CDC Updates Guidance for Schools, Setting A Clear Path for Reopening

On Friday, February 12, the Centers for Disease Control (CDC) finally published their updated guidance on how to reopen schools safely. The data-driven document provides guidance on mitigation strategies like wearing masks, social and physical distancing, ventilation needs, and contact tracing, among other important aspects of keeping COVID-19 at bay.

The document focuses largely on the mitigation strategies needed as part of an approach to re-open schools safely, and how to layer those strategies. It goes further than the July guidance and also provides a chart that categorizes COVID-19 by color and provides mitigation strategies recommended by which zone the schools are in, vaccination guidance, screening testing guidelines, and more.

At a time when Biden’s plan to reopen schools within 100 days feels more pipe dream than reality, the guidance is a necessary step forward in the nationwide reopening push he’s been calling for, alongside billions in dollars to school districts to actually make what the CDC asks for possible. Let’s get into the “essential elements” of the document.

Clear Guidance on Maskwearing, Handwashing, Etc.

The document says that there are five essential and necessary mitigation strategies that need to be followed in schools that reopen to in-person learning: mask-wearing (universally and correctly), physical distancing of at least six feet or more, handwashing, and what they refer to as “respiratory etiquette” (Don’t cough on people, people), and cleaning schedules and contact tracing.

Mask wearing is probably the most important and meaningful way to limit the spread of COVID-19 besides physical distancing, and the CDC guidance says that it’s totally necessary, even in areas where there is low community transmission. Physical distancing is also heavily leaned upon. “Cohorting or podding is recommended to minimize exposure across the school environment,” the document reads. Cohorting is a commonly accepted and utilized practice in schools that are open because it limits COVID outbreaks to small groups of people within the building.

A Helpful Color-Coded Community Transmission Rate Risk Chart

The CDC suggests in their guidance that school administrators should work with public health officials to address the COVID-19 risk within the communities that they operate. Two measures of community burden will or should be utilized to determine the risk of transmission: the total number of new cases per 100,000 people in the past week and the percentage of COVID-19 tests, specifically the NAAT test, that has been positive in the past week.

The CDC will rank opening/closing risk on a colored chart. The color-coded chart was created to guide schools on what mitigation strategies they need to employ from screening testing to physical distancing to being open at all based on positivity rates. Low transmission is “blue” and means there have only been 0-9 new cases per 100,000 people in the last week and less than 5 percent of tests have come up positive. Moderate transmission is “yellow” and accounts for 10-49 cases per 100,000 people with a positivity NAAT test rate of 5-7.9 percent. Substantial transmission is “orange” and is 50-99 total new cases per 100,000 people in 7 days and a percentage of 8-9.9 percent of positive tests. High transmission is “red” and is when over 100 new cases per 100,000 people have occurred over the last 7 days and if over 10 percent of tests are positive.

The CDC suggests that “blue” and “yellow “schools should consider reopening for full-time, in-person learning. Schools with the “orange” transmission rate should still consider reopening with an extra focus on mitigation strategies and in “red” transmission communities, only elementary schools are recommended to consider reopening, whereas the CDC suggests that middle and high school students should stay home.

In terms of community transmission, the document states some of the obvious: “If community transmission is high, but school and community mitigation strategies are implemented and strictly followed as recommended, then the risk of transmission of SARS-CoV-2 in a school will decrease.”

Genuine Guidance on Mitigation Strategies — and When They’re Needed

While the document might sound vague, it’s actually the clearest guidelines yet for schools across the country as they navigate several realities, like the lack of ability to physically distance or poor ventilation systems or even how important cleaning might be.

For example, physical distancing isn’t as important (but should still be followed) in “blue” low-transmission schools — whereas, in “red” high-transmission communities, it is non-negotiable. Similarly, podding and cohorting are recommended in “yellow,” “orange,” and “red” zones to make testing and contact tracing easier.

The CDC says schools should prioritize in-person learning over sports and school events and that research show so far that since younger children (elementary school students) appear to carry COVID less, their schools should remain open due to lessened risk compared to middle and high school students.

The CDC also suggests that schools provide flexibility to students who may be immunocompromised or live with people who are immunocompromised and give them access to remote learning, that schools that are at more severe risk of widespread learning loss be prioritized in reopening, and that schools should always keep students with disabilities at top of mind when building their reopening plans.

A Testing Plan

The CDC suggests that schools should offer testing to anybody who works at the school or any student when they exhibit symptoms of COVID-19 and should conduct contact tracing whenever a student or staffer does get sick. School nurses can be deputized to test on campus and should be equipped with proper PPE. The CDC guides schools to work with public health officials on what to do when a positive test does come up at their school and advises positive people to quarantine at home.

The CDC also brings up screening testing — which can be used to identify asymptomatic people or to nip an outbreak before it begins. They define it as yet another mitigation strategy alongside mask-wearing, washing hands, etc, and specifically recommend it at “yellow,” “orange,” and “red” community transmission areas regardless of symptoms. The CDC also recommends it for asymptomatic teachers and staff at schools in the “blue” zone. The results must be reported to the public health officials and the testing should be offered on a voluntary basis with the consent of a parent or legal guardian.

Real Guidance on Vaccines for Teachers

The CDC officially placed teachers and school staff as group 1b in the vaccination priority line — making them frontline essential workers. That being said, the CDC doesn’t go further in the document than to say that “state, territorial, local and tribal officials should consider giving high priority to teachers in early phases of vaccine distribution” and point out the fact that frontline essential workers should be prioritized for vaccine allocations in phase 1b after health care workers and long-care facility residents.

They also call vaccination of teachers and staff yet another part of the layer of mitigation strategies that can help both students and teachers work more safely. That being said, the CDC held strong on a previous statement that “access to vaccination should not be considered a condition for reopening schools for in-person instruction,” and that even after teachers and staff are vaccinated “schools need to continue mitigation measures for the foreseeable future.”

It’s possible that the vaccination line will get the most attention out of the CDC guidelines and may be what teacher’s unions struggle with the most. Understandably, they want teachers to be as protected as possible and might consider it an essential mitigation strategy alongside other measures like cohorting, mask-wearing, distancing, and increased ventilation.