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ULSTER COUNTY DEPARTMENT OF HEALTH

239 Golden Hill Lane, Kingston, NY 12401-6441, (845) 340-3150, Fax (845) 334-8337



PATRICK K. RYAN
County Executive

CAROL M. SMITH, MD, MPH
Commissioner of Health and Mental Health

Considerations for the Safe Return of Students and Staff to Full-Time In-Person School Learning

Background


The COVID-19 pandemic has disrupted in-person learning in the United States, with approximately one half of all students receiving online-only instruction since March 2020. Discontinuation of in-person schooling has resulted in many hardships which disproportionately affected families of lower socioeconomic status. This negative impact hits hardest the more than 6 million special education children in the United States, who need in-person assistance and education. In 2019, there are 498,491 school age students who received special education programs and services in NYS. There are 4124 students reported as students with disability in Ulster County according to NYSED, which is roughly 20 percent of the students enrolled county-wide.

On January 30, 2020, World Health Organization (WHO) declared novel Coronavirus a public health emergency. On January 31, Health and Human Secretary Alex Azar declared a Public Health Emergency for the United States. On February 11, 2020, the causative virus was named Severe Acute Respiratory Syndrome Coronavirus -2 (SARS CoV-2) and the disease Coronavirus disease 19 (COVID-19). On March 7, Governor Cuomo declared state of Emergency in the State of New York. On March 11, WHO declared it a global pandemic. On March 13, County Executive Patrick Ryan declared a State of Emergency in Ulster County and all the schools were ordered to close at 4:00 PM that day. Rigorous public health measures and lock down resulted in the flattening of the curve for new infections, however cases rose sharply in the fall and continued through winter of 2020. Schools reopened in the fall of 2020 prior to the second surge in Covid-19 infections in Ulster County. Many Ulster County school districts opted to go full remote from the Thanksgiving break until after Martin Luther King Day.

Evidence Supporting a Safe Full-Time Return to In-Person Learning is Possible

However, despite the high community transmission, and because of the extraordinary efforts of the school administrations to keep students and teachers safe, little evidence of local transmission within the schools was noted. Ulster County school districts adopted a hybrid model of learning during the fall and winter season with some students opting for remote only and some students learning exclusively in person. All of this has resulted in various challenges for students, parents, teachers, school administrators and public health officials alike. Research has shown that disruption in children's schooling is globally detrimental to their learning, social development, emotional growth and well-being because "Schools and school-supported programs are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, either in-person or virtually; social and emotional skills; safety; reliable nutrition; physical/occupational/speech therapy; mental health services; health services; and opportunities for physical activity, among other benefits. Beyond supporting the educational development of children and adolescents, schools play a critical role in addressing racial and social inequity." (American Academy of Pediatrics, January 2021)

According to the Centers for Disease Control and Prevention (CDC), mental health-related emergency room visits among pediatric population have increased between March and October of 2020. As compared to 2019, the emergency department visits increased by 24 % for children aged 5-11 and 31% for children 12-17 years of age.

Mitigation Strategies

When making decisions on when to reopen schools for in-person learning, it is important to understand SARS-CoV-2 transmission within the surrounding community to determine the possible risk of introduction and transmission of SARS-CoV-2 within the school. According to the New York State Health Department’s Percentage Positive Tracker the 7-day average for Ulster County as of 3/10/21 is 2.4%.
Regardless of the level of community transmission, all schools should use multiple mitigation strategies to mitigate transmission. Five key mitigation strategies are essential to safe delivery of in-person instruction:

  • Universal and correct use of masks
  • Physical distancing
  • Handwashing and respiratory etiquette
  • Cleaning and maintaining healthy facilities
  • Contact tracing in combination with isolation and quarantine, in collaboration with the health department

The risk for COVID-19 spread throughout the community rises with increased close contact with others. While not exhaustive, the CDC guidance titled Operating schools during COVID-19: CDC’s Considerations provides a stratification that attempts to characterize the risks of spread among students, teachers, and staff across this continuum.

Ulster County Actions and Recommendations

Ulster County prioritized vaccinating teachers and school staff to facilitate full-time in-person learning. By Saturday March 13, 2021 nearly all teachers and school staff members who requested the vaccine will have been vaccinated with at least one dose and will have completed both doses by the time they return from Spring Break. Ulster County has also worked with the school districts to provide PPE and Covid-19 rapid tests. Ulster County believes that if the following measures are taken, schools should be able to operate full-time in person 4 or 5 days a week during the balance of this year and continue to keep in-school transmission low like it was in the Fall prior to the holiday season. In the end it is the decision of the local school district to make the decision on how and when to return to full-time in-person school. These measures, which serve as the foundation for safe school reopening, are as follows:

  • All relevant stakeholders should be involved in this decision process • Intense preparation should take place prior to school reopening to ensure that all feasible, practical, and acceptable migration measures are in place. • It is also critically important to develop strategies that can be quickly revised and adapted, depending on the level of viral transmission in the school and throughout the community, as this may change rapidly. • Social distancing of 6 feet is still considered by the CDC and the NYSDOH to be the best measure to reduce virus spread, however, if 6 feet of separation is not attainable, then the installation of barriers such as sneeze guards and partitions may be considered, however the separation must be no less than 3 feet.
  • Add physical barriers, such as plastic flexible screens, between bathroom sinks especially when they cannot be at least 6 feet apart.
  • Provide physical guides, such as tape on floors or sidewalks and signs on walls, to ensure that staff and children remain at least 6 feet apart in lines and at other times (e.g. guides for creating “one-way routes” in hallways).
  • Close communal use shared spaces such as dining halls and playgrounds with shared playground equipment if possible; otherwise, stagger use and clean between use.
  • Turn desks to face in the same direction (rather than facing each other), or have students sit on only one side of tables, spaced apart.
  • Modify learning stations and activities as applicable so there are fewer students per group, placed at least 6 feet apart if possible.
  • Create distance between children on school buses (e.g., seat children one child per row, skip rows) when possible. If this distancing is not possible, windows must be open at all times.
  • All children and staff must always wear masks while on the bus.
  • As the weather gets warmer, classes should only take mask breaks outdoors and with students more than 6 feet socially distanced.
  • Install approved HVAC systems and ensure proper ventilation.
  • Continue to offer remote learning and allow parents to opt out of in-person learning.

The Ulster County Department of Health understands concerns that schools may have in their ability to adequately comply with best practice recommendations for safe school reopening. Please know that we support reasonable efforts to take feasible mitigation measures and are happy to discuss the safety plans that a school district wishes to put in place to bring students and staff back to in-school learning. We would also consider the ability to assist and support procurement of barriers or other supplies necessary to comply with these best practices for any district that comply proof of hardship.

Conclusion

Ulster County believes it is possible for a safe return to full-time in-person learning. Ultimately, it is a decision that must be made by each school district with consultation with all stakeholders including teachers, parents, and others in the school community. Factors of overall health, including mental health impacts, socialization, and additional resources for students with disabilities must be weighed against the risks of a possible increase in local in-school transmission. Ulster County stands ready to assist the districts in whatever way necessary to ensure that those that choose to resume full-time in-person schooling can do so in the safest way possible.