On Nov. 12, 2020, Governor Parson announced changes to school guidance from Missouri’s Departments of Health and Education (DHSS and DESE) due to the strain placed on educators, school leaders and families in recent weeks from the large number of students, teachers and school staff members quarantined. In response to this information, and the negative educational impacts of quarantine on schools, the Cedar County Health Department is implementing a modified quarantine process that applies only to K-12 schools in Cedar County.

Modified quarantine is solely an effort to keep children in the learning environment, while managing the risk for the spread of COVID-19. The local educational system has proactively demonstrated the ability to develop and implement mitigation strategies to slow the spread of COVID-19 and serve as a key partner in contact tracing. Future research and evidence will be taken into consideration for its ongoing implementation.

Based on the current positivity rate for Cedar County and the state as a whole, the local health care system capacity, and the increased number of cases in the last 28 days, the Cedar County Health Department Board of Trustees adopts the following modified quarantine guidance to apply to Cedar County K-12 schools until Dec. 31, 2020. Guidance will be reviewed at that time to determine the need to continue with the modified quarantine guidelines or revise procedures at that time.

Criteria for Modified Quarantine

Criteria for modified quarantine must be met, before being applied:

1. Schools must have a mask mandate in place.

2. Under modified quarantine, if the person diagnosed with COVID-19 and the close contact were both wearing masks appropriately during the time of exposure in the school setting, the close contact would be allowed to attend classes and would follow standard quarantine for all other areas. The individual with COVID-19 still must isolate and not return to school until the criteria are met for release from isolation. This updated guidance applies to students, teachers and staff at Cedar County K-12 schools.

3. The school shall maintain significant mitigation strategies.

a. Design of classroom to limit spread and maximize social distance

b. Increased hand hygiene activities

c. Screening for COVID-19 and immediate isolation of anyone with symptoms of COVID-19

4. Face masks must be worn at all times. Any time without mask use while around the infectious individual will result in standard quarantine practices. These times would include lunch, recess (Modified quarantine only applies during recess for students in grades K-5.), and bus transportation to/from school. The established criteria listed above are applicable.

5. Face shields and single layer gaiters are not acceptable alternatives to masking; and if worn around the infectious individuals, will result in standard quarantine practices. Individuals who are not able to wear a mask due to a medical exemption will be required to follow standard quarantine procedures.

6. If either the infectious individual or others around them are not wearing masks properly, modified quarantine is not allowed.

7. Modified quarantine begins when there is a case with exposure in the school setting. If additional cases occur within the same classroom or are linked to another classroom, standard quarantine practices will occur. Standard quarantine practices will remain in place for that classroom until there is a minimum 14 days without additional cases.

8. Modified quarantine only applies to the educational environment during the school day. Exposures outside of the normal school day, including extracurricular activities, are not considered for modified quarantine.

9. Modified quarantine will be suspended in facilities that are experiencing multiple clusters of disease resulting from school-based transmission. During periods of suspension, standard quarantine practices will be utilized.

Modified Quarantine

Close contacts are defined as anyone who has been closer than 6 ft. for a cumulative 15 minutes or more within a 24-hour period to someone who is infectious with COVID-19. When the above criteria are met, modified quarantine may be used. Modified quarantine allows for students, teachers and school staff members to continue to attend the classroom setting. During the period in which the student, teacher, staff would be in quarantine, the following must occur:

1. Outside of the regular school day educational activities, the student, teacher, staff must quarantine at home (they may not participate in or attend extracurricular activities).

2. Face masks are to be worn at all times, except while eating or drinking.

a. When the mask is removed the student, teacher, staff must be a minimum of 6 feet from others.

b. The student, teacher, staff are not to participate in any activity in which a mask cannot be worn.

3. Monitoring for symptoms must occur daily within the school day.

4. A screening PCR test for COVID-19 is encouraged between 5-10 days from the most recent exposure.

If the student, teacher, staff in modified quarantine develops any symptoms of COVID-19, they should immediately be isolated and excluded from school, isolate at home, and be tested for COVID-19. If the circumstances of the individual’s symptoms meet the criteria for antigen testing, it can serve as an acceptable alternative for a PCR test. The individual should remain at home for a minimum of 10 days unless a current negative test result is provided.

Adopted by the Cedar County Memorial Hospital/Cedar County Health Department Board of Directors 11/16/20—Revised 11/23/20