Infectious Disease Prevention for Schools and Early Childcare Programs

Updates as of June 5, 2023:

On May 11th, 2023, the federal COVID-19 public health emergency declaration ended

COVID-19 Community Levels have been replaced with COVID-19 hospital admission levels to guide prevention measures

COVID-19 is no longer an individually reportable condition, although schools and early childcare programs should continue to report COVID-19 outbreaks and/or clusters of cases of concern

The following guidance is for respiratory infections including influenza, respiratory syncytial virus (RSV), and COVID-19

The Delaware County Health Department (DCHD) is committed to the health and safety of the families and staff members in schools and childcare environments. Our role as a health department is to offer support and resources for these organizations to adopt as part of their facility health and safety plans for prevention and mitigation of disease transmission. The following is information based on the most recent Centers for Disease Control and Prevention (CDC) and Commonwealth of Pennsylvania guidance. Schools and daycare programs should put in place a core set of infectious disease prevention strategies as part of their normal operations.

Each school district and/or childcare program will develop their own health and safety policy and protocols to share with their families. DCHD is available for technical assistance as facilities develop and update their plans, and for support during disease clusters or outbreaks. The information on this page is best practice guidance for school districts and childcare programs when creating and updating their health and safety plans. As conditions evolve, DCHD will continue to update this information.

I. Respiratory Illness Reporting, Surveillance, & Mitigation Strategies in Schools and Early Childcare Education (ECE) Programs

1. DCHD aligns with CDC’s Operational Guidance for K-12 Schools and Early Education Programs to Support In-Person Learning.
2. DCHD is available for consultation to Delaware County K-12 Schools and ECE programs that identify a significant increase in cases or an outbreak of respiratory illness. During times of significant increase in cases or outbreaks, K-12 Schools and ECE programs should consider the following prevention strategies:
   1. Encouraging staff and families to stay up-to-date on vaccinations
   2. Encouraging everyday prevention including staying home when sick, getting tested, improving ventilation, hand hygiene, respiratory etiquette, and cleaning and disinfection.
   3. Communication with the school/program community
   4. “Masking Sprint” for a week (5 days) for the outbreak setting, e.g., per Children’s Hospital of Philadelphia, Policy Lab, Guidance for Updated COVID-19 School Mitigation Plans for Academic Year 2022-23
   5. Temporarily stopping high-risk activities
3. For additional guidelines for ECE Programs see PA Department of Education - Office of Child Development and Early Learning (OCDEL) and Early Learning Resource Center Region 15.
4. Delaware County K–12 schools and early childcare programs should report respiratory illness including influenza, RSV, and COVID-19 outbreaks to DCHD via DCHDinfectioncontrol@co.delaware.pa.us or are also welcome to reach DCHD through our 24 hour wellness line (484-276-2100, DelcoWellness@co.delaware.pa.us).

II. Respiratory Illness Outbreaks in K-12 Schools and ECEs

1. While individual cases of respiratory illness (including COVID-19) do not need to be reported to DCHD, outbreaks should be reported. An outbreak can be defined as the following:
   1. Two or more staff or students with the same confirmed respiratory illness (e.g., flu, RSV, or COVID-19) within a 7-day period who share a classroom, wing, or attended a group activity together -OR-
   2. The facility has a high level of respiratory infections which are impacting staffing/absenteeism, spreading rapidly, or causing severe disease.

III. COVID-19 Levels in the County

1. Protection against COVID-19 is essential in school and childcare settings. CDC encourages schools and childcare programs to follow prevention steps based on CDC’s hospital admission levels for Delaware County.
2. Schools and childcare programs can stay up to date with Delaware County hospital admission levels through the CDC webpage:
   1. At all COVID-19 hospital admission levels:
      1. Stay up to date with COVID-19 vaccines.
      2. Get tested if you have symptoms.
   2. When the COVID-19 hospital admission level is Medium or High:
      1. If you are at high risk for severe illness, talk to your healthcare provider about whether you need to wear a mask and take other precautions.
      2. Stay up to date with COVID-19 vaccines.
      3. Get tested if you have symptoms.
   3. When the COVID-19 hospital admission level is high:
      1. Wear a mask indoors in public.
      2. Stay up to date with COVID-19 vaccines.
      3. Get tested if you have symptoms.
      4. Additional precautions may be needed for people at high risk for severe illness.

IV. Vaccine Information

1. Promoting vaccination within communities is one of the most important strategies for reducing the transmission of infectious diseases, including COVID-19.
2. Those who are up to date on their vaccinations are at a reduced risk of experiencing severe illness or death. Vaccinated people can still be infected and spread the virus to others, but symptoms tend to be milder.
   1. Vaccinations are available throughout Delaware County - visit Vaccines.gov or the Delaware County COVID 19 vaccination website for more information

V. COVID-19 Testing Information

1. It is still important to get tested if a person has symptoms or has possibly been exposed to COVID-19 to continue to limit transmission in school communities.
   1. Maintaining the capacity to test symptomatic students at school as needed is a helpful mitigation strategy. In school testing can also help mitigate exposures related to extracurricular activities involving transportation and/or overnight travel.
   2. At a high COVID-19 Hospital Admission Level, schools and childcare settings can consider implementing screening testing for students and staff for high-risk activities (for example, close contact sports, band, choir, theater); at key times in the year, for example before/after large events (such as prom, tournaments, group travel); and when returning from breaks (such as, holidays, spring break, at the beginning of the school year). In any screening testing program, testing should include both vaccinated and unvaccinated people.
2. More information about COVID-19 testing can be found on the PA DOH and Delaware County Department of Health webpages.

VI. Mitigation Strategies & Best Practices

1. Ventilation
   1. Ventilation is one component of maintaining healthy environments and is an important COVID-19 prevention strategy for schools and early childcare programs.
   2. Ventilation in facilities can reduce the number of viral particles in the air. Opening doors and windows (when possible) can allow for fresh air to circulate the building, creating better ventilation throughout the facility. Child-safe fans may also help to circulate air throughout the facility. In school transportation vehicles, opening the windows a few inches (when safe to do so) can help to circulate air through the vehicle. More information, including an Interactive School Ventilation Tool, is available on the CDC’s website.
   3. When illness levels increase or in response to an outbreak, schools and childcare programs can take additional steps to increase outdoor air intake and improve air filtration. Schools and childcare programs may also consider holding some activities outside if feasible when the COVID-19 Hospital Admission Level is high.
2. Staying Home When Sick
   1. Staying home when sick can lower the risk of spreading infectious diseases, including COVID-19, to other people. People who have symptoms of respiratory or gastrointestinal infections, such as cough, fever, sore throat, vomiting, or diarrhea, should stay home.
   2. In accordance with applicable laws and regulations, schools and early childcare programs should allow flexible, non-punitive, and supportive paid sick leave policies and practices.
   3. Schools should also provide excused absences for students who are sick, avoid policies that incentivize coming to school while sick, and support children who are learning at home if they are sick.
3. Cleaning and Maintaining Facilities
   1. Cleaning surfaces once a day is typically adequate to remove viruses. Using approved disinfectants will reduce the risk of transmission of infection.
   2. Information on EPA-approved products suitable for cleaning schools is available on EPA’s website.
   3. More information about cleaning and maintaining facilities can be found on the CDC webpage.

Additional Resources

Influenza Quicksheet | DCHD
Infectious Disease Prevention for Schools and Early Childcare Programs | DCHD
RSV (Respiratory Syncytial Virus) | CDC
Protect Your Child from RSV Infographic | CDC
RSV in Infants and Young Children (cdc.gov)
Flu Childcare (pa.gov
Information for Schools & Childcare Providers | CDC
Guidance for School Administrators to Help Reduce the Spread of Seasonal Influenza in K-12 Schools | CDC
Operational Guidance for K-12 Schools and Early Care and Education Programs to Support Safe In-Person Learning | CDC
Isolation and Precautions for People with COVID-19 | CDC
Symptoms of COVID-19 | CDC
COVID-19 Testing: What You Need to Know | CDC
Stay Up to Date with COVID-19 Vaccines | CDC
When and How to Clean and Disinfect a Facility | CDC
Improving Ventilation In Buildings | CDC

Last Updated: June 6, 2023

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For more information and assistance, the Delaware County Health Department Wellness Line is available 24 hours a day, 7 days a week. In addition to responding to phone calls, the Wellness Line also responds to email inquiries.

Phone: (484) 276-2100 (Available 24/7)
Email: DelcoWellness@co.delaware.pa.us