Management of Ill Students and Staff

Managing Students and Staff

Do schools need to conduct temperature checks and symptom screening and/or require parents to provide attestation of negative symptom screening on a daily basis?

No. Both the CDC and IDPH no longer recommend fever and symptom screening or attestation of symptom screening upon arrival at school. Instead, self-screening for symptoms of COVID-19 and other common respiratory viruses and ailments, prior to arriving on school grounds or boarding school transportation, continues to be recommended. Schools should continue to post signage and communicate with students and staff that they are discouraged from entering buildings or boarding school transportation if ill.

What actions should be taken by students/staff sent home with COVID-19-like symptoms?

All students and staff (regardless of vaccination status) excluded with COVID-19-like symptoms should be diagnostically tested with a PCR or rapid antigen or molecular test with emergency use authorization by the FDA. Rapid antigen tests are acceptable for symptomatic individuals. Schools must exclude any student or staff that exhibit symptoms of COVID-19

until they test negative for COVID-19 (home testing is not acceptable) or for a minimum of 5 days

until they are fever free for 24 hours, and symptoms are improving, and

until 24 hours after diarrhea and vomiting have ceased AND must be able to wear a well-fitted mask through Day 10 at all times

At schools where testing is available, individuals should be tested before being sent home with COVID-19-like symptoms. If negative for COVID-19, students may return when if fever free for 24 hours without fever reducing medication, diarrhea/vomiting have ceased for 24 hours, and other symptoms have improved. Even if not related to COVID-19, several other communicable diseases, such as influenza and norovirus, can cause similar symptoms and warrant exclusion from school until symptoms resolve. For all other symptoms, students can return to school if they test negative for COVID-19 within 48 hours after symptom onset.

Students and staff who are confirmed or probable cases of COVID-19 must be excluded from school and may not return until asymptomatic or symptoms have improved (fever free without fever reducing medication, diarrhea/vomiting ceased for 24 hours, and other symptoms have improved) and at least after five calendar days have passed from the date of specimen collection of the positive test (Day 0) if asymptomatic or following onset of symptoms if symptomatic (Day 0) or as otherwise directed by the local health department AND mask consistently through day 10. Individuals who meet the above criteria may return to school even if other household members are in isolation or quarantine in the home as long as they mask consistently through day 10.

Students and staff with COVID-19-like symptoms who do not get tested for COVID-19, must be excluded for five calendar days from the date of first symptom onset and be fever-free for 24 hours without use of fever-reducing medications, vomiting and diarrhea ceased for 24 hours, and other symptoms have improved before returning to school and will be allowed to return to school as long as they wear a well-fitted mask through day 10. If symptoms persist, they should remain home up to 10 days.

COVID-19 diagnostic testing is strongly recommended for all persons with COVID-19-like symptoms.

If a student is sent home sick with suspected COVID-19 symptoms (e.g., cough, fever, diarrhea, shortness of breath, etc.), must all their siblings/household members be sent home as well?

If the ill household member is tested within 24 hours of first notification of symptoms, household members do not need to be sent home unless there is a high suspicion the ill person has COVID-19 (e.g., they are a known close contact, they have lost sense of taste and smell). Pending test results, household members can remain in school with consistent use of well-fitting masks both indoors, as required, and outdoors. If the ill household member tests positive for COVID-19, then any household members who are unvaccinated or unboosted (if eligible) should be removed from the school immediately. If testing does not occur within 24 hours, unvaccinated household members must be excluded per the Public Health Interim Guidance for Local Health Departments and Pre-K-12 Schools – COVID-19 Exclusion Protocols (“COVID-19 Exclusion Protocols”).

How many symptoms does a person need to have to be considered a suspect COVID-19 case?

Students and staff exhibiting one or more COVID-19-like symptoms are considered suspect cases and should be immediately isolated and evaluated. Schools should evaluate each symptomatic student/staff to determine if this symptom is new or if it is part of an existing condition.

The COVID-19 Exclusion Protocols and CDC Screening in K-12 were recently updated to limit the symptoms for which students should be screened for suspect COVID-19 infection. Many symptoms of COVID-19 are also symptoms of common illnesses like seasonal allergies, colds, and chronic conditions like asthma. To prevent potentially excluding students repeatedly, the list of symptoms has been limited to those most likely to be part of an infectious syndrome. However, if a student/staff has a COVID-19 symptom not listed on the COVID-19 Exclusion Protocols, but the school health staff has an increased concern due to community spread or known close contact (as shown in Box A and Box B of the COVID-19 Exclusion Protocols), the school health staff should exclude the individual and require testing or an alternative diagnosis for return.

What temperature is the fever threshold to be considered a symptom of COVID-19 and for the purposes of sending ill students and staff home?

CDC recommends that schools use 100.4oF or greater as the threshold for fever.

What are the recommendations for someone who has previously tested positive for COVID-19?

For those who have had prior diagnoses of COVID-19 confirmed by viral testing within three months,  exclusion is not needed. If they develop COVID-19-like illness, they should be excluded and be tested.