Fall 2021 Frequently Asked Questions About Cases and Contacts in School

Reopening Guidance from the Albany County DOH

Q. What guidance is available for schools for fall 2021?

Health Screening

Q. Are parents required to ensure that their child or children do not show symptoms of COVID-19 or a fever before boarding the bus or entering school each day?

  • Regardless of vaccination status, ill individuals (students, teachers, staff, contractors, visitors, etc.) should stay home if they have any symptom of COVID-19.
  • Daily health screenings and temperature checks may be used to increase protection against transmission of COVID-19, but are not required. All schools must have policies in place that clearly explain what students, teachers, and personnel with new or worsening symptoms must do. Such policies should be applied irrespective of vaccination status for those individuals with new or worsening symptoms.

Testing for symptomatic individuals

Q. Is a COVID-19 test required for symptomatic students, teachers, staff, contractors, etc.?

  • COVID-19 testing is a necessary strategy for appropriate public health control of disease and is recommended for any new onset of symptoms consistent with COVID-19 regardless of vaccination status.
  • For a list of symptoms, visit the CDC Symptoms of Coronavirus webpage.
  • Knowing if you or your child tests positive can assist you in protecting other family members and the school community. Should you choose not to be tested, there is a possibility that family and school contacts will be placed on quarantine, possibly resulting in preventable disruptions of their activities.
  • If you need assistance finding a medical provider, don’t hesitate to get in touch with the Albany County Department of Health at (518) 447-4659.

Q. Where can individuals get tested for COVID-19?

  • For an updated listing of COVID-19 testing sites in Albany County visit this Albany County DOH page, and/or this NYS DOH page.
  • There is no out-of-pocket charge for COVID-19 tests conducted at many locations, though insurance information may be requested. It is always advisable to check with the site or your insurance provider to confirm if there will be any costs associated with the test.

Q. Is a specific type of COVID-19 test required for symptomatic individuals?

  • A negative antigen test in a symptomatic individual is not sufficient for return to school. A negative nucleic acid amplification test (NAAT) is required for people with new or worsening symptoms of COVID-19 to return to school. NAATs include but are not limited to polymerase chain reaction (PCR) tests. A lab-based NAAT is the preferred test.
  • Testing of symptomatic individuals should always be done with an FDA-approved diagnostic test which includes: at-home antigen tests, rapid (point of care) molecular and antigen tests, and lab-based molecular and antigen tests.
  • A positive result from any of these tests in a symptomatic individual, regardless of vaccination status, will always be considered positive, and additional testing is not recommended.

Q. Are siblings of symptomatic students required to quarantine as well?

  • During periods of substantial or high transmission in the community, as determined by the CDC, ACDOH recommends excluding asymptomatic unvaccinated household members (including siblings or children) of symptomatic students/staff while awaiting health care provider evaluation and/or COVID -19 testing results of the symptomatic student/staff.

Refusal to Test

Q. What if a symptomatic student, teacher, staff contractor, etc., refuses to be tested for COVID-19?

  • Schools are required to notify the local health department of students or staff who have been excluded or are absent with symptoms of COVID-19 and have not had a negative test result or appropriate medical evaluation after 48 hours using the form – ACDOH COVID-19 Daily Report of Symptomatic Students or Staff – More Than 48 Hours.
  • Each individual should be evaluated and marked for either “meeting” or “not meeting” clinical criteria (i.e., any one symptom from List A OR two or more symptoms from List B):

List A (any 1 symptom)

  • Cough
  • Shortness of breath or difficulty breathing
  • Olfactory disorder
  • Taste disorder
  • Confusion or change in mental status
  • Persistent pain or pressure in the chest
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
  • Inability to wake or stay awake

List B (2 or more symptoms)

    • Fever (measured or subjective)
    • Chills
    • Rigors
    • Myalgia
    • Headache
    • Sore throat
    • Nausea or vomiting
    • Diarrhea
    • Fatigue
    • Congestion or runny nose

 

 

Q. When symptomatic students or staff meet the clinical criteria on the ACDOH COVID-19 Daily Report of Symptomatic Students or Staff – More Than 48 Hours form, what will be the next steps by the school and ACDOH?

  • ACDOH will call the family or staff member to confirm the situation and educate on the importance of being tested. ACDOH will contact the school, as needed, to determine the next steps, including investigating the need to quarantine additional students or staff.

Q. When does the 48-hour period begin for symptomatic students or staff?

  • The 48-hour period begins with the onset of symptoms. For example, if a student becomes symptomatic at noon on Tuesday, then their 48-hour period will end at noon on Thursday.

Q. When the 48-hour period ends on a weekend or holiday, is the school required to submit the form then or the next day that school is in session?

  • Schools may submit the form the next day that school is in session.

Cases and Contacts

Q. When and how should the school report positive COVID-19 cases to ACDOH?

  • If the school is notified before ACDOH of a student’s or staff member’s positive test result, immediately notify ACDOH by calling (518) 447-4640.
  • Case investigation and contact tracing continue after regular business hours and over the weekend.

Q. When a positive case is identified to have been in school during the infectious period, what immediate actions should the school take? (The infectious period begins two days before the onset of symptoms, or two days before the date of specimen collection if asymptomatic, and lasts until the case meets the criteria for discontinuing home isolation, generally ten days after.)

  • Contacts identified using the latest guidance on contact tracing in schools should be sent home immediately and provided quarantine guidance by the school. This guidance should include information on how the school works with ACDOH, in conjunction with the New York State Department of Health, to complete contact tracing and then individually contact families to provide more detailed quarantine guidance.
  • Families should follow ACDOH quarantine guidance until they receive a call from a contact tracer.

Q. Will contact tracers release the name of positive individuals to their contacts?

  • No. Contact tracers will tell potentially infected persons that they were exposed. They will not disclose the identity of the person to whom they were exposed. In some situations, the positive case has already reached out to their contacts and notified them of their positive status.

Q. After testing positive, completing isolation, and subsequently returning to school, should a case be included in surveillance testing?

  • No. Cases are not recommended for additional testing for 90 days after the initial onset of illness (or specimen collection date, if asymptomatic) as long as they do not have a new onset of symptoms during that period of time.

Return to School

Q. When can individuals with positive COVID-19 test results (cases) return to school?

  • Cases can return to school in accordance with CDC’s guidance for the discontinuation of home isolation. Typically, ten days must have passed since symptom onset (or specimen collection date, if asymptomatic); the case must be fever-free for at least the most recent 24 hours without having used any fever-reducing medication; and respiratory symptoms need to be improving.

Q. When can symptomatic individuals identified as close contacts to positive cases, but without any COVID testing results, return to school?

  • Symptomatic individuals who have been quarantined by a public health agency as a close contact to a case who refuse COVID testing should be excluded until meeting the return to school criteria for cases (above).

Q. When can asymptomatic individuals quarantined due to close contact to a case by a public health agency return to school?

  • Contacts who have remained asymptomatic can return to school after completing ten days of quarantine from the last known exposure to the case. Every contact quarantined by a public health agency will receive orders (typically via email) indicating their quarantine dates.

Q. For symptomatic individuals not identified as close contacts and without any COVID-19 testing results, will a general note from a healthcare provider stating that the acute illness is not due to COVID-19 but is instead an unspecified upper respiratory infection or cold suffice for return to school?

  • A note from a health care provider must be provided, specifically stating an alternate diagnosis that explains the onset of symptoms OR indicating a negative COVID-19 test result.
  • General terms such as respiratory tract infection, gastroenteritis, or viral sore throat will not be accepted without a negative COVID-19 test result or a lab result confirming that an alternative pathogen is the cause of the symptoms (i.e., influenza, rhinovirus, S. pyogenes, etc.).
  • School nurses or other designated school personnel can approve the return to school using the above criteria; review of alternative diagnoses by ACDOH is not recommended nor required.

Q. What if the symptomatic individual not identified as a close contact and without any COVID-19 testing results has a chronic medical condition (i.e., allergies, migraines)?

  • A negative NAAT test is recommended for any individual experiencing a new onset of symptoms. With the negative test result, a healthcare provider can provide a letter indicating the expected symptoms associated with the chronic condition and for how long those symptoms can be expected.