COUNTY HEALTH GUIDELINES FOR WESTCHESTER SCHOOLS OPENING IN THE TIME OF COVID

WPCNR CORONAVIRUS REPORT. From the Westchester County Board of Health. August 12, 2020

FAQ for Schools Prek-12th Grade Westchester Country Department of Health (WCDOH)


Q1: When and how should we report positive COVID-19 cases to WCDOH?
A: Immediately notify WCDOH if a student, faculty or staff member tests positive for COVID-19:

914-813-5110 (weekday hours)

914-813-5000 (evening and weekend hours)

Q2. Are schools responsible for contact tracing for students, faculty and staff?
A. While WCDOH has the primary responsibility for contact tracing, effective contact tracing is a joint collaborative effort -WCDOH will need the assistance of schools in providing staff and student lists and schedules and other information to identify exposed individuals, arrange for testing, etc.

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. What resources will an isolating or quarantined person require?
A. An isolating or quarantined person will need access to a private room and a private bathroom. Individuals will also need access to food, medications and other essential items that will allow them to remain in quarantine. People who need assistance during quarantine or isolation can call 866-588-0195.

Q6. When should an exposed individual get tested for COVID-19?
A. Testing should be conducted approximately 5 days after exposure. 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 WCDOH). Even if the test is negative, the individual must continue to quarantine for the full 14 days.

Q7. Where can students, faculty and staff get tested for COVID-19?
A. A list of testing sites can be found on the WCDOH health website (https://health.westchestergov.com/2019-novelcoronavirus) under the testing, results and treatment tab. Students, faculty and staff can also call the NYS COVID-19 hotline at 1-888-364-3065 for assistance locating a testing site.

Q8. Is there a charge for COVID-19 tests conducted at state-run facilities?
A. No, there is no out of pocket charge for COVID-19 tests conducted at
state-run facilities. (Insurance information
may be requested)
Department of Health 25 Moore Avenue Mount Kisco, New York 10549 Telephone: (914) 813-5000 Fax: (914) 813-5970

Q9. When can a person who has tested positive return to school? Is it the same process for students, faculty and staff?
A. If the individual who tested positive has symptoms (Fever, Cough, Shortness of Breath/Difficulty Breathing, Chills, Repeated Shaking with Chills, Muscle Pain, Headache, Sore Throat, or New Loss of Taste or Smell) the Clearance Criteria for release from isolation are:

It’s been at least 10 days since the individual first started experiencing symptoms; AND

The individual hasn’t had a fever in at least 3 days, without taking fever-reducing medication (such as Tylenol); AND

Any shortness of breath/coughing/difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell has improved.

If the individual who tested positive is asymptomatic the Clearance Criteria are:

It’s been at least 10 days since the person’s first positive COVID-19 test was collected; AND

The individual hasn’t had any subsequent illness

Q10. 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. A different test would be needed to determine active infection.

Q11. 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 factsheet.

Q12. Do students coming back from vacation from states on Governor Cuomo’s travel advisory need to quarantine?
A. Yes, students 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. (https://coronavirus.health.ny.gov/covid-19-traveladvisory#restricted-states)

Q13. What qualifies as an exposure to COVID-19?
A. Close contact is defined 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 a classroom or office, but greater than 6 feet from a person displaying symptoms of or testing positive for COVID-19. WCDOH will determine if a proximate contact should be under quarantine.

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 Westchester 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 Westchester 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. So for instance, if a Westchester County resident tests at a location in Connecticut, that lab result is reported to the Connecticut Department of Health, who transfers it to New York State Department of Health, and subsequently the Westchester Department of Health. (Note: please 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). NYSDOH obtains lab reports on individuals who do not live (but work) in Westchester County and provides these to WCDOH.


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 and what it means 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 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 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):


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

Please note if your quarantine starts at noon on day 1, then it would end at noon on the last day.

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. I 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

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 I 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

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

Please note if your quarantine starts at noon on day 1, then it would end at noon on the last day.

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 the student have to quarantine if the parent had contact and 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 from the household members. 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 timeframe for contract tracing? Will you work with the school immediately? What if we are notified in the evening and siblings may be at school in am.

A. WCDOH will notify relevant school staff upon learning of a positive test for COVID-19 at the school. WCDH 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 INFO/PARENTAL PERMISSION


Q24. Do schools need parental permission to send COVID-19 related medical information to DOH?
A. COVID-19 is a reportable communicable disease mandated under the New York State Sanitary Code (10NYCRR 2.10, 2.14), including reporting by schools nurses (10NYCRR 2.12).
https://regs.health.ny.gov/volume-title-10/content/reporting-cases-records https://www.health.ny.gov/forms/instructions/doh-389_instructions.pdf
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. §
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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.
(Extracted from https://www.networkforphl.org/resources/faqs-covid-19-and-health-data-privacy/)
See also https://studentprivacy.ed.gov/
THRESHOLD QUESTIONS:
Q25. Is there a threshold of infections or absentee rates that would indicate a school should close?
A. The Westchester County Department of Health does not make the decision as to whether a school or classroom should be closed because of COVID-19. That decision rests solely with the school and school district. The Westchester County Commissioner of Health has the legal authority to determine who needs to isolate and quarantine due to COVID-19 positive cases and/or exposure to a COVID-19 case.


Q26. 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)


Q27. In regards 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. (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 when ever symptoms are recognized.

Q28. Previously, if there was a case, we had to close a building for 24 hours. Is that still the case?
A. Typically a 24 hr. 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:

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 Go to the NYSED guidance for more information: http://www.nysed.gov/common/nysed/files/programs/reopeningschools/nys-p12-school-reopening-guidance.pdf
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