August 12, 2020
Updated Oct. 21, 2020
Please note schools are required to adhere to the NYSDOH guidance (attached hereto)
Q1: When and how should we report positive COVID-19 cases to OCDOH?
A .Immediately notify OCDOH if a student, faculty, staff member or volunteer tests positive for COVID-19 at 845-291-2330, 24 hours a day/ 7 days a week.
The OCDOH will maintain a list with contact information for two point of contact individuals within each school (1 school nurse and 1 administrator) to discuss issues pertaining to COVID-19. Please provide that updated information to firstname.lastname@example.org
Q2. Are schools responsible for contact tracing for students, faculty and staff?
A. Contact tracing is an important component to reduce the spread of COVID-19. Effective contact tracing is a joint collaborative effort which will require the assistance of schools in providing staff and student lists, schedules, and other information to identify exposed individuals. Hence, it is imperative to confidentially maintain sign in logs with full contact information (name, address, phone number, e-mail address) of all individuals presenting to any of the facilities. See attachment for an example sign-in Jog and a copy of the Orange County contact tracing spreadsheet for schools.
Q3. Will contact tracers release the name of the positive individual to their contacts?
A. No. Contact tracers will tell potentially infected persons that they were exposed. They will not disclose the identity of the person to whom they were exposed.
Q4. How long will contacts to positive COVID-19 cases be required to quarantine?
A. Individuals who are exposed to someone with COVID-19 will be required to quarantine for 14 days from the day they were last exposed. Please note that a negative test does not release an individual from quarantine.
Q5. When should an exposed individual get tested for COVID-19?
A. Testing after exposure is a decision between the individual and their primary care provider (PCP). The exposed individual must contact their PCP to schedule testing. Exposed individuals must remain on quarantine until being tested and must immediately return to quarantine following such testing. If a person tests positive, they will be placed in isolation (for a period determined by the OCDOH). Even if the test is negative, the individual must continue to quarantine for the full 14 days.
Q6. Where can students, faculty and staff get tested for COVID-19?
A. Students, families, faculty and staff are encouraged to contact their primary care provider (PCP) first to schedule testing, in order to preserve the continuity of care.
A list of testing sites can be found on the OCDOH health website found here:
https://www.orangecountygov.com/1949/Anti-Body-Testing or by calling the Orange County COVID-19 Hotline at 845-291-2330.
Students, families, faculty and staff can also download the Orange County NY Health mobile app available free of charge from the Google Play/Android and Apple app stores.
Students, families, faculty and staff can also call the NYSDOH COVID Hotline at 1-888-364-3065 for assistance locating a testing site.
Q7. ls there a charge for COVID-19 tests?
A. Insurance information may be requested at some testing facilities including healthcare provider offices and pharmacies. There is no out-of-pocket-charge for COVID-19 tests conducted at state-run facilities. The closest state-run facility is Rockland Anthony Wayne Recreational Area Palisades Parkway located at Palisades Interstate Pkwy Exit 17, Bear Mountain, NY 10911. More information can be found here: https ://coronavirus.health. ny. gov/find-test-site-near-you.
Q8. When can a person who has tested positive return to school? Is it the same process for students, faculty and staff?
A. An individual who tested positive must obtain written clearance from their primary care provider (PCP), that complies with CDC guidance for the return to school of students, faculty, and staff following illness or diagnosis of a confirmed case of COVID-19 clearance criteria include but may not be limited to the following CDC guidelines: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html.
Q9. Can we assume that students with antibodies are safe from contracting COVID-19?
A. No. We do not have enough information about whether antibodies protect individuals from re-infection and how long antibodies may provide protection. Antibody tests also CANNOT diagnose if an individual has active infectious COVID-19. A positive result can mean you had infection with COVID-19 in the past.
Q10. Are rapid tests (Antigen or Molecular) reliable?
A. Rapid tests provide results in under an hour, though they have a high rate of false negatives. Negative rapid antigen tests which are the most commonly performed rapid COVID-19 test cannot rule out COVID- 19 and should be followed up by a molecular test. Please see the attached FDA Coronavirus Testing Basics fact sheet or find it here: https://www.fda.gov/media/140161/download
Q11. Do individuals coming back from vacation from states on Governor Cuomo’s travel advisory need to quarantine?
A. Yes, individuals who are coming to New York from any of the states on the travel advisory need to quarantine for 14 days. The most up-to-date list of states is available here:
Q12. What qualifies as an exposure to COVID-19? How does the DOH define “close or proximate contact?” The CDC suggests 6 feet or less for a duration of 15 minutes or more. Does that hold true here?
A. Close contact is defined (by NYSDOH and Johns Hopkins) as being within 6 feet of a person displaying symptoms of or testing positive for COVID-19 for 10 minutes or longer. Close contacts will be required to quarantine. Proximate contact is defined as being in the same enclosed environment such as an office, but greater than 6 feet from a person displaying symptoms of COVID-19 or testing positive for COVID-19. OCDOH will determine if a proximate contact should be under quarantine.
However, bus rides and classrooms are more congregate settings than the general guidelines consider, and it is prudent to consider any individual in the same classroom as a close contact.
Q13. Is a health care provider’s note mandatory in Orange County schools to return to school if any member of the school (student, staff, or faculty) is not attending due to potential symptom(s) of COVID-19, confirmed positive/ diagnosis of COVID-19, and/ or post exposure to COVID-19 positive case quarantine or travel-related quarantine?
A. A health care provider’s note is mandatory in Orange County schools to return to school if any member of the school (student, staff, or faculty) is not attending due to potential symptom(s) of COVID-19, confirmed positive/ diagnosis of COVID-19, and/ or post exposure to COVID-19 positive case quarantine or travel-related quarantine, including but not limited to the following scenarios:
1. For a COVID-Related Symptom: If a student/staff/faculty member displays a COVID-19-related symptom, they must obtain a healthcare provider note to return to school. Symptoms of COVID-19 include but are NOT limited to: fever or chills (100 degrees F or greater, persistent cough, shortness of breath of
difficulty breathing, extreme fatigue, muscle or body aches, headache, sore throat, new loss of taste or smell, congestion or runny nose, nausea, vomiting, diarrhea, unexplained rash, pinkeye).
2. For Pertinent Exposure: Examples of this includes recent travel including international travel or travel to a state listed on the NYSDOH travel advisory website (https://coronavirus.health.ny.gov/covid-19-traveladvisory) where precautionary quarantine should be completed for 14 days from the date when the person left the restricted state or after completion of mandatory quarantine following exposure to a confirmed COVID-19 case.
3. Following COVID-19 Diagnosis and Subsequent Isolation Period: If a student/staff/faculty member tests positive for the virus (SARS-CoV-2) that causes COVID-19, they must have a health care provider note AND the following conditions must be met: symptom resolution, at least 10 days have passed since the onset of symptoms for symptomatic individuals or 10 days from the collection date (test date) of the positive COVID-19 test for asymptomatic individuals; AND at least 24 hours have passed since the resolution of fever without the use of fever-reducing medication. A negative COVID-19 test will not be required, unless specifically requested by the Department of Health, but may be provided in addition to the health care
Healthcare provider notes must include AT MINIMUM the following information:
1. The individual is cleared to return to school/work
2. The individual has an alternate diagnosis unrelated to COVID (for scenario number 1 above) OR the individual has no subsequent illness after completing their quarantine period (for scenario 2 above) OR the individual has successfully completed their isolation period and meet the current CDC clearance guidance (for scenario 3 above).
3. The alternate diagnosis does not have to be listed in the note but may need to be discussed confidentially with the school nurse and/ or the local health department.
QUARANTINE & ISOLATION CLARIFICATIONS
Q14. Why is the isolation period for an infected person shorter than the quarantine period of a contact?
A. The time period for incubation is different from the time period of illness and infectiousness. When a person is exposed to COVID-19, it can take anywhere from 2-14 days for the person to develop the disease (incubation), hence the quarantine period is 14 days. Once the disease develops, a person is infectious from 2 days prior to symptoms appearing to, at minimum, 10 days after the symptoms develop, hence the isolation period is at minimum 10 days, but can be longer.
Q15. Can you leave quarantine for a COVID-19 test or does your quarantine start all over after you went out to get that test?
A. Yes, you can leave quarantine for a COVID-19 test; however, during travel to and from testing, you should minimize contact with others, wear a mask/face covering, observe distancing and utilize private means for transportation. No, your quarantine period does not re-start. However, even if you test negative, you must continue to quarantine until the full 14 days from the last exposure to a COVID-19 positive individual.
CONTACT TRACING QUESTIONS:
Q16. In the event there is a large exposure, what is the plan if the DOH gets overwhelmed with the case load once school starts?
A. The Orange County Department of Health has been working in conjunction with the New York State Department of Health on contact tracing, using a joint system for tracking cases and contacts. This system also allows for both the county and state to have increased capacity of contact tracing should it be needed.
Q17. How do those testing positive at sites or who live outside of Orange County or NYS integrate into the NYSDOH systems?
A. Lab reports from ‘out of jurisdiction’ are transferred and reported to the state/county of residence (of record) of the individual. For instance, if an Orange County resident tests at a location in New Jersey, that lab result is reported to the New Jersey Department of Health, who transfers it to New York State Department of Health, and subsequently the Orange County Department of Health. lt is imperative to make sure your current phone and address are correct at a testing location, so the results can be reported to the correct jurisdiction and local health department can follow up with communication.
QUESTIONS RELATED TO HOUSEHOLD CONTACTS
Q18. If a child tests positive and has a sibling in the school, should the school keep the sibling out of school?
A. Yes. Unless the siblings reside in separate households, the sibling must be placed on quarantine which would mean that the sibling should not attend school during the required period for quarantine.
Q19. If a student/staff member is home on quarantine and then develops symptoms, please explain how that impacts attendance to school/work. What does it mean for the siblings that may have been continuing to go to school?
A. If a student or staff tests positive, their household members will likely be considered close contacts and will need to quarantine. Students or staff testing positive will require isolation for a minimum of 10 days.
Q20. If someone has to quarantine and has a family member in isolation, is it 10 days + 14 days for the quarantine. Or would it be 4 more days?
A. Determining quarantine periods can vary depending on the particular situation: the specifics will be determined in conversation with the Orange County Department of Health case investigators and contact tracers. Here are some sample scenarios (CDC: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html
General Scenario 1: Close contact with someone who has COVID-19-will not have further close contact
I had close contact with someone who has COVID-19 and will not have further contact or interactions with the person while they are sick ( e.g., co-worker, neighbor, or friend).
Your last day of quarantine is 14 days from the date you had close contact.
Date of last close contact with person who has COVID-19 + 14 days = end of quarantine
General Scenario 2: Close contact with someone who has COVID-19-live with the person but can avoid further close contact
I live with someone who has COVID-19 ( e.g., roommate, partner, family member), and that person has isolated by staying in a separate bedroom. l have had no close contact with the person since they isolated.
Your last day of quarantine is 14 days from when the person with COVID-19 began home isolation.
Date person with COVID-19 began home isolation + 14 days = end of quarantine
General Scenario 3. Under quarantine and had additional close contact with someone who has COVID-19
I live with someone who has COVID-19 and started my 14-day quarantine period because we had close contact. What if l ended up having close contact with the person who is sick during my quarantine? What if another household member gets sick with COVID-19? Do I need to restart my quarantine?
Yes. You will have to restart your quarantine from the last day you had close contact with anyone in your house who has COVID-19. Any time a new household member gets sick with COVID-19 and you had close contact, you will need to restart your quarantine.
Date of additional close contact with person who has COVID-19 + 14 days = end of quarantine
General Scenario 4: Live with someone who has COVID-19 and cannot avoid continued close contact
I live in a household where I cannot avoid close contact with the person who has COVID-19. I am providing direct care to the person who is sick, don’t have a separate bedroom to isolate the person who is sick, or live in close quarters where I am unable to keep a physical distance of 6 feet.
You should avoid contact with others outside the home while the person is sick, and quarantine for 14 days after the person who has COVID-19 meets the criteria to end home isolation.
Date the person with COVID-19 ends home isolation + 14 days = end of quarantine
School Scenario 1: A staff member who has no contact with a student but has contact with other staff who had contact with a student that tested positive.
The consideration is whether someone is a direct contact. The staff member with direct contact to a student that tested positive would be a direct contact and would need to go on mandatory quarantine for 14 days. The staff member without direct contact would not need to quarantine.
School Scenario 2: A staff member or a student has a positive case in their household. The staff or student has contact with other staff, faculty or students.
The staff member or student should quarantine and monitor symptoms. Testing should be a decision between the exposed individual and their healthcare provider. If the individual becomes positive, contact tracing would identify students or other staff that would be direct contacts and those individuals would be placed on quarantine for 14 days.
School Scenario 3: A student in a class tests positive.
All classmates and teachers or staff of the positive case should be placed on mandatory quarantine for 14 days.
School Scenario 4: An exposed individual has completed their quarantine period following an exposure to a positive case. The individual would like to return to school.
All quarantined individuals should contact their primary care provider (PCP) to discuss their return to school. This will ensure that the individual adequately completed their quarantine without the development of symptoms based on their individual health circumstances.
Q21. If a person travels to a state with a mandatory quarantine upon return to NY, but their child, who lives with them, did not travel, does the child also have to quarantine, or can they attend school?
A. No. The child can attend school as long as the traveler in the household remains asymptomatic and does not test positive for COVID-19.
Q22. Does a student have to quarantine if a family member is quarantining, but does not have symptoms?
A. If a member of the household is quarantining because of either a known exposure to a COVID-19 positive individual or because of travelling, other members of the household can leave the home if that person can quarantine properly away from the household members, remain asymptomatic and does not test positive for COVID-19.
A quarantined person should:
- Separate themselves from other members of the household
- Use a separate bedroom and bathroom
- Do not share linens, towels, eating utensils, cups and plates
- Limit time in common household areas, such as kitchens.
Q23. What is the time frame for contact tracing? Will you work with the school immediately?
A. OCDOH will notify relevant school staff upon learning of a positive test for COVID-19 at the school. OCDOH also verifies that individuals reporting a positive COVID test have a positive lab test result in order to proceed with further measures. Labs are required to report to New York State Department of Health any positive test results immediately, and local health departments aim to contact positive individuals within 24 hours of receiving that lab report. Schools should be conducting daily health screenings, including asking whether the child/staff has been in contact with a person who has tested positive.
SHARING OF MEDICAL INFORMATION/PARENTAL PERMISSION
Q24. Do schools need parental permission to send COVID-19 related medical information to the Orange Department of Health?
A. COVID-19 is a reportable communicable disease mandated under the New York State Sanitary Code (1 ONYCRR 2.10, 2.14), including reporting by schools nurses (1 ONYCRR 2.12).
While the Family Educational Rights and Privacy Act (FERPA) generally requires parental permission for school personnel to disclose personally identifiable information from a student’s education record (including health information). But the law provides exceptions allowing disclosure without consent. Under the “health or safety emergency” exception, even though a student’s positive COVID-19 test would be considered personal identifiable information, the school may report this information without parental consent to individuals whose knowledge of the information is necessary to protect the health or safety of students or other individuals. (See 20 U.S.C. § 7 1232g(b)(1)(I); 34 C.F.R. §§ 99.31(a)(10) and 99.36.) These may include public health officials, school administration, trained medical personnel, school staff, and parents. The “health or safety emergency” exception is limited in time to the period of the emergency and generally does not allow for a blanket release of personal identifiable information from student education records.
See also https://studentprivacy.ed.gov/.
Q25. Should masks be worn on the bus and in schools?
A. Yes. Proper use of masks (see attached CDC guidelines: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html ) is recommended for all individuals over the age of 2 while on the bus and in school. The gold standard of disease prevention includes social distancing, along with the use of masks and proper hand hygiene. The use of cloth face coverings at work and in other congregate settings, should be used in addition to other control measures, including engineering controls such as implementing social distance practices and physical partitions or barriers; and administrative controls such as frequent cleaning and disinfection protocols. Face coverings worn by students not only protect other students, but also protect teachers, aides, and others who move around the school.
IMPORTANT NOTES REGARDING MASK USAGE: It is important to properly store, clean, and don and doff masks. Individuals should not touch external, especially contaminated surfaces and then adjust the ties/ loops of the mask. Hand hygiene is an important infection prevention and control measure. Wash your hands with soap and water for at least 20 seconds after putting on, touching, or removing respirators, masks, or cloth face coverings. Hand sanitizer, with a minimum of 60% alcohol may be used if soap and water are not available.
Each district/school plan should have written protocols regarding students taking mask breaks. When possible, mask breaks should occur outside or in other areas with good air flow, and where maximum social distancing can be accomplished.
Q26. What conditions would require special accommodation for students/staff?
A. Medically fragile individuals with special needs, and/or underlying medical conditions requiring special accommodations ( ex. unable to wear mask, present to school in person, etc.) may be more vulnerable and susceptible to COVlD-19 and complications. An outline of the special needs accommodations, as well the safety plan from the primary care provider (licensed medical professional), that include safety measures to protect the medically fragile individual from possibly contracting COVID-19, as well as potentially transmitting COVID-19 to others in a congregate setting, will be instrumental in assisting with the local impact of this global pandemic.
Q27. What parameters/conditions/metrics should we use as an early warning sign that positive cases or absenteeism are increasing beyond an acceptable rate?
A. Generally, schools in regions in Phase IV (which the Mid-Hudson entered on July 7th) can reopen if daily infection rate remains below 5% using a 14- Day Average. Schools will close if regional infection rate raises over 9% after August 1st. (To see the regional rate, go to https://forward.ny.gov/early-warning-monitoring-dashboard).
Q28. With regard to screening, should it be prior to entering the building or before they leave their house?
A. School districts are required to have a protocol in place to perform temperature and health screenings for COVID symptoms. Screenings by the parent/guardian prior to school are preferred to help prevent the spread of disease in the school. (See the NYSED Reopening Guidance). Symptomatic individuals should not leave their households. Parents/guardians/students should be provided with information explaining the importance of monitoring for symptoms and remaining at home whenever symptoms are recognized.
Q29. Previously, if there was a case, we had to close a building for 24 hours. Is that still the case?
A. Typically a 24-hour time period may be required for disinfection of an area or building. If disinfection can be conducted over night or during a weekend, disruption of classes could be minimized. The CDC and NYSDOH recommend the following:
- Closing off areas used by a sick person and not using these areas until after cleaning and disinfection has occurred:
- Opening outside doors and windows to increase air circulation in the area.
- Waiting at least 24 hours before cleaning and disinfection. If waiting 24 hours is not feasible, wait as long as possible:
- Clean and disinfect all areas used by the person suspected or confirmed to have COVID-19 such as offices, classrooms, bathrooms, lockers, and common areas.
Further information can be found here: https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility.html and https://coronavirus.health.ny.gov/system/files/documents/2020/03/cleaning_guidance_schools.pdf
Q30. Can assemblies, sports games, and other events take place?
A. No, assemblies, sports games, and other events that create crowded conditions (gathering of more than 50 individuals) are not recommended at this time due to the increased transmission potential.
Q31. Do you have any advice on use of cohorts?
A. Yes. Schools should recognize that as cohorts intermingle, there is inherently greater risk of transmission of COVID-19 to more people. Accordingly, schools are encouraged to use cohort models.
Q32. Can COVID-19 remain in the air?
A. There is growing evidence to suggest that the coronavirus may linger in the air, especially once aerosolized, including several documented cases that linked poor ventilation to spread of the virus. NYSDOH has noted that while masks are the best defense against that, better ventilation can help too, that means masks, and social distancing, and hand-washing – and safer air. Assessment of optimal filtration, air flow into classrooms, restrooms and congregate setting environments is prudent.
Paying particular attention to the possible aerosolization of particles, restrooms pose a concern due to the potential for congregating. Hence social distancing measures, masking requirements, adequate signage for proper hand hygiene, along with an evaluation of frequently touched surfaces and availability of touchless soap/hand sanitizer dispensers, as well as automatic towel dispensers instead of air hand dryers would be ideal.
Schools are required to adhere to the NYSDOH guidance (attached). NYSED also provides guidance which can be found here:
OCDOH updated information is available via the OCDOH website found here:
Orange County NY Health social media page:
Orange County NY Health mobile app available free of charge from the Google Play/ Android and Apple app stores.
OCDOH call center at 845-291-2330