The answer to this question has been a moving target as research on COVID-19 evolves. The Centers for Disease Control and Prevention last month tweaked its own guidelines to districts—which most states have mirrored in their own guidance—to recommend that those who have had close contact with anyone infected with COVID-19 quarantine themselves for 7 to 10 days after their exposure, down from the prior recommendation of 14 days.
The move suggests different ways districts could isolate students based on exposure, symptoms, or a positive COVID-19 test. The move suggest different ways districts could isolate students based on exposure, symptoms, or a positive COVID-19 test. But in states where coronavirus tests remain hard to come by, quarantines are based either on a standard number of days, or days since the start of symptoms. Some districts, such as In Jackson County, Miss., for example, have even made quarantining voluntary for students who were exposed but had not had a positive coronavirus test.
Quarantines work by preventing sick people from coming into contact with others during the period in which they are infectious—a time that for the coronavirus can begin two days before symptoms start and stretch to more than a month in some cases. Many state and district isolation procedures call for students to be isolated at least 10 days after symptoms start, or after a positive test, and until symptoms improved and the student has gone 24 hours without fever, without using medicine that reduces fever.
However, the CDC opted to lower the number of isolation days in part because on average, infected people begin to develop symptoms by around the fifth day after being exposed, and studies have found more than 97 percent of those who show symptoms do so by day 11.
Children’s Symptom Differ From Adults
However, studies of pediatric and adult patients have found that even the most common COVID-19 symptoms are far less common among children than adults. One study found while 71 percent of adults with coronavirus had fever above 100.4 degrees, only 56 percent of the infected children studied had a fever. And, while 80 percent of the adults had a cough, that was the case for 54 percent of children. The pattern was similar when it came to shortness of breath, which affected 43 percent of adults and only 13 percent of the children in the study.
That has meant symptom-based quarantines are less likely to capture child infections, and day-based quarantines have been more likely to keep healthy students home. Fewer and shorter quarantines are intended to encourage those who are asked to isolate to do so.
Too Many Days Lost?
Since the start of school, some 2,000 students in the Licking Valley Local Schools in Newark, Ohio, have been quarantined because they had come within six feet of someone who tested positive with the coronavirus for 15 minutes or more over a 24-hour period. For a high school student who typically moved through seven to eight classes a day, Superintendent David Hile said, 15 students could end up as close contacts on average. Each of those students had to go into isolation and take virtual classes for 14 days.
“We’ve been a 1-to-1 computing district with Chromebooks for years ... so it’s been a fairly seamless transition for us, but learning is still best in a classroom with your teacher and peers. It’s not nearly as effective when it’s all remote,” Hile said. “We had one student who was a contact three times; she lost six weeks of schooling and never tested positive.”
That student wasn’t alone. After tracking outbreaks, the Licking County health department found none of the quarantined students developed COVID-19 themselves as a result of their exposure. Moreover, while the district had to shut down just before Thanksgiving after a dozen staff members caught COVID-19, all of the infections were traced back to social activities outside the school—church, family activities, and so on—and no staff members have been infected by students since the start of the pandemic, Hile said.
As a result, the county health department and the district opted to change their quarantine procedures, so that a student will no longer be considered in need of quarantine if he or she stayed at least three feet from the infected person and both wore masks. Hile said the change not only helps to keep students in class, but has motivated students and parents to wear masks in school.
An Exception for Mask-Wearing
Missouri is testing the same option statewide, with Gov. Mike Parson asking districts Nov. 12 to consider not quarantining close contacts if they and the infected person were both wearing masks.
Oklahoma has not changed who is quarantined but is experimenting with how. Through Dec. 23, the state health department is allowing districts to provide “in-school quarantines,” in which a whole class which would have been sent home based on contact with an infected student can continue to be taught in-person, while being kept only within their cohort, masked and socially distanced, and tested frequently. Any student who tests positive for the coronavirus would go into full quarantine. Mustang public schools, the first district to volunteer for the pilot, noted that it has had only 1.24 percent of quarantined students later turn up positive for COVID-19.
Experts recommended that if districts choose to experiment with a new quarantine procedure, they work closely with their local health department, and a set out clear ways to track infection rates and spread in the schools.
A version of this news article first appeared in the Inside School Research blog.
A version of this article appeared in the December 09, 2020 edition of Education Week as How should schools quarantine students who have been exposed to coronavirus?