Nemaha County Community Health Services
November 3, 2020
Updated Contact Tracing and Exclusion of Contacts in a low risk school setting
Nemaha County Community Health Services is releasing the following updated public health guidance for K-12 schools. The recommendations are based on currently available data and science, as well as other expert analysis from the Centers for Disease Control and Prevention (CDC) and the Kansas Department of Health and Environment (KDHE). Nemaha County Community Health Services works closely with regional health departments and school administrators to quickly identify cases and close contacts within the schools and monitor spread of COVID-19 through case and contact investigation. Nemaha County Community Health Services is issuing this updated guidance to modify the exclusion policy when following public health mitigation measures in a low risk environment and to incentivize the usage of masks within the school settings.
Nemaha County Community Health Services staff and school officials continue to partner on contact tracing activities to ensure that spread of COVID-19 transmission in schools or at school-related activities is minimal. School officials assist with contact tracing within the school setting, while Nemaha County Community Health Services will be responsible for identifying and quarantining contacts. Quarantining close contacts of infected individuals is a tried and true public health mitigation technique. If possible, contact tracing should be completed the same day a school is notified by any person of a confirmed positive COVID-19 case.
Specific circumstances constituting high risk and low risk exposures to a confirmed positive COVID-19 case are further defined below. Circumstances not included in the definitions below will be evaluated by health department staff on a case by case basis.
High Risk Exposures
- Contact with anyone unmasked, when less than 6 feet for longer than 10 minutes
- Eating breakfast/lunch/snack less than six feet apart, unless otherwise approved (by Nemaha County Community Health Services or KDHE) or physical barriers are not in place (i.e. Plexiglas)
- Physical exertion, indoors or outdoors, when less than 6 feet for longer than 10 minutes
- High-risk sports, as defined by the National Federation of State High School
- Playing woodwind and brass instruments without other precautions (mask, distance)
- Singing/shouting without other precautions, when less than 6 feet for longer than 10 minutes
- Being in the same classroom with proper mask wearing
- On the same bus with appropriate mask wearing.
Associations, including “sports that involve close, sustained contact between participants,
lack of significant protective barriers, and high probability that respiratory particles will be transmitted between participants.”
Low Risk Exposures
- Playground, even if unmasked, (social distancing and cohorts maintained); this moves into a high-risk exposure if kids have sustained contact with physical exertion for more than 10 minutes
- Walking in the same hallway masked
- Attending a class during the period after a positive individual was present in the classroom
Not considered Exposed or close contact
Wearing of Masks Exclusion Protocol
Mask wearing has been shown to be an effective way to prevent the spread of COVID-19. Individuals who are wearing masks and are in close contact (6 feet for 10 minutes or more) with an infectious individual wearing a mask are considered low risk for contracting COVID-19. Because schools have policies and monitoring capabilities for mask wearing, Nemaha County Community Health Services does not recommend excluding students and staff who are close contacts of a COVID-19 positive individual, as long as masks were being worn correctly (covering nose and mouth) and in what is otherwise considered to be a low risk exposure. In those situations, quarantine of close contacts would not be required. Individuals who were unmasked within 6 feet for 10 consecutive minutes or more or participated in a high-risk activity with a COVID-19 positive individual during their infectious period, or who were directly exposed to respiratory droplets/excretions for any amount of time, will be excluded for 14 days from their last interaction with the individual.
Exclusion of a Group
The risk of COVID-19 transmission is low if public health mitigation techniques such as proper
masking, physical distancing and hand hygiene are being followed. If transmission is occurring
within a group setting (such as a classroom, bus route, sports team, outside on the playground, etc.), it is an indication that public health measures may not have been followed. If there are two or more positives in a group*, contact Nemaha County Community Health Services to determine if there is evidence of COVID-19 transmission. If transmission is identified, the entire group may be excluded for 14 days from the last exposure to an infectious individual.
If an individual is tested during their 14-day quarantine period and is negative for COVID-19, they still need to complete the 14-day quarantine before returning to school, as symptoms can take up to 14 days to develop.
*Groups are considered to be collections of students in a classroom, bus riders, clubs, etc. It is critical that seats and cohort groups are assigned and adhered to, so that contacts can be traced; if contacts cannot be traced and public health measures are not being followed, the entire group may be excluded following a single positive case.
Community and school transmission of COVID-19 is continuously monitored. This plan may be modified as new data is collected.