Return to School: A guide to responding to COVID-19 cases in
K-12 school settings. 2020-2021

January 13, 2021
		
	Fresno County Department of Public Health.

Return to School: A guide to responding to COVID-19 cases in K-12 school settings

This document was designed to provide guidance for Fresno County K-12 schools in response to COVID-19 related scenarios. As students return to school and in-person instruction resumes, we recognize the importance of protecting the health and safety of our students, school staff, and community. The goal of this document is to help school staff respond to different scenarios and cases of COVID-19. This document is applicable to all K-12 schools, public or private, throughout Fresno County.

As schools prepare to resume-in person instruction, we advise schools to prepare plans for remote instruction for students who may need to isolate or quarantine. Schools should also be prepared for short-term and long-term school closures.

The following guidance is included in this document:

•	COVID-19 Prevention and Best Practices •	COVID-19 School Scenario Guidance
•	Guidelines for COVID-19 Exposure Scenarios for Schools

We will continue to revise these documents as necessary and as guidance from the California Department of Public Health and CDC is updated.

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COVID-19 Prevention & Guidance for Schools

Fresno County Department of Public Health’s Best Practices

•	Perform symptom screening (including temperature check) for all students upon entry into first classroom of the day, AND for all staff, volunteers, or others when entering school buildings.
•	Implement universal face coverings for all students, teachers, staff, volunteers, etc. •	Availability of hand sanitizer at all entrances and commonly visited locations.
•	Practice Social Distancing (6 feet apart) in all indoor and outdoor settings including cafeterias, gyms, and libraries.
•	Assess adequacy of ventilation in all indoor school settings.

•	Maximize space between students and between students and the driver on school buses, and open windows and keep air circulation on to the greatest extent practicable.
o Keep windows open and circulation on during bus rides.

•	For activities where social distancing is difficult to maintain we recommend: o students stay in pods of 10 or less
o limit these activities to 15 minutes or less o stay outdoors as much as possible
•	Maintain capacity for isolation of symptomatic students in a room with a separate entrance when students are on campus, with staff with appropriate PPE immediately available.
•	Cleaning and disinfecting all used facilities each day after school has ended, and high-use surfaces more frequently.
•	In classrooms where seats are shared by multiple students (middle and high school), desks should be cleaned and disinfected before and/or after each class.
•	Minimize opportunities for contact where students/staff may congregate, i.e. start/end of the school day, lining up for lunch, etc.

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Covid-19 School Scenario Guidance

Potential Scenarios	Key Contributing Factors	Potential Responses/Actions

□ Student has tested positive for COVID-19

□ Student feels ill and is waiting for test results

□ Student develops COVID symptoms while at school

□Member of student’s household tests positive

□ Teacher tests positive

□ Student feels ill with COVID symptoms but parent will not be testing child

□ Student tests negative but has COVID symptoms (possible false negative)

□ Administrator or staff member, or volunteer tests positive

□ Administrator or staff, or volunteer feels ill with COVID symptoms

□ AM Kindergarten student or teacher tests positive

□ Outbreak of cases on campus

□ Bus driver, or student rider on bus, tests positive

□ Student or teacher in after school program tests positive
	
□ Was index case wearing mask properly?

□ Was social distancing maintained?

□ Duration of exposure to index case.

□ COVID-19 confirmed or suspected

□ Index case symptomatic or asymptomatic

□ Location of exposure -classroom, outdoors, other indoor setting

□ Proper PPE used?

□ Prior positive cases in classroom?

□ Prior positive cases on school campus?

□ Type of transportation to and from school

□Windows open or closed on bus

□ Presumed source of spread to index case-school vs community

□ Household contacts at other schools

□ Close contacts in school sports or other after-school programs
	
□ Notify school community of COVID positive cases in the child’s classroom or school

□ Complete contact tracing

□ Quarantine close contacts

□ Inform potential close contacts to self-monitor, follow up with physician if symptoms develop.

□ Sanitize and disinfect potentially contaminated equipment, supplies, and rooms

□ Close classroom

□ Contact the Fresno County Department of Public Health (FC DPH)

□ Recommend testing if not already done

□ Recommend evaluation from physician

□ Follow up contact with index case and/or close contacts scheduled

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Guidelines for COVID-19 Exposure Scenarios for Schools

This following is guidance for steps to take in response to confirmed and suspected positive cases on your school campus.

Scenario
	
Response and Isolation Steps
	
Communication and Contact Tracing Steps
	
1. Student has tested positive for COVID-19
	Student to remain at home for 10/1. If asymptomatic, the 10 days begins on the date the student was tested. If symptomatic, the 10 days begins on the day the symptoms began.
If symptoms persist beyond 10 days, student to remain at home until at least1 day after symptoms have resolved without the use of medication.

Identify locations where the index case spent more than 15 minutes over a 24-hour period in the two days prior to the day the positive test was collected OR to symptom onset: classroom, library, cafeteria, school bus, etc. If these locations have not been cleaned and sanitized since the student was present, close location for as close to 24 hours as practical for cleaning and sanitizing.
	School to identify close contacts in the two days prior to the day the positive test was collected OR to symptom onset, up to the tim the student was last in class. School to send notification letter to all close contacts.

e
	
			Advise ALL household and close contacts t quarantine for 10 days and self-monitor for COVID-19 symptoms through Day 14 and i
	o

				f
		
			symptoms occur, immediately self-isolate and
		
			contact their local public health department or
		
			healthcare provider and seek testing.

If other school-aged children are in the household, notify their respective school sites.

Notify FCDPH liaison.

Notify school community including staff and parents of a new positive case. Notification to indicate the date the school was informed of the positive case and the number of new positive cases that day without releasing information that would identify whether the positive case was a student or staff member or what grade or class was involved.
	
2. Student becomes ill off school campus and is waiting for test results
	Student to remain at home for 10/1 or if symptoms persist beyond 10 days, for at least one day after symptoms resolve without the use of medication. OK to return to school if test negative for COVID AND symptoms have resolved for at least one day OR if a licensed health care provider determines that symptoms are not new or worsening based on a chronic medical condition OR if a licensed health care provider has made an alternative diagnosis based on a diagnostic test such as a positive strep screen or a positive screen for influenza.
	Recommend student follow up with physician for evaluation and testing.

Notify student’s family that other school-aged household contacts should not return to school for 10 days from last contact with index case. Household contacts may return if student tests negative for COVID AND household contacts have been asymptomatic for at least one day OR if a licensed health care provider determines that symptoms are not new or worsening based on a chronic medical condition OR if a licensed health care provider has made an alternative diagnosis based on a diagnostic test such as a positive strep screen or a positive screen for influenza.

Notify classroom teacher and advise teacher to monitor other students for symptoms.

If second confirmed or suspected case in classroom, school to identify close contacts in classroom and other school settings in the two days prior to illness up to the time the student

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case to
	quarantine for 10 days and self-
		
monitor for COVID-19 symptoms through Day
	
14 and if symptoms occur, immediately self-
		
isolate and contact their local public health
		
department or healthcare provider and seek
		
testing.

		was last in class, including key contributing factors. Identify close contacts with symptoms and advise them to quarantine for 14 days and notify FCDPH liaison.
If student tests positive for COVID, identify and notify close contacts, school community, and FCDPH liaison.
	
3. Student develops COVID symptoms while at school
	Student placed in isolation room with separate entrance until transported home or to higher level of care. More than one student may be placed in isolation room if all masked and socially distanced as much as possible. If unable to maintain six feet distance from index case, staff person with full PPE (N95 or higher mask, goggles/eye protector, gown, and gloves) must be immediately available to evaluate or assist student if necessary, or arrange for prompt transfer to appropriate level of care.

Student may be accompanied while moving from classroom or other school site to isolation room by staff person with face covering AND observing social distancing protocols. If closer contact required, staff person with full PPE must accompany child to isolation room.

Isolation room to be cleaned and sanitized after symptomatic student leaves. Room cannot be re-used until cleaning and sanitizing completed.

Student to remain at home for 10/1 or if symptoms persist beyond 10 days, for at least one day after symptoms resolve without the use of medication. OK to return to school sooner if test negative AND symptoms have resolved for at least one day without the use of medication OR if a licensed health care provider determines that symptoms are not new or worsening based on a chronic medical condition OR if a licensed health care provider has made an alternative diagnosis based on a diagnostic test such as a positive strep screen or a positive screen for influenza.
	Recommend student follow up with physician for evaluation and testing.

Notify student’s family that all household contacts should not return to school or work
	
		for
	10 days
	from last contact with student.
	
		Household contacts may return if index case tests negative for COVID AND household contacts have been asymptomatic for at least one day without the use of medication OR if a licensed health care provider determines that symptoms are not new or worsening based on a chronic medical condition OR if a licensed health care provider has made an alternative diagnosis based on a diagnostic test such as a positive strep screen or a positive screen for influenza.

Notify classroom teacher and advise teacher to monitor other students for symptoms.

If second confirmed or suspected case in classroom, school to identify close contacts in classroom and other school settings in the two days prior to illness up to the time the student was last in class, including key contributing factors. Identify close contacts with symptoms and advise them to quarantine for 14 days and notify FCDPH liaison.

If student tests positive for COVID, identify and notify close contacts, school community, and FCDPH liaison.
	
4. Member of student’s household tests positive
	Student, and ALL household contacts, including other school-aged household contacts, need to quarantine and not return to work or school for 10 days from date of last contact with index case during index case isolation period.
	Student sharing household with positive index

Advise all other school-aged household
	
		contacts to
	quarantine for 10 days and self-

6

			monitor for COVID-19 symptoms through Day
		
			14
	.

If student sharing household becomes symptomatic, refer to scenario #2 above. If student tests positive for COVID, refer to scenario #1 above.

Notify school community including staff and parents of a new positive case. Notification to indicate the date the school was informed of the positive case and the number of new positive cases that day without releasing information that would identify whether the positive case was a student or staff member or what grade or class was involved.
	
5. Teacher tests positive
	Teacher to remain at home for 10/1. If asymptomatic, the 10 days begins on the date the teacher was tested. If symptomatic, the 10 days begins on the day the symptoms began.
If symptoms persist beyond 10 days, teacher to remain at home until at least1 day after symptoms have resolved without the use of medication.

If not cleaned and sanitized since teacher was last in class or in any other school setting for 15 minutes or more over a 24 hour period since the two days prior to testing positive or becoming symptomatic, close classroom or other school settings for as close to 24 hours as practical for cleaning and sanitizing.
	School to identify close contacts in the two days prior to the day the positive test was collected OR to symptom onset, up to the ti the teacher was last in class. School to send notification letter to all close contacts.

Advise ALL household and close contacts to

me
	
			quarantine for 10 days and self-monitor fo
	r
		
			COVID-19 symptoms through Day 14 and if
		
			symptoms occur, immediately self-isolate and
		
			contact their local public health department or
		
			healthcare provider and seek testing.
		
		If there are school-aged children are in the household, notify their respective school sites.

Notify FCDPH liaison.

Notify school community including staff and parents of a new positive case. Notification to indicate the date the school was informed of the positive case and the number of new positive cases that day without releasing information that would identify whether the positive case was a student or staff member or what grade or class was involved.
	
6. Student feels ill with COVID symptoms, but parent/guardian will NOT be testing child.
	Student to remain at home for 10/1. The 10 days begins on the day the symptoms began. If symptoms persist beyond 10 days, student to remain at home until at least 1 day after symptoms have resolved without the use of medication OR if a licensed health care provider determines that symptoms are not new or worsening based on a chronic medical condition OR if a licensed health care provider has made an alternative diagnosis based on a diagnostic test such as a positive strep screen or a positive screen for influenza.
	Recommend testing and follow up with physician for index case.

Notify teacher of symptomatic student and to monitor class to determine if others become ill.

If second confirmed or suspected case in classroom, school to identify close contacts in classroom and other school settings in the two days prior to illness up to the time the student was last in class, including key contributing factors. Identify close contacts with symptoms
	
		and advise them to
	quarantine for 10 days
		
			and self-monitor for COVID-19 symptoms
		
			through Day 14 and if symptoms occur,

7

Advise all household and close contacts to
		
quarantine for 10 days and self-monitor for COVID-19 symptoms through Day 14 and i
	
f
	
symptoms occur, immediately self-isolate and
		
contact their local public health department or
	
healthcare provider and seek testing.

			immediately self-isolate and contact their local
		
			public health department or healthcare
		
			provider and seek testing.

If student tests positive for COVID, identify and notify close contacts, school community, and FCDPH liaison.
	
7. Student tests negative but has COVID symptoms (possible false negative)
	Student to remain at home while symptoms persist consistent with screening protocols at school. Ok to return to school after negative COVID test AND all symptoms have resolved without the use of medications OR if a licensed health care provider determines that symptoms are not new or worsening based on a chronic medical condition OR if a licensed health care provider has made an alternative diagnosis based on a diagnostic test such as a positive strep screen or a positive screen for influenza.
	Recommend testing and follow up with physician for index case.

Notify teacher of symptomatic student and to monitor class to determine if others become ill.

If second confirmed or suspected case in classroom, school to identify close contacts in classroom and other school settings in the two days prior to illness up to the time the student was last in class, including key contributing
	
		factors to
	quarantine for 10 days and self-
		
			monitor for COVID-19 symptoms through Day
		
			14 and if symptoms occur, immediately self-
			
			isolate and contact their local public health
			
			department or healthcare provider and seek
			
			testing.

8. Administrator or other staff member, or volunteer tests positive
	Index case to remain at home for 10/1. If asymptomatic, the 10 days begins on the date the index case was tested. If symptomatic, the 10 days begins on the day the symptoms began.
If symptoms persist beyond 10 days, index case to remain at home until at least1 day after symptoms have resolved without the use of medication.

Identify locations where the index case spent more than 15 minutes over a 24-hour period in the two days prior to the day the positive test was collected OR to symptom onset: classroom, library, cafeteria, school bus, etc. If these locations have not been cleaned and sanitized since the index case was present, close location for as close to 24 hours as practical for cleaning and sanitizing.
	School to identify close contacts in the two days prior to the day the positive test was collected OR to symptom onset, up to the time the index case was last on campus. School to send notification letter to all close contacts.

Notify FCDPH liaison.

Notify school community including staff and parents of a new positive case. Notification to indicate the date the school was informed of the positive case and the number of new positive cases that day without releasing information that would identify whether the positive case was a student or staff member or what grade or class was involved.
	
9. Administrator or other staff or volunteer feels ill with COVID symptoms
	Index case is sent home immediately or placed in isolation room with separate entrance until transported home or to higher level of care.
	Recommend testing and follow up with physician for index case.

If second confirmed or suspected case on campus is identified, school to identify close contacts in classroom and other school

8

	Isolation room to be cleaned and sanitized after symptomatic index case leaves. Room cannot be re-used until cleaning and sanitizing completed.

Index case to remain at home for 10/1 or if symptoms persist beyond 10 days, for at least one day after symptoms resolve without the use of medication. OK to return to school sooner if test negative AND symptoms have resolved for at least one day without the use of medication OR if a licensed health care provider determines that symptoms are not new or worsening based on a chronic medical condition OR if a licensed health care provider has made an alternative diagnosis based on a diagnostic test such as a positive strep screen or a positive screen for influenza.
	settings in the two days prior to illness up to the time the index case was last in class, including key contributing factors. Identify close contacts with symptoms and advise them
	
		to
	quarantine for 10 days and self-monitor for
		
			COVID-19 symptoms through Day 14 and if
		
			symptoms occur, immediately self-isolate and
		
			contact their local public health department or
		
			healthcare provider and seek testing.

If index case tests positive for COVID, identify and notify close contacts, school community, and FCDPH liaison. Send notification letter.
	
10. AM Kindergarten student or teacher tests positive
	PM Kindergarten sharing classroom with AM class with positive case shall move class to another location on the day of notification unless classroom cleaned since index case tested positive.

See scenario #1 and/or #8 regarding student tests positive for additional guidance, or #5
if teacher tests positive.
	See scenario #1, #5, and/or #8 above.
	
11. Outbreak of cases on campus
	Review all situations when one or more positive cases on a school campus with FCDPH, or three or more positive cases within a 2-week period on a school campus with FCDPH consistent with CDPH guidance.
	Consider classroom or school shutdown on case by case basis in coordination with FCDPH and consistent with CDPH guidance.
	
12. What should a school do if a student is not wearing a face covering?
	Per the Oct 9, 2020 Health Officer Order, students need a medical exemption from a licensed health care provider based on a diagnosis that is documented in their medical record to not wear a face covering. Students with a medical exemption from a licensed health care provider based on a diagnosis that is documented in their medical record to not wear a face covering are expected to wear a face shield with a drape.
		
13. What should a school do if a student has a medical exemption from a licensed health care provider to not wear a face covering and is not wearing a face shield and drape?
	Schools should consider assigning students to sit in seats that incorporate plexiglass dividers to shield them from others in the classroom if they have a medical exemption from a licensed health care provider based on a diagnosis that is documented in their medical record to not wear either a face covering or a face shield with a drape.

9

14. What should a school do for students in TK to second grade if the student is not wearing a face covering or a face shield and drape?
	Per CDPH Guidance, students in second grade or younger are strongly encouraged to wear face coverings but it is not required. Schools should consider assigning students in second grade and younger who are not wearing face coverings or face shields to sit in seats that incorporate plexiglass dividers to shield them from others in the classroom.
		
15. What should a school do if a student engages in high risk behaviors such as speaking loudly, yelling, or singing without a mask or face shield with drape, or not following directions to maintain social distancing?
	Consider alternative educational models other than in person schooling in the classroom.
		
16. What if a student or staff member has a chronic condition causing one of the COVID-19 symptoms?
	FCDPH Health Officer Order of 10-9-20 requires individuals with new or worsening COVID-19 symptoms to isolate for 10 days and until they no longer have symptoms, unless they subsequently test negative for COVID-19 and no longer have symptoms. Students and staff members with a chronic condition that in the opinion of a licensed health care provider is causing one of the COVID-19 symptoms can return to school if they have a note from a licensed health care provider indicating that their symptoms are related to a chronic condition and are not new or worsening. The licensed health care provider should document in their medical record the chronic condition that is the basis for the symptom(s) in question. Students or teachers who have fever, cough, or shortness of breath when they are screened upon entry to school or during school are not allowed in school even if they have been diagnosed with a chronic condition that in the opinion of a licensed health care provider is causing one of the COVID-19 symptoms.
		
17. What if a student or staff member has one of the COVID symptoms but has been diagnosed with another infectious disease or medical condition?
	Students or staff members may also return to school sooner than 10 days if their symptoms have resolved and if a licensed health care provider has determined that the cause for their symptoms is due to another infectious process or medical condition that is confirmed by diagnostic testing, such as a positive strep test for sore throat, or a positive influenza test for flu symptoms. Students or teachers who have fever, cough, or shortness of breath when they are screened upon entry to school or during school are not allowed in school even if they

10

	have been diagnosed with a condition other than COVID-19.
		
	18. Can schoo nurses that are
	l
		School nurses identified as close contacts
			
				may return to work during staffing shortages

t
		
	identified as close
			after Day 7 from the date of last exposure
				
	contacts quarantine
			with a PCR test performed after Day 5 and
	a
			
	under the health care
			negative result. After this time, contacts mus
			
	worker guidance?
			use surgical face masks at all times during
			
		work and continue to use face coverings
			
		when outside the home through Day 14 after
			
		last exposure. They must Self-monitor for
			
		COVID-19 symptoms through Day 14 and i
	f
		
		symptoms occur, immediately self-isolate and
			
		contact their local public health department
			
		or healthcare provider and seek testing.

Transportation Services

Scenario
	
Response and Isolation Steps
	
Communication and Contact Tracing Steps
	
18. Bus driver or student rider on bus tests positive
	Refer to #1, #5, and/or #8 above.
	Refer to #1, #5, and/or#8 above. Conduct contact tracing consistent with guidance for school scenarios described above, paying attention to key contributing factors. Consult with FCDPH if questions regarding determining close contacts on bus.

After school programs

Scenario
	
Response and Isolation Steps
	
Communication and Contact Tracing Steps
	
19. Student or teacher or staff tests positive, or has symptoms
	Ensure availability of space to isolate children or staff with symptoms, with staff person with appropriate PPE available to monitor while awaiting disposition to home or for higher level of care consistent with guidance in above scenarios.

Refer to #1, #3, and/or #8 above.
	Conduct contact tracing consistent with guidance for school scenarios described above, while determining if close contacts in alternative settings utilized by after-care program.

If any close contacts with symptoms identified, consider key contributing factors and notify FCDPH.

Refer to #1, #3, and/or #8 above.

Notify school community of positive cases.

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Definitions:

10/1: Current CDC guidelines state that the index case must self-isolate for at least 10 days from the date symptoms began (for symptomatic patients) OR at least 10 days from the day the positive test was collected, PLUS one day with no symptoms without the use of medications. If index case has serious underlying medical conditions, contact FCDPH for consultation regarding isolation period.

Index case: person with a positive COVID test. In these scenarios, index case also refers to the person (student, teacher, or staff) who reports symptoms.

Close contact*:
	Close contact is defined as someone who has been within 6 feet of an infected person for
	
a total of 15 minutes or more over a 24-hour period, cumulative time, during the infectious period; B.
		
For the purposes of determining a close contact, cumulative time is defined as the period of time of exposure to ANY/ALL COVID-19 positive person(s), and is calculated as 15 minutes or more of time
		
where a close contact has been in contact to a person(s) positive with COVID-19 while that person(s) was
	
infectious - i.e. – 2 days prior to symptom onset while symptomatic, or 2 days prior to test date if
		
asymptomatic, up to the last contact with the COVID-19 positive person(s)If questions about whether an
		
individual meets the criteria for a close contact, refer to key contributing factors. Refer additional
		
questions regarding close contact criteria to FCDPH.

Outbreak: Two or more confirmed COVID positive cases in a classroom OR three or more confirmed COVID positive cases on the school campus within 14 days.

Quarantine: Separates individuals who are close contacts of a confirmed COVID positive case but who are
not yet ill.
	Individuals who are close contacts and asymptomatic may discontinue quarantine after Day 10
		
from the date of last exposure without testing. Household close contacts quarantine for 10 days after last close contact with index case while they are in isolation. All contacts released from quarantine before Day
	
14 must Self-monitor for COVID-19 symptoms through Day 14 and if symptoms occur, immediately self-
		
isolate and contact their local public health department or healthcare provider and seek testing.

School nurses may return to work during staffing shortages after Day 7 from the date of last exposure with a PCR test performed after Day 5 and a negative result. After this time, contacts must use surgica
	
l
	
face masks at all times during work and continue to use face coverings when outside the home through
	
Day 14 after last exposure.

Isolation: Separates infected people who have a confirmed COVID test from others. Symptomatic COVID positive individuals must isolate for a minimum of 10 days from onset of symptoms and at least one day without fever and an improvement in respiratory symptoms. Asymptomatic COVID positive individuals must isolate for 10 days from test collection date.

* If there is social distancing in classrooms including in the configuration of student desks, and teachers and students wear masks when unable to socially distance (for example when student and teacher are working at the student’s desk) then classroom contacts not necessarily considered close contact.

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Sample Notification Letter for Positive Case

Dear Parent or Guardian:

Your student had a positive COVID-19 test.

Coronavirus (COVID-19) is an illness caused by a virus that can spread from person to person. The virus that causes COVID-19 is a new coronavirus that has spread throughout the world. COVID-19 symptoms can range from mild (or no symptoms) to severe illness. You can become infected by coming into close contact (about 6 feet or two arm lengths) with a person who has COVID-19. COVID-19 is primarily spread from person to person. You can become infected from respiratory droplets when an infected person coughs, sneezes, or talks. You may also be able to get it by touching a surface or object that has the virus on it, and then by touching your mouth, nose, or eyes.

___________________________ and the Fresno County Department of Public Health recommend the following steps:

1. Your student is required to self-isolate at home, including complete separation from others in the house. This means no contact, no time together in the same room, and no sharing of any spaces, such as same bathroom or bedroom.
2. Your student may return to school:

a. after being completely symptom-free for 24 hours without the use of medication, b. AND a minimum of 10 days have passed since the symptoms began OR when the
positive test was completed.

3. Any other students or adults in the household are now considered close contacts and must quarantine for 10 days.
a. Quarantine for 10 days following date of last exposure to the student with a positive COVID-19 test, including complete separation from the person in your house with COVID-19.
i. If unable to completely separate from student with COVID-19, any other students or adults in the household must quarantine for 10 days after the last contact with the student with COVID-19 during their isolation period.
b. If any household contacts develop symptoms during the 10 days, they should contact their medical provider for evaluation. The medical provider may or may not recommend testing for COVID-19.
4. We recommend evaluation by your student’s medical provider if you have any questions or if their symptoms worsen, or go to the emergency room or call 911 if your student has any trouble breathing, continued pain or pressure in the chest, or bluish lips or face.
5. Notify the school(s) of any changes in status.

If you have general questions about COVID-19, you can visit the health department’s web site at www.fcdph.org/covid19.

If you need resources, please contact __________________.

If you would like to speak to someone on the school campus, please contact ______________________.

Sample Notification Letter – Symptoms

Dear Parent or Guardian:

Coronavirus (COVID-19) is an illness caused by a virus that can spread from person to person. The virus that causes COVID-19 is a new coronavirus that has spread throughout the world. COVID-19 symptoms can range from mild (or no symptoms) to severe illness. You can become infected by coming into close contact (about 6 feet or two arm lengths) with a person who has COVID-19. COVID-19 is primarily spread from person to person. You can become infected from respiratory droplets when an infected person coughs, sneezes, or talks. You may also be able to get it by touching a surface or object that has the virus on it, and then by touching your mouth, nose, or eyes.

Because your student has symptoms of COVID 19 and because your school wants to protect your student’s health and the health of others, your student cannot return to school until the following are true:
1. Your student had a negative test result for COVID 19 and has no further symptoms (be prepared to show proof of negative COVID 19 test)
OR
2. At least 10 days have passed from the day symptoms were first identified AND
At least 24 hours without symptoms and fever free without fever reducing medication.

COVID 19 and other illnesses are potentially very serious. Please consult your medical provider for any questions you may have regarding your students condition or testing. If your student has symptoms that are worsening, particularly any trouble breathing, continued pain or pressure in the chest, or bluish lips or face, immediately contact your medical provider or go to the emergency room or call 911.

If you do not have a negative COVID 19 test for your student, the earliest date your ill student can return is ___________________________ (NOTE: Calculate based on 10 days from date symptoms were identified)

In addition, any other students living in the household of the sick student may not return for 10 days after the last day they were in contact with the ill child. You should try to isolate the sick student from well family members while at home.

Names of other students in house: _______________________________________________________

Return to school date if able to isolate other students from your student: __________ (NOTE: Calculate based on 10 days from last date of close contact with index case. Recommend follow-up to determine if close contact was able to remain quarantined from index case- if not will need to extend date of return to school to end of isolation period for index case, plus additional 10 days of quarantine)

Staff name: ___________________________________________________________

For additional information on isolation and quarantine, please visit the Fresno County Dept of Public Health website at:
https://www.co.fresno.ca.us/departments/public-health/covid-19/covid-19-orders Please contact the site health service staff if you have questions regarding returning.

Sample Notification Letter – Exposure

Dear Parent or Guardian:

Your student may have been exposed to COVID-19 on ___________________ at ___________________,

Coronavirus (COVID-19) is an illness caused by a virus that can spread from person to person. The virus that causes COVID-19 is a new coronavirus that has spread throughout the world. COVID-19 symptoms can range from mild (or no symptoms) to severe illness. You can become infected by coming into close contact (about 6 feet or two arm lengths) with a person who has COVID-19. COVID-19 is primarily spread from person to person. You can become infected from respiratory droplets when an infected person coughs, sneezes, or talks. You may also be able to get it by touching a surface or object that has the virus on it, and then by touching your mouth, nose, or eyes.

_________________________ and the Fresno County Department of Public Health requires the following steps:

1. Your student must quarantine for 10 days from the date listed above. 2. Your student may return to school:
a. If 10 days have passed and no symptoms have developed. Return date would be: ____________.
3. 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

o If any of these symptoms develop,

i. contact your medical provider for evaluation or go to the emergency room if getting worse or trouble breathing. The medical provider may or may not recommend testing for COVID-19.
ii. Student must be isolated, as much as possible, from the rest of the household. iii. Student may return to school after being completely symptom free for 24 hours
without the use of medication, AND a minimum of 10 days have passed since the symptoms began, which may extend the quarantine period beyond the original 10 days.
iv. Notify the school of any changes in status.

If your student is confirmed positive for COVID 19, please follow these guidelines:

1. Your student must be isolated, as much as possible, from the rest of the household.

2. We recommend evaluation by your student’s medical provider if their symptoms worsen, or go to the emergency room if any trouble breathing.
3. Any other children or adults in the household are now considered close contacts and must quarantine for 10 days.
a. If any household contacts develop symptoms during the 10 days, please contact your physician for evaluation. The physician may or may not recommend testing for COVID-19.
4. Your student may return to school after being completely symptom free for 24 hours without the use of medication, AND a minimum of 10 days have passed since the symptoms began OR when the positive test was completed.
5. Notify the school(s) of any changes in status.

If you have general questions about COVID-19, you can visit the health department’s web site at www.fcdph.org/covid19.

If you need resources, please contact ____________________.

If you would like to speak to someone on the school campus, please contact ______________________.