Guidance for COVID-19 Prevention in K-12 Schools

The following guidance is based on updated CDC guidance for COVID-19 prevention in K-12 schools and the State of Illinois Executive Orders. Executive Order 2021-18 requires that masks be worn indoors by all teachers, staff, students, and visitors to P-12 schools, regardless of vaccination status. Executive Order 2021-22 requires that all school personnel be fully vaccinated against COVID-19 by September 19, 2021 or submit to at least weekly testing. Further, effective September 17, 2021, Executive Order 2021-24 requires all schools and school districts to exclude students and school personnel from school who are confirmed or probable cases of COVID-19, who are close contacts to a case, or who exhibit COVID-19 like symptoms. Schools must provide remote instruction to any student that is excluded under Executive Order 2021-24.

Additionally, the following COVID-19 prevention strategies, as outlined in this guidance, remain critical to protect students and community members who are not fully vaccinated, especially in areas of moderate to high community transmission levels, and to safely deliver in-person instruction. Schools must implement these other layered prevention strategies to the greatest extent possible and taking into consideration factors such as community transmission, vaccination coverage, screening testing, and occurrence of outbreaks, consistent with CDC guidance.

1. Promote and/or provide COVID-19 immunization for all school personnel and eligible students.
2. Facilitate physical distancing. Schools should configure their spaces to provide space for physical distancing to the extent possible in their facilities.
3. Implement or provide provisions for COVID-19 diagnostic testing for suspected cases, close contacts, and during outbreaks, as well as screening testing for unvaccinated students according to the CDC’s testing recommendations.
4. Improve ventilation to reduce the concentration of potentially virus-containing droplets in schools’ indoor air environments.
5. Promote and adhere to hand hygiene and respiratory etiquette.
6. Encourage individuals who are sick to stay home and get tested for COVID-19.
7. Clean and disinfect surfaces in schools to maintain healthy environments.

It is important to note that these requirements are subject to change pursuant to changing public health conditions and subsequent updated public health guidance, including from the CDC.

1. Executive Summary
2. IDPH Health and Safety Requirements
3. Require that all school personnel be fully vaccinated against COVID-19 or submit to at least weekly testing. Collect school personnel vaccination and testing documentation. Promote and/or provide COVID-19 immunization for all school personnel and eligible students
   
   1. Testing Requirements for School Personnel Who Decline Vaccination
   2. Collecting Vaccination Status Information
4. Require all teachers, staff, students, and visitors to P-12 schools to wear a mask while indoors, regardless of vaccination status
   
   1. Additional Face Mask Guidance
   2. Other Recommendations for use of PPE
5. Facilitate physical distancing. Schools should configure their spaces to provide space for physical distancing to the extent possible in their facilities
6. Employ contact tracing in combination with adaptive pause and exclusion of students and staff consistent with public health guidance or requirements
   
   1. Contact Tracing
   2. Definition of a Close Contact
   3. Mandatory Exclusion of Students and School Personnel
   4. Test to Stay Protocol
7. Implement or provide provisions for COVID-19 diagnostic testing for suspected cases, close contacts, and during outbreaks, as well as screening testing for unvaccinated students according to CDC’s testing recommendations
8. Improve ventilation to reduce the concentration of potentially virus-containing droplets in schools’ indoor air environments
9. Promote and adhere to handwashing and respiratory etiquette
10. Encourage individuals who are sick to stay home and get tested for COVID-19
11. Clean and disinfect surfaces in schools to maintain healthy environments

In-person learning with the appropriate protective measures should be both safe and essential to students’ mental health and academic growth. In its scientific brief on transmission of SARS-CoV-2 in K-12 schools, the Centers for Disease Control and Prevention (CDC) cites several sources that suggest lower prevalence of disease, susceptibility, and transmission in children – especially those under the age of 10 – although additional studies are needed to further understand this finding. Further, the authors cite recent studies documenting that, with prevention strategies in place, in-person learning was not associated with higher levels of transmission when compared to communities without in-person learning.

The majority of students need full-time in-person access to their teachers and support network at school to stay engaged, to learn effectively, and to maintain social-emotional wellness. A recent study from the CDC suggests that remote learning can be challenging for many students, leading not only to learning loss, but also worsening mental health for children as well as parents. CDC found that students of color were more likely to miss out on in-person learning: nationwide, in April, only 59 percent of Hispanic students, 63 percent of Black students, and 75 percent of White students had access to full-time in-person school. Restoring full-time in-person learning for all students is essential to our state’s commitment to educational equity.

Please note that additional studies are needed to better understand transmission in all populations. Specifically, there are risks of transmission in schools and adult populations (teachers, school staff, parents) continue to be at risk of transmission when in-person learning is resumed. While most COVID-19-associated hospitalizations occur in adults, severe disease occurs in all age groups, including adolescents aged 12 to 17 years, who were hospitalized at a

rate of 49.9 per 100,000 from March 2020 to April 2021. As the Delta variant becomes more common across the United States, including in Illinois, the greatest risk for infection and severe complications is among people who are not fully vaccinated, including children younger than 12 years old who are not yet eligible for the COVID-19 vaccine. For example, recent evidence from the United Kingdom, where the highly transmissible variant is already widespread, found five times higher rates of infection among children aged 5 to 12 years and young adults aged 18 to 24 years compared to those aged 65 years and older, with the majority of infections in the younger group occurring among the unvaccinated.

Vaccination is currently the leading public health prevention strategy to end the COVID-19 pandemic. People who are fully vaccinated against COVID-19 are at low risk of symptomatic or severe infection. A growing body of evidence suggests that people who are fully vaccinated against COVID-19 are less likely to have an asymptomatic infection or transmit COVID-19 to others than people who are not fully vaccinated. 

Immunization of P-12 teachers in Illinois began in February 2021 with much success protecting school staff from COVID-19. In April 2021, all Illinoisans age 16 and older became eligible for vaccination, followed by 12- to 15-year-old individuals in May 2021. In August 2021, following the U.S. Food and Drug Administration’s full approval of the Pfizer-BioNTech COVID-19 vaccine, Illinois began requiring all school personnel to be fully vaccinated or submit to at least weekly testing for COVID-19,  pursuant to Executive Order 2021-22 Schools can promote vaccinations among teachers, staff, families, and eligible students by providing information about COVID-19 vaccination, encouraging vaccine trust and confidence, and establishing supportive policies and practices that make getting vaccinated as easy and convenient as possible.

As the newer, more transmissible Delta variant becomes more common across the U.S., and following the release of updated CDC guidance for K-12 schools, this joint guidance from the Illinois Department of Public Health (IDPH) and the Illinois State Board of Education (ISBE) makes important updates to the essential, layered mitigation strategies that facilitate the safe return to full-time in-person instruction beginning with the start of the 2021-22 school year.

IDPH is issuing this guidance under its broad authority to protect the public health in an effort to restrict and suppress the continued spread of COVID-19 and allow students across Illinois to safely and fully return to the in-person learning conditions that they need to thrive. Students in Illinois and across the country returned safely to in-person learning throughout the 2020-21 school year with limited transmission occurring in school facilities due to students’ and teachers’ adherence to public health requirements. This guidance reflects what we have learned about preventing the transmission of COVID-19 in school settings, incorporates the efficacy of the vaccine, accounts for widespread availability of COVID-19 testing and the increasing number of students and educators who are fully vaccinated, and aligns with the updated guidance for COVID-19 prevention in K-12 schools issued by the CDC on July 9, 2021, and updated most recently on August 5, 2021.

The State of Illinois has adopted the CDC’s updated guidance regarding COVID-19 prevention in K-12 schools. Based on that guidance, and the State of Illinois Executive Orders, ISBE and IDPH have updated the public health requirements for schools and associated guidance in these guidelines. This guidance applies to all public and nonpublic schools that serve students in prekindergarten through grade 12 (P-12).

Districts and schools should proactively prepare staff and students to prevent the spread of COVID-19 and any other infectious disease. All employees should be trained on health and safety protocols related to COVID-19.

Everyone 12 years of age and older is now eligible to get a free COVID-19 vaccination. Please see the CDC website for the most updated eligibility guidance. On August 23, 2021, the U.S. Food and Drug Administration (FDA) gave full approval to the Pfizer-BioNTech COVID-19 vaccine.

COVID-19 vaccines are safe and effective. The CDC scientific brief on COVID-19 vaccines and vaccination cites research in clinical trials and real-world settings documenting that vaccination in adults and children as young as 12 years old reduces the chances of contracting the virus that causes COVID-19, including several variants. The CDC also cites evidence that fully vaccinated people are less likely to have asymptomatic infection or transmit SARS-CoV-2 to others. Importantly, the evidence also suggests that the COVID-19 vaccine is highly effective at reducing odds for severe complications, hospitalizations, and death.

At this time, there are limited data on vaccine protection in people who are immunocompromised. Fully vaccinated persons with immunocompromising conditions, including those taking immunosuppressive medications (e.g., drugs such as mycophenolate or rituximab to suppress rejection of transplanted organs or to treat rheumatologic conditions), should discuss the need for personal protective measures with their health care provider after vaccination.

Due to the proven efficacy and safety of the vaccine, and its critical role in stopping the spread of COVID-19, Illinois has taken an additional step to protect the health and safety of school communities by requiring that all school personnel either become fully vaccinated against COVID-19 or submit to at least weekly testing.

Executive Order 2021-22 and 23 Ill. Admin. Code 6 require that all school personnel be fully vaccinated against COVID-19 in accordance with the timelines set forth below or submit to at least weekly testing:

1. School personnel acting in their school-based role on or before the effective date of Executive Order 2021-22 must receive, at a minimum, the first dose of a two-dose vaccine series or a single-dose vaccine by September 19, 2021, and, if applicable, the second dose of a two-dose COVID-19 vaccine series within 30 days following the administration of their first dose.
2. School personnel first starting in their school-based role after the effective date of Executive Order 2021-22 must receive, at a minimum, the first dose of a two-dose vaccine series or a single-dose vaccine within 10 days of their start date in the school-based role, and, if applicable, the second dose of a two-dose COVID-19 vaccine series within 30 days following the administration of their first dose.

Schools shall require school personnel who are fully vaccinated against COVID-19 to provide proof of vaccination against COVID-19 to the school by September 19, 2021, or immediately upon becoming fully vaccinated.

“School” means any public or nonpublic elementary or secondary school, including charter schools, serving students in pre-kindergarten through 12th grade, including any State-operated residential schools such as the Philip Rock Center and School, the Illinois School for the Visually Impaired, the Illinois School for the Deaf, and the Illinois Mathematics and Science Academy. The term "School" does not include the schools operated by the Illinois Department of Juvenile Justice.

“School Personnel” means any person who (1) is employed by, volunteers for, or is contracted to provide services for a School or school district serving students in pre-kindergarten through 12th grade, or who is employed by an entity that is contracted to provide services to a School, school district, or students of a School, and (2) is in close contact (fewer than 6 feet) with students of the School or other School Personnel for more than 15 minutes at least once a week on a regular basis, as determined by the School. The term “School Personnel” does not include any person who is present at the School for only a short period of time and whose moments of close physical proximity to others onsite are fleeting (e.g., contractors making deliveries to a site where they remain physically distanced from others or briefly entering a site to pick up a shipment).

Schools may implement stricter requirements regarding the vaccination or testing of school personnel, except that schools must continue to exempt individual school personnel from a vaccination requirement if: (1) the vaccination is medically contraindicated, which includes any individual who is entitled to an accommodation under the Americans with Disabilities Act (ADA) or any other law applicable to a disability-related reasonable accommodation; or (2) vaccination would require the individual to violate or forgo a sincerely held religious belief, practice, or observance.

Beginning September 19, 2021, schools shall require all school personnel who are not fully vaccinated against COVID-19 for any reason, including, but not limited to, a religious exemption or medical contraindication, to comply with the testing requirements set forth below.

Schools shall exclude from the school premises and/or refuse admittance to the school premises any school personnel who are acting in their school-based role and are not fully vaccinated against COVID-19 unless such school personnel comply with the testing requirements.

Promoting and/or providing vaccination for students and school personnel is a primary way to protect staff and students and to slow the spread of COVID-19. Strategies that minimize barriers to access vaccination for school personnel, such as vaccine clinics at or close to the place of work, are optimal. School officials and local health departments should work together to support messaging and outreach regarding vaccination for members of school communities, including students under 12 years old as they become eligible for vaccination in their jurisdictions. For more information, see IDPH’s answers to frequently asked questions (FAQs) about COVID-19 vaccination for young people.

ISBE and IDPH have provided resources to support school districts in hosting vaccination events or communicating with school communities about other options for eligible children and families to receive the COVID-19 vaccine.

Beginning September 19, 2021, school personnel who are not fully vaccinated against COVID-19 for any reason, including, but not limited to, a religious exemption or medical contraindication, must undergo testing for COVID-19 with either a Nucleic Acid Amplification Test (NAAT), including PCR tests, or an antigen test, that either has Emergency Use Authorization by the FDA or is operating per the Laboratory Developed Test requirements by the U.S. Centers for Medicare and Medicaid Services (CMS), until they are fully vaccinated.

Testing must occur at least weekly for unvaccinated school personnel. If a school is experiencing an outbreak of COVID-19 and school personnel who are not fully vaccinated may be part of the outbreak as determined by public health authorities, such school personnel must be tested for COVID-19 two times per week for the duration of that outbreak. The Illinois Department of Public Health recommends PCR testing with less than 48-hour turnaround time. 

Such testing for school personnel who are not fully vaccinated against COVID-19 must be conducted on-site at the school or the school must obtain proof or confirmation from the school personnel of a negative test result obtained elsewhere.

Schools are encouraged but not required to provide testing opportunities for school personnel. Schools can use federal pandemic relief funds to purchase tests and pay the staff necessary to operate a testing program. However, ultimately, school personnel who decline vaccination are responsible for ensuring they meet the testing requirements. Schools may direct school personnel to community or commercial testing sites.

Non-school district entities that employ individuals who fall within the definition of school personnel may request permission from the school districts they serve to have those employees participate in the weekly COVID-19 testing services that those school districts provide to their employees. School districts are encouraged, but not required, to grant permission for the employees of entities who provide services to their schools to participate in the school district’s COVID-19 testing program.

School personnel who are not fully vaccinated may be permitted to enter or work at the school while they are awaiting the results of their weekly test. Schools shall exclude from school premises and/or refuse admittance to the school premises school personnel acting in their school-based role who are not fully vaccinated against COVID-19 unless they comply with these testing requirements.

All school personnel must provide proof of vaccination against COVID-19 immediately upon becoming fully vaccinated. “Proof of Vaccination Against COVID-19” means: (1) a CDC COVID-19 vaccination record card or photograph of such card; (2) documentation of vaccination from a health care provider or an electronic health record; or (3) state immunization records.

Adults can authorize release of such proof for themselves by completing a request for immunization records from the Illinois Comprehensive Automated Immunization Registry Exchange (I-CARE). (Chicago residents can complete the request for immunization records using this form.) Adults can also access their vaccination records through IDPH’s immunization portal, Vax Verify, which allows Illinois residents 18 years and older to check their COVID-19 vaccination record. 

Federal laws do not prevent employers from requiring employees to bring in documentation or other confirmation of vaccination. This information, like all medical information, must be kept confidential and stored separately from the employee’s personnel files under the ADA.

All schools must maintain a record for school personnel employed by the school or school district that identifies them as one of the following: fully vaccinated; unvaccinated and compliant with the testing requirements; or excluded from the premises in accordance with 23 Ill. Admin. Code 6.

Each school shall maintain the following documentation for each school personnel employed by the school or school district, as applicable:

1. Proof of vaccination against COVID-19.
2. The results of COVID-19 tests.

Schools shall maintain any school personnel medical records in accordance with applicable law.

Beginning September 19, 2021, for school personnel who are not employed by the school or school district but are providing services through another entity (e.g., a contractor or service provider of the school), the school may determine that such school personnel are compliant with the vaccination or testing requirements by requiring the entity to:

1. collect proof of vaccination against COVID-19 from the school personnel or proof of compliance with the testing requirements; and  
2. submit an attestation to the school that they will collect this proof for any school personnel they provide to the school. 

Schools that plan to request voluntary submission of documentation of students’ COVID-19 vaccination status should use the same standard protocols that are used to collect and secure other immunization or health status information from students. For example, Illinois state law and administrative code requires children enrolled in child care or school to be immunized against certain preventable communicable diseases, including highly contagious viral illnesses such as measles, mumps, and varicella (chickenpox). Prior to entering any public, private, independent, or parochial school, every child in Illinois must provide the school with documentation from their health care provider that verifies their immunizations, with certain exceptions. Schools that request proof of vaccination for COVID-19 may use this existing infrastructure to document students’ vaccination status.

The protocol to collect, to secure, to use, and to further disclose this information should comply with relevant statutory and regulatory requirements, including Family Educational Rights and Privacy Act (FERPA) statutory and regulatory requirements.

Local school authorities are permitted to access the statewide immunization database to review student immunization records. Only employees who have direct responsibility for ensuring student compliance with 77 Ill. Admin. Code 665.210 can apply for and receive access to I-CARE, the statewide system. No access will be granted to other personnel, such as superintendents or human resource managers. All individuals with I-CARE access are subject to all requirements and penalties authorized by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). School employees may apply for access to I-CARE by following the instructions in the I-CARE access enrollment packet. Contact I-CARE program staff via email at dph.icare@illinois.gov for more information.

Adults can authorize release of such proof for their children by completing a request for immunization records from I-CARE. (Chicago residents can complete the request for immunization records using this form.)  

As families and communities continue to increase vaccine uptake, schools and districts must ensure all students, no matter their vaccination status, continue to have access to safe full-time in-person instruction.

This guidance is based on updated recommendations in CDC guidance for COVID-19 prevention in K-12 schools and an updated Executive Order for the State of Illinois. Executive Order 2021-18 requires that all teachers, staff, students, and visitors to P-12 schools who are two years of age or older and medically able to tolerate a mask, regardless of vaccination status, to wear a mask while indoors.

The following categories of people are exempted from the requirement to wear a mask:

• Children under 2 years of age.
• A person who cannot wear a mask or cannot safely wear a mask because of a disability as defined by the ADA (42 U.S.C. 12101 et seq.). Schools and districts should discuss the possibility of a reasonable accommodation with workers who are unable to wear a mask, or who have difficulty wearing certain types of masks because of a disability.
• A person for whom wearing a mask would create a risk to workplace health, safety, or job duty as determined by the relevant workplace safety guidelines or federal regulations.

IDPH recommends that any individual with a condition or medical contraindication (e.g., difficulty breathing) that prevents them from wearing a mask be referred to a health care provider licensed to practice medicine in all branches of medicine, as defined in 105 ILCS 5/27-8.1, to provide certification of such medical contraindication.

All persons, regardless of vaccination status, must wear a face mask at all times when in transit to and from school via group conveyance (e.g., school buses), unless a specific exemption applies. This is in accordance with the CDC Order, in effect as of February 1, 2021, which requires “the wearing of masks by people on public transportation conveyances or on the premises of transportation hubs to prevent the spread of the virus that causes COVID-19.”

Masks may be temporarily removed at school in the following circumstances:

• When eating.
• For children while they are napping with close monitoring to ensure no child leaves their designated napping area without putting their mask back on.
• For staff when alone in classrooms or offices with the door closed.
• For staff and students when they are outdoors. However, particularly in areas of substantial to high transmission, per CDC COVID Data Tracker or IDPH’s COVID-19 County & School Metrics, staff and students who are not fully vaccinated should wear a mask in crowded outdoor settings or during activities that involve sustained close contact with other people who are not fully vaccinated.

Staff and students who remove their face mask in these limited situations should be monitored and should maintain physical distancing to the greatest extent possible given the space in their facilities, with at least 3 feet recommended, but not required, between students and at least 6 feet recommended, but not required, between adults or between students and adults.

Most people, including those with disabilities, can tolerate and safely wear a face mask. Students with an Individualized Education Program or 504 Plan who are unable to wear a face mask or face shield due to a medical contraindication may not be denied access to an in-person education if the school is offering in-person education to other students. Staff working with students who are unable to wear a face mask or shield due to a medical contraindication should wear approved and appropriate personal protective equipment (PPE) based on job-specific duties and risks and maintain physical distancing as much as possible. Other students should also remain distant from students who are unable to wear a face mask or face shield due to a medical contraindication. Schools should consult with their local health department regarding appropriate PPE for these situations.

It is recommended that districts and schools update procedures to require wearing a face mask while on school grounds according to the provisions noted above and handle violations in the same manner as other policy violations.

According to the CDC scientific brief on transmission of SARS-CoV-2, the virus that causes COVID-19, the principal mode by which people are infected is through exposure to respiratory fluids, most commonly by inhalation of smaller droplets or direct splashes or sprays of larger droplets that are deposited in someone’s mouth, nose, or eyes. Masks act as source control to block the release of exhaled respiratory droplets and filter some droplets to reduce exposure by inhalation. There is significant evidence that face masks provide protection and decrease the spread of COVID-19, including in schools. According to the CDC scientific brief on the use of cloth masks to control the spread of SARS-CoV-2, at least 10 studies have confirmed the benefit of universal masking, documenting that new COVID-19 infections fell significantly following directives for universal masking.

The face mask should have two or more layers to stop the spread of COVID-19 and should be worn over the nose and mouth, be secured under the chin, and should fit snugly against the sides of the face without gaps. Reusable face masks should be machine washed or washed by hand and allowed to dry completely after each use. Additionally, pay special attention to putting on and removing face masks for purposes such as eating. After use, the front of the face mask is considered contaminated and should not be touched during removal or replacement. Hand hygiene should be performed immediately after removing and after replacing the face mask. See CDC guidance on how to wear and take off a mask for additional instruction. Districts and schools may wish to maintain a supply of disposable face masks in the event that a staff member, student, or visitor does not have one for use. School leaders, local leaders, and others respected in the community should set an example by correctly and consistently wearing masks. For additional information, see CDC guidance for wearing masks.

Face masks with exhalation valves or vents are not recommended for source control because they do not prevent the user from spreading respiratory secretions when they breathe, talk, sneeze, or cough. The CDC does not recommend use of single-layer athletic face masks (e.g., “gaiters”/neck warmers) as a substitute for multi-layered cloth face masks. Additional studies indicate that gaiters can be worn as face coverings when they contain two layers of fabric or a single layer can be folded to make two layers, according to updated CDC guidance (February 12, 2021).

Face shields do not provide adequate source control because respiratory droplets may be expelled from the sides and bottom. They may only be used as a substitute for face masks in the following limited circumstances:

• Individuals who are under the age of 2.
• Individuals who are unconscious, incapacitated, or otherwise unable to remove a face mask without assistance.
• Students and staff who provide a health care provider’s note as documentation that they have a medical contraindication (a condition that makes masking absolutely inadvisable) to wearing a face mask.
• Teachers needing to show facial expressions where it is important for students to see how a teacher pronounces words (e.g., English Learners, early childhood, world language, etc.). However, teachers will be required to resume wearing face masks as soon as possible. Preferred alternatives to teachers wearing face shields include clear face masks or video instruction. There must be strict adherence to physical distancing when a face shield is utilized in lieu of a face mask.

Ensure that appropriate PPE is made available to and used by staff, as needed, based on exposure risk. Provide training to staff prior to the start of student attendance on the proper use of PPE, including the sequence for putting on and removing PPE. In addition, training should also include directions on the proper disposal of PPE since inappropriate application or removal of PPE can increase the transmission. Employers are required to comply with Occupational Safety and Health Administration (OSHA) standards on bloodborne pathogens, including the proper disposal of PPE and regulated waste.

The highest level of safety for school health personnel who are screening a sick individual includes wearing a fit-tested N95 mask, eye protection with face shield or goggles, gown, and gloves. School health personnel performing clinical evaluation of a sick individual will use enhanced droplet and contact transmission-based precautions and should use appropriate PPE, including:

• Fit-tested N95 mask
• Eye protection with face shield or goggles
• Gown
• Gloves

Any staff member who may be involved in the assessment or clinical evaluation of a student or staff member with COVID-19-like symptoms should be trained on the type of PPE required and how to put on and remove it correctly and safely. 

Respirators such as N95 masks must be used as part of a written respiratory protection program.   OSHA requires that N95 masks be fit-tested prior to use. This is an important step to ensure a tight fit for the mask to be effective in providing protection. If a fit-tested N95 mask is not available, the next safest levels of respiratory protection include, in the following order, a non-fit-tested N95 mask, a KN95 mask on the list approved by the FDA, or a surgical mask.

Staff should continue to follow all recommended infection prevention and control practices, including wearing a face masks for source control while at work, actively monitoring themselves for fever or  COVID-19 symptoms prior to work and while working, and staying home if ill. See https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html.

Physical distancing provides protection, minimizes risk of exposure, and limits the number of close contacts. CDC recommends schools maintain at least 3 feet of physical distance between students within classrooms to reduce transmission risk. No school may restrict a student’s access to in-person learning in order to keep a minimum distance requirement.

Schools should provide for the maximum space possible between students and between students and staff, within the school facilities’ physical capabilities. Districts and schools may wish to post visual reminders throughout school buildings and lay down tape or other indicators of safe distances in areas where students may remove masks, congregate, or line up (e.g., arrival and departure, lunchroom lines, hallways, recess lines, libraries, cafeterias). When face masks are removed in limited situations (e.g., lunchrooms), it is especially important that school staff facilitate physical distancing to the greatest extent possible within the school facilities’ physical capabilities. Districts and schools may consider increasing physical distancing measures when community transmission levels are substantial or high.

Physical distance should be measured as the distance between persons (i.e., “mouth to mouth”) rather than between furniture (e.g., desk to desk). A distance of at least 3 feet is recommended between unvaccinated students, but not required. A distance of at least 6 feet is recommended between unvaccinated adults or between unvaccinated adults and students, but not required.

There is no recommended capacity limit for school transportation. Schools should facilitate physical distancing on school transportation vehicles to the extent possible given the space on such vehicles.

Mealtimes represent one of the highest-risk settings within the school. Masks are removed and the act of eating and talking, usually with increased projection, can increase transmission risk. Physical distancing of 3 feet is recommended for students while eating or drinking. Given the risk of transmission among unvaccinated persons while unmasked, a distance of at least 6 feet is recommended for all unvaccinated individuals while eating and drinking, but is not required.

Districts and schools may wish to consider “staggering” schedules for arrivals/dismissals, hall passing periods, mealtimes, bathroom breaks, etc. to ensure the safety of unvaccinated students and staff. Staff and students should abstain from physical contact, including, but not limited to, handshakes, high fives, and hugs.

Cohorts (or “pods”) are activities or classes that are grouped together to the extent possible during the school day in order to minimize exposure to other individuals in the school environment. When implementing cohorts, schools should keep them as static as possible by having the same group of students stay with the same teachers or staff (all day for young children, and as much as possible for older children). If additional space is needed to support cohorting, consider all available safe spaces in school and community facilities. Limit mixing between cohorts. Students and staff in the same cohort who are not fully vaccinated should continue to wear masks at all times, except as otherwise noted in this guidance.

It is important to consider services for students with disabilities, English Learners, and other students when developing cohorts so that such students may receive services within the cohort, but also to assure adherence to equity, integration, and other requirements of civil rights laws, including federal disability laws. If itinerant staff (e.g., speech language pathologists, Title I targeted assistance teachers) are required to provide services within existing cohorts, mitigation measures should be taken to limit the potential transmission of SARS-CoV-2 infection, including providing face masks and any necessary PPE for staff and children who work with itinerant staff. Itinerant staff members should keep detailed contact tracing logs.

School athletics must comply with the latest Sports Safety Guidance.

Evidence suggests that staff-to-staff transmission is more common than transmission from students to staff, staff to student, or student to student. Districts and schools should address staff-to-staff transmission and limit these exposures, primarily focused on unvaccinated staff. Nonessential exposures among unvaccinated staff should be minimized, including both physical and professional meetings. For example, staff break areas should be arranged to facilitate physical distancing and break times should be staggered to minimize exposure while eating with face mask off near others. Measures to prevent transmission among staff, including promotion of COVID-19 precautions outside of the school and vaccination, will likely reduce in-school transmission.

Pursuant to 77 Ill. Admin. Code 690.361, districts and schools are required to investigate the occurrence of cases and suspect cases in schools and identify close contacts for purposes of determining whether students or school personnel must be excluded from school premises, extracurricular events, or any other event organized by the school.

Districts and schools, as well as students and families, must work with local health departments to facilitate contact tracing of infectious students, teachers, and staff, and consistent implementation regarding isolation of cases and quarantine of close contacts, as well as for exclusion from school per Executive Order 2021-24. Contact tracing is used to prevent the spread of infectious diseases. In general, contact tracing involves identifying people who have a confirmed or probable case of COVID-19 (cases) and individuals with whom they came in contact (close contacts) and working with such individuals to interrupt disease spread. When conducted by the local health department, this includes asking people with COVID-19 to isolate and their contacts to quarantine at home voluntarily. When conducted by schools, this includes excluding cases and their contacts from school premises and activities.

Schools can prepare and provide information and records to local health departments to aid in the identification of potential unvaccinated contacts, exposure sites, and mitigation recommendations that are consistent with applicable laws, including those related to privacy and confidentiality. Local health department collaboration with P-12 school administration to obtain contact information of other unvaccinated individuals in shared rooms, class schedules, shared meals, or extracurricular activities will expedite contact tracing and control the spread of COVID-19 infection.

Additionally, schools must conduct their own contact tracing in the school to determine if students or school personnel must be excluded from school, regardless of whether an isolation or quarantine order has been issued by the local health department. Schools should also institute a tracking process to maintain ongoing monitoring of individuals excluded from school because they have COVID-19-like symptoms, have been diagnosed with COVID-19, or have been exposed to someone with COVID-19. Tracking ensures CDC and local health department criteria for discontinuing home isolation, quarantine or exclusion by the school are met before a student or staff member returns to school. Tracking methods include checking in with the school health personnel upon return to school to verify resolution of symptoms and that any other criteria for discontinuation of isolation, quarantine or exclusion have been met. Tracking should take place prior to a return to the classroom. Schools should communicate this process to all members of the school community prior to the resumption of in-person learning. This communication should be translated into the languages appropriate for the communities served.

Monitoring of continual communicable disease diagnoses and monitoring of student and staff absenteeism should occur through collaboration of those taking absence reports and school nurses/school health personnel. Employees and families must be encouraged to report specific symptoms, COVID-19 diagnoses, and COVID-19 exposures when reporting absences. Districts and schools should maintain a current list of community testing sites to share with staff, families, and students. Districts and schools must be prepared to offer assistance to local health departments when contact tracing is needed after a confirmed case of COVID-19 is identified. This may include activities such as identifying the individual’s assigned areas and movement throughout the building.

Individuals who exhibit symptoms should be referred to a medical provider for evaluation, treatment, and information about when they can return to school, according to the Public Health Interim Guidance for Local Health Departments and Pre-K-12 Schools – COVID-19 Exclusion Protocols (“COVID-19 Exclusion Protocols”). Confirmed cases of COVID-19 should be reported to the local health department by the school health personnel or designee as required by the Illinois Infectious Disease Reporting requirements issued by IDPH.

Districts and schools should inform the school community of outbreaks per local and IDPH guidelines while protecting the confidentiality of students and staff. In addition to the previously referenced COVID-19 Exclusion Protocols, schools should also refer to the IDPH Interim Post-Vaccination Considerations for Schools for details on procedures for handling children/staff with symptoms after vaccination.

For all individuals where exposure occurred outside of the classroom setting and for adults in the indoor P-12 classroom setting, CDC defines a close contact as an individual not fully vaccinated against COVID-19 who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period. A student who was within 3-6 feet of a confirmed or probable case in a classroom setting is not considered a close contact if both confirmed case or probable case and close contact were consistently masked for the entire exposure period. Individuals who are fully vaccinated or who tested positive for COVID-19 within prior 90 days and are currently asymptomatic are not considered close contacts.

In general, individuals who are solely exposed to a confirmed case while outdoors should not be considered close contacts. Schools may coordinate with their local health department to determine the necessity of exclusion for higher-risk outdoor exposures.

The longer a person is exposed to an infected person, the higher the risk of exposure or transmission. The infectious period of close contact begins two calendar days before the onset of symptoms (for a symptomatic person) or two calendar days before the positive sample was obtained (for an asymptomatic person). If the case was symptomatic (e.g., coughing, sneezing), persons with briefer periods of exposure may also be considered contacts. Persons who have had lab-confirmed COVID-19 within the past 90 days who are asymptomatic or those fully vaccinated, according to CDC guidelines, are not required to be excluded if identified as a close contact to a confirmed case.

Schools must investigate the occurrence of cases, suspect cases or carriers in schools and identify close contacts for purposes of determining whether students or school personnel must be excluded pursuant to 77 Ill. Admin. Code 690.361. 

All schools and school districts are required to:

1. Exclude any student or school personnel who is a confirmed case or probable case for a minimum of 10 days following onset date if symptomatic or date of test if asymptomatic, or as otherwise directed by the school’s local health authority.
2. Exclude any student or school personnel who is a close contact for a minimum of 14 days or as otherwise directed by the school’s local health authority, which may recommend options such as Exclusion for 10 days or 7 days with a negative test result on day 6. As an alternative to exclusion, schools may permit close contacts who are asymptomatic to be on the school premises, extracurricular events, or any other events organized by the school if both the confirmed case or probable case and the contact were masked for the entire exposure period and provided the contact tests negative on days 1, 3, 5 and 7 following the exposure.
3. Exclude any student or school personnel for a minimum of 10 days who exhibit symptoms of COVID-19 until they are fever free for 24 hours and until 48 hours after diarrhea or vomiting have ceased.

For purposes of Executive Order 2021-24, 77 Ill. Admin. Code 690.361, and this guidance, “exclude” means a school’s obligation to refuse admittance to the school premises, extracurricular events, or any other event organized by the school regardless of whether an isolation or quarantine order issued by a local health department has expired or has not been issued. Exclusion from a school shall not be considered isolation or quarantine.

ISBE and IDPH now allow a strategy for close contacts to remain in school following exposure to COVID-19 through a Test to Stay protocol, as has been documented by the CDC. Following any indoor exposures (with the exception of household exposures), if schools test close contacts on days one, three, five, and seven from date of exposure with a NAAT (such as a PCR test) or rapid antigen test with Emergency Use Authorization by the FDA, close contacts who were masked during the entire exposure are permitted to remain in the classroom as long as the results are negative. Rapid antigen testing (e.g., BinaxNOW) may be most appropriate for Test to Stay given the short turnaround time for results. Testing must be conducted in school and, preferably, should be performed at the start of the school day before entering the classroom. If the close contact is identified five days or more from the date of exposure, adjust testing accordingly, ideally on days five and seven after the last exposure. When testing in the outlined cadence is not possible due to weekends and holidays, students and staff who are not fully vaccinated should be tested at the earliest possible opportunity. Test to Stay is only applicable when both the COVID-19-confimed case and close contact were engaged in consistent and correct use of well-fitting masks, regardless of vaccination status (universal masking), as required by Executive Order 2021-18.

Test to Stay may be used for any indoor exposure, with the exception of household exposures, for both students and staff who are not fully vaccinated where both the COVID-19 case and close contact were engaged in consistent and correct mask use for the entire exposure period. Additionally, the individual must be able to maintain physical distancing and masking at all times when returning to school for the full 14 days; for classrooms where masking is strictly adhered to, physical distance of 3 to 6 feet is acceptable for return, including on transportation when windows are opened and/or HEPA filters are used. Physical distancing of 6 feet should be used in lunchrooms when masks are removed for the full 14 days.

While engaged in Test to Stay after an exposure, students and staff who are not fully vaccinated may participate in extracurricular activities, as long as they remain consistently and correctly masked and physically distanced for the full 14-day period. Students should not participate in sports competitions for 14 days. Test to Stay participants should avoid social gatherings and remain at home when not at school functions for the full 14-day period. Local Health Departments have the authority to assess high risk exposures and recommend exclusion without the option of Test to Stay.

If at any time the student or staff person who is not fully vaccinated tests positive or becomes symptomatic, they should be immediately isolated and sent home, excluded from school, and the local health department notified. School personnel are responsible for monitoring and ensuring student and staff compliance with Test to Stay protocols. At the conclusion of the Test to Stay period, the school should notify the local health department that the individual has successfully completed testing and remained negative.

Test to Stay should be deployed in addition to weekly screening testing as recommended by the CDC.

If the local health department issues an isolation or quarantine order that requires the individual to remain in isolation at home, the school must exclude the student as required by the isolation or quarantine order.

See IDPH’s Interim Guidance on Testing for COVID-19 in Community Settings and Schools for more details on testing in schools.

Viral testing strategies are an important part of a comprehensive mitigation approach. Testing is most helpful in identifying new cases to prevent outbreaks, to reduce risk of further transmission, and to protect students and staff from COVID-19. The COVID-19 Exclusion Protocols should be used to guide testing approaches of symptomatic staff or students and need for use of a NAAT (i.e. PCR test) for confirmation. For additional guidance on testing, including what types of tests are appropriate for use on asymptomatic individuals, refer to the IDPH Interim Guidance on Testing for COVID-19 in Community Settings and Schools. Schools can find more information in IDPH’s answers to FAQs about COVID-19 testing in schools.

The hierarchy of testing for COVID-19 in schools is first for persons with symptoms of COVID-19, regardless of vaccination status, followed by close contacts to a confirmed case, and all staff and students with possible exposure in the context of an outbreak. Testing may also be used for screening purposes. This involves serial testing of asymptomatic persons, including at least weekly testing for all school personnel who are not fully vaccinated against COVID-19, as required by Executive Order 2021-22. In areas where community spread of COVID-19 is low (i.e., fewer than 10 new cases per 100,000 population in the past seven days), IDPH recommends schools adopt weekly screening testing of unvaccinated students that are participating in extracurricular activities. Persons who are fully vaccinated or who have recovered from COVID-19 in the past three months should be exempted from screening testing. Contact tracing should immediately begin if anyone tests positive for COVID-19.

The state of Illinois has made testing for students available free of charge to all schools in Illinois through SHIELD Illinois. Those interested in establishing a K-12 testing program using the SHIELD Illinois saliva test should complete this interest form: https://bit.ly/interestedSHIELD. Note: SHIELD Illinois is also able to offer BinaxNOW rapid antigen testing along with its weekly saliva testing program. Those interested in implementing a K-12 testing program using the BinaxNOW rapid antigen test should email dph.antigentesting@illinois.gov. (See the IDPH Interim Guidance on Testing for COVID-19 in Community Settings and Schools for complete information on testing.)

Outbreak testing is strongly recommended for students in schools that are in outbreak status and required for unvaccinated school personnel who may be part of the outbreak, as determined after consultation with public health authorities. Outbreak status is currently defined as two or more cases linked epidemiologically that do not share the same household and are not listed as close contacts of each other outside the outbreak setting. Implementation of outbreak testing should begin as soon as possible from the date the outbreak is declared and at least within three days. IDPH recommends schools acquire parental consent for student testing at the beginning of the school year to accommodate outbreak testing should the need arise. Schools should conduct twice weekly testing of unvaccinated students targeted to the impacted classroom(s), grade(s), extracurricular participants, or entire student body, depending on the circumstances, unless the local health department recommends otherwise.  Unvaccinated school personnel who may be part of the outbreak, as determined after consultation with by public health authorities, must be tested twice weekly. Testing should continue until the school has gone two incubation periods, or 28 days, without identifying any new cases. If testing is not already in place for screening, schools should make plans to deploy outbreak testing when needed. A listing of free testing sites is available at http://dph.illinois.gov/testing.

Additionally, SHIELD Illinois can be quickly deployed to a school setting by completing this interest form. For schools partnering with SHIELD Illinois for weekly student screening, outbreak testing is included in the testing program. For districts without weekly student screening, outbreak-only testing through SHIELD Illinois is available by completing this interest form: https://bit.ly/3mMejKH. However, prioritization of outbreak testing will be given to districts with weekly student screening programs. Schools can also utilize BinaxNOW rapid antigen testing for their outbreak response by emailing dph.antigentesting@illinois.gov.

Results from COVID-19 point-of-care (POC) antigen tests (e.g., BinaxNOW) should be interpreted based on the test sensitivity and specificity, whether the individual being tested has symptoms, and level of transmission in the community and the facility. A confirmatory NAAT, such as a PCR test, may be needed in certain situations. Because laboratory-based NAATs are considered the most sensitive tests for detecting SARS-CoV-2, the virus that causes COVID-19, they can also be used to confirm the results of lower sensitivity tests, such as POC NAATs or rapid antigen tests, such as BinaxNOW. While the SHIELD Illinois saliva test is a highly reliable laboratory-based NAAT and does not require an additional confirmatory test when used as a primary diagnostic test, CDC recommends collecting and testing an upper respiratory specimen, such as nasopharyngeal, nasal mid-turbinate, or anterior nasal, when using NAATs for confirmatory testing. An upper respiratory test, such as the BinaxNOW rapid antigen test, should be confirmed by a laboratory-based NAAT performed on an upper-respiratory specimen.

Schools should work to improve ventilation to the extent possible, including some or all of the following activities: 

• Increase outdoor air ventilation, using caution in highly polluted areas.
  
  • When weather conditions allow, increase fresh outdoor air by opening windows and doors. Do not open windows and doors if doing so poses a safety or health risk (e.g., risk of falling, triggering asthma symptoms) to children using the facility.
  • Use child-safe fans to increase the effectiveness of open windows. Position fans securely and carefully in or near windows so as not to induce potentially contaminated airflow directly from one person over another. Strategically place fans to help draw fresh air into the classroom from open windows or to blow air from the classroom out open windows.
  • Decrease occupancy in areas where outdoor ventilation cannot be increased.
• Ensure ventilation systems operate properly and provide acceptable indoor air quality for the current occupancy level for each space.
• Increase total airflow supply to occupied spaces, when possible.
• Disable demand-controlled ventilation controls that reduce air supply based on occupancy or temperature during occupied hours.
• Further open outdoor air dampers to reduce or eliminate heating, ventilation, and air conditioning (HVAC) air recirculation. In mild weather, this will not affect thermal comfort or humidity; however, this will be difficult to do in cold, hot, or humid weather.
• Improve central air filtration:
  
  • Increase air filtration to as high as possible without significantly diminishing design airflow.
  • Inspect filter housing and racks to ensure appropriate filter fit and check for ways to minimize filter bypass
  • Check filters to ensure they are within service life and appropriately installed.
• Consider running the HVAC system at maximum outside airflow for two hours before and after the school is occupied.
• Ensure restroom exhaust fans are functional and operating at full capacity when the school is occupied.
• Inspect and maintain local exhaust ventilation in areas such as restrooms, kitchens, cooking areas, etc.
• Use portable high-efficiency particulate air fan/filtration systems to help enhance air cleaning (especially in higher risk areas, such as the health office).
• Generate clean-to-less-clean air movement by re-evaluating the positioning of supply and exhaust air diffusers and/or dampers (especially in higher risk areas, such as the health office).
• Consider using ultraviolet germicidal irradiation as a supplement to help inactivate the virus that causes COVID-19, especially if options for increasing room ventilation are limited.
• Consider that ventilation is also important on school buses.

Districts and schools should encourage frequent and proper handwashing. Ensure availability of supplies, such as soap, paper towels, and hand sanitizer for all grade levels and in all common areas of the building. Cloth towels should not be used. Handwashing with soap and water is always the first recommended line of defense, but where this is not feasible or readily accessible, the use of hand sanitizer with at least 60% alcohol may be used. Districts and schools should be cognizant of any students or staff members with sensitivities or allergies to hand sanitizer or soap and ensure easy access to appropriate alternatives.

Hands should be washed often with soap and water for at least 20 seconds. Consider ways to build routines for hand hygiene into the school day. It is recommended that hand hygiene is performed upon arrival to and departure from school; after blowing one’s nose, coughing, or sneezing; following restroom use or diaper changes; before food preparation or before and after eating; before/after routine care for another person, such as a child; after contact with a person who is sick; upon return from the playground/physical education; and following glove removal. Districts and schools should determine any “hot spots” where germ transmission may easily occur and ensure hand sanitation/handwashing supplies are readily available.

Additionally, districts and schools should adhere to recommendations for safe hand sanitizer use, including:

• Alcohol-based hand sanitizers should be used under adult supervision with proper child safety precautions and stored out of reach of young children to reduce unintended, adverse consequences. It will be necessary to ensure that students do not ingest hand sanitizer or use it to injure another person.
• Alcohol-based hand sanitizers must be properly stored – which includes away from high temperatures or flames – in accordance with National Fire Protection Agency recommendations.
• Hand sanitizers are not effective when hands are visibly dirty. Use soap and water to clean visibly soiled hands.
• Alcohol-based hand sanitizers do not remove allergenic proteins from the hands.
• Staff preparing food in the cafeteria/kitchen should ALWAYS wash their hands with soap and water. The IDPH Food Service Sanitation Code does not allow persons who work in school cafeteria programs to use hand sanitizers as a substitute for handwashing.
• The FDA controls sanitizers as over-the-counter drugs because they are intended for topical antimicrobial use to prevent disease in humans.

Educate staff and students on healthy hygiene and handwashing to prevent the spread of infection. Monitor to ensure adherence among staff and students. Schools may wish to post handwashing posters in the bathrooms, hallways, classrooms, and other areas, as appropriate. See CDC’s Handwashing: Clean Hands Save Lives for free resources. Ensure availability of resources for teachers, school health personnel, and other staff members so they can appropriately train students or review handwashing procedures. Various classroom lesson, activities, and resources are available.

Respiratory etiquette should be taught and reinforced frequently. Respiratory etiquette practices include masking the nose and mouth with a tissue when coughing or sneezing, disposing of the used tissue in a trash receptacle, and then immediately washing hands. If wearing a mask, turn away from others and cough/sneeze into the crook of the elbow. If the mask become moist, soiled, or torn, it should be replaced with a clean, dry mask. Districts and schools should also consider additional signage to display on the correct methods for sneezing and coughing.

Staff and students should be directed and encouraged to avoid touching the face (eye, nose, mouth) to decrease the transmission of COVID-19 or other infectious diseases.

Schools should post signage and otherwise communicate to students and staff that they are discouraged from entering buildings or boarding school transportation if ill.

Both the CDC operational guidance for K-12 schools and this joint guidance no longer recommend fever and symptom screening by school staff upon arrival at school. Instead, self-screening for COVID-19-like symptoms, as well as any other symptoms of common respiratory viruses and ailments, prior to arriving on school grounds or boarding school transportation continues to be recommended.

Schools must exclude any student or school personnel that exhibit symptoms of COVID-19 (1) until they test negative for COVID-19 or for a minimum of 10 days, (2) until they are fever free for 24 hours and (3) until 48 hours after diarrhea and vomiting have ceased. Individuals who have or self-report a temperature greater than 100.4 degrees Fahrenheit/38 degrees Celsius or currently have known symptoms of COVID-19 may not enter school buildings.  Symptoms of COVID-19 include fever, cough, shortness of breath or difficulty breathing, chills, fatigue, muscle and body aches, headache, sore throat, new loss of taste or smell, vomiting, or diarrhea. Individuals who exhibit or self-report symptoms should be referred to a medical provider for evaluation, testing, treatment, and information about when they can return to school, according to the COVID-19 Exclusion Protocols and Interim Post-Vaccination Considerations for Schools.

Districts and schools should develop sanitation procedures per recommendations of the CDC, IDPH, and local health departments. In April 2021, the CDC issued a scientific brief on SARS-CoV-2 and surface transmission for indoor environments that concluded:

Routine cleaning performed effectively with soap or detergent, at least once per day, can substantially reduce virus levels on surfaces. When focused on high-touch surfaces, cleaning with soap or detergent should be enough to further reduce the relatively low transmission risk from fomites in situations when there has not been a suspected or confirmed case of COVID-19 indoors. In situations when there has been a suspected or confirmed case of COVID-19 indoors within the last 24 hours, the presence of infectious virus on surfaces is more likely and therefore high-touch surfaces should be disinfected.

Clean with products containing soap or detergent to reduce germs on surfaces and objects that will remove contaminants and may weaken or damage some of the virus particles to decrease the risk of infection from surfaces. Clean high-touch surfaces and shared objects at least once a day. For more information on cleaning and disinfecting schools, see Cleaning and Disinfecting Your Facility.

Clean more frequently and disinfect surfaces and objects if certain conditions apply:

• High transmission of COVID-19 in your community
• Low number of people wearing masks or improper mask usage
• Infrequent hand hygiene
• The space is occupied by people at increased risk for severe illness from COVID-19

If someone in your school is sick or someone who has COVID-19 has been in your school in the last 24 hours, clean and disinfect the facility.

Ensure that U.S. Environmental Protection Agency (EPA)-approved disinfectants for use against COVID-19 are available to staff responsible for cleaning. If not available, consult your local health department for guidance on alternative disinfectants.

• Gloves and other appropriate personal protective equipment (PPE) must be used during cleaning and disinfection. Ensure that appropriate PPE is made available to and used by staff, as appropriate, based on job-specific duties and risk of exposure.
• Always follow label directions.
• Allow the required wet contact time.
• Keep all disinfectants out of the reach of children.
• Do not mix bleach or other cleaning products and disinfectants together.

Before students and staff return to a school or childcare building that has been closed for an extended time, look for ways to reduce potential hazards. Flush plumbing (including all sink faucets, water fountains, water bottle fillers, hoses, and showers) to replace all water inside building pipes with fresh water. This can help protect occupants from possible exposure to lead, copper, and Legionella bacteria. You can also follow the EPA 3Ts – Training, Testing, and Taking Action – for reducing lead in drinking water at schools and childcare centers. Follow guidance to check your building for mold and remediate as needed.