with substantial or high transmission, with a low teacher, staff, or student vaccination rate, and without a screening testing program should continue to require masks for people who are not fully vaccinated and might decide that they need to continue to maximize physical distancing.

CDC continues to recommend masking and physical distancing as key prevention strategies. However, if school administrators decide to remove any of the prevention strategies for their school based on local conditions, they should remove them one at a time and monitor closely (with adequate testing through the school and/or community) for any increases in COVID-19 cases. Schools should communicate their strategies and any changes in plans to teachers, staff, and families, and directly to older students, using accessible materials and communication channels, in a language and at a literacy level that teachers, staff, students, and families understand.

Health Equity

Schools play critical roles in promoting equity in learning and health, particularly for groups disproportionately affected by COVID-19. People living in rural areas, people with disabilities, immigrants, and people who identify as American Indian/Alaska Native, Black or African American, and Hispanic or Latino have been disproportionately affected by COVID-19; these disparities have also emerged among children. For these reasons, health equity considerations related to the K-12 setting are a critical part of decision-making and have been considered in CDC’s updated guidance for schools. School administrators and public health officials can ensure safe and supportive environments and reassure families, teachers, and staff by planning and using comprehensive prevention strategies for in-person learning and communicating those efforts.  Schools can work with parents to understand their preferences and concerns for in-person learning.

School administrators can promote health equity by ensuring all students, teachers, and staff have resources to support physical and mental health. School administrators can offer modified job responsibilities for staff at higher risk for severe illness who have not been fully vaccinated while protecting individual privacy. Federal and state disability laws may require an individualized approach for working with children and youth with disabilities consistent with the child’s Individualized Family Service Plan (IFSP), Individualized Education Program (IEP), or Section 504 plan. Administrators should consider adaptations and alternatives to prevention strategies when serving people with disabilities, while maintaining efforts to protect all children and staff from COVID-19.

Section 1: Prevention Strategies to Reduce Transmission of SARS-CoV-2 in Schools

Schools will have a mixed population of both people who are fully vaccinated and people who are not fully vaccinated. Elementary schools primarily serve children under 12 years of age who are not eligible for the COVID-19 vaccine at this time. Other schools (e.g., middle schools, K-8 schools) may also have students who are not yet eligible for COVID-19 vaccination. Some schools (e.g., high schools) may have a low percentage of students and staff fully vaccinated despite vaccine eligibility. These variations require K-12 administrators to make decisions about the use of COVID-19 prevention strategies in their schools to protect people who are not fully vaccinated.

Together with local public health officials, school administrators should consider multiple factors when they make decisions about implementing layered prevention strategies against COVID-19. Since schools typically serve their surrounding communities, decisions should be based on the school population, families and students served, as well as their communities. The primary factors to consider include:

• Level of community transmission of COVID-19.
• COVID-19 vaccination coverage in the community and among students, teachers, and staff.
• Use of a frequent SARS-CoV-2 screening testing program for students, teachers, and staff who are not fully vaccinated. Testing provides an important layer of prevention, particularly in areas with substantial to high community transmission levels.
• COVID-19 outbreaks or increasing trends in the school or surrounding community.
• Ages of children served by K-12 schools and the associated social and behavioral factors that may affect risk of transmission and the feasibility of different prevention strategies.

Prevention Strategies

• Promoting vaccination
• Consistent and correct mask use
• Physical distancing
• Screening testing to promptly identify cases, clusters, and outbreaks
• Ventilation
• Handwashing and respiratory etiquette
• Staying home when sick and getting tested
• Contact tracing, in combination with isolation and quarantine
• Cleaning and disinfection

These COVID-19 prevention strategies remain critical to protect people, including students, teachers, and staff, who are not fully vaccinated, especially in areas of moderate-to-high community transmission levels. The need for layering specific prevention strategies will vary, and localities might implement fewer COVID-19 prevention strategies based on community transmission levels, vaccination coverage, and local policies and regulations. CDC continues to recommend masking and physical distancing. However, if considering whether and how to remove prevention strategies, one prevention strategy should be removed at a time and students, teachers, and staff should be closely monitored (with adequate testing through the school or community) for any outbreaks or increases in COVID-19 cases.

1. Promoting Vaccination

Achieving high levels of COVID-19 vaccination among eligible students as well as teachers, staff, and household members is one of the most critical strategies to help schools safely resume full operations.

Vaccination is currently the leading public health prevention strategy to end the COVID-19 pandemic. People who are fully vaccinated against COVID-19 are at low risk of symptomatic or severe infection. A growing body of evidence suggests that people who are fully vaccinated against COVID-19 are less likely to have an asymptomatic infection or transmit COVID-19 to others than people who are not fully vaccinated. In most settings, people who are fully vaccinated can safely resume activities they did before the pandemic, except where prevention measures are required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance.

People 12 years and older are now eligible for COVID-19 vaccination. Schools can promote vaccinations among teachers, staff, families, and eligible students by providing information about COVID-19 vaccination, encouraging vaccine trust and confidence, and establishing supportive policies and practices that make getting vaccinated as easy and convenient as possible.

When promoting COVID-19 vaccination, consider that certain communities and groups have been disproportionately affected by COVID-19 illness and severe outcomes, and some communities might have experiences that affect their trust and confidence in the healthcare system. Teachers, staff, students, and their families may differ in their level of vaccine confidence. School administrators can adjust their messages to the needs of their families and community and involve trusted community messengers as appropriate, including those on social media, to promote COVID-19 vaccination among people who may be hesitant to receive it.

To promote vaccination, schools can:

• Visit vaccines.gov to find out where teachers, staff, students, and their families can get vaccinated against COVID-19 in the community and promote COVID-19 vaccination locations near schools.
• Encourage teachers, staff, and families, including extended family members that have frequent contact with students to get vaccinated as soon as they can.
• Consider partnering with state or local public health authorities to serve as COVID-19 vaccination sites, and work with local healthcare providers and organizations, including school-based health centers. Offering vaccines on-site before, during, and after the school day and during summer months can potentially decrease barriers to getting vaccinated against COVID-19. Identify other potential barriers that may be unique to the workforce and implement policies and practices to address them. The Workplace Vaccination Program has information for employers on recommended policies and practices for encouraging COVID-19 vaccination uptake among workers.
• Find ways to adapt key messages to help families, teachers, and staff become more confident about the vaccine by using the language, tone, and format that fits the needs of the community and is responsive to concerns.
• Use CDC COVID-19 Vaccination Toolkits to educate members of the school community and promote COVID-19 vaccination. CDC’s Workers COVID-19 Vaccine Toolkit is also available to help employers educate their workers about COVID-19 vaccines, raise awareness about vaccination benefits, and address common questions and concerns. HHS also has an On-site Vaccination Clinic Toolkitexternal icon to help community groups, employers, and other host organizations work directly with vaccine providers to set up vaccination clinics in locations that people know and trust.
• Host information sessions to connect parents and guardians with information about the COVID-19 vaccine. Teachers, staff, and health professionals can be trusted sources to explain the safety, efficacy, and benefits of COVID-19 vaccines and answer frequently asked questions.
• Offer flexible, supportive sick leave options (e.g., paid sick leave) for employees to get vaccinated or who have side effects after vaccination. See CDC’s Post-vaccination Considerations for Workplaces.
• Promote vaccination information for parents and guardians, siblings who are eligible for vaccines, and other household members as part of kindergarten transition and enrollment in summer activities for families entering the school system.
• Provide students and families flexible options for excused absence to receive a COVID-19 vaccination and for possible side effects after vaccination.
• Work with local partners to offer COVID-19 vaccination for eligible students and eligible family members during pre-sport/extracurricular activity summer physicals.

2. Consistent and Correct Mask Use

When teachers, staff, and students who are not fully vaccinated consistently and correctly wear a mask, they protect others as well as themselves. Consistent and correct mask use by people who are not fully vaccinated is especially important indoors and in crowded settings, when physical distancing cannot be maintained.

• Indoors: Mask use is recommended for people who are not fully vaccinated including students, teachers, and staff. Children under 2 years of age should not wear a mask.
• Outdoors: In general, people do not need to wear masks when outdoors. However, particularly in areas of substantial to high transmission, CDC recommends that people who are not fully vaccinated wear a mask in crowded outdoor settings or during activities that involve sustained close contact with other people who are not fully vaccinated.

Based on the needs of the community, school administrators may opt to make mask use universally required (i.e., required regardless of vaccination status) in the school. Reasons for this can include:

• Having a student population that is not yet eligible for vaccination (e.g., schools with grades prekindergarten-6).
• Increasing or substantial or high COVID-19 transmission within the school or their surrounding community.
• Increasing community transmission of a variant that is spread more easily among children and adolescents or is resulting in more severe illness from COVID-19 among children and adolescents.
• Lacking a system to monitor the vaccine status of students and/or teachers and staff.
• Difficulty monitoring or enforcing mask policies that are not universal.
• Awareness of low vaccination uptake within the student, family, or teacher/staff population or within the community.
• Responding to community input that many teachers, staff, parents, or students would not participate in in-person learning if mask use was not universal.

Schools that continue to require people older than 2 years of age to wear a mask should make exceptions for the following categories of people:

• A person who cannot wear a mask, or cannot safely wear a mask, because of a disability as defined by the Americans with Disabilities Act (ADA) (42 U.S.C. 12101 et seq.). Discuss the possibility of reasonable accommodationexternal icon with workers who are not fully vaccinated who are unable to wear or have difficulty wearing certain types of masks because of a disability.
• A person for whom wearing a mask would create a risk to workplace health, safety, or job duty as determined by the relevant workplace safety guidelines or federal regulations.

When masks are worn by teachers and school staff in the workplace, the masks should meet one of the following criteria:

• CDC mask recommendations
• ASTM International Standard Specification for Barrier Face Coveringsexternal icon
• NIOSH Workplace Performance and Workplace Performance Plus masks

Schools should be supportive of people who are fully vaccinated, but choose to continue to wear a mask, as a personal choice or because they have a medical condition that may weaken their immune system. School administrators will also need to ensure their selected mask use policy does not conflict with local, state, and territorial laws, policies, and regulations.

During school transportation: CDC’s Order applies to all public transportation conveyances including school buses. Regardless of the mask policy at school, passengers and drivers must wear a mask on school buses, including on buses operated by public and private school systems, subject to the exclusions and exemptions in CDC’s Order. Learn more here. For example, if a student attends a school where mask use is not required due to vaccination status (e.g., a high school with a high rate of vaccination), the student is still required to wear a mask on the school bus.

Schools should provide masks to those students who need them (including on buses), such as students who forgot to bring their mask or whose families are unable to afford them. No disciplinary action should be taken against a student who does not have a mask as described in the U.S. Department of Education COVID-19 Handbook, Volume 1external icon.

3. Physical Distancing

Because of the importance of in-person learning, schools where not everyone is fully vaccinated should implement physical distancing to the extent possible within their structures, but should not exclude students from in-person learning to keep a minimum distance requirement. In general, CDC recommends people who are not fully vaccinated maintain physical distance of at least 6 feet from other people who are not in their household. However, several studies from the 2020-2021 school year show low COVID-19 transmission levels among students in schools that had less than 6 feet of physical distance when the school implemented and layered other prevention strategies, such as the use of masks.

Based on studies from 2020-2021 school year, CDC recommends schools maintain at least 3 feet of physical distance between students within classrooms, combined with indoor mask wearing by people who are not fully vaccinated, to reduce transmission risk. When it is not possible to maintain a physical distance of at least 3 feet, such as when schools cannot fully re-open while maintaining these distances, it is especially important to layer multiple other prevention strategies, such as indoor masking, screening testing, cohorting, improved ventilation, handwashing and covering coughs and sneezes, staying home when sick with symptoms of infectious illness including COVID-19, and regular cleaning to help reduce transmission risk. Mask use by people who are not fully vaccinated is particularly important when physical distance cannot be maintained. A distance of at least 6 feet is recommended between students and teachers/staff, and between teachers/staff who are not fully vaccinated.

Cohorting: Cohorting means keeping people together in a small group and having each group stay together throughout an entire day. Cohorting can be used to limit the number of students, teachers, and staff who come in contact with each other, especially when it is challenging to maintain physical distancing, such as among young children, and particularly in areas of moderate-to-high transmission levels. The use of cohorting can limit the spread of COVID-19 between cohorts but should not replace other prevention measures within each group. Cohorting people who are fully vaccinated and people who are not fully vaccinated into separate cohorts is not recommended. It is a school’s responsibility to ensure that cohorting is done in an equitable manner that does not perpetuate academic, racial, or other tracking, as described in the U.S. Department of Education COVID-19 Handbook, Volume 1external icon.  

4. Screening Testing

Screening testing identifies infected people, including those with or without symptoms (or before development of symptoms) who may be contagious, so that measures can be taken to prevent further transmission. In K-12 schools, screening testing can help promptly identify and isolate cases, quarantine those who may have been exposed to COVID-19 and are not fully vaccinated, and identify clusters to reduce the risk to in-person education. CDC guidance provides that people who are fully vaccinated do not need to participate in screening testing and do not need to quarantine if they do not have any symptoms; though decisions regarding screening testing may be made at the state or local level. Screening testing may be most valuable in areas with substantial or high community transmission levels, in areas with low vaccination coverage, and in schools where other prevention strategies are not implemented. More frequent testing can increase effectiveness, but feasibility of increased testing in schools needs to be considered. Screening testing should be done in a way that ensures the ability to maintain confidentiality of results and protect student, teacher, and staff privacy. Consistent with state legal requirements and Family Educational Rights and Privacy Act (FERPA)external icon, K-12 schools should obtain parental consent for minor students and assent/consent for students themselves.

Screening testing can be used to help evaluate and adjust prevention strategies and provide added protection for schools that are not able to provide optimal physical distance between students. Screening testing should be offered to students who have not been fully vaccinated when community transmission is at moderate, substantial, or high levels (Table 1); at any level of community transmission, screening testing should be offered to all teachers and staff who have not been fully vaccinated. To be effective, the screening program should test at least once per week, and rapidly (within 24 hours) report results. Screening testing more than once a week might be more effective at interrupting transmission. Schools may consider multiple screening testing strategies, for example, testing a random sample of at least 10% of students who are not fully vaccinated, or conducting pooled testing of cohorts. Testing in low-prevalence settings might produce false positive results, but testing can provide an important prevention strategy and safety net to support in-person education.

To facilitate safe participation in sports, extracurricular activities, and other activities with elevated risk (such as activities that involve singing, shouting, band, and exercise that could lead to increased exhalation), schools may consider implementing screening testing for participants who are not fully vaccinated. Schools can routinely test student athletes, participants, coaches, and trainers, and other people (such as adult volunteers) who are not fully vaccinated and could come into close contact with others during these activities. Schools can implement screening testing of participants who are not fully vaccinated up to 24 hours before sporting, competition, or extracurricular events. Schools can use different screening testing strategies for lower-risk sports. High-risk sports and extracurricular activities should be virtual or canceled in areas of high community transmission unless all participants are fully vaccinated.

Funding provided through the ELC Reopening Schools award is primarily focused on providing needed resources to implement screening testing programs in schools aligned with the CDC recommendations. Learn more ELC Reopening Schools: Support for Screening Testing to Reopen & Keep Schools Operating Safely Guidancepdf icon.

¹ Levels of community transmission defined as total new cases per 100,000 persons in the past 7 days (low, 0-9; moderate 10-49; substantial, 50-99, high, ≥100) and percentage of positive tests in the past 7 days (low, <5%; moderate, 5-7.9%; substantial, 8-9.9%; high, ≥10%.)

² The NCAA has developed a risk stratification for sports. See https://ncaaorg.s3.amazonaws.com/ssi/COVID/SSI_ResocializationDevelopingStandardsSecondEdition.pdfpdf iconexternal icon.  Examples of low-risk sports are diving and golf; intermediate-risk sport examples are baseball and cross country; high-risk sport examples are football and wrestling.

³High-risk extracurricular activities are those in which increased exhalation occurs, such as activities that involve singing, shouting, band, or exercise, especially when conducted indoors.

5. Ventilation

Improving ventilation is an important COVID-19 prevention strategy that can reduce the number of virus particles in the air. Along with other preventive strategies, including wearing a well-fitting, multi-layered mask, bringing fresh outdoor air into a building helps keep virus particles from concentrating inside. This can be done by opening multiple doors and windows, using child-safe fans to increase the effectiveness of open windows, and making changes to the HVAC or air filtration systems.

During transportation, open or crack windows in buses and other forms of transportation, if doing so does not pose a safety risk. Keeping windows open a few inches improves air circulation.

For more specific information about maintenance, use of ventilation equipment, actions to improve ventilation, and other ventilation considerations, refer to:

• CDC’s Ventilation in Schools and Child care Programs
• CDC’s Ventilation in Buildings webpage
• CDC’s Ventilation FAQs and
• CDC’s Improving Ventilation in Your Home

Additional ventilation recommendations for different types of school buildings can be found in the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) schools and universities guidance documentpdf iconexternal icon.

Funds provided through the Elementary and Secondary Schools Emergency Relief Programs and the Governor’s Emergency Education Relief Programs can support improvements to ventilation. Please see question B-7 of the U.S. Department of Education Uses of Fundspdf iconexternal icon guidance for these programs.

6. Handwashing and Respiratory Etiquette

People should practice handwashing and respiratory etiquette (covering coughs and sneezes) to keep from getting and spreading infectious illnesses including COVID-19. Schools can monitor and reinforce these behaviors and provide adequate handwashing supplies.

• Teach and reinforce handwashing with soap and water for at least 20 seconds.
• Remind everyone in the facility to wash hands frequently and assist young children with handwashing.
• If handwashing is not possible, use hand sanitizer containing at least 60% alcohol (for teachers, staff, and older students who can safely use hand sanitizer). Hand sanitizers should be stored up, away, and out of sight of young children and should be used only with adult supervision for children under 6 years of age.

7. Staying Home When Sick and Getting Tested

Students, teachers, and staff who have symptoms of infectious illness, such as influenza (flu) or COVID-19, should stay home and be referred to their healthcare provider for testing and care. Staying home when sick with COVID-19 is essential to keep COVID-19 infections out of schools and prevent spread to others. It also is essential for people who are not fully vaccinated to quarantine after a recent exposure to someone with COVID-19. Schools should also allow flexible, non-punitive, and supportive paid sick leave policies and practices that encourage sick workers to stay home without fear of retaliation, loss of pay, or loss of employment level and provide excused absences for students who are sick. Employers should ensure that workers are aware of and understand these policies.  If a student becomes sick at school see What to do if a Student Becomes Sick or Reports a New COVID-19 Diagnosis at School. If a school does not have a routine screening testing program, the ability to do rapid testing on site could facilitate COVID-19 diagnosis and inform the need for quarantine of close contacts and isolation. Schools that do not have a universal mask requirement could require masking by students, teachers, and staff if they are experiencing onset of upper respiratory infection symptoms at school while waiting to be picked up or leave the school. Mask use could also be required prior to onsite testing (if available) and/or after diagnosis to help prevent spread.

CDC guidance provides that people who are fully vaccinated and do not have COVID-19 symptoms do not need to quarantine or get tested after an exposure to someone with COVID-19. Schools should educate teachers, staff, and families about when they and their children should stay home and when they can return to school. During the COVID-19 pandemic it is essential that parents keep children home if they are showing signs and symptoms of COVID-19 and get them tested.

Getting tested for COVID-19 when symptoms are compatible with COVID-19 will help with rapid contact tracing and prevent possible spread at schools, especially if key prevention strategies (masking and distancing) are not in use. Some localities might choose to use testing to shorten quarantine periods.

8. Contact Tracing in Combination with Isolation and Quarantine

Schools should continue to collaborate with state and local health departments, to the extent allowable by privacy laws and other applicable laws, to confidentially provide information about people diagnosed with or exposed to COVID-19. This allows identifying which students, teachers, and staff with positive COVID-19 test results should isolate, and which close contacts should quarantine. See the added exception in the close contact definition for the exclusion of students in the K-12 indoor classroom who are within 3 to 6 feet of an infected student with masking and other prevention strategies. See the Department of Education’s Protecting Student Privacy FERPA and the Coronavirus Disease 2019external icon for more information.

Schools should report, to the extent allowable by applicable privacy laws, new diagnoses of COVID-19 to their state or local health department as soon as they are informed. School officials should notify, to the extent allowable by applicable privacy laws, teachers, staff, and families of students who were close contacts as soon as possible (within the same day if possible) after they are notified that someone in the school has tested positive. Fully vaccinated people who were in close contact with someone who has COVID-19 but do NOT have COVID-19 symptoms do not need to quarantine or be tested.

9. Cleaning and Disinfection

In general, cleaning once a day is usually enough to sufficiently remove potential virus that may be on surfaces. Disinfecting (using disinfectants on the U.S. Environmental Protection Agency COVID-19 listexternal icon) removes any remaining germs on surfaces, which further reduces any risk of spreading infection.

For more information on cleaning a facility regularly, when to clean more frequently or disinfect, cleaning a facility when someone is sick, safe storage of cleaning and disinfecting products, and considerations for protecting workers who clean facilities, see Cleaning and Disinfecting Your Facility.

If a facility has had a sick person or someone who tested positive for COVID-19 within the last 24 hours, clean AND disinfect the space.

Section 2: Additional Considerations for K-12 Schools

Disabilities or Other Health Care Needs

Provide accommodations, modifications, and assistance for students, teachers, and staff with disabilities and other health care needs when implementing COVID-19 safety protocols:

• Work with families to better understand the individual needs of students with disabilities.
• Remain accessible for students with disabilities:
  • Help provide access for direct service providers (DSP) (e.g., paraprofessionals, therapists, early intervention specialists, mental health and healthcare consultants, and others). If DSPs who are not fully vaccinated provide services at more than one location, ask whether any of their other service locations have had COVID-19 cases.
  • Ensure access to services for students with disabilities when developing cohorts.
• Adjust strategies as needed
  • Be aware that physical distancing and wearing masks can be difficult for young children and people with certain disabilities (for example, visual or hearing impairments) or for those with sensory or cognitive issues.
  • For people who are not fully vaccinated and only able to wear masks some of the time for the reasons above, prioritize having them wear masks during times when it is difficult to separate students and/or teachers and staff (e.g., while standing in line or during drop off and pick up).
  • Consider having teachers and staff who are not fully vaccinated wear a clear or cloth mask with a clear panel when interacting with young students, students learning to read, or when interacting with people who rely on reading lips.
  • Use behavioral techniques (such as modeling and reinforcing desired behaviors and using picture schedules, timers, visual cues, and positive reinforcement) to help all students adjust to transitions or changes in routines.

Please see Guidance for Direct Service Providers for resources for DSPs serving children with disabilities or other health care needs during COVID-19.

Visitors

Schools should review their rules for visitors and family engagement activities.

• Schools should limit nonessential visitors, volunteers, and activities involving external groups or organizations with people who are not fully vaccinated, particularly in areas where there is moderate-to-high COVID-19 community transmission.

• Schools should not limit access for direct service providers, but can ensure compliance with school visitor polices.

• Schools should continue to emphasize the importance of staying home when sick. Anyone, including visitors, who have symptoms of infectious illness, such as flu or COVID-19, should stay home and seek testing and care.

Food Service and School Meals

• Maximize physical distance as much as possible when moving through the food service line and while eating (especially indoors). Using additional spaces outside of the cafeteria for mealtime seating such as the gymnasium or outdoor seating can help facilitate distancing. Note: students, teachers, and staff who are fully vaccinated do not need to distance while eating.
• Given very low risk of transmission from surfaces and shared objects, there is no need to limit food service approaches to single use items and packaged meals.
• Clean frequently touched surfaces. Surfaces that come in contact with food should be washed, rinsed, and sanitized before and after meals.
• Promote hand washing before, after, and during shifts, before and after eating, after using the toilet, and after handling garbage, dirty dishes, or removing gloves.
• Improve ventilation in food preparation, service, and seating areas.
• U.S. Department of Agriculture has issued several Child Nutrition COVID-19 Waivers. Learn more hereexternal icon.

Recess and Physical Education

In general, people do not need to wear masks when outdoors (e.g., participating in outdoor play, recess, and physical education activities). However, particularly in areas of substantial to high transmission levels, people who are not fully vaccinated are encouraged to wear a mask in crowded outdoor settings or during activities that involve sustained close contact with other people who are not fully vaccinated. When physical education activities or recess are held indoors, it is particularly important for people who are not fully vaccinated to wear masks and maximize distance when possible.

Sports and Other Extracurricular Activities

School-sponsored sports and extracurricular activities provide students with enrichment opportunities that can help them learn and achieve, and support their social, emotional, and mental health. People who are fully vaccinated no longer need to wear a mask or physically distance in any setting, including while participating in sports and extracurricular activities. People who are fully vaccinated can also refrain from quarantine following a known exposure if asymptomatic, facilitating continued participation in in-person learning, sports, and extracurricular activities. Due to increased exhalation that occurs during physical activity, some sports can put players, coaches, trainers, and others who are not fully vaccinated at increased risk for getting and spreading COVID-19. Close contact sports and indoor sports are particularly risky. Similar risks might exist for other extracurricular activities, such as band, choir, theater, and school clubs that meet indoors.

Prevention strategies for those who are not fully vaccinated in these activities remain important and should comply with school day policies and procedures. Students should refrain from these activities when they have symptoms consistent with COVID-19 and should be tested. Students who are not fully vaccinated and participate in indoor sports and other higher-risk activities should continue to wear masks and keep physical distance as much as possible. Schools should consider using screening testing (Table 1) for student athletes and adults (e.g., coaches, teachers, advisors) who are not fully vaccinated who participate in and support these activities to facilitate safe participation and reduce risk of transmission – and avoid jeopardizing in-person education due to outbreaks.

Coaches and school sports administrators should also consider specific sport-related risks for people who are not fully vaccinated:

• Setting of the sporting event or activity. In general, the risk of COVID-19 transmission is lower when playing outdoors than in indoor settings. Consider the ability to keep physical distancing in various settings at the sporting event (i.e., fields, benches/team areas, locker rooms, spectator viewing areas, spectator facilities/restrooms, etc.).
• Physical closeness. Spread of COVID-19 is more likely to occur in sports that require sustained close contact (such as wrestling, hockey, football).
• Number of people. Risk of spread of COVID-19 increases with increasing numbers of athletes, spectators, teachers, and staff.
• Level of intensity of activity. The risk of COVID-19 spread increases with the intensity of the sport.
• Duration of time. The risk of COVID-19 spread increases the more time athletes, coaches, teachers, staff and spectators spend in close proximity or in indoor group settings. This includes time spent traveling to/from sporting events, meetings, meals, and other settings related to the event.
• Presence of people more likely to develop severe illness. People at increased risk of severe illness might need to take extra precautions.

Section 3: School Workers

Workers at increased risk for severe illness from COVID-19 include older adults and people of any age with certain underlying medical conditions if they are not fully vaccinated. Workers who have an underlying medical condition or are taking medication that weakens their immune system may NOT be fully protected even if fully vaccinated and may need to continue using additional prevention measures. Policies and procedures addressing issues related to workers at higher risk of serious illness should be made in consultation with occupational medicine and human resource professionals, keeping in mind Equal Employment Opportunity concerns and guidanceexternal icon. Employers should also understand the potential mental health strains for workers during the COVID-19 pandemic. CDC recommends that school  administrators should educate workers on mental health awareness and share available mental health and counseling services. Employers should provide a supportive work environment for workers coping with job stress and building resilience, and managing workplace fatigue.

As part of each school’s response plan, administrators should conduct workplace hazard assessmentsexternal icon periodically to identify COVID-19 transmission risks and prevention strategies, when worksite conditions change, or when there are instances of COVID-19 transmission within the workplace. Strategies to prevent and reduce transmission are based on an approach that prioritizes the most effective practices, known as the hierarchy of controls. School employers should engage and train all workers on potential workplace hazards, what precautions should be taken to protect workers, and workplace policies for reporting concerns. Schools should ensure communication and training for all workers are frequent and easy to understand. Additionally, schools should ensure communication and training are in a language, format, and at a literacy level that workers understand.

Workers in K-12 have the right to a safe and healthful workplace. The Occupational Safety and Health Administration (OSHA) has issued Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplaceexternal icon. This guidance contains recommendations to help employers provide a safe and healthy workplace free from recognized hazards that are causing, or are likely to cause, death or serious physical harm. It also contains descriptions of mandatory safety and health standards. If a worker believes working conditions are unsafe or unhealthful, they or a representative may file a confidential safety and health complaintexternal icon with OSHA at any time. In states where public sector employers and workers are not covered by OSHA-approved State Plans,external icon there may be agencies that provide public worker occupational safety and health protections and enforce such workers’ rights to safe workplaces. Workers should contact state, county, and/or municipal government entities to learn more.

Appendix 1: Planning and Preparing

Emergency Operations Plans

Each school district and school should have an Emergency Operations Plan (EOP) in place to protect students, teachers, staff, and families from the spread of COVID-19 and other emergencies. The EOP should:

• Describe COVID-19 prevention strategies to be implemented.
• Describe steps to take when a student, teacher, or staff member has been exposed to someone with COVID-19, has symptoms of COVID-19, or tests positive for COVID-19.
• Document policy or protocol differences for people who are fully vaccinated for COVID-19 versus those who are not fully vaccinated.
• Be developed in collaboration with regulatory agencies and state, local, territorial, and tribal public health departments, and comply with state and local licensing regulations.
• Be developed with involvement of teachers, staff, parents and guardians, and other community partners (for example, health centers).
• Utilize the Whole School, Whole Community, Whole Child (WSCC) model to outline EOP policies and protocols across each component. Tools and resourcesexternal icon from the U.S. Department of Education can be used by K-12 administrators to develop and update their EOP.

New COVID-19 Variants and Prevention in K-12 Schools

New variants of the virus that causes COVID-19 are spreading in the United States. Current data suggest that COVID-19 vaccines authorized for use in the United States offer protection against the circulating variants. CDC will continue to monitor variants to see if they have any impact on prevention strategies and how COVID-19 vaccines work in real-world conditions and will update guidance accordingly. For more information see CDC’s webpage on the effectiveness of COVID-19 vaccines.

Vaccination Verification

Existing laws and regulations require certain vaccinations for children attending school. K-12 administrators regularly maintain documentation of people’s immunization records.  Since recommended prevention strategies vary by COVID-19 vaccination status, K-12 administrators who maintain documentation of students’ and workers’ COVID-19 vaccination status can use this information, consistent with applicable laws and regulations, including those related to privacy, to inform masking and physical distancing practices, testing, contact tracing efforts, and quarantine and isolation practices. Schools that plan to request voluntary submission of documentation of COVID-19 vaccination status should use the same standard protocols that are used to collect and secure other immunization or health status information from students. The protocol to collect, secure, use, and further disclose this information should comply with relevant statutory and regulatory requirements, including Family Educational Rights and Privacy Act (FERPA) statutory and regulatory requirements. Policies or practices related to providing or receiving proof of COVID-19 vaccination should comply with all relevant state, tribal, local, or territorial laws and regulations.

As part of their workplace COVID-19 vaccination policy, schools should recognize that a worker who cannot get vaccinated due to a disability (covered by the ADA), has a disability that affects their ability to have a full immune response to vaccination, or has a sincerely held religious belief or practice (covered by Title VII of the Civil Rights Act of 1964) may be entitled to a reasonable accommodation that does not pose an undue hardship on the operation of the employer’s business. Additionally, school employers should advise workers with weakened immune systems about the importance of talking to their healthcare professional about the need for continued personal protective measures after vaccination. Currently, CDC recommends continued masking and physical distancing for people with weakened immune systems. For more information on what you should know about COVID-19 and the ADA, the Rehabilitation Act and other Equal Employment Opportunity Laws visit the Equal Employment Opportunity Commissionexternal icon website.

Appendix 2: Testing Strategies for COVID-19 Prevention in K-12 Schools

Testing Benefits

School testing gives communities, schools, and families added assurance that schools can open and remain open safely for all students. By identifying infections early, testing helps keep COVID-19 transmission low and students in school for in-person learning, sports, and extracurricular activities. Screening testing is likely to be most feasible in larger settings and for older children and adolescents.

Collaboration between Education and Public Health

Before implementing COVID-19 testing in their schools, K–12 school leaders should coordinate with public health officials to develop a testing plan and build support from students, parents, teachers, and staff and must, if their school receives funding under a program administered by the Department of Education, develop and adopt policies in consultation with parents regarding the administration of such screening testing to students. COVID-19 testing introduces challenges that schools may not have considered in the past (for example, requirements to perform on-site tests and to refer people for confirmatory testing), and public health officials can provide guidance on federal, state, and local requirements for implementing testing. Both school leaders and public health officials should assure the testing plan has key elements in place, including:

• Protocols for screening testing frequency based on community transmission rates, vaccination levels, and prevention strategies implemented at the school.
• Protocols for providing or referring to diagnostic testing for students, teachers, and staff who come to school with symptoms and for students, teachers, and staff who are not fully vaccinated following exposure to someone with COVID-19.
• Physical space to conduct testing safely and privately.
• Ability to maintain confidentiality of results and protect student, teacher, and staff privacy.
• Ways to obtain parental consent for minor students and assent/consent for students themselves.
• A mechanism to report all testing results, to the extent allowable by or consistent with applicable federal, state, or local laws and regulations, including privacy laws such as FERA, as required by the state or local health department.
• Roles and responsibilities for contact tracing for each party, including identification of close contacts.

If these elements are not in place, schools may consider referring students, teachers, and staff to community-based testing sitesexternal icon.

Collaboration among local counsel, education, and public health is recommended to ensure appropriate consent is obtained and maintained and results are maintained, used, and further disclosed with appropriate privacy and confidentiality in accordance with the Americans with Disabilities Act (ADA)external icon,  Family Educational Rights and Privacy Act (FERPA)external icon, the Protection of Pupil Rights Amendment (PPRA)external icon, and other applicable laws and regulations. School administrators who have questions about FERPA (or PPRA) may contact the Department of Education’s Student Privacy Policy Office (SPPO) at https://studentprivacy.ed.govexternal icon.

Testing Strategies

Schools may consider testing a random sample of at least 10% of students who are not fully vaccinated or may conduct pooled testing for COVID-19. Random sampling can reduce costs and eliminate bias in the testing design but may require more logistics and planning. Pooled testing increases the number of people who can be tested at once and reduces testing resources used. Pooled testing works best when the number of positives is expected to be very low. Ideally, specimens should be pooled at the laboratory rather than in the classroom.  If the pooled test result is positive, each of the samples in the pool will need to be tested individually to determine which samples are positive. This allows for faster isolation of cases and quarantine of close contacts.

More frequent testing may be needed for students, teachers, staff, and adult volunteers who are not fully vaccinated and engaged in school athletics and other extracurricular activities. Testing at least once per week is recommended for high-risk sports and extracurricular activities (those that cannot be done outdoors or with masks) at all community transmission levels. In areas of substantial-to-high community transmission levels, testing twice per week is recommended for participation in these activities. Additionally, if the school is not tracking COVID-19 vaccination status of participants and support teacher and staff screening testing should be encouraged.

Fully vaccinated students, teachers, and staff with no COVID-19 symptoms do not need to be tested following an exposure to someone with COVID-19. People who have tested positive for COVID-19 within the past 3 months and recovered do not need to get tested following an exposure as long as they do not develop new symptoms. Any fully vaccinated person who experiences symptoms consistent with COVID-19 should isolate themselves from others, be clinically evaluated for COVID-19, and tested for SARS-CoV-2 if indicated.

People with COVID-19 have reported a wide range of symptoms from no or mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the SARS-CoV-2 virus. Because some of the symptoms of flu, common cold, and COVID-19 are similar, it is hard to tell the difference between them based on symptoms alone. Testing can help confirm a diagnosis, and inform medical treatment and care. Also, testing will confirm the need to isolate from others for at least 10 days and quarantine close contacts.

Choosing a Test

When considering which tests to use for screening testing, schools or their testing partners should choose tests that can be reliably supplied and provide results within 24 hours. If available, saliva tests and nasal tests that use a short swab may be more easily implemented and accepted in schools. A viral test tells a person if they have a current infection. Two types of viral tests can be used: nucleic acid amplification tests (NAATs) and antigen tests. Frequency of testing should be determined by the performance characteristics of the test being used. The intended use of each test, available in the Instructions for Use and in the Letter of Authorization for each test, defines the population in which the test is intended to be used, the acceptable specimen types, and how the results should be used.

Reporting Results

Schools performing on-site tests (i.e., that are not sent to a laboratory) must apply for a Clinical Laboratory Improvement Amendments (CLIA)external iconcertificate of waiver, and report test results to the extent allowable by or consistent with applicable privacy laws to state or local public health departments and as may be mandated by the Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116-136pdf iconexternal icon). Schools should work closely with their local health department when establishing on-site testing so that their performance of CLIA-waived or FDA-authorized point-of-care tests for SARS-CoV-2 is done in accordance with regulations and should work closely with local counsel to ensure the reporting of test results is done in accordance with applicable privacy laws and regulations.

Parents, guardians, and caregivers should be asked to report new diagnoses of COVID-19 to schools and public health authorities to facilitate contact tracing and communication planning for cases and outbreaks. In addition, school administrators should notify teachers, staff, families, and emergency contacts or legal guardians immediately of any case of COVID-19 while maintaining confidentiality in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAAexternal icon), the Americans with Disabilities Act (ADAexternal icon), the Family Educational Rights and Privacy Act (FERPAexternal icon) and other applicable laws and regulations. Notifications must be accessible for all students, teachers, and staff, including those with disabilities or limited English proficiency (for example, through use of interpreters or translated materials).

Ethical Considerations for School-Based Testing

• Testing should be conducted with informed consent from the person being tested (if an adult) or the person’s parent or guardian (if a minor), consistent with applicable state laws related to consent. Informed consent requires disclosure, understanding, and free choice, and is necessary for teachers, staff (who are employees of a school) and students’ families, to act independently and make choices according to their values, goals, and preferences.
• Consider distributing consent forms with the other paperwork for returning to school and making them easily accessible.
• Differences in position and authority (i.e., workplace hierarchies), as well as employment and educational status, can affect a person’s ability to make free decisions. CDC provides guidance and information related to consent for COVID-19 testing among employees.
• The benefits of school-based testing need to be weighed against the costs, inconvenience, and feasibility of such programs to both schools and families. These challenges must be considered carefully and addressed as part of plans for school-based testing developed in collaboration with public health officials. The burden of testing is likely to be higher for younger children and therefore screening testing may be more feasible and acceptable for older children and adolescents.

Resources to Support School Screening Testing Programs

• CDC ELC Cooperative Agreement Reopening Schools Awardpdf icon provides $10 billion to support COVID-19 screening testing in schools for safe, in-person learning.
• COVID-19 Testing and Diagnostics Working Group | HHS.govexternal icon develops testing-related guidance and provides tailored or focused investments to expand the available testing supply and maximize testing capacity.
• Increasing Community Access to Testingexternal icon provides COVID-19 testing resources and support to underserved school districts.
• Operation Expanded Testing expands national COVID-19 testing capacity and support for K-8 schools and groups at higher risk of COVID-19 through three regional hubs:
  • Northeast and Southexternal icon
  • Midwestexternal icon
  • Westexternal icon
• National Institutes of Health RADx Initiativeexternal icon rapidly scales up testing across the country to enhance access to those most in need and provides a When to Testexternal icon impact calculator which illustrates how different mitigation strategies can minimize the spread of COVID-19.
• Shah Family Foundation Open and Safe Schoolsexternal icon toolkit provides school leaders resources and tools to implement COVID-19 screening testing.
• Rockefeller Foundation has created a playbookexternal icon with detailed, step-by-step guidance to help design and implement effective testing programs in schools. It addresses the operational challenges and everyday realities of implementing a complex, logistical program in an easy-to-understand, practical guide.
• The U.S. Department of Education’s COVID-19 Resources for Schools, Students, and Familiesexternal icon provides up-to-date guidance and policies to support life-long learning while addressing challenges presented by COVID-19.