Vermont Agency of Education With testing no longer a first-line strategy for COVID-19 prevention in Vermont, school nurses should revisit their pre-COVID-19 school sickness policies. This is an opportunity to identify possible improvements based upon lessons learned during the COVID-19 pandemic, keeping in mind public health principles in the prevention of all respiratory diseases. Good communication with pediatric medical homes in your district is paramount to the success of implementing these illness policies. Aligning your approach with local medical practices will promote better outcomes.
COVID-19 Sickness Policy Considerations for Fall 2022
• If the student or staff member is presenting with mild symptoms, the decision to test or return to class should be made by the school nurse based upon their clinical decision-making. Mild respiratory disease symptoms include runny nose or nasal congestion, minimal cough, and absence of fever in an individual with no current or recent household exposure to Covid-19.
• If a student or staff member is not well enough to learn or participate, regardless of whether they are tested for COVID-19, they should be sent home from school. A student who is being sent home due to illness may be required to wear a mask while awaiting pick-up. The decision to require masking should be made by the school nurse based on clinical decision-making. They may return to school if their symptoms have improved, and they meet school criteria for their illness. COVID-19 testing should not be required for symptomatic students or staff to return to school.
• If a student or staff member has confirmed COVID-19, they should follow the Vermont Department of Health isolation guidance.
• Schools should continue to have access to isolation spaces if a student needs to isolate due to illness. When able to do so, an isolation space should have a door and allow for ventilation to the outside. This space serves as an extension of a Health Office to accommodate symptomatic students and staff as they wait to go home to minimize the spread of infection among school health personnel, students, and staff.
• School nurses should follow best practices for infection control. CDC Standard Precautions are the minimum infection prevention practices that apply to all settings providing direct care, regardless of suspected or confirmed infection status of the person. This includes the school health office where healthcare is delivered. These practices are designed to minimize the spread of infection among school health personnel, students, and staff.
• SU/SDs or schools may consider identifying a school nurse leader to establish, review, and implement health and safety protocols. School nurse leaders are qualified to interpret guidelines and ensure they are implemented to the best standard of practice, while working with administrators, teachers, paraeducators, custodians, and other critical school staff to ensure the safety and health of the school.
• Recommend that students and staff keep up to date on all vaccinations.
• Encourage good respiratory hygiene practice. The CDC has published this resource which can be used to promote respiratory hygiene. Staff and students should be permitted to exercise their own or their family’s decision-making to wear a mask in school settings.
• Encourage frequent and thorough hand washing using soap and water or hand sanitizer with at least 60% alcohol (soap and water are preferred when hands are visibly dirty) to prevent the spread of communicable diseases. When done correctly, hand washing will help students, school staff, and visitors avoid spreading and receiving germs.
COVID-19 Testing Recommendations for Fall 2022
• Antigen and LAMP tests should be used exclusively for symptomatic students and staff; school nurses should use their clinical judgment in determining when to use tests in schools. COVID-19 testing should not be required for symptomatic students or staff to stay at or return to school. Schools will require consent from families to do in-school testing.
• Tests can be administered in school or be sent home for symptomatic students and staff.
• If an antigen test is negative, and the student or staff member is presenting with mild symptoms that may be attributable to another diagnosis, the student or staff member may return to class. This decision should be made by the school nurse based on clinical decision-making. A second test should be sent home with the student or staff member so it can be repeated before the start of school the next day. Testing is not required to attend school.
• A LAMP test can be used on a student or staff member if two or more antigen tests are negative, and the individual remains symptomatic.
• Antigen tests may be sent home to families of symptomatic students and staff; school nurses should use their clinical judgment in determining when to dispense tests home. Fewer LAMP tests will be distributed to schools, so these tests should be reserved for in-school student or staff member use only.
• If a public or independent school requires additional tests to meet the needs of symptomatic students and staff, they may order more through the AOE website.
Source: Vermont Agency of Education