Lucas County Back to School COVID-19 Guidance 2021 2022 - Toledo-Lucas County Health Department

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Lucas County Back to School COVID-19 Guidance 2021 2022 - Toledo-Lucas County Health Department
Toledo-Lucas County Health Department

     Lucas County
    Back to School
  COVID-19 Guidance
      2021 - 2022

            Updated 8-19-2021
Lucas County Back to School COVID-19 Guidance 2021 2022 - Toledo-Lucas County Health Department
Lucas County Back to School COVID-19 Guidance
Contents
Guidance Updates for 2021-2022 School Year ....................................................................... 3
  Key Guidance Recommendations ....................................................................................................................... 4
School and Health Department COVID-19 Collaboration Process ........................................... 5
Masking/Face Coverings in Grades K-12 ................................................................................ 6
School Nurse Algorithm for COVID-19 Symptoms and Exposure ............................................ 7
Handling symptoms & household exposures of students, staff, and faculty........................... 8
Lucas County Quarantine Guidance ....................................................................................... 9
School Specific Quarantine Guidance Updates..................................................................... 10
School Contact Tracing & Reporting Requirements .............................................................. 11
  School Reporting ............................................................................................................................................... 11
  Contact Tracing Definitions and Guidance ....................................................................................................... 12
How is a close contact determined in schools? .................................................................... 13
When to stay home and when an individual should be sent home: .................................... 14
COVID-19 Symptoms vs Seasonal Allergies .......................................................................... 15
COVID-19 Symptoms vs Common Colds & Flu ...................................................................... 16
Additional Resources ........................................................................................................... 17
Record of Change ................................................................................................................ 18

        As the pandemic response continues to evolve, this guidance is subject to change.
                          This document may not cover all scenarios.

Revised 8-19-21                                                                                                                                  Page |2
Lucas County Back to School COVID-19 Guidance 2021 2022 - Toledo-Lucas County Health Department
Lucas County Back to School COVID-19 Guidance
Guidance Updates for 2021-2022 School Year

          Vaccination is currently the leading public health prevention strategy to control
           the COVID-19 pandemic as well as many other vaccine preventable diseases.

 Ohio schools are now responsible for implementing measures and restrictions deemed necessary to address
  the impact and spread of COVID-19 in their buildings, on their grounds, and during transportation. The
  Toledo-Lucas County Health Department is providing recommendations to assist Lucas County K-12 schools
  in their planning based on guidance currently available from the Ohio Department of Health and the Centers
  for Disease Control and Prevention (CDC).
 School Transportation: CDC’s Public Transportation Order applies to all public transportation conveyances
  including school buses. Regardless of the mask policy at school, passengers and drivers must wear a mask
  on school buses, including on buses operated by public and private school systems, subject to the exclusions
  and exemptions in CDC’s Order. Masks are required regardless of vaccination status. More information is
  Available Here.
 The CDC continues to recommend schools follow COVID-19 prevention measures implemented during the
  2020-2021 school year.
     o These prevention measures include universal and correct use of masks by staff and students and
        physical distancing of a minimum of 3 feet (6 feet preferred) in the classroom (6 feet required in
        some settings).
     o Per the CDC, masks should be worn indoors by all individuals (age 2 and older) who are not fully
        vaccinated when around non-household members.
 The American Academy of Pediatrics (AAP) recommends that all students (age 2 and older), along with staff,
  should wear masks in school, regardless of COVID-19 vaccination status, unless medical or developmental
  conditions prohibit use.
     o Universal masking provides protection against other respiratory illness that would also take time
         away from school
 The Ohio Department of Health issued their Ohio K-12 School Guidance document for the 2021-2022
  Key highlights include:
     o Strongly recommends COVID-19 vaccinations for staff and eligible students.
     o Layering prevention measures including good ventilation, regular cleaning, handwashing, covering
         coughs/sneezes, and staying home when sick.
     o   Strongly recommends those who are not fully vaccinated to consistently wear masks, which have
         proven to be a very effective tool for reducing the spread of the virus.

Sections updated for the 2021-2022 school year within this document:
   School and Health Department COVID-19 Collaboration Process
   School Mitigation and Prevention Strategies for the 2021-2022 School Year
   School Nurse Algorithm for Symptoms & Exposure
   Handling symptoms & household exposures of students, staff, and faculty
   Lucas County Quarantine Guidance
   School Specific Quarantine Guidance Updates
   School Contact Tracing & Reporting Requirements

Revised 8-19-21                                                                                 Page |3
Lucas County Back to School COVID-19 Guidance 2021 2022 - Toledo-Lucas County Health Department
Lucas County Back to School COVID-19 Guidance
Key Guidance Recommendations

 Promote Vaccination: vaccination is currently the leading public health prevention strategy to end the
  COVID-19 pandemic. Promoting vaccination can help schools safely return to in-person learning as well as
  extracurricular activities and sports.

 Face Coverings/Masks: masks should be worn indoors by all individuals (age 2 and older) who are not fully
  vaccinated. Consistent and correct mask use by people who are not fully vaccinated is especially important
  indoors and in crowded settings, when physical distancing cannot be maintained.

 Universal Masking: universal masking in all schools should be considered as a significant portion of the
  student population is not eligible for vaccination; difficulty in monitoring or enforcing mask policies for
  unvaccinated individuals; possibility of low vaccine uptake in surrounding community; continued concerns
  for variants that spread more easily among children, adolescents, and adults; protection against spreading
  other respiratory.

 Reduce Transmission Risk: maintain at least 3ft of physical distance between students in class combined
  with indoor mask wearing by anyone not fully vaccinated.

 Layered Prevention Strategies: multiple prevention strategies should be used to prevent spread:
  vaccination, good ventilation, regular cleaning, masks, hand washing and respiratory etiquette
  (coughing/sneezing into elbow or tissue), contact tracing and monitoring, and staying home when sick.

 Parents, Visitors, and Guests: require all parents, guests, and visitors to wear a mask and social distance
  when visiting the school regardless of vaccination status.

 Screening/Testing: encourage individuals to monitor for symptoms. Everyone with COVID-19 symptoms
  should stay home, contact their doctor, and get tested.

 Hybrid Strategies: consider offering distance learning or hybrid schedules for students required to isolate,
  quarantine, or who are medically fragile.

 Contact Tracing: report new cases and exposures to local health department as soon as possible. Promote
  parent cooperation with ODH contact tracers and monitoring.

 Public Health Partners: contact PCG with questions on current isolations or quarantines or the Health
  Department for assistance with guidance and best practices.

Revised 8-19-21                                                                                 Page |4
Lucas County Back to School COVID-19 Guidance
School and Health Department COVID-19 Collaboration Process
Student / Staff is confirmed positive for COVID-19 with diagnostic test (nose/throat swab)
                                School learns of COVID positive
                                                                                  Health Department learns
                               Student/Staff or their exposure to
                                                                                   of COVID+ school case
                                   COVID positive individual

                                 School Completes TLCHD Online
                                         Reporting Form

                                  Link: https://tinyurl.com/LCSchoolCOVID
                                    Complete excel template and
                                    submit through link above.

                              PCG interviews confirmed cases and                      PCG informs school of
                              enrolls close contacts in OCTS system                   staff or student cases

                               School notifies parents/guardians of
                                exposure and quarantine/isolation
                                          requirements

        Close contact completes quarantine           Close contact develops symptoms or
               period symptom free                        tests positive for COVID-19

           14 days based on last exposure*

                                                      Case completes isolation period and
                                                      meets all criteria to return to school

                                                         Minimum 10 days from symptom
                                                           onset have passed
                                                         Fever free 24 hours without using
                                                           fever reducing medicine
                                                         Significant improvement in
                                                           symptoms

        Individual Returns to School

Revised 8-19-21                                                                                         Page |5
 *Quarantine duration may vary based on individual circumstances and school policy.
Lucas County Back to School COVID-19 Guidance
School Mitigation and Prevention Strategies for the 2021-2022 School Year
Masking/Face Coverings in Grades K-12
    Recommend masking indoors (except while eating) for:
        o Universal masking for all individuals while on school grounds and transportation;
        o Recommend distance of 6 feet between individuals when eating;

    Recommend masking outdoors when:
        o In crowded spaces and distancing cannot be maintained;
        o Masks may not be necessary when you are outside by yourself away from others,
          or with people who live in your household.

                                  Masking/ Face Covering
                                      Grades K - 12

                                  *Masks required on all school
                                    transportation/busses

            Fully Vaccinated                          Unvaccinated Individuals

Fully Vaccinated Teachers, Staff, and           All unvaccinated individuals whether by
Students over 12 years old:                     choice or ineligible to receive vaccination
                                                due to age or medical condition:
 Universal masking is fully recommended
  regardless of vaccination status;              Quarantine if identified as a close
 Social distancing recommended, use              contact;
  good judgement;
 No quarantine required if identified as a      Indoors:
  close contact                                    Universal masking recommended
                                                   Social distancing (3ft+) recommended
          COVID-19 Symptoms                      Outdoors:
                                                   Mask not required, but should be
    If symptoms develop, all                       considered in crowded spaces
       individuals must isolate regardless         Maintain social distancing
       of vaccination status

Revised 8-19-21                                                                   Page |6
Lucas County Back to School COVID-19 Guidance
School Nurse Algorithm for COVID-19 Symptoms and Exposure
  Scenarios 1 & 2 are the same for all individuals regardless of COVID-19 Vaccination status
         Scenario 1                                    Scenario 2                                          Scenario 3
                                                 >2 Low Risk Symptoms
    1 Low-Risk Symptom                                     OR                                            Confirmed
           AND                                    1 High Risk Symptom                                 COVID-19 Exposure
         No Exposure                                      AND
                                                       No Exposure

                                                                                                                 Fully
                                        Evaluation by                                                         Vaccinated?
                                                                           Test Strategy
                                      Healthcare Provider
                                                                                                        NO                  YES
                                                                                                    Return to             No
                                       Evaluation and a                     Positive               school after        Quarantine
                                      specific alternative        Negative Molecular*                14ⱡ day            Required
                                       medical diagnosis         Molecular*  Test                  quarantine           Continue with
                                         provided on                Test      Or                  from date of last      school and
                                       physician s note                     No Test                  contact with     activities; wear a
                                                                                                        positive      mask indoors as
                                                                                                     individual. If   much as possible
                                                                                                      symptoms         and monitor for
                                                                                                    develop, get a    symptoms for 14
                                                                                                       PCR Test.           days**.
   Return to school 24                       Return to school 24
   hours after symptom                       hours without fever
                                                                                               Symptoms Develop /
        resolution                         and symptoms improve
                                                                                                  Test Positive
     High Risk Symptoms                Low Risk Symptoms
        New/worsening cough              Fever (100 degrees or higher)                       Return to School After:
        Shortness of breath              Chills
        Difficulty breathing             Fatigue                                        Minimum 10 days from symptom onset
        New loss of taste or smell       Muscle or body aches                            have passed
                                          Headache                                       Fever free 24 hours without using fever
         Symptoms Key                     Sore throat                                     reducing medicine
                                          Congestion or runny nose
                                          Nausea or vomiting                             Significant improvement in symptoms
                                          Diarrhea

RE-EXPOSURE: After completing their isolation period, unvaccinated individuals that test positive for COVID-19 via molecular test will
not need to quarantine or isolate if exposed again for at least 3 months from their test or symptom onset date. Fully vaccinated
individuals do not need to quarantine after exposure but must isolate if symptoms develop.
ⱡ QUARANTINE DURATION: see pages 9-11 for more detailed information and alternative quarantine options.
*TEST TYPE: individuals are encouraged to verify with the test site if the test they are receiving is a molecular test (e.g. PCR) or an
antigen test. Negative antigen tests are not sufficient to clear an individual to return to school under Scenario 2's Test Strategy.
**FULLY VACCINATED EXPOSURES: wear mask indoors for 14 days or until individual tests negative at least 3-5 days after last exposure.

 Revised 8-19-21                                                                                                        Page |7
Lucas County Back to School COVID-19 Guidance
Handling symptoms & household exposures of students, staff,
and faculty

    Do they have 2 or more Low Risk
      or 1 High Risk Symptom(s) of
       COVID-19 without known                   Are they a Close Contact of a
     exposure to a COVID+ person?                   known COVID+ case?                   Do they live with a symptomless
                                                                                              quarantined person?
             Yes, Symptoms                          Yes, Close Contact:
   Are they waiting for COVID-19
            test results?                       Are they fully vaccinated?
                                                                                             Are they fully vaccinated?
   Yes, waiting on test results:             Yes, Fully Vaccinated
                                                                                         Yes, Fully Vaccinated
      The individual is excluded from
                                               The individual may continue to              Individual may continue to
       school until test results come
                                                attend school and activities                 attend school and activities
       back. If positive, they must
                                                without restriction.                         without restriction, even if their
       follow isolation guidance.
                                                                                             household member develops
                                               Monitor symptoms for 14 days.
    If a negative PCR test result is                                                        symptoms and needs to isolate
                                                If symptoms develop, individual
     received, the student/staff may
                                                must isolate immediately.                   If the quarantined person
     return based on guidance for
                                                                                             develops symptoms, fully
     predominate symptoms.                   No, Unvaccinated                                vaccinated close contacts
   No testing has been conducted:                                                            should monitor for symptoms
                                            The student/staff person is                      for 14 days after the household
      Students may return to school        excluded from school until:                      person s isolation ends
       if their physician evaluates and        14 days* have past from last
       provides a specific alternate            known exposure to the COVID+             No, Unvaccinated
       diagnosis for symptoms.                  person.
       Student/Staff may return after                                                       Contacts of a quarantined
       24 hours without fever and            Note: Receiving a negative                     household members without
       symptoms improve based on              COVID-19 test result will not                  symptoms are considered
       guidance for diagnosis/                change the length of the                        contacts of a contact and may
       predominate symptoms.                  quarantine period, and does not                continue to attend school and
                    OR                        allow individuals to return to                 should monitor for symptoms.
                                              school or extracurricular
   The student/staff person is                                                              Quarantined household
                                              activities early.
   excluded from school until:                                                               members should try to
      Minimum 10 days from                                                                  physically distance from others
                                          Last Exposure                                      by using separate bedrooms and
       symptom onset have passed
                                                                                             bathrooms as much as possible.
      Fever free 24 hours without
       using fever reducing medicine                                                        If a contact of a quarantined
                                                                                             household member develops
      Significant improvement in                           Last Day of Quarantine           symptoms, they should stay
       symptoms                                                                              home and call their medical
                                                                                             provider to be tested for COVID-
                                                                     Image source: CDC       19.
 *Number of days may change under certain circumstances or exceptions
 determined by TLCHD epidemiologists.

Revised 8-19-21                                                                                                     Page |8
Lucas County Back to School COVID-19 Guidance
Lucas County Quarantine Guidance

 The Toledo-Lucas County Health Department strongly recommends unvaccinated individuals exposed to a
 COVID-19 positive person to quarantine for fourteen (14) days from the date of the last exposure (day zero).
 Individuals should quarantine for a minimum of ten (10) days and monitor for symptoms through day
 fourteen (14).

In accordance with the CDC's updated guidance, the Toledo-Lucas County Health Department recognizes the
following quarantine options:

  Gold Standard Quarantine              Alternative Quarantine                   Isolation Period

 Unvaccinated individuals           Unvaccinated individuals           Any individual showing signs or
   exposed to COVID-19 should          exposed to COVID-19 should          symptoms of COVID-19 should
   quarantine at home for 14           quarantine at home through          isolate at home for 10 days from
   days from the date of               day 10 from date of                 symptom start or test date (day
   exposure (day zero).                exposure(day zero) and              zero).
                                       monitor for symptoms
 Lowest Risk of spreading             through day 14.                   Isolation period is independent
   COVID-19.                                                               from any time spent in
                                                                           quarantine.

*Vaccinated individuals exposed to a COVID-19 positive person do not need to quarantine but
should monitor for symptoms for 14 days.

                             *Any individual developing symptoms should
                             immediately isolate and get a COVID-19 test.

Revised 8-19-21                                                                                 Page |9
Lucas County Back to School COVID-19 Guidance
School Specific Quarantine Guidance Updates
Isolation and quarantine fall under the public health authority granted by the Ohio Revised Code.
Isolation and quarantine requirements for individuals who test positive for COVID-19 or are exposed to
a positive individual have NOT changed for the 2021-2022 school year, except for considerations of
vaccination status.
Quarantine is used for students, teachers, and staff who might have been exposed to COVID-19. Close
contacts, identified through contact tracing, are required to quarantine unless they are fully vaccinated,
or have tested positive in the last 3 months, and do not have or develop any symptoms.
                        Scenario 1: Full Prevention Measures Remain In Place
 In Situations Where:
   Exposure occurred in the classroom or in the school transportation setting;
   Positive case & close contact(s) were masked and social distanced at least 3 ft
 Recommendation:
   Close contact(s) may attend school in person and participate in extracurricular activities regardless
         of vaccination status.

                       Scenario 2: Without Full Prevention Measures in Place
 In Situations Where:
   Exposure occurs in classroom or school transportation setting without appropriate masking and
         social distancing
 Recommendation:
   Close contact(s) required to quarantine outside of school for 14 days* from last exposure unless
         they are fully vaccinated.
     Contacts cannot be permitted to attend in-person school or participate in extracurricular activities.

                         Scenario 3: Any Exposure Outside Classroom Setting
 In Situations Where:
   Exposure occurs outside the controlled classroom setting or outside the school transportation
         setting
 Recommendation:
   Close contact(s) required to quarantine outside of school for 14 days* from last exposure unless
      they are fully vaccinated.
     Contacts cannot be permitted to attend in-person school or participate in extracurricular activities.

                              In *Any* scenario, individuals developing symptoms
                              should immediately isolate and get a COVID-19 test.
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*Quarantine duration may vary based on individual circumstances and school policy.
Lucas County Back to School COVID-19 Guidance
School Contact Tracing & Reporting Requirements
The Toledo-Lucas County Health Department has engaged with the state-contracted Personal
Consulting Group (PCG) to provide continued contact tracing services and capacity for Lucas
County.

 PCG Responsibilities:
       o Interview all confirmed and probable cases and enroll close contacts into the Ohio Contact Tracing
         System (OCTS);
       o Communicate case and contact information to school designated contact;
       o Monitor all contacts in OCTS (via text or phone calls) and send suspected outbreak or probable case
         information to TLCHD
       o Answer isolation and quarantine related questions from schools regarding case and contact status;

 TLCHD Responsibilities
       o   Investigate school-outbreaks;
       o   Provide schools with specific infection prevention and control guidance as needed;
       o   Provide secure method for schools to submit case and contact information;
       o   Collect and submit school reports to state;

 Lucas County School Responsibilities
       o Submit contact tracing spreadsheet with positive case and associated close contact information
         through the secure webform to TLCHD.
       o Notify all parents/guardians of exposure, inform them of quarantine, and explain they will receive
         follow-up from the Ohio Department of Health’s (ODH) contact tracers;
       o Report the number of student and staff cases weekly to TLCHD;

School Reporting

 Schools are required to report students, staff, or faculty that test positive for COVID-19 or
  were exposed to an individual that tested positive. This includes vaccinated individuals.
       o Cases and exposures must be submitted on the approved excel template through the secure Report
         COVID School webform at https://tinyurl.com/LCSchoolCOVID.
       o The template is available for download at this link.
             To protect personal and private information, schools must not email this excel template and
                should only use the secure webform above.

 Schools are required to report the total new and cumulative COVID-19 cases every Monday
  by 12 noon to TLCHD.
       o Schools must use the approved excel template;
       o Schools must submit this template to reportcovid@co.lucas.oh.us.

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Lucas County Back to School COVID-19 Guidance
Contact Tracing Definitions and Guidance

 Fully Vaccinated Individual: a person is considered fully vaccinated 2 weeks after their second dose of
  a two-dose series vaccine (Pfizer & Moderna), or 2 weeks after their first dose of a single-dose series vaccine
  (Johnson & Johnson).

   Any individual who does not meet the criteria of a fully vaccinated individual is considered
   “unvaccinated” for the purposes of this guidance.

 Close Contact Definition
     o Standard Definition:
            A close contact is any individual who was within 6 feet of a person diagnosed with COVID-19
              for a cumulative total of 15 minutes or more over a 24-hour period. This definition applies
              regardless of whether the person was wearing a mask.

       o School Definition:
             If all of the following conditions are met, a close contact is defined as any individual who was
                within 3 feet of the person diagnosed with COVID-19 for cumulative total of 15 minutes or
                more over a 24-hour period. This definition applies regardless of whether the person was
                wearing a mask.
             Conditions:
                     Exposure occurred in the classroom setting or in the school transportation setting;
                     All individuals were wearing masks properly and consistently (includes the positive
                        case and any individual 6 or less feet from the positive case);
                     Students are facing forward and separated by 3 feet or more of distance;
                     This definition applies regardless of whether the person was wearing a mask unless
                        they are fully vaccinated.
             Any exposure outside of the classroom setting or outside the school transportation setting
                must use the standard definition when determining close contacts to a positive case.
       o NOTE: All close contacts should be reported to TLCHD (even if vaccinated). This provides consistent
         reporting and vaccination surveillance.

 Quarantine: quarantine separates people who were exposed to a contagious disease to see if they become
  sick. Quarantine lowers the risk of transmission to others if a close contact gets sick or tests positive for
  COVID-19.

   A person with COVID-19 is considered contagious 2 days (48 hours) before they started having symptoms. If
   they never have symptoms, they are considered contagious 2 days (48 hours) before their COVID-19 test
   was performed.

 Isolation: isolation separates people who are sick or who have tested positive for COVID-19 from people
  who are not sick or have not been exposed to prevent transmission and spread of illness.

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Lucas County Back to School COVID-19 Guidance
How is a close contact determined in schools?

            CLASSMATES                               LUNCH MATES                                 PLAY MATES
 Classmates within 3 feet* of the           Lunch mates of students if sitting          Playmates on the playground or in
 contagious individual for longer than      within 6 feet of the contagious             the gym within 6 feet of the
 15 minutes, either in the classroom or     individual. This is a higher risk time as   contagious     individual    unless
 on the bus. This would typically be the    face coverings cannot be worn.              interactions are consistently kept
 1 to 2 rows of students sitting closest                                                very brief, no common items are
 to the contagious individual.                                                          shared, and no locker room time is
                                                                                        shared.

       OTHER CLASSMATES                                TEAMMATES                          OPPOSING TEAMMATES
 Any others that had interactions with      Sports teammates within 6 feet of the       Opposing teammates in sporting
 the contagious individual lasting over     contagious       individual      unless     events sharing time on the field/
 15 minutes in confined areas such as       interactions are consistently kept very     court with the contagious individual
 bathrooms, office rooms, etc. where        brief, no common items are shared,          unless it can be confirmed no close
 distancing of 6 feet is difficult.         and no locker room time is shared.          interactions within 6 feet occurred
                                                                                        with specific teammates and there
                                                                                        was no contact with shared items.

                                                    CLOSE CONTACT
    ENTIRE CLASSROOMS                       Close contact with a confirmed COVID-
                                                                                                     OTHERS
If the contagious individual is a teacher   19 case is defined as being within 3        Any other person outside of school
and was not keeping 3 feet away from                                                    that had similar exposure to a
                                            feet* of a COVID positive person for at
students while teaching and not                                                         contagious individual is considered a
                                            least 15 minutes, with or without a
following precautions, the entire class                                                 close contact.
will need to be quarantined.                mask in the classroom or on the bus.
                                                                                        *Refer to page 9-10 for alternative
                                            Other circumstances and may result in
                                            high-risk exposures even over distances     quarantine guidance & page 12 for
                                            >6 feet, or time shorter than 15 min.       close contact definitions/exceptions.

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Lucas County Back to School COVID-19 Guidance
When to stay home and when an individual should be
sent home:
Students and staff with symptoms of COVID-19 should not go to school or
any school activities or sports, regardless of vaccination status. If
symptoms start while at school, the individual should be sent home as
soon as possible.
Anyone who tests positive for COVID-19 must stay home and isolate regardless of vaccination status.

    Until everyone in the community and school-based population are eligible to be vaccinated and enough
    individuals become vaccinated, there will be no way to prevent all risks of COVID-19 spread in schools.
    Public Health’s goal is to keep the risk as low as possible while encouraging vaccination for all eligible
    individuals to keep school and school activities as safe as possible.

Symptoms of COVID-19*
     Fever or chills                              Fatigue                                    Congestion or runny nose
      o Fever of 100 degrees or higher             Muscle or body aches                       Nausea of vomiting
     Cough                                        Headache                                   Diarrhea
     Shortness of breath or                       New loss of taste or smell
      difficulty breathing                         Sore throat
                   *Refer to School Nurse Algorithm on page 7. COVID-19 shares many similar symptoms with the Flu,
                   the common cold, seasonal allergies and more. See symptom comparisons on the following pages.
Testing:
The parent or guardian of a student with COVID-19 symptoms should be instructed to call their health care
provider, or to follow up with a local clinic or urgent care center. Many local testing sites are listed on the Health
Department’s website at www.lucascountyhealth.com/covidtest. Staff with symptoms of COVID-19 should be
advised to follow up with their healthcare provider and to get a COVID-19 PCR test.
Child or staff has symptoms of COVID-19 and tests positive for COVID-19:
Keep out of school until it has been at least 10 days* from the first day symptoms started, they have gone 24
hours with no fever without using medication to reduce fever, and their other symptoms have improved. If they
meet these criteria there is no need to get a “negative test” or a doctor’s note to clear the child or staff to return
to school. (*Number of days may change under certain circumstances or exceptions determined by TLCHD epidemiologists)
Child or staff has symptoms of COVID-19 and no testing for COVID-19 was done:
Keep out of school until it has been at least 10 days* from the first day symptoms started, they have gone 24
hours with no fever without using medication to reduce fever, and their other symptoms have improved. They
may return to school if their health care provider diagnoses them with a specific alternate cause for their
symptoms on note from the provider.
Child or staff has COVID-19 symptoms and sees a physician or tests negative for COVID-19:
Must have a specific alternate diagnosis from a physician or a negative test without known exposure to return
to school. Otherwise, keep out of school until it has been at least 10 days from the first day of symptoms, they
have gone 24 hours fever free without using medication to reduce fever, and other symptoms have improved.

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Lucas County Back to School COVID-19 Guidance
COVID-19 Symptoms vs Seasonal Allergies

Seasonal allergies and COVID-19 share many similar symptoms. If your child regularly exhibits seasonal allergy
symptoms talk with your doctor to understand when it might be common allergies and when it might be a cold
or COVID-19. See additional symptom comparisons on the following page.

          Common Symptoms                         Shared               Common Symptoms
             of COVID-19                        Symptoms                  of Allergies

                                          Cough
    Fever and chills                                                         Itchy or watery eyes
                                          Fatigue
    Muscle and body aches                                                    Sneezing
                                          Headache
    New loss of taste or
                                          Sore throat
     smell
                                          Shortness of breath or
    Nausea or vomiting
                                           difficulty breathing*
    Diarrhea
                                          Congestion or runny
                                           nose

   *Season allergies do not usually cause shortness of breath or difficulty breathing, unless a person has
   a respiratory condition such as asthma that can be triggered by exposure to pollen.

                                          Adapted from CDC guidance

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Lucas County Back to School COVID-19 Guidance
COVID-19 Symptoms vs Common Colds & Flu
     Symptoms of          Strep     Common               Flu   Asthma   Seasonal
       COVID-19          Throat       Cold                              Allergies

   FEVER

   COUGH

   SORE
   THROAT

  SHORTNESS
  OF BREATH

  FATIGUE

  DIARRHEA
  OR
  VOMITING

   RUNNY
   NOSE

   BODY/
   MUSCLE
   ACHES
                                  Adapted from CDC guidance

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Lucas County Back to School COVID-19 Guidance
Additional Resources
 Centers for Disease Control & Prevention (CDC)
      o CDC K-12 Guidance:
             https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-
                guidance.html
      o Face Masks on Public Transport:
             https://www.cdc.gov/coronavirus/2019-ncov/travelers/face-masks-public-
                transportation.html
             https://www.cdc.gov/quarantine/masks/mask-travel-guidance.html
      o Isolation Release Criteria:
             https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html
      o Fully Vaccinated Individual Guidance
             https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html

 American Academy of Pediatrics
      o COVID-19 Guidance for Safe Schools
           https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-
              guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/

 Ohio Department of Health
      o Education & Sector Recommendations:
            https://coronavirus.ohio.gov/wps/portal/gov/covid-19/responsible-restart-ohio/sector-
               specific-operating-requirements/sector-specific-operating-requirements
      o ODH K-12 School Guidance
            https://coronavirus.ohio.gov/static/responsible/schools/K-12-Schools-Guidance.pdf
      o Ohio Infectious Disease Reporting Manual
            https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/infectious-disease-control-
               manual/welcome

 Toledo-Lucas County Health Department:
      o Lucas County Corona Virus Data:
            https://lucascountyhealth.com/coronavirusupdates/
      o Lucas County School Guidance & Reporting:
            https://lucascountyhealth.com/covidschools/
      o Lucas County Vaccination Information:
            https://lucascountyhealth.com/covidvaccine/
      o Lucas County Testing Sites:
            http://www.lucascountyhealth.com/covidtest

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Lucas County Back to School COVID-19 Guidance
Record of Change
August 19, 2021
   Updated scenarios on page 10, close contact definitions on page 12, and made other
     updates for consistency and clarity throughout.

August 11, 2021
   Updated guidance throughout document to include ODH & CDC recommendation that
     fully vaccinated individuals exposed to a COVID positive individual should wear a mask
     indoors for 14 days from the date of last exposure or until the individual tests negative at
     least 3-5 days after last exposure.
   Removed CDC guidance stating unvaccinated adults could not use the 3ft/fully masked
     close contact definition when determining which individuals needed to quarantine from
     classroom exposure. TLCHD guidance now aligns with ODH guidance stating that
     unvaccinated individuals exposed in the classroom setting do not need to quarantine if
     they were at least 3 feet from the positive case and where the case and contacts were all
     wearing masks consistently and correctly.
August 5, 2021
   Original guidance released

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