School Health and Related Guidelines

School Health
  • COVID-19 Teams and COVID-19 Staff Requirements

    Updated November 19, 2020 | COVID-19 School Health and Related Guidelines (PDF)

    Future phased returns of students for in-person instruction may necessitate additional changes.


    ACPS Liaison/ADH Point of Contact

    School COVID-19 Teams

    Contact Tracing Procedures

    Quarantine Instructions

    Student and Staff Health Screening Protocol During COVID-19

    Temperature Screenings

    COVID-19 Screening Questions for Staff

    Daily Health Screening for Students

    Non-ACPS Visitors

    Prevention and Mitigation Strategies

    Protocols for Students Who Become Ill at School

    Protocol for Mask Breaks

    ACPS Return to In-Person Instruction Checklists

     

     

    ACPS Liaison/ADH Point of Contact

    ACPS will assign an ACPS liaison (and two back-ups) to liaise with Alexandria Health Department (AHD) on COVID-19 Response. (AHD Recommendation).

    • In ACPS, the ACPS liaison is the Chief of Student Services & Equity.  The two back-ups are the Executive Director of Student Support Teams and the Executive Director of Student Services.  
    • Once a school is notified of a positive case, they will contact the ACPS liaison.
    • The ACPS liaison notifies the AHD School Response Team and submits the Authorization to Exchange Information Form to AHD via a predetermined secure messaging platform.
    • The ACPS liaison notifies AHD of any newly positive cases that occur within a school.
    • After consultation with the AHD, ACPS shall disseminate AHD-approved communications to appropriate staff, students, and parents.
      • Liaison should be reachable evening and weekend hours by phone or email.

     

    School COVID-19 Teams

    Each school will designate a “School COVID-19 Team,” consisting of trained administrators and staff members, with back-up(s), to be responsible for responding to COVID-19 concerns and for communicating with the ACPS liaison to AHD. (AHD Recommendation).

    • Notify all staff and families of how to contact the School COVID-19 Team for questions and concerns related to COVID-19.
    • Ensure a point person from the School COVID Team is available daily to respond to COVID-19 concerns in the school and to respond to parents’/guardians’ telephone calls.

    The School COVID-19 team supports the items below: 

    • Public health isolation and quarantine instructions are followed within the school.
    • Basic infection prevention practices within the facility are reinforced, as detailed in the ACPS school reopening plan.
    • The gathering of information regarding potentially exposed staff and students
    • Coordinates the collection of classroom seating charts to include addresses and phone numbers of staff and students as well as copies of the Authorization to Exchange Information Forms (See below) for staff and students.  This makes them quickly available to support potential needs for contact tracing.

    Authorization to Exchange Information Form (MS Word) Amharic | Arabic | English | Spanish

      

    Contact Tracing Procedures 

    Adapted from Alexandria Health Department documents

    Should ACPS become aware of a case of a staff member or student who has COVID-19 or may be suspected of having COVID-19:

    • The school or department administrator contacts the ACPS liaison once they are aware of a positive case.
    • The ACPS liaison notifies the AHD School Response Team of a newly positive case and provides any available preliminary information:
      • Name of staff member or student
      • Address and contact information of staff member or student
      • Date when symptoms began
      • Date when staff member or student was last in an ACPS facility
        • Informal information as to who they may have been in close contact with on that date(s)
      • Date of testing
      • Date positive test was returned
      • Note that a person with COVID-19 is considered to be contagious 2 days prior to the onset of symptoms.  If they are asymptomatic, they are considered contagious 2 days before they tested positive for COVID-19. 
    • The School COVID-19 Team, in consultation with the ACPS liaison, provides the documents below to the positive case for them to complete and fill out if not already done so. Note that this is a priority:
      • Authorization to Exchange Information Form (MS Word) 
        • Amharic | Arabic | English | Spanish (if not already on file)
        • Should written consent on the document not be feasible, please discuss other options with the ACPS liaison
      • Preliminary COVID-19 Questionnaire (for the positive case to complete when possible)
    • Confidentiality MUST be maintained during this process by the ACPS liaison and the School COVID-19 Team.  No additional communication should occur to other parties at this time per HIPAA rules.
    • The School COVID-19 Team provides the completed documents to the ACPS liaison, who send them through secure electronic means to the AHD or via in person exchange, both the release and the listing of all potentially exposed staff and students.
    • The AHD School Response Team, upon receipt of all available information, works with the ACPS liaison to determine the potential amount of risk as well as recommend general communication to a school or division community and specific communication to any close contacts.  
    • After consultation with and approval from AHD (and not before), ACPS works with the Department of School and Community Relations as well as the School COVID-19 Team to disseminate appropriate communications to identified staff, students, and parents, following the designated Internal Communications Process for a Positive COVID-19 Case:
      • A General Notification Letter from ACPS to staff and parents/guardians/students which provides an explanation that only those identified as close contacts will receive an additional Contact Notification Letter.
      • If permissible and needed, a Contact Notification Letter advising of being a close contact and to parents/guardians and staff deemed by AHD to be close contacts:
        • This communication informs close contacts/parents of close contacts that they will be contacted by AHD for symptom monitoring and additional guidance on health precautions and quarantine.
        • Note: AHD performs additional contact tracing for community contacts external to the school for students and staff who reside in the City of Alexandria.

     

    Quarantine Instructions

    The quarantine instructions for students/staff identified as close contacts are:

    • Students and staff deemed as close contacts (within 6 feet for greater than 15 minutes (cumulative) within a 24-hour period during the infectious period of the ill individual) must quarantine for 14 days per the AHD COVID-19 When You Can Be Around Others.
      • Any questions or special circumstances would be addressed in consultation with the AHD.
    • Staff or parent/guardian of student close contacts that have been identified and placed under quarantine should follow the guidelines and requests from the AHD.
    • Additionally, AHD will be enrolling them into an electronic symptom monitoring program.
    • Staff identified for quarantine should consult with the ACPS liaison if staff cannot self-quarantine at home.

     

    Student and Staff Health Screening Protocol During COVID-19

    Screening and monitoring are essential components of limiting the spread of COVID-19. Alexandria City Public Schools (ACPS) encourages sick staff and students to be aware of symptoms of COVID-19 and stay home if they are ill.

    Symptoms of COVID-19

    People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

    • Fever or chills (AHD defines this as 100.0oF or greater)
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

    This list does not include all possible symptoms. CDC will continue to update this list as we learn more about COVID-19.

    Source: CDC

     

    Temperature Screenings

    Students and staff will be required to have their temperature taken with an infrared thermometer prior to entering an ACPS school.  The temperature screening will be contact-free.  The screener will explain the process and take the temperature of the person with a clinical forehead thermometer. They will show the temperature screen to the person. 

    • If the temperature is less than 100 degrees (per Alexandria Health Department) the screener clears the person to enter the school.
    • If the temperature is 100 degrees or greater for a staff member, on the first screen the person may rest to the side for 5 minutes and the temperature can be retaken one additional time.  If waiting for the temperature to be retaken, the person should not be around others and should remain masked.  If the second screening remains 100 degrees or greater, the screener tells the person that they cannot report to work at an ACPS worksite. They are then advised to call their supervisor and notify them that they were not cleared due to an elevated temperature. The supervisor will refer the person to contact their health care provider. 
    • If the temperature is 100 degrees or greater on the first screen for a student, the student may rest to the side for 5 minutes and the temperature can be retaken one additional time.  If waiting for the temperature to be retaken, the student should not be around others and should remain masked (if possible).  If the second screening remains 100 degrees or greater, the student will be directed to the health annex and the parent or guardian will be contacted to pick up their child within one hour.  The parent or guardian will be referred to contact their health care provider.

     

    COVID-19 Screening Questions for Staff

    Daily health screens of staff for COVID-19 symptoms are a recommendation of the Centers for Disease Control (CDC). ACPS, in partnership with the AHD, will require staff to complete an online symptom checklist each day before reporting to work. This form will be submitted electronically to administrators within each school for review each day.  If any answers are “YES” staff should not report to work and should contact their supervisor for further instructions.

    Current temperature:

     

     ___________

    Have you experienced any of the following symptoms in the past 48 hours:

    • fever or chills
    • Cough
    • shortness of breath or difficulty breathing
    • Fatigue
    • muscle or body aches
    • Headache
    • new loss of taste or smell
    • sore throat
    • congestion or runny nose
    • nausea or vomiting
    • diarrhea

     YES

     NO

    Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19?

     YES

     NO

    Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19?

     YES

     NO

    Are you currently waiting on the results of a COVID-19 test?

     YES

     NO

    If an individual has a temperature above 100 degrees and/or answers YES to any of the screening questions before arriving, they should stay home and not enter the building. If an individual reports COVID-19 symptoms upon arrival, the school should activate the emergency protocol for COVID-19.

    Source: CDC

     

    Daily Health Screening for Students

    Daily health screens of students for COVID-19 symptoms are a recommendation of the Centers for Disease Control (CDC). ACPS, in partnership with the AHD, will require students or their families to complete a symptom checklist each day before reporting to school.  The form may be completed online (submitted electronically to the school nurse and administrative assistant) or on paper to the school nurse or administrative assistant within each school. If an individual has a temperature above 100 degrees and/or answers YES to any of the screening questions before arriving, they should not report to school and should contact their health care provider for further instructions.

    Current temperature:

     

     ___________

    Have you experienced any of the following symptoms in the past 48 hours:

    • fever or chills
    • Cough
    • shortness of breath or difficulty breathing
    • Fatigue
    • muscle or body aches
    • Headache
    • new loss of taste or smell
    • sore throat
    • congestion or runny nose
    • nausea or vomiting
    • diarrhea

     YES

     NO

    Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19?

    YES

     NO

    Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19?

     YES

     NO

    Are you currently waiting on the results of a COVID-19 test?

    YES

     NO

    If an individual has a temperature above 100 degrees and/or answers YES to any of the screening questions before arriving, they should stay home and not enter the building. If an individual reports COVID-19 symptoms upon arrival, the school should activate the emergency protocol for COVID-19.

    COVID-19 Daily Student Symptom Checker

    Source: CDC

    Non-ACPS Visitors

    Visitors from outside of ACPS facilities are largely prohibited while in-person instruction is occurring in order to prioritize the safety and health of ACPS staff and students.  Visitors who need to enter buildings while in-person instruction is taking place in order to comply with federal, state, or ACPS policy must have prior approval from district or school administration and must complete both temperature screenings as well as the daily health screening questions prior to admittance to an ACPS facility.  All visitors must wear face masks while they are in the ACPS facility. All visitors are reminded to remain home if they are feeling unwell or exhibiting any symptoms of COVID-19.

     

    Prevention and Mitigation Strategies

    Hand Washing and Hand Sanitizing

    • Frequent handwashing is the most critical practice for preventing the spread of disease. 
    • Washing hands with soap and water for at least 20 seconds is the gold standard.
    • Both staff and students should wash their hands upon arriving in the classroom, before/after eating, before/after using the bathroom, and before/after recess at a minimum.
    • Sanitizing is appropriate when the opportunity for hand washing is not available. 
    • Hand sanitizer is available for staff and students in classrooms and throughout ACPS facilities.
    • Resources:

     

    Water Bottles and School Supplies

    Water fountains will only be allowed for water bottle refills. Students should provide their own water bottles each day.

    Students should only use their own school supplies during the day.  The sharing of school or related supplies between students should be minimized to the highest extent possible.  Student supplies or items should be stored in a designated location specific to the student each day they are in attendance to avoid any potential cross contamination and spread of germs.

    Students should plan on bringing a paper or plastic bag with them to school in which they can place their mask during times they may be eating at their desk or during a brief mask break (See section on Protocols for Mask Breaks).

     

    Cleaning, Transportation, and Building Protocols

    Classroom and building cleaning and set-up, transportation cleaning and scheduling, and other protocols related to the use of ACPS facilities, such as schools, should be followed as determined by the Office of Facilities and Operations:

    Health and Safety Procedures (from the Office of Facilities and Operations)

      

    Face Masks and Training in Donning and Doffing PPE

    School staff who return to in-person instruction will receive opportunities to train and complete checklists in the use of face masks, PPE, or other mitigation measures as appropriate for their position and situation.  The videos and handouts below can assist individuals or school teams in practicing and preparing for appropriate donning and doffing procedures as well as the appropriate way to put-on and take-off a face mask, for themselves and to teach students:

     

    Protocols for Students Who Become Ill at School

    Classroom vs. Health Clinic/Health Annex 

    Minor first aid situations, to the degree possible, should be handled in the classroom to prevent office congregation and possible cross exposure. The goal is to keep otherwise healthy students out of the clinic where they can be exposed to illness.

     CLASSROOM

     NURSE

    • Itching bug bite
    • Scratch/Scrape
    • Bleeding scab
    • Band aid
    • Loose tooth/toothache
    • Earache
    • Ice pack
    • Migraine headache
    • Chapped lips
    • Itching head/head lice
    • Anxiety/stress/psychological issue try calming techniques and/or contact school psychologist or counselor 

     Call nurse to room if needed

    • Head or face injury
    • Severe stomach pain
    • Nosebleed >5 minutes
    • Diabetic Emergency
    • Asthma attack
    • Possible broken bone
    • Deep cut
    • Insect sting 
    • Fainting or seizure
    • Allergic reaction
    • COVID-19 symptoms*

     

    *COVID-19 Symptoms

    People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

    This list does not include all possible symptoms. CDC will continue to update this list as we learn more about COVID-19.

    Source: CDC

    If a student is unwell with COVID-19 symptoms the student should report to the health clinic for further evaluation by the school nurse. 

    • School nurses and other school health services staff should don provided PPE to include face shields, gloves, etc. to assess the student.  
    • Students should maintain the wearing of face masks on their way to and while in the clinic.
    • The classroom, clinic, and health annex area in which the student was seated or active should be cleaned and wiped down per procedures and guidelines developed by Facilities and Operations

    If COVID-19 Symptoms are noted by the school nurse:

    • Ask the student to apply a face mask, if not already wearing.  Note that some students may not be able to wear a mask, particularly students with more significant disabilities or those with specific documented health conditions.
    • Send student to the Health Annex room (isolation room monitored by another adult) for further evaluation and parent or guardian contact to pick up the student within one hour.
      • Health Annex Room staff should wear the provided PPE while any students are in the room.
      • If there are multiple students in the Health Annex Room, the maximum amount of social distancing allowable in the space should be maintained between the students at all times.
    • Monitor student symptoms and gather additional information, noting it on the COVID-19 Symptoms Monitoring Sheet
    • Based upon responses to the COVID-19 Symptoms Monitoring Sheet, provide the parent or guardian with the appropriate information regarding when a student may return to school, using the COVID-19 Guidance from the Virginia Department of Health and the COVID-19 When You Can Be Around Others guidance from the Alexandria Health Department.  Please inform school or program administrators to discuss the potential need for the student to engage with virtual instruction for a set period of time:
    • Parents or guardians will be told that students should not return to school until either the applicable return-to-school criteria from the AHD and VDH have been met or the student has received clearance and documentation from a medical provider that they are safe to return to in-person instruction.  
    • If a child is sent to in-person school prior to meeting the applicable return-to-school AHD and VDH criteria or receiving clearance from a medical provider, the child will be sent to the Health Annex room and their parents or guardians will be called to pick up their child within one hour.

     

    Health Clinic Guidelines for School Year  2020-2021

    In general the school will need to establish the following three areas:

    • General Waiting: Students waiting to be triaged (present to office with unscheduled needs)
    • Well Student Area: Area for well students with health care needs that cannot be addressed in the classroom (diabetic and other non contagious health care needs)
    • Health Annex (Isolation Room): Area for students with possible COVID symptoms 
      • The student arriving at the clinic or health annex must wear a face mask and stop at the designated distancing sign. 
      • The clinic and health annex staff must wear a face mask and face shield/eye protection and additional PPE as needed.
      • The school health staff member will ask the student what their presenting symptoms are and check the student’s temperature

    If the student presents with any of the following:

    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

    *Look for emergency warning signs or COVID-19. If someone is showing any of these signs, seek emergency medical care immediately:

    • Trouble breathing
    • Persistent pain or pressure in the chest
    • New confusion
    • Inability to wake or stay awake
    • Bluish lips or face

    *This list is not all possible symptoms. Please call your medical provider for any other symptoms that are severe or concerning to you.

    Call 911 or call ahead to your local emergency facility: Notify the operator that you are seeking care for someone who has or may have COVID-19.

      • Students must continue to wear a face mask and will be directed to the Health Annex area.
      • Staff must continue to wear a face mask, face shield/eye protection, and will apply additional appropriate personal protective equipment (PPE) to include gloves, a gown, and N-95 respirator.
      • Students must be spaced at least 6 feet apart and monitored for the entire duration they are in the waiting area.
      • Parents or guardians should be notified promptly that their child will need to be picked up and will need to seek medical attention.
      • Parents or guardians will not be able to enter the building.  School health personnel will need to communicate where the parents or guardians may pick-up their student.

     

     Once the student has left, the area must be disinfected per guidelines from Facilities and Operations, the staff member removes PPE and performs hand hygiene.  Information on the proper donning and doffing of PPE can be found on the CDC website.  CDC: Using PPE

     If the student presents to the clinic for:

    • Injuries
    • Chronic conditions
    • Daily medications

    Note: Treat students who have an asthma care plan according to that plan and do not send them to the Health Annex unless experiencing respiratory distress.

      • Students must continue to wear a face mask. Staff must continue to wear a face mask and face shield/eye protection.
      • The student may enter the clinic.
      • Gloves will be worn for standard precaution procedures as needed.

    Once care has been completed, the student must wash their hands prior to leaving and the area used must be disinfected per guidelines from Facilities and Operations.

    Health and Safety Procedures (from the Office of Facilities and Operations)

     

    Protocol for Mask Breaks

    Face masks are required at school and on the bus for all students in grades Pre-K to 12 as well as all ACPS staff.  Students and staff may require or request mask breaks from time to time.  Mask breaks may be completed under the conditions below:

    • Students and staff are able to maintain a distance of six feet from each others for the duration of the break
    • School or program administrators are notified of the break or schedule of breaks (if applicable)
    • The mask break should take place outside whenever possible
    • If the mask break is held indoors, a minimum of six feet of distance is required.  Students should all be facing the same direction and engaged in a quiet activity, such as sustained silent reading, for the duration of the break.
    • The doffing (taking off) and donning (placing on) of face mask protocols are followed by staff and students (See section on Face Masks and Training in Donning and Doffing PPE)

    How to Take Off a Face Mask (Doff)

    • Ensure that students and staff are at least 6 feet away from one another for the duration of the break.
    • Remove mask using the following procedure:
      • Wash hands with soap and water or use hand sanitizer
      • Avoid touching the front of the mask
      • If the mask has ear loops: hold both of the ear loops and gently lift and remove the mask.  
      • If the mask has ties: untie the bottom first, then untie the top and pull the mask away from you as the ties are loosened.  
      • If the mask has bands: lift the bottom strap over the head first, then pull the top strap over the head
    • Once removed the mask should be carefully folded in half with the inside of the mask touching, and place the mask in a labeled paper bag or in rolled up paper towel.
    • If the mask is soiled, dispose in trash (if disposable mask) and put on a clean mask after break.
    • If a cloth mask is soiled put it in a separate bag and put it in a backpack to bring home for laundering. Put on a clean cloth mask after break.
    • Wash hands with soap and water or use hand sanitizer.

    How to Put on a Mask (Don)

    • Clean hands with soap and water or use hand sanitizer
    • Put on the mask using the following procedure
      • Remove mask from paper bag or paper towel.  Do not touch the outside (front) of the mask
      • If the mask has ear loops: hold the mask by the ear loops and place a loop around each ear.
      • If the mask has ties:  bring the mask to your nose level, tie the top tie first followed by the bottom tie.  Secure ties with a bow.
      • If the mask has bands:  Bring the mask to nose level without touching the outside (if reusing mask) and pull the top strap over your head followed by the bottom strap.
      • Make sure the mask covers your nose, mouth and chin.
      • Wash hands or use hand sanitizer.

     

    ACPS Return to In-Person Instruction Checklists

    For Parents/Guardians/Students

    • Current physical, up to date grade level immunizations and TB screen
    • Updated Health Information and IHP form on file
    • Emergency medications and related authorizations, if applicable, in school clinic
    • Current demographic information, with up to date phone numbers for parents/guardians/emergency contacts
    • Authorization to Exchange Information Form (MS Word) (Strongly Recommended)
    • For students with complex medical issues, medical clearance from a primary care provider to receive educational services at school AND school nurse is aware of any specialized physical healthcare services (Strongly Recommended)
    • Prepare students for the wearing of face masks: 
    • COVID-19 Parent or Guardian Commitment Form (MS Word) (Strongly Recommended)

    For School Based Staff

    • PPE (one month supply at school site)
    • Authorization to Exchange Information Form (MS Word) (Strongly Recommended)
    • Air purifier (in health clinics and other locations as determined by Facilities and Operations)
    • Two persons in school building trained for medication administration 
    • On-site school based staff trained in Epinephrine (EpiPen) administration per the COVID-19, Food Allergies, and Meals in the Classroom guidance.
    • Walk-through with checklist for clinic and health annex completed (School Health staff)
    • Table top/simulation exercises completed with Alexandria Health Department
    • Training completed for PPE selection, handwashing, and donning/doffing PPE
    • N-95 respirator fit testing (School Health staff)
    • Staff should complete blood-borne pathogens (BBP) training before returning to  a school building 
    • School based COVID-19 team identified and trained per ACPS/AHD training specifications
    • Classroom seating charts to include addresses and phone numbers of staff and students as well as copies of the Authorization to Exchange Information Forms for staff and students are provided to the school or program administrator and the school nurse to support potential needs for contact tracing.