CDC updates COVID-19 guidelines; masks now recommended for all in schools

The Missouri Department of Elementary and Secondary Education updated its school COVID-19 guidance Friday to align with the Centers for Disease Control and Prevention's guidance that was updated this month. However, on Tuesday, the CDC changed its guidance again.

The CDC updated its guidance for schools July 9 to align with its general guidance that said those who are fully vaccinated do not need to wear masks. However, it changed its guidance again Tuesday to recommend everyone in K-12 schools wear masks regardless of vaccination status and that people who are fully vaccinated resume wearing masks indoors in areas with high levels of the virus.

Now, it's likely DESE's COVID-19 guidance for schools - created with the Department of Health and Senior Services - will be updated again.

"DESE and DHSS officials are working together now to determine how Missouri guidance may be updated for K-12 schools," DESE Communications Director Mallory McGowin said. "We do not have a timeline in place yet for those updates but will work as quickly as possible to update this resource for school leaders."

The rest of the CDC's guidance for schools remains the same. It emphasizes the need for students to return to in-person learning and recommends schools use multiple prevention strategies.

DESE's guidance document said it's important to note the recommendations are issued from the state level and school districts should work with local public health agencies to determine appropriate mitigation strategies at the local level, as the delta variant "appears to be more quickly transmissible, more impactful on unvaccinated populations, and affecting more adolescents than what was experienced with COVID-19 last year."

The CDC's guidance also allows flexibility at the local level. Since many schools serve children younger than 12 who are not eligible for vaccination, the CDC recommends schools use multiple prevention strategies to protect those who are not fully vaccinated. It said school districts "should monitor community transmission, vaccination coverage, screening testing, and occurrence of outbreaks to guide decisions on the level of layered prevention strategies."

These recommendations could be updated again before the 2021-22 school year.

Masks

Given new evidence on the delta variant, the CDC now recommends all students, staff and school visitors wear masks, regardless of vaccination status. DESE's current guidance states those who are not fully vaccinated should wear masks, but this will likely be updated again to align with the CDC's new guidance.

DESE's current guidance states school mask policies should be made at the discretion of the school board "after consideration of community transmission and positivity rates within a community, and should be considered for adjustment as public health circumstances dictate." The policies should be developed with consultation of state or local health authorities, the guidance states.

Vaccines

The CDC and DESE recommend schools promote vaccinations among teachers, staff, families and eligible students by "providing information about COVID-19 vaccination, encouraging vaccine trust and confidence, and establishing supportive policies and practices that make getting vaccinated as easy and convenient as possible," according to the CDC.

Missouri expects school districts to work with local public health agencies or other state-enrolled vaccinators to offer vaccinations to eligible staff and students, according to DESE. Children 12 and older are eligible for COVID-19 vaccinations.

There is currently no federal guidance on whether a school district has the authority to require proof of vaccination status for students. While there is nothing that prevents school districts from asking each student for their vaccination status, "there is not a clear mechanism or legal authorization for a student or his or her parent or guardian to be compelled" to provide this information to the district, according to DESE.

DESE recommends school districts "collaborate with local public health agencies to gain public health insights and community transmission information" before making decisions that affect the public health of students. It also recommends districts consult with their legal counsel or appropriate advisory association on what factors could affect these decisions, such as the Freedom of Educational Rights and Privacy Act and Health Insurance Portability and Accountability Act.

Social distancing

DESE and the CDC recommend schools continue to space students 3 feet apart in classrooms. However, they emphasize spacing should not be an obstacle to getting children back in schools. If 3 feet of distance is not possible, they recommend using other mitigation strategies.

DESE's guidance said schools can keep students in cohorts to limit the number of students, teachers and staff who come in contact with each other, especially when social distancing is difficult to maintain or in areas of moderate or high transmission levels. However, students in each cohort should also use other prevention measures. Putting students who are fully vaccinated and people who are not fully vaccinated into separate cohorts is not recommended.

Food services

Social distancing should be maintained as much as possible when eating and moving through lunch lines. However, DESE's guidance states students and staff members who are fully vaccinated do not need to distance themselves while eating.

Given the low risk of transmission from surfaces and shared objects, there is no need to limit food items to packaged meals or single-use items, according to the CDC. However, DESE still recommends cleaning frequently-touched objects and surfaces that come in contact with food before and after meals. Schools should also promote proper hand hygiene before and after meals.

Screening tests

Screening tests identify infected people - with or without symptoms - so measures can be taken to prevent further transmission. In schools, screening tests can help "promptly identify and isolate cases, quarantine those who may have been exposed to COVID-19 and are not fully vaccinated, and identify clusters to reduce the risk to in-person education," according to DESE.

The CDC guidance said people are not fully vaccinated do not need to participate in screening tests and do not need to quarantine if they do not have any symptoms. The CDC provides screening test recommendations for K-12 schools by level of community transmission in its updated guidance.

Sports, extracurricular activities

If a student, coach or teacher who is not fully vaccinated has COVID-19 symptoms, they should be tested and refrain from extracurricular activities, according to DESE.

The CDC recommends students who are not fully vaccinated and participate in indoor sports and other higher-risk activities continue to wear masks and social distance as much as possible.

Schools should consider using screening testing for student athletes, coaches and teachers who are not fully vaccinated and participate in activities, according to the CDC.

Additional preventative measures

Screening tests, ventilation, hand washing, respiratory etiquette, staying home when sick and getting tested, contact tracing in combination with quarantine and isolation, and cleaning and disinfecting are also important prevention strategies to keep schools safe, according to the CDC.

Cole County schools

All Cole County school leaders meet with the Cole County Health Department regularly to determine plans and ensure they are up to date on local conditions.

Most Cole County schools do not plan to have any COVID-19 restrictions, including Helias Catholic High School and Lighthouse Preparatory Academy in Jefferson City, the Blair Oaks R-2 School District in Wardsville, and the Cole County R-5 School District in Eugene.

The Cole County R-1 School District in Russellville plans to keep students in cohorts, and the Jefferson City School District expects to have a plan next week to share with staff and families.

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