GENESEE AND ORLEANS COUNTY HEALTH DEPARTMENTS

Paul A. Pettit, MSL Public Health Director

Genesee County Health Department 3837 West Main Street Road Batavia, NY 14020
Phone (585) 344-2580 x5555 Fax (585)344-4713

Orleans County Health Department 14016 Route 31 West, Suite 101 Albion, NY 14411
Phone (585)589-3278 Fax (585) 589-2878

Brenden A. Bedard, MPH Deputy Public Health Director

AUGUST 13, 2020

FREQUENTLY ASKED QUESTIONS AND RECOMMENDATIONS TO SUPPORT LOCAL SCHOOL REOPENING

Genesee and Orleans County Health Departments (GO Health) appreciate all the effort of local school districts to reopen amid COVID-19 safety requirements and reopening plans. We understand that school districts face many unique and complex challenges, and we are here to support your measures for health and safety for both students and staff at this time. The health and safety of our communities is our paramount concern. We understand that there are likely to be lingering questions for the reopening process, and the following Frequently Asked Questions (FAQs) are meant to assist reopening plans and general communication between local schools and GO Health. These FAQs are dynamic, subject to change, and can be expanded upon as necessary. Our guidance and suggestions remain dependent upon and secondary to guidance provided by New York State.

GENERAL GUIDANCE FOR NYS SAFETY PLANNING:

1. What documents are essential to consider for NYS reopening of schools?

Found at https://forward.ny.gov/phase-four-industries, NYS guidance for Pre-K to Grade 12 Schools is offered through four separate documents: summary guidelines, detailed guidelines with required affirmation, reopening plan checklist, and supplemental guidance. Specific links can be found as follows:

View Summary Guidelines – https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/P12_EDU_Summary_Guidelines.pdf Read and Affirm Detailed Guidelines – https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/Pre-K_to_Grade_12_Schools_MasterGuidence.pdf
Reopening Plan Checklist – https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/P12_Checklist.pdf
Supplemental Guidance – https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/Supplemental_Guidance_PreK-12.pdf

Similar guidance can also be found through the NYS Education Department at http://www.nysed.gov/coronavirus/guidance-p-12-schools, which includes their own FAQ document found at http://www.nysed.gov/common/nysed/files/programs/reopening-schools/school-reopening-faq.pdf

COMMUNICATIONS FROM AND WITH GO HEALTH

2. Should the school district have a designated representative for COVID-19, and what should this representative do?
Yes, GO Health recommends school districts designate an internal COVID-19 representative (CR). This could be, for example, one CR for the district, or one CR for each building or a number that makes sense for the district. CRs are responsible for answering questions from students, faculty, staff, and parents or legal guardians of students regarding COVID-19 public health emergency and plans implemented by the school. CRs should also work closely with GO Health and other schools to monitor public health conditions and jointly develop monitoring strategies. A recommended way for the CR to be trained in the basics of COVID-19 and contact tracing is through the online course offered by Johns Hopkins University at: https://www.coursera.org/learn/covid-19-contact-tracing?edocomorp=covid-19-contact-tracing.

Genesee and Orleans County Health Departments	FAQ for School Reopening 8/13/2020

3. How and when should the school district communicate with GO Health? GO Health should be contacted Monday-Friday as follows:
	At (585) 589-3278 from 8-4pm for Orleans County

	At (585) 344-2580 ext. 5555 from 8:30-5pm for Genesee County

If there is reason to believe that a confirmed positive COVID-19 case may have not yet been reported to GO Health, please contact us as soon as possible during regular business hours. For any more urgent needs, please refer to our internal contact protocol.

4. Does GO Health know about all cases of COVID-19?

GO Health receives all confirmed cases of COVID-19 in Genesee and Orleans from residents that are electronically transmitted from laboratories, by law. Importantly, confirmed cases in all district employees that live outside of GO Health counties will be investigated by the jurisdiction that they reside in, and will likely receive first contact from their local county health department. If a district is made aware of a case, and no contact has yet occurred from GO Health, please contact us as soon as possible.

5. What information will GO Health share, and what will remain confidential?

GO Health will only discuss names of cases with preapproved school personnel consistent with HIPAA. After informing the parents/guardians, schools will be notified of all students and staff placed under mandatory quarantine or isolation, as well as when there is release from quarantine or isolation, as this status will affect necessary absences.

Positive cases will be identified in press releases for the media as follows: 	By school district for a staff member
	By school district and building for a student

No further information will be shared about location of positive cases with the media by GO Health.

TESTING

6. To what extent will GO Health assist with COVID-19 testing?
GO Health recommends COVID-19 testing source and location to be prioritized as follows: 	Primary care physicians or urgent care as needed
	Appointment based NYS-run testing sites (currently at Monroe Community College, Niagara Community College, and Perry St. next to the KeyBank center in Buffalo)
	Further information can be found at https://coronavirus.health.ny.gov/find-test-site-near-you. 	GO Health is not currently a viable option for necessary negative COVID-19 testing.

7. When is a negative COVID-19 test necessary?

In addition to documentation from a healthcare provider, all students and staff who screen “positive” according to appropriate screening questions and symptom assessment must receive a negative COVID-19 test before returning to in-person instruction.

CONTACT TRACING

8. Who does the contact tracing for COVID-19 positive cases?

GO Health will do case investigations for all COVID-19 positive cases who live in their counties. If a positive case lives in an adjoining county, that county’s health department is responsible for conducting the case investigation. If a case who lives outside Genesee or Orleans County has contact with any Genesee or Orleans County residents, GO Health is notified and follows up with those contacts.
Genesee and Orleans County Health Departments	FAQ for School Reopening 8/13/2020

9. How does contact tracing work?

GO Health receives lab results from all its residents through an automated system. As soon as GO Health is notified of a positive resident, a nurse or epidemiologist from GO Health interviews the positive person and finds out who they have had recent close contact with (less than 6’ for 10 minutes or more). People with COVID-19 are often contagious up to 2 days before coming down with symptoms, so GO Health staff ask all patients about their contacts beginning two days before they began to feel sick. The person with COVID-19 is placed on mandatory isolation for at least 10 days after the day they first felt sick. If the person with COVID-19 is a child, GO Health staff speak with the parent(s), guardian(s), and/or teacher(s) of the child to figure out who the close contacts are. GO Health staff then call all of the contacts of the positive person, notify them of the date of their exposure, ask them if they are having any symptoms, and place the contact on mandatory quarantine for 14 days after their last date of close contact with the
COVID-19 positive person.

10. What is the difference between isolation and quarantine?
Isolation is required to separate a case (someone who tests positive for COVID-19) from his/her contacts for a minimum of 10 days. Quarantine is required to separate people who have been exposed to COVID-19 (as a result of interacting with a case or travel from a designated area) from other well persons during the incubation period of an illness, which is 14 days. Close contacts are required to be quarantined according to NYS Department of Health for 14 days after last contact with a case and are monitored by GO Health and NYS contact tracing efforts. During the period of quarantine, a contact could become a case and isolated.

11. What is the difference between a close contact and a proximate contact? Per NYS guidelines, a close contact is defined by any of the following:
	within 6 feet of a positive case for more than 10 minutes up to 48 hours before case’s symptom onset to case’s isolation
	exposed to or give care to positive case 	direct touching
	shared food
	exposed to sneezing or coughing
A proximate contact is considered as being in the same enclosed environment such as a classroom, bus, office, or gatherings but greater than 6 ft. from a person displaying symptoms of COVID-19 or someone who has tested positive for COVID-19. Many factors affect the degree of concern associated with proximate contacts, and proximate contacts will be quarantined at the discretion of GO Health.

12. What is a Person Under Investigation (PUI)?
A PUI is a person who has signs and symptoms of COVID-19 and either is a contact to a case or traveled to an area with a high disease burden. PUIs are monitored by GO Health and the NYS contact tracing effort.

13. What can school districts do to assist GO Health with contact tracing efforts? GO Health recommends the following:
	Attendance list and designated seating charts specific to classrooms 	Attendance list and designated seating charts specific to buses
	Attendance list for all staff that includes records of location
	Awareness and record of substitute travel and work at multiple districts 	Awareness and record of outside vendors or visitors
Such records should be kept on hand and made available to GO Health should need arise to investigate a confirmed case.

Genesee and Orleans County Health Departments	FAQ for School Reopening 8/13/2020

14. What should be done after an elevated temperature reading or other positive symptom screening? Temperatures and other known symptoms should be monitored daily for all students and staff, and be measured above any normal baseline to assess new illness onset. Environmental factors should be considered as part of the screening process. Should reason exist to doubt the validity of a temperature reading, body temperature can be retaken at the discretion of school district protocol. Any student being sent home as the result of a positive screening should be immediately separated from other students and supervised until their parent/legal guardian or emergency contact can retrieve them from school. Staff should also be immediately sent home without any further in-person interactions. Any staff or students with a positive screen should follow established protocols for any return to in-person instruction.

15. Are teachers considered essential workers, and therefore eligible to work while under quarantine according to provisions allowed for essential workers?
This determination is made by NYS, as seen at https://esd.ny.gov/guidance-executive-order-2026, and districts are encouraged to work within ongoing State guidance on this issue. Any essential worker must follow State guidelines for return to work, found at https://coronavirus.health.ny.gov/system/files/documents/2020/04/doh_covid19_essentialpersonnelreturnto work_rev2_033120.pdf

PARENTAL/GUARDIAN CONCERNS OVER CONTACT TRACING

16. As a parent, I heard from someone else that my child had contact with a COVID-19 positive person. What should I do?
If your child was indeed a close contact with a COVID-19 positive person, you and your child will be contacted as soon as possible by the GO Health contact tracing effort.

17. My child has been isolated due to a positive test for COVID-19. What does this mean for our family? Your child will have to isolate in your home for at least 10 days after your child started feeling sick. Household members will be placed on mandatory quarantine, meaning they can’t leave the home, and can’t have any visitors. If any household members are essential workers, they may be allowed to continue going to work only if they are healthy and free of any COVID-like symptoms, and they and their employer meet certain New York State requirements. New York State offers paid leave for many workers who have to miss work due to being quarantined: https://paidfamilyleave.ny.gov/COVID19

18. My child was out sick from school with COVID-19. She has been in isolation for 10 days now, and is all better. When can she go back to school?
New York State currently requires that children who had COVID-19 get a negative test before they can go back to school, out of an abundance of caution, as well as documentation from a healthcare provider. Once your child has recovered from COVID-19, and once 10 days have passed since your child first got sick, she will be released from isolation by the health department. That means GO Health will no longer be monitoring your child, and she will be able to leave the home and see family and friends again.

19. My child has been quarantined due to close contact with a classmate or teacher who tested positive for COVID-19. What does that mean for our family?
Your child will have to quarantine in your home for 14 days following the last date of close contact with the positive person, meaning the child can’t leave the home, and can’t have any visitors. The family members of the child are not under quarantine, and are able to continue going to work, school, etc. If the child is too young to be home alone, a parent or guardian will have to miss work to take care of him/her. In that case, New York State offers paid leave for many workers who have to miss work due to caring for a quarantined child: https://paidfamilyleave.ny.gov/COVID19.

Genesee and Orleans County Health Departments	FAQ for School Reopening 8/13/2020

20. Can’t my child just be tested for COVID-19 to get off of quarantine earlier?

Unfortunately, no. After being infected with COVID-19, it takes people between two and fourteen days to start feeling sick. People often don’t test positive for COVID-19 until about the time that they start feeling sick. This means that, even if your child tests negative during the quarantine period, he/she may still be infected with COVID-19 and may get sick.

21. I’m pretty sure my family already had COVID-19. If my child has a positive antibody test, can he/she avoid being quarantined?
No, for two reasons. Firstly, the antibody test may come back positive because your child was recently infected with one of the other coronaviruses that infects humans, not with the coronavirus that causes COVID-19. Four of these different coronaviruses cause cold symptoms in people, and are common. Secondly, we don’t know yet if having COVID-19 antibodies will fully protect your child from getting COVID-19 again. That is why New York State doesn’t allow us to take antibody test results into consideration when quarantining people.

22. My child’s classmate had COVID-19 and only had to isolate for 10 days, but my child has to quarantine for 14. Why is that?
The purpose of isolation is to keep contagious people away from healthy people, to stop the spread of COVID-19. Studies show that people who have COVID-19 start out being very contagious just before they start to feel sick, and then become less and less contagious as the days pass during their illness. Unless
someone is extremely sick or has a weakened immune system, by the tenth day of their illness, people are no longer contagious. This is why isolation ends after the 10th day, as long as the patient is feeling better. The purpose of quarantine is to keep people who may become contagious away from healthy people. We know that when someone is infected with the virus that causes COVID-19, it takes between two and fourteen days for that person to start to feel sick. This is why we quarantine potentially infected people for fourteen days after their last date of exposure.

23. I think my child’s classmate had a false positive. Why does my child still have to quarantine?

The way COVID-19 tests work, it is possible for a negative test to be wrong, meaning it’s possible for the test to be unable to find the virus even though a person really is infected. This can happen if the sample wasn’t collected properly, or if the person was tested too early or too late in their illness. But it is nearly impossible for a positive test to be wrong, that is, it’s extremely unlikely for the test to find the virus even though a person is really not infected. Many people who have COVID-19 don’t have symptoms, or have symptoms that they confuse with something else like allergies or indigestion. People who test positive for COVID-19, even if they don’t have symptoms or think their symptoms are caused by something else, may still be able to transmit the infection to others. Because of this, all positive test results are treated as positives by GO Health. People who are COVID-19 positive are required to isolate, and their close contacts are required to quarantine.

24. My child was wearing a mask when she was exposed, and so was the positive person. Why does my child still have to quarantine?
Cloth masks aren’t all equally effective. Some are made of tightly woven materials or multiple layers, while others are made of materials that allow more droplets to pass through. Some fit more snuggly to the face, and others have large gaps. Some people wear their mask properly over their nose and mouth, and other people let their mask slide down so their nose is exposed. All of these factors have a huge effect on how much protection a mask provides, and make it very difficult for investigators to determine the exact level of risk someone who was exposed while wearing a cloth mask. Because of this, and out of an abundance of caution, New York State requires that we quarantine people who had close contact with a positive case, even if the positive case or the contact were wearing cloth masks at the time.

Genesee and Orleans County Health Departments	FAQ for School Reopening 8/13/2020