Citing a continued decline in the recent coronavirus surge, the state public health department updated its school COVID-19 guidance, laying out an option for K-12 schools to start treating the virus more like other infectious diseases in schools.

The new recommended COVID response focuses more on responding to “case clusters, outbreaks, and evidence of ongoing transmission in schools” — and less on quarantining of staff and students after exposures to COVID in school, according to a state health department news release.

“As COVID-19 case rates, (test) percent positivity, and hospitalization rates continue to decrease and stabilize, it is appropriate for schools to choose a more typical routine disease control model,” Dr. Rachel Herlihy, state epidemiologist, said in the release.

She added: “This approach will help schools, parents, and teachers continue in-person learning with fewer disruptions, but schools should consider transitioning to this option cautiously, as moving too soon could result in an increase in transmission.” 

The announcement cautioned that school administrators should be prepared for the emergence of new coronavirus variants or “substantial waning immunity” and the need to switch back to a focus on individual COVID cases.

Here’s a look at what’s in the new guidance.

Moving away from quarantine

Strategies that would not be continued in a more-routine COVID response model — unless a cluster or outbreak is detected — include:

• Individual case investigation and contact tracing. (Contact tracing is a term for when public health workers notify people that they may have been exposed to someone with COVID.)

• Quarantine of students and staff with school-associated exposures to COVID. But given the much greater risk of household exposures compared to non-household exposures, schools should continue to follow quarantine guidance for students and staff who report household exposures, according to the state health department.

Practices that would remain under a more-routine response model include:

• Continuing to encourage vaccination of staff and students.

• Following isolation requirements for students and staff who are ill or have tested positive for COVID. (“Isolation” refers to the steps a person should take after a confirmed infection. Quarantine, on the other hand, is when people avoid others after exposure to the virus and wait to see whether sickness occurs.)

• Continuing to support regular mask use by staff and students even when not required by local public health orders. The federal Centers for Disease Control and Prevention (CDC) continues to recommend indoor masking for all teachers, staff, students and visitors to K-12 schools, regardless of vaccination status.

• Implement new cluster or outbreak detection strategies, including public health reporting of school absenteeism data and participation in wastewater surveillance. (Testing can be used to show amounts of COVID in an area’s wastewater.) The state health department is exploring funding mechanisms to support that work, according to the state’s COVID website.

See Colorado’s outbreak definitions here.

When to relax guidance

The state health department’s suggested implementation date for the transition to the looser guidance is Feb. 28, but the department cautioned that the move should also depend on the level of COVID spread nearby.

“To avoid an increase in outbreaks and greater disruption to in-person learning, schools should ideally transition to a routine disease control model once local transmission risk falls below a high or substantial level and stabilizes,” the department said in the news release.

See a map of counties with “high” and “substantial” levels of COVID spread here.

A routine disease-control model would more closely align COVID efforts with public health response strategies that are used for other infectious diseases in schools, according to the news release.

When it will be safe to begin treating COVID like a routine disease is unclear, given the uncertainty surrounding how the pandemic will continue to unfold.

Recently, the more-contagious nature of the omicron variant fueled sky-high rates of new COVID cases while at the same time causing less-severe illness than the earlier delta variant.

Public health analysts recently cited high levels of immunity in Colorado due to either infection or vaccination, according to a Tri-County Health Department news release in late January.

While “natural immunity may not last as long as that from vaccines, it will likely last at least three months, providing a bridge to the warmer months of the year when COVID-19 transmission is less of a risk,” Tri-County Health wrote in the release.

But “we can’t be certain that prior infection with any particular variant will protect against future ones, which is why we think that up-to-date vaccination — which is more likely to have broader protection — is so important,” John Douglas, the head of Tri-County Health, has told Colorado Community Media.

It's unclear whether COVID variants will become milder or more severe in the future, Douglas added.

‘Test to Stay’ offers way out of quarantine

The state health department recently launched a “Test to Stay” program to provide a pathway out of quarantine for students and staff with school-associated exposures to COVID if they remain asymptomatic and test negative twice, according to a Feb. 1 news release.

School administrators may also choose to include staff and students with non-household community exposures to COVID to participate in Test to Stay, according to the release.

Enrollment in the Test to Stay program is optional for schools, according to the state’s COVID website.

Under the program, the state health department provides schools with Abbott BinaxNOW rapid over-the-counter tests, the release said.

The program is open to everyone, but individuals who are up to date on their vaccinations do not have to quarantine after being exposed to someone at school who tested positive for COVID, according to the release.

People are considered up to date if they have received all the recommended vaccinations, including a third, or booster, dose for those 12 and older, according to the release.

Unvaccinated individuals who choose not to participate in Test to Stay and who are exposed to a positive case at school would generally not be allowed to remain at school and would need to complete the normal five-day quarantine, followed by five days of wearing a well-fitting mask in school, according to the release.