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Enhanced Mitigation and Response to Cases
This toolkit and the resources included within it were developed in collaboration with the Colorado Department of Public Health and Environment, the Colorado Association of Local Public Health Officials and the Colorado Department of Education.
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Extra precautions may be necessary for high risk activities including athletic competitions and musical performances.
Vaccinations or serial testing are strongly recommended for students participating in extracurricular activities.
In person-learning should always be prioritized over extracurricular activities.
CDPHEs Practical Guide for Operationalizing CDC’s School Guidance applies to all circumstances where a teacher or caregiver cares for multiple children outside the home of children. This includes extracurricular activities and sports where the participants are in grades K-12.
More details related to sports can be found on the CDPHE Organized Sports webpage.
Local public health officials have the authority to make public health policy decisions including adopting stricter standards than the national and state recommendations for schools and extracurricular activities, based on conditions in their areas.
Related Links and Resources
Choir, chorus, band, and indoor athletic pursuits (whether artistic or competitive) are among the highest risk activities, given that all inherently involve forceful respiration in a confined space. Evidence shows that forceful respiration is high risk for a super spreader event. As schools within our state work through multiple challenges in the times ahead, music education is an important component to a well-rounded education to support the well-being of all students and the entire school community. The physical, mental, and emotional safety of our children is our first concern, and, working together, we can continue to sustain the quality of education in Colorado.
When greater than normal respiratory effort occurs, measures in addition to 6-foot distancing are required to prevent viral transmission. Studies have shown that vocal performers and wind and brass instruments also emit high levels of small respiratory droplets and aerosols.
Because no single tactic can completely eliminate the risk of disease transmission, the transmission mitigation tactics below are intended to work together. Because the contexts of performing arts education are specific to the local school/district community and grade level, schools should develop an individual plan.
Schools and districts are also encouraged to work with their local public health agency, including sharing school plans for feedback. The Colorado Department of Public Health and Environment is also available to provide feedback to school plans, if requested.
- Participants (e.g., players, performers, actors, competitors, entertainers, etc.) in events should have their symptoms checked, and participants who are symptomatic, test positive or have been in close contact with an exposed or symptomatic person should not participate.
- Participants should wear a mask before, during, and after performances and rehearsals, excepting individuals playing wind or brass instruments while actively playing their instruments. Individuals playing wind or brass instruments should utilize a bell cover designed for their instrument during performance and rehearsal, including solo practice in shared spaces.
- Individual vocalists and performers of wind or brass instruments should be positioned 6 feet from one another. Instrument bells should not be directed towards other individuals, and vocal performers should not directly vocalize towards other individuals. Condensate from wind and brass instruments should be collected in appropriate receptacles and disposed of properly.
- Allow for at least 30 minutes or 3 air exchanges (whichever is shorter) between room occupancy after activities involving vocal speech or singing, wind or brass instruments, or activities that cause heavy breathing.
- Portions of a class with increased aerosol activities should be done outside to provide more social distancing, weather permitting. Outdoor rehearsals and performances are best because they allow for rapid air exchange.
- Avoid activities that require physical contact.
- Develop live-performance alternatives or substitutes that meet ‘Performing’ and/or 'Expression' state standards, following national guidelines.
- Give special consideration to locker room/dressing room/green room usage, sanitation, and ventilation.
- Use markings on the floor or student workstations to adhere to physical distance requirements in classrooms requiring movement.
- Consider adding temporary hand washing stations to classrooms or areas where sinks are not available.
- High touch surfaces, such as music stands, must be disinfected following the NFHS, NAfME, and NAMM Instrument Cleaning Guidelines and Information, and every effort should be made to reduce touching surfaces by separate players. Avoid sharing wind or brass instruments. Wash hands before and after playing instruments with soap and water. Hand sanitizer may be used if hand washing is not available..
- K-5 Grades Notes:
- Universal masking indoors is strongly recommended for children between 3-10 years.
- In elementary classrooms, singing, chanting, humming, etc. may all be integral parts of the normal in-classroom curriculum, and there should not be any issue with continuing these instruction methods as appropriate for the grade level of the students.
- It may not be developmentally appropriate for elementary-aged students to maintain 6 foot distancing throughout the school day. The greatest emphasis on spacing should be placed on distancing during high risk activities, including vocal performance and rehearsal and playing wind/brass instruments.
- Apply the performing arts audience guidance (below) for public performances planned.
- Please apply the above guidelines with guidance from the Colorado Bandmasters Association.
By law, certain diseases and conditions are reportable to public health for surveillance and investigation purposes, and so disease control measures can be implemented as necessary.
Per Colorado regulation 6 CCR 1009-1 “Rules and Regulations Pertaining to Epidemic and Communicable Disease Control,” people either treating or having knowledge of a reportable disease, whether the disease is suspected or confirmed, must report the case to the state or local public health agency. A list of diseases and conditions reportable in Colorado is available on the CDPHE website. This website also contains a link to the Colorado statutes and regulations that address disease reporting. Suspected outbreaks of any disease in any setting must be reported to the state or local public health agency immediately.
When a communicable disease case/outbreak is reported quickly, there is a better chance that the public health agency will be able to prevent transmission and stop an outbreak early.
Public health is well equipped to help schools manage cases and outbreaks.
Per Colorado state law, schools are required to work closely with public health in the event of cases and/or outbreaks, to determine best mitigation strategies for schools.
When a suspected or confirmed disease case is reported, public health agencies may conduct an investigation to confirm the diagnosis, determine the cause of the illness, determine if anyone else has been exposed, and implement appropriate methods of disease control.
Outbreaks of any disease, in any setting must be reported to the state or local public health agency immediately. In an outbreak situation, the state or local public health agency will work with the child care facility or school to achieve the following:
- Control and prevent further spread of disease;
- Identify ill people so they can receive proper treatment if indicated;
- Attempt to identify the source of the outbreak;
- Determine who might have been exposed to the source or ill people;
- Identify infection risk factors;
- Evaluate existing prevention strategies.
When a school has a child or staff member ill with an infectious disease, the question often comes up as to whether the facility needs to send a letter home to parents/guardians of other children, or post a notice at the facility informing parents/guardians of the illness. This is often dependent on the disease, the potential risk of spread to others, the presence of symptoms in other children/staff, and policies in place at the facility. Public health can assist a facility in determining whether or not a letter or notice is necessary. In outbreak situations, it is common for public health to work with the facility to draft a letter to share with parents/guardians, as well as a health alert to distribute to health care providers in the area.
Know who to contact in the event of a case or outbreak and when mitigation strategies may be required or recommended by your LPHA.
Enhanced mitigation measures may be required by your local public health agency if, during the previous 14 days:
- Trends in illness are rapidly increasing
- Increase in number of separate, unique outbreaks in different cohorts in the school (e.g. different classrooms, grade levels, extracurricular activities)
- Cases identified in non-classroom high risk setting/exposures (e.g. choir, band, athletics including indoor or high contact competitions)
- High absenteeism rates reported
- Low community vaccination rates
- Illness observed in school setting with individuals at higher risk for severe disease
- Limited adherence to best practice prevention measures
Schools will be asked to take a layered mitigation approach to address outbreaks. Additional mitigation measures may include:
- Masking requirements, if not already in place
- Enhanced contact tracing and quarantine
- Maximizing outdoor activities
- Cancelation or restrictions on high-risk extracurricular activities
- Vaccine promotion
We’ve all been through a lot during the COVID-19 pandemic. We’ve also learned a lot about how to stop the transmission of illnesses in schools. All of the strategies used during the first year of the pandemic can be reinstated at any time to quickly control outbreaks not only of COVID-19 but also other communicable diseases.
Schools should have a plan to respond to and quickly address outbreaks of COVID-19, influenza, norovirus and any other communicable illness outbreak that occurs. (Mitigation may include measures such as screening, testing, contact tracing, isolation, quarantine, considering masking, distancing and remote learning.)
State law requires school compliance with the Rules and Regulations Governing Schools in the State of Colorado, 6 CCR 1010-6. Requirements for Outbreak Response Plans can be found in section 6.13 on page 26
Related Links and Resources
January 4, 2022 - Updated CDPHE and CDC recommendations on quarantine and isolation do apply to K-12 School settings.
Isolation separates people identified as ill with a contagious disease from people who are not knowingly ill.
Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.
Keeping cases of COVID-19 out of school settings is essential for schools to stay safe, opened and operating.
Isolation is foundational to keeping transmission as low as possible in schools.
Isolation or self-isolation includes people who:
- Have a positive COVID-19 test.
- Have symptoms of COVID-19.
- Are getting ill and think they might have COVID-19. Symptoms, especially early on, may be mild and feel like a common cold. Early symptoms could include a combination of cough, body aches, fatigue, and chest tightness. Some people may not develop fever or fever may not appear until several days into the illness.
Under state law, isolation of positive cases is required and must be enforced by local public health and school districts. COVID-19 is a reportable condition in Colorado. Schools must report cases to public health. Per State statute §25-1-122, § 25-1-506, and C.R.S. and Board of Health Rule 6 CCR 1009-1:).
Schools should be safe places for everyone, especially those at increased risk for severe disease from COVID-19.
Individuals should discuss their personal risk factors with their health care providers. Individuals determined to be at higher risk for severe disease should, after consultation with their health care provider, be vaccinated as soon as they are eligible. If these individuals are not eligible for vaccination, or vaccination is not medically advised, serial testing and masking indoors is strongly recommended. Schools may consider masking requirements, ventilation improvements, and other protective measures when they serve or employ or work with high-risk or vulnerable individuals.
Vaccination, serial testing, masking and other mitigation strategies become essential to protect those at increased risk for severe disease.
Schools may consider having options to support students and families that are not comfortable attending in person school.
Related Links and Resources
- CDE COVID-19 Learning Impacts Toolkit
- CDPHE - Back to School Vaccination Toolkit
- Chiefs for Change – Fall 2021 School Reopening Toolkit (PDF)
- Chiefs for Change – Maximizing Instruction for the 2021-22 School Year
- Chiefs for Change – Using Incentives to Encourage COVID-19 Vaccination
- National Association of School Nurses - COVID-19 Reference
- CDPHE - Practical Guide for Operationalizing CDC’s School Guidance
- CDC - Guidance for COVID-19 Prevention in K-12 Schools
- CDC - Easy to Read COVID-19 Materials
- CDC - Poster: How to Protect Yourself and Others (PDF)
- CDC - Operational Considerations for Schools
- CDC COVID -19 Communications Toolkit
- American Academy of Pediatrics - COVID-19 Guidance for Safe Schools