This content was last updated on October 4, 2022.

The Health Department strongly recommends universal masking for a two-week period upon return from extended break/holiday, such as summer vacation, winter and spring breaks, and extended holidays.

While the risk of monkeypox to children and adolescents is low, schools and ECEs should take the same precautions that are utilized to stop the spread of other infectious diseases. This includes children, staff, and teachers staying home when sick. It also includes providing adequate handwashing supplies and cleaning and disinfecting facilities. For more information, visit the CDC’s monkeypox page and the latest on monkeypox in Philadelphia.

This 22-23 school year, the Health Department will be providing rapid at-home COVID-19 test kits, point-of-care test kits, masks, and other resources for early childhood education center communities, including staff and families. To request test kits and supplies, email COVID.schools@phila.gov.

For guidance on pediatric common clinical scenarios, visit Resources for schools and early childhood education and look under Supplemental Guidance.

Summary

As we enter the third year of the pandemic and begin a new school year, we have drawn on lessons learned and input from schools and communities to create a framework that helps children continue in-person learning. To get the most from their education, children need to connect with peers and their surroundings in-person. As we adapt to the ever-changing pandemic, we know more and have more tools to help us let teachers teach and students learn with fewer disruptions.

In-person instruction and learning for all ages coupled with physical, behavioral, and mental health services offered in schools and ECEs not only benefits students, but also parents, families, and communities. By aligning with the CDCs latest guidance and eliminating quarantine (see “Exposures” below for details), we can keep children in school and learning and let parents and caregivers stay at work.

This guidance gives some flexibility for ECEs to look at the transmission rate in their area and the unique variables of their community to make decisions about which strategies to use to stop transmission. It emphasizes layered preventative measures for spread of COVID-19 as well as other infectious diseases, such as influenza (flu), respiratory syncytial virus (RSV), and norovirus, to support safe and healthy learning environments for all. Although universal case investigation and contact tracing are no longer recommended by the CDC, continued attention to ventilation, handwashing, and having people who are sick isolate at home (see Isolation section below) remain crucial to prevent transmission. The Health Department will continue to provide support in the case of outbreaks in childcare settings.

In order to best meet our community’s diverse needs, we have created a set of baseline or minimum recommendations based on guidelines from the Health Department, the Centers for Disease Control and Prevention (CDC), and the Pennsylvania Department of Education that serve as best practices within the school setting for mitigating the risk of COVID-19 for students and staff.

The detailed guidance is categorized by the following key practices:

• Encouraging the wider school community to get vaccinated against COVID-19.
• Staying home when sick.
• Enhancing ventilation.
• Hygiene and cleaning.
• Managing exposures and cases.
• Strongly encouraging universal and correct use of face masks when indoors for all staff and students 2 years of age and older:
  • when staff and students return from 5-day isolation and masking is strictly required on days 6-10.
  • for 10 days when staff and students are exposed.
  • when transmission levels are medium or high in the community and masks are recommended.

Vaccination, including booster shots, remains the best strategy to protect students and staff and the community and reduce interruptions in learning. Everyone 6 months and older can now be vaccinated. Read more about staying up to date with COVID-19 vaccines.

COVID-19 vaccines are free to everyone living in the United States.

Anyone who is eligible should be vaccinated and receive all recommended doses. There are many opportunities for vaccination in Philadelphia.

Make sure you have all the vaccines you are eligible for at CDC’s vaccine’s schedule at-a-glance (PDF).

Staying home when sick

As with any infectious disease in the ECE setting, individuals who are sick should stay home when they are not feeling well or if they have tested positive for COVID-19. Anyone with symptoms who has not yet received their test result yet should also stay at home. See a full list of COVID-19 symptoms. Once isolation has finished, and if they are able to mask, individuals must wear a high-quality (N95 or KN95) mask in school through day 10. (Day 0 is when symptoms began or if no symptoms, when a positive test result was received.)

If an individual has symptoms of COVID-19 they should test as soon as possible. Individual cases who cannot mask because they are under 2 years old or for medical reasons, must isolate for 10 days. Read complete guidelines below, under Managing Exposures and Cases: Isolation for cases.

People who are at risk for getting very sick with COVID-19 who test positive should consult with a healthcare provider right away for possible treatment, even if their symptoms are mild.

For more information on staying home when sick with COVID-19, including recommendations for isolation and mask use for people who test positive or who are experiencing symptoms consistent with COVID-19, see isolation and precautions for people with COVID-19.

Ventilation

Schools and ECEs should take advantage of all ventilation strategies available to them especially when transmission in the community is high or there is an outbreak in the school. This includes safely opening doors and windows in classrooms, common areas, and on busses, to create greater air flow.

If possible, increase ventilation in the building by either:

• Opening windows and/or doors on opposite sides of the room and consider using fans to blow outside air through the room,

OR

• Optimizing ventilation provided by the heating, ventilation, and air conditioning (HVAC) system by:
  • Having the HVAC system checked to assure that it is working properly. If it can be adjusted, the system should be set to provide at least 6 air exchanges per hour if possible or the maximum possible setting.
  • Maximizing the amount of outside air circulated by the system.
  • Installing filters with minimum efficiency reporting values (MERV) of 13, or the highest compatible with the filter rack.
  • Checking that the external air inlet duct is not blocked and that it is at least 15 feet from persons.

Hygiene and cleaning

Handwashing & respiratory etiquette
Training students in proper hand washing techniques will help curb the spread of COVID-19 and other highly transmissible diseases in the classroom. Schools and ECE programs should monitor and reinforce these behaviors, especially during key times in the day (for example, before and after eating, after using the restroom, and after recess) and should also provide adequate handwashing supplies, including soap and water. Hand sanitizer with at least 60% alcohol can also be used. (When not in use, it should be stored out of reach of children.)

Staff should practice hand hygiene before and after preparing food and drinks and before and after any medication administration.

Schools and ECE programs should teach and reinforce covering coughs and sneezes to help keep individuals from getting and spreading infectious diseases, including COVID-19.

Maintaining healthy facilities
Maintain a cleaning schedule of cleaning surfaces within the school and on school buses regularly to reduce the risk of germs being spread by touching surfaces.  For more information, see cleaning and disinfecting your facility.

Managing exposures & cases

Individuals who have been exposed and are able to mask no longer need to quarantine but are required to mask for 10 days following the exposure.

There are two ways to implement masking after an exposure:

1. All close contacts of a case’s exposed cohort (class, grade, team etc.) should mask to stay in school, ideally with rapid or molecular testing* within 48 hours and again on or after day 5. Masking should be maintained for 10 days after exposure. Masks should be high-quality (N95 or KN95).
2. Should a high number (~10% or more of school population) test positive, the Health Department recommends universal masking for the entire population.

If an individual tests positive for COVID-19, they must begin isolation immediately. If test results are negative, they must continue to mask for full 10-day period. Individuals who are able to mask cannot test out of the 10-day masking period.

Exposures who cannot mask

Some children have different abilities or neurodivergences that make it impossible for them to tolerate masking. Others have medical conditions that make masking impossible. Others are under the age of two. Because these children cannot mask, they will need to be tested.

Anyone who cannot mask can test at regular intervals (every other day) for 10 days.

Children older than 2 who cannot mask for medical reasons stated above should receive an antigen test every other day until day 10 in order to limit transmission.

Children who cannot test should either:

• stay at home for 10 days, OR
• may return to school after exposure if they are under 2 with masking of those who surround the students (staff and others who are over 2) for 10 days.

We recommend building a safety net with other strategies in the classroom, including masking and vaccination of staff, ventilation and increasing space between individuals.

Individuals or schools may continue to choose to implement quarantine if desired. Quarantine or modified testing strategies may be more appropriate for children less than age 2 and those who cannot mask.

All close contacts must monitor themselves for fever and cough, shortness of breath and other COVID-19 symptoms for 10 days after their last exposure to someone with COVID-19. Parents and guardians must monitor younger children. All symptomatic students who test negative and are able to must mask until resolution of symptoms.

* Testing is recommended but not required. Rapid antigen tests are preferable to PCR when used to detect current infection for those with recent history of COVID-19 infection.

The CDC continues to support implementation of diagnostic COVID-19 testing programs in schools and supports and encourages program participation among parents and staff regardless of community transmission level or vaccination status. This is the best way to stop outbreaks before they start.

Isolation for cases

Staff and students diagnosed with COVID-19 must isolate for 5 days and then can return to school, but must wear a high quality (N95, KN95, or KF94) mask consistently during days 6-10 and must eat in a designated area separate from others.

Those individual cases who cannot mask–because they are under 2 years of age or have a medical condition which prevents them from masking–or are unwilling to mask must isolate for a full 10 days.

Read CDC’s full isolation guidance.

Face masks

Face masks help to prevent the transmission of COVID-19. Learn more about why, when, and how to wear a mask (PDF).

The Health Department strongly recommends universal masking in all indoor public settings including schools and early childhood education settings at a medium or high transmission level in the community.

When the COVID-19 community transmission level is high, people at risk for getting very sick with COVID-19 should wear masks or respirators that provide greater protection, such as N95s or KN95s.

If the Health Department determines that masking is necessary for schools, masking is strongly recommended for indoors throughout the school and on school busses.

Individuals may choose to wear a mask at any time as an additional precaution to protect themselves and others. Anyone at high risk for severe illness should consider wearing a mask indoors in public and taking additional precautions.

• Those individuals capable of masking must wear a mask after an exposure.
• Double masking with a cloth mask over a surgical mask or, if preferred, a well-fitted KN95, KF94, or N95 mask is more protective than a single cloth or surgical mask. For those who wear a single mask, a surgical mask is preferred instead of a cloth mask alone.
• Did you know? Surgical masks or respirators (KN95, KF94, or, for older children N95) can be made available to schools and early childhood education settings. Reach out to us for more information: (215) 685-5488 OR email covid.schools@phila.gov.

Additional COVID-19 prevention in schools

As the COVID-19 pandemic in Philadelphia evolves, there may be additional changes to the guidance, so please connect to the COVID-19 texts (text COVIDPHL to 888-777) to have the most up-to-date information.

Student and staff screening 

Parents should screen their children for symptoms daily, including screening for fever, symptoms, and exposure. Staff should screen themselves daily. Check the full list of symptoms from the CDC.

The Health Department has developed a COVID-19 sample screening tool. If an individual has symptoms consistent with COVID-19, they should not enter the facility.

Plan for when someone becomes sick

Encourage staff and parents to talk to their own and their children’s physicians about their individual risk factors for COVID-19 and the risks of working at or attending ECE. We strongly recommend flexibility and accommodations for staff who are at higher risk for severe illness from COVID-19, such as those 65 years and older and those with weakened immune systems.

• Ensure facility has updated contact information (including date of birth, phone number, home address, grade level, and cohort) for all staff and families to facilitate contact tracing and rapid communication.
• The Health Department has created a sample parent/guardian agreement that describes their commitment to keeping their children home when sick and seeking appropriate medical care.
• Schools should designate an isolation room or area for anyone who experiences COVID-19 symptoms. If using the nurse’s office, this area should be at least six feet apart from where other children or staff use the nurse’s office. If possible, use screens or curtains to create a barrier between individuals who are ill and in the nurse’s office.
• Staff who develop symptoms of COVID-19 should immediately be sent home. If they need to be picked up, they must wait in the designated isolation room or area while waiting and must wear a high quality (N95, KN95, or KF94) mask.
• If students develop symptoms, they should be brought to a designated isolation room while waiting to be picked up. The staff member waiting with the student should wear a N95, KN95, or KF94 mask or should double mask.
• Cleaning/disinfecting after a COVID-19 case or COVID-19 symptoms: Clean and disinfect all areas used by the person who is sick, such as classroom, offices, bathrooms, common areas, and your isolation room or area and in the classroom where the sick child or staff member was after the sick child or staff member has gone home.

Reporting

In order to continue to make public safety recommendations, the Health Department’s COVID-19 Containment Division’s Pediatric Partnerships team has been tracking patterns of transmission in schools, daycares, and other settings.

All COVID-19 cases (student or staff) must be reported to the Philadelphia Department of Public Health.

• Reporting COVID-19 cases to the Philadelphia Department of Public Health can be done by completing a REDCap Pediatric Survey. If your ECE is not receiving daily REDCap surveys, please call (215) 685-5488 OR email schools@phila.gov for further guidance.
• To report COVID-19 cases to Certification, see Childcare Sites Reporting COVID Positive Cases.

The Department will consult with you on management issues for your facility. ECEs should expect a response from the Pediatric Partnerships team for completed surveys in the case of missing or incomplete information, need for further investigation, or to facilitate and intervention in the form of testing.

If 10% of a ECE’s population is positive, contact the Health Department at (215) 685-5488 OR email covid.schools@phila.gov for contact tracing and further guidance on response, access to outbreak testing or possible pauses to in-person learning.

ECE facilities should follow the PA Office of Child Development and Early Learning (OCDEL) protocols where applicable, including reporting requirements.

Pauses

Currently the Health Department is not recommending school or class-wide pauses and will only do so in exceptional circumstances.

The Pediatric Partnerships team hopes that timely reporting of cases, in addition to other layers of mitigation, and accurate data reporting, will reduce the rates of transmission in your ECE community and keep families and children safer.

Where authorized, the Health Department may direct pausing or closure of centers with notification of credentialing agencies, the Pennsylvania Office of Child Development and Early Learning (OCDEL), and the Early Childhood Education Division of the Philadelphia Office of Children and Families.

Read CDC’s full guidance for isolation and quarantine.

Visit designated Resource Hubs for masks, tests, and information:

Additional resources

• Resources for schools and early childhood education providers
• Pediatric testing
  • Philadelphia community testing sites tracker and calendar
  • CHOP COVID-19 testing tool
  • St. Christopher’s COVID-19 testing
• Vaccination opportunities for eligible populations:
  • Partner-run vaccine clinics
• Other resources:
  • CDC quarantine guide
  • CDC symptoms guide
  • Isolation, exposure, and testing guidance (PDF)
  • Home care instructions for COVID-19 (PDF)
  • Recommendations for people awaiting test results of a household member
  • COVID-19 FAQ
  • ECE masks signage