Update August 31, 2021
This local Health Unit (Windsor Essex County Health Unit) has been consulted in the making of this COVID-19 Guidance School Case, Contact, and Outbreak Management plan (Appendix A). It is intended to support the Board and school administrators in the safe reopening and operation of schools for the 2021 – 2022 school year. This provides the direction on the management of COVID-19 cases, contacts and outbreaks in schools.
There may be variability in scenarios based on local context and epidemiology and the information in this document, thus direction from the Chief Medical Officer of Health from the local Health Unit shall prevail.
- Case Definitions
The Ministry of Health maintains case definitions for probable case and a confirmed case of COVID-19.
A probable case is defined as a person who:
Has symptoms compatible with COVID-19 (see self-assessment for symptoms):
- Traveled to, or from an affected area (including inside of Canada) in the 14 days prior to symptom onset, OR
- Had high-risk exposure (i.e. close contact) with a confirmed case of COVID-19, OR
- Was exposed to a known cluster or outbreak
- In whom a laboratory-based test has not been completed, OR
- In whom a laboratory-based test result is inconclusive, OR
- Is asymptomatic and had a high-risk exposure (i.e. close contact) with a confirmed case of COVID-19 or was exposed to known cluster or outbreak and a laboratory test was inconclusive.
B. A confirmed case is defined as:
A person with confirmation of COVID-19 infection documented by:
- Validated laboratory-based testing OR
- Validated rapid point of care test "PCR"
C. A close contact is defined as:
A person who had a high-risk exposure to a confirmed or probable case during their period of communicability. This includes household, community, health care and school exposures.
- Outbreak Protocols
This operational guidance defines an outbreak in a school as two or more lab-confirmed COVID-19 cases in students or staff (or other visitors) in a school with an epidemiological link, within a 14-day period, where at least one case could have reasonably acquired their infection in the school (including transportation and before or after school care).
The local Health Unit will work with the Board to determine whether epidemiological links (for example, cases in the same class, cases that are part of the same before and after school care cohort, cases that have assigned bus seats in close proximity to each other) exist between cases and whether transmission may have occurred in the school.
The local Health Unit is responsible for:
- Determining if an outbreak exists.
- Declaring an outbreak.
- Providing direction on outbreak control measures to be implemented.
- Declaring that an outbreak is over.
The local Health Unit will determine which cohort(s) may be sent home (for self-isolation) in response to a case, an outbreak or if full school closure is required based on the extent of an outbreak. In some instances, the local Health Unit may give school Principals discretion, if necessary, to dismiss individuals or cohorts while awaiting the results of the public health investigation.
An outbreak can be declared over by the local Health unit when:
- At least 14 days have passed with no evidence of ongoing transmission that could reasonably be related to exposures in the school.
- No further ill or symptomatic individuals have been reported by the school who are associated with the initial exposure cohorts.
- Prevention and Outbreak Responsibilities
In addition to the duties and responsibilities of the local Health Unit this operational guidance further assigns duties and responsibilities to the Board and school Principals.
The School Principal is responsible for:
- Implementing prevention measures as prescribed in the Board's COVID-19 Safety Plan.
- This includes having an accessible process in place to implement on-site screening procedures.
- Cooperate and coordinate with the local Health Unit, School nurses and other stakeholders.
- Communicate with early years partners and other co-locates about COVID-19 in the school.
- Maintain accurate records of staff, students and visitors for the last 30 days.
- Upon learning of a COVID-19 case (probable or confirmed), communicating the proper information as prescribed with parents / guardians, school staff in coordination with the Board's COVID-19 Lead and the local Health Unit.
- Communicating with the School Community
The Board will continue to maintain it's COVID-19 advisory section on the website. This serves to post information and updates regarding confirmed cases of COVID-19 that involves a student or a staff member in a school setting. No personal information will be made public.
- Management of Individuals Exposed to COVID-19
This section is further broken down as follows:
- Management of ill or symptomatic individuals in the school setting.
Management of individuals exposed to COVID-19 outside of a school setting.Management of confirmed diagnosis of COVID-19 in the school community.
- Exhibiting Symptoms at School
- Procedure for use of Isolation Room
- Isolation Kit
- If ill Person tests negative for COVID-19
- If ill person tests positive for COVID-19
- School Work
- If a child does not pass screening (child care programs before, during and after school)
- Management of ill or symptomatic individuals in the school setting.
This section applies to students, staff or other members or visitors to the school community, who become ill during the school day and on school premises.
With any symptoms of illness – COVID-19 related or not – sick individuals should stay home and seek assessment from their regular healthcare provider if required.
All individuals are expected to screen every day before attending school. Any staff, student or visitor that does not pass the screening will not be able to attend school.
Students should be made aware, in age-appropriate language, how to identify symptoms of COVID-19 and should be instructed to speak to a staff member immediately if they feel ill.
Exhibiting symptoms at school:
There are many symptoms associated with COVID-19. If the individual has a preexisting condition, then the symptoms may not be new or worsening. For example, if the individual has seasonal allergies, sneezing and runny nose are not new or worsening symptoms. The Provincial self-assessment tool is helpful here to qualify.
It would be up to the discretion of the principal on using the Isolation room. In some cases, students/staff member may be sent home to self-monitor symptoms. They are to take the on-line self-assessment tool which will guide their next actions. The student/staff member is welcome back at school/work, providing there is no direction from the WECHU to self-isolate, after 24 hours of being symptom free.
If an ill person tells the school that they are waiting for COVID-19 test results, then they are to be marked ill and are to self-isolate at home until the results are communicated to them.
As per Ministry direction, we are not to ask for medical notes for students.
Procedure for use of Isolation Room:
If a staff member, student or any other person in the school/workplace exhibit the symptoms of COVID-19 while at school/workplace that are new or worsening, and there is no pre-existing condition, the following procedure must be strictly followed:
- The ill person is to be immediately directed to the Isolation Room to self-isolate.
- The ill person should be given a mask to wear if not already wearing one and must continue to wear their mask while in the isolation room. Those exempt from wearing a mask will not need to wear one.
- Designated staff person(s), preferably with first aid training, will assist the ill person.
- If it is an emergency, then call "911" immediately. Notify parent/guardians/staff member directly. Designated staff member will wait with student/staff member until EMS arrives.
- The ill person must be isolated and physically distanced from any other person by two metres.
- Tissues, touch-less garbage pail, and hand sanitizer must be available in the Isolation Room.
- Designated staff member will supervise students.
- Designated staff member will wear all PPE in the Isolation Kit and are to physically distance from the ill person.
- Respiratory etiquette and hand washing must be followed.
- There will be a checklist for the designated staff member to complete as they engage with the ill person. This checklist will be provided to the parent/guardian/student/staff member upon leaving.
- The locations of COVID-19 screening facilities will be provided to the person who picks up.
- The Principal may contact their school nurse for screening and advice on next steps.
- Parent/guardian will be contacted to pick up their child. Emergency contacts will be called if parent/guardian cannot be reached.
- If there is more than one ill person, then all the ill people must be physically distanced from each other, and from the designated staff member. Ideally, there will be more than one isolation room, but if not available, then the additional ill person must be isolated and physically distanced from any other person by at least two metres.
- After the ill person leaves the premises, then the Isolation Room will be cleaned and sanitized based on health and safety guidelines.
- Privacy and confidentiality are essential for the ill person.
Every school/workplace will have a designated Isolation Kit that will be available for the designated staff member, who is preferably trained in First Aid, to use. These kits consist of the following stored in a plastic container.
- Instructions on its proper use on the outside or inside of the kit,
- Alcohol-based hand rub,
- Disposable gloves,
- Disposable surgical/procedural mask,
- Eye protection, and,
- Disposable gown.
Staff are to wear the gown, eye protection, mask, and gloves when speaking to the student or staff member. Items will be replenished directly to ensure that the kit is always ready.
If the ill person tests negative for COVID-19:
- The staff member or student can return to school once they are symptom-free for 24 hours.
If the ill person tests positive for COVID-19:
- The local Health Unit will contact the parent/guardian or staff member if they test positive and will follow up with the principal with further information.
- If the family or staff member notifies the school first, then the principal is to contact their school nurse.
- Principal/supervisors are to fully cooperate with the local Health Unit to provide information to conduct contact tracing which may include, but is not limited to, lists of all persons whom have been in and out of their school/facility, class lists with student names, seating plans, parent/guardian names, and contact information, summary of the steps taken when the ill person came to the attention of the principal/supervisor, and timetable.
- The local Health Unit will assess potential exposures within 14 days prior to symptom onset and will determine potential transmission among close contacts.
- All staff is to fully comply with any local Health Unit investigation to the source of the outbreak.
- The local Health Unit will provide medical exclusion letters for students and staff members with the date of return. Students exclusion letters to be filed in Ontario Student Record. Staff documentation to be forwarded to Human Resources.
- The local Health Unit will direct any communication that is to be sent from the school/workplace to families.
- As per privacy legislation, the ill person's name is to be held confidential and not be shared with staff, students, nor the school community. The local Health Unit will conduct their investigation and will identify close contacts for appropriate advice on self-isolation.
- There will be areas required for cleaning and disinfecting based on where that ill person has been or has been in contact with, for example desk, chair, learning materials. If the materials cannot be cleaned, such as paper, books, then they are to be sealed in a container for 7 days. These items are to be stored in a secured confidential area with the date clearly marked.
- If there are two or more confirmed cases that are related in a school within 14 days and one or more are acquired at school, it will be deemed as an outbreak.
- Parent/guardians are to call in their child's absence when ill or if awaiting test results. Students will be marked ill.
- School work will be provided to the student/cohort to complete.
- If there is a cohort or a school who is self-isolating, teachers will pivot to on-line learning for the duration of the self-isolation period.
- The teacher will keep in contact with the medically excluded student which will ease the transition back to school.
- Each case may be different in terms of the length of time for recovery, so it is essential to communicate with the family.
If a child does not pass screening at Child Care Program:
Before School Program:
- Children should not return to the Child Care program until they have been assessed and advised by their health care provider.
- Symptomatic children, staff or parents/guardians who test negative for COVID-19 must be excluded from before and after school and child care programs and services until 48 hours* after symptom resolution.
- Using the Information Sharing consent, Child Care staff will inform the school administrator prior to the start of the school day, that a child has not passed screening and will not attend school.
- Child Care staff will inform the parent/guardian of the child who did not pass screening that they will be sharing the information with the school, as per the Information Sharing consent.
- Parents/guardians should be advised to call and report absence to the school, as per the school attendance reporting procedures.
During the School Day
- Child is sent to School's Isolation Room or informs the school that they are sick
- Using the Information Sharing consent, school staff will inform the Before and After School supervisor prior to the start of the Before and After School program, that a child has become ill or informed the school that they are sick and will not attend the Before and After School program.
- School staff will inform the parent/guardian of the child who was sent to the Isolation room that they will be sharing the information with the Before and After School program, as per the Information Sharing consent.
- Parents/Guardian should be advised to call and report the absence to the Before and After School program, as per the Before and After School program attendance reporting procedures.
Child sent to Isolation Room or informs that they are sick during the After-School Program
- Using the Information Sharing Consent, Child Care staff will inform the school administrator prior to the start of school of the next school day, that a child has become ill or has become sick and that they have advised the parents/guardian that their child should not return to the After School program, until they have been assessed and advised by their health care provider.
- Please note: Symptomatic children, staff or parents who test negative for COVID-19 must be excluded from before and after school programs and services until 48 hours (*) after symptom resolution.
- Child Care staff will inform the parent of the child who was sent to the Isolation room or became ill during the After School program, that they will be sharing the information with the school as per the Information Sharing consent.
- Parents/guardians should be advised to call and report their child's absence to the school for the following day, as per the school attendance,
b. Management of Individuals Exposed to COVID-19 Outside of a School Setting
This section applies to individuals closely related to a school community, such as bus drivers, parents or members of a student's or staff member's household, who test positive for COVID-19 outside of the school.
Situations will arise where students, staff, essential visitors, or contractors may be exposed to COVID-19 outside of the school environment (for example, to family members that don't attend the school, social contacts outside of school).
Individual who are not fully immunized or previously positive and have been identified as a high-risk close contact of a COVID-19 case, such as household members, should not attend school. These individuals should follow directions from the local Health Unit on testing and self-isolation.
In general, isolation and testing of a cohort may not be necessary if the student or staff acquired the infection outside of the school setting and did not attend school while communicable. This will be determined and communicated by the local Health Unit.
- Management of a Confirmed Diagnosis of COVID-19 in the School Community
This section applies to a student, staff member or a member of a school community who is regularly in the school, who informs the school that they have tested positive for COVID-19.
Please note the following:
- Every individual who has tested positive for COVID-19 will be contacted by the local Health Unit.
- Any individual who tests positive for COVID-19 must isolate and cannot attend school until they are cleared by the local Health Unit. Individuals do not need to provide a medical note or proof of a negative result to return to school.
- The local Health Unit will notify the school of a positive COVID-19 diagnosis.
- Where the local Health Unit determines there was a transmission risk to others in the school, students and staff will be assessed by the local Health Unit to determine their risk of exposure and whether they will require testing and isolation.
- Classroom cohorts (students and staff affiliated with the cohort) will generally be considered at high risk of exposure.
- All students and staff who are identified as high risk close contacts should get tested regardless of their immunization status. In general, individuals who are fully immunized or previously positive will not require isolation, unless otherwise directed by the local Health Unit.
- A negative test result does not alter or shorten the isolation duration as they may still be incubating the virus.