Considerations for schools

As communities in the United States consider how to safely re-open K-12 school buildings for in-person learning and activities and keep them open, CDC offers updated considerations for mitigation strategies that school administrators can use to help protect students, teachers, and staff and slow the spread of the virus that causes COVID-19. These updated Considerations for Schools are intended to aid school administrators as they consider how to protect the health, safety, and wellbeing of students, teachers, staff, their families, and communities:

1. Promoting behaviors that reduce COVID-19’s spread

2. Maintaining healthy environments

3. Maintaining healthy operations

4. Preparing for when someone gets sick

Schools should determine, in collaboration with state and local health officials to the extent possible, whether and how to implement each of these considerations while adjusting to meet the unique needs and circumstances of the local community. Implementation should be guided by what is feasible, practical, acceptable, and tailored to the needs of each community. It is also critically important to develop strategies that can be revised and adapted depending on the level of viral transmission in the school and throughout the community, as this may change rapidly. Strategies should be implemented in close coordination with state, local, or tribal public health authorities, recognizing the differences between school districts, including urban, suburban, and rural districts. These considerations are meant to supplement—not replace—any Federal, state, local, territorial, or tribal health and safety laws, rules, and regulations with which schools must comply (e.g., Individuals with Disabilities Education Actexternal icon).

More information for schools

After reviewing the suggestions listed on this page, school administrators can use CDC’s School Considerations: Readiness and Action Planning Toolpdf icon to protect students, staff and communities.

School-based health facilities may refer to CDC’s Guidance for U.S. Healthcare Facilities and may find it helpful to reference the Ten Ways Healthcare Systems Can Operate Effectively During the COVID-19 Pandemic. School nurses can refer to CDC’s Information for Pediatric Healthcare Providers page for information on symptoms, testing, isolation, and quarantine of school-aged children.

Top of Page

Guiding principles to keep in mind

Opening schools for in-person learning as safely and quickly as possible, and keeping them open, is important given the many known and established benefits of in-person learning. In order to enable in-person learning and assist schools with their day-to-day operations, it is important to adopt and diligently implement actions to slow the spread of the virus that causes COVID-19 inside the school and out in the community. Implementing these actions in schools will reduce the risk of in-school spread of COVID-19 regardless of the underlying community burden – with risk being the lowest if community spread is low and proven mitigation strategies are implemented consistently.

COVID-19 in Children and Adolescents

While fewer children than adults have had COVID-19 in the United States, the number of school-aged children with COVID-19 has been increasing.¹ Children and adolescents can be infected with the virus that causes COVID-19, can get sick with COVID-19, and can spread the virus to others.²

Most children and adolescents with the virus that causes COVID-19 have mild symptoms and some have no symptoms at all.^2-4 The symptoms of COVID-19 are similar in adults and children and can look like other common illnesses, such as colds, strep throat, influenza, or allergies.^2-4 Children, like adults, who are infected but have no symptoms can still spread the virus to others.⁵ For more information on symptoms of COVID-19 in children, visit COVID-19 in Children and Teens.

Children and adolescents with underlying medical conditions are at increased risk for severe illness from COVID-19. Additionally, some children may develop the rare but serious condition associated with COVID-19 called Multisystem Inflammatory Syndrome in Children (MIS-C). While the number of children who have been hospitalized with COVID-19 has been low compared with adults, one-third of hospitalized children with COVID-19 have been admitted to the intensive care unit.⁶ Most deaths in the U.S. from COVID-19 are among adults; however, children in the United States have died from COVID-19.⁷

Because children with the virus that causes COVID-19 can spread it to other children and to adults,^2,5,8,9 it is important to take measures to minimize risk of spread in school settings. Implementation of multiple mitigation strategies can limit the spread of the COVID-19 in many settings.^10,11 Application and adherence to multiple mitigation measures provided in this document help schools reopen and stay open safely for in-person learning.

Resuming and maintaining in-person learning may pose risks to children, teachers, school administrators, and other staff in the school environment, and their families and household members. Among adults, older age and having underlying medical conditions increases the risk for severe illness from COVID-19. For information about who is at increased risk, visit People at Increased Risk.

Deciding how to open for in-person learning

School officials should make decisions about school opening and about staying open for in-person learning based on CDC’s Indicators for Dynamic Decision-making. The many benefits of in-person schooling should be weighed against the risks of spreading COVID-19 in the school and community. Working with States, Tribes, Localities, and Territories (STLT), schools can weigh levels of community transmission and their capacity to implement appropriate mitigation measures in schools to protect students, teachers, administrators, and other staff.

Top of Page

Taking actions to reduce the spread of the virus that causes COVID-19

The virus that causes COVID-19 is mostly spread during close contact by respiratory droplets released when people talk, sing, breathe, cough, or sneeze. The virus that causes COVID-19 can sometimes be spread through the air by airborne transmission or through touching contaminated surfaces or objects. Therefore, personal prevention practices (such as handwashing, staying home when sick) and environmental cleaning and disinfection are important principles that are discussed below. Fortunately, there are a number of actions school administrators can take to help lower the risk of COVID-19 exposure and spread during school sessions and activities.

In order to reach the goal of reopening schools as safely and as quickly as possible for in-person learning, and help schools remain open, it is important to adopt and diligently implement actions to slow the spread of COVID-19 inside the school and out in the community. This means that students, families, teachers, school staff, and all community members take actions to protect themselves and others where they live, work, learn, and play.

Continuum of risk

By learning model and implementation of proven mitigation strategies

In general, the risk of spread of COVID-19 in schools increases across the continuum of virtual, hybrid, to in-person learning. The risk for hybrid and in-person learning can be lowered depending on the mitigation strategies put in place and the extent to which they are followed.

While not exhaustive, this stratification attempts to characterize the risks of spread among students, teachers, and staff across this continuum:

Lowest risk:

• Students and teachers engage in virtual-only classes, activites, and events.

Some risk:

• Hybrid Learning Model, where most students and teachers participate in virtual learning and some students and teachers engage in in-person learning, with:

  • Small, in-person classes, activities, and events

  • Cohorting and alternating or staggered schedules, rigorously applied

  • No mixing of groups of students and teachers throughout/across school days

  • No sharing of objects between students and teachers

  • Students, teachers, and staff following all steps to protect themselves and others at all times including proper use of face masks, social distancing, and hand hygiene

  • Regularly scheduled and consistent (i.e., at least daily or between uses) cleaning of frequently touched areas

Medium risk:

• Hybrid Learning Model, where most students and teachers engage in in-person learning and some students and teachers participate in virtual learning, with:

  • Larger in-person classes, activities, and events

  • Cohorting and alternating or staggered schedules applied with some exceptions

  • Some mixing of groups of students and teachers throughout/across school days

  • Minimal sharing of objects between students and teachers

  • Students, teachers, and staff following all steps to protect themselves and others such as proper use of face masks, social distancing, and hand hygiene

  • Regularly scheduled (i.e., at least daily or between uses) cleaning of frequently touched areas

Higher risk:

• Students and teachers engage entirely in in-person learning, activities, and events with:

  • Some mixing of groups of students and teachers throughout/across school days

  • Some sharing of objects between students and teachers

  • Students, teachers, and staff following some steps to protect themselves and others such as proper use of face masks, social distancing, and hand hygiene

  • Irregular cleaning of frequently touched areas

Highest risk:

• Students and teachers engage entirely in in-person learning, activities, and events with:

  • Students mixing freely between classes and activities

  • Students and teachers freely sharing objects

  • Students, teachers, and staff do not/are not following steps to protect themselves and others such as proper use of face masks, social distancing, and hand hygiene

  • Irregular cleaning of frequently touched areas

Top of Page

Plan and prepare

Emergency operations plans: review, update, and implement EOPs

The most important actions for school administrators to take before reopening in-person services and facilities are planning and preparing. To best prepare, schools should expect that students, teachers, or staff may become sick with COVID-19 or be exposed to someone with COVID-19, and schools must know what to do when this happens. Regardless of the number of cases in a community, every school should have a plan in place to protect staff, children, and their families from the spread of COVID-19 and a response plan in place for if/when a student, teacher, or staff member tests positive for COVID-19. This plan should be developed in collaboration with state and local public health departments; school nurses, parents, caregivers, and guardians; student leaders; community members; and other relevant partners. Schools should prioritize EOP components that address infectious disease outbreaks and their consequences.

• Reference key resources on emergency preparedness while reviewing, updating, and implementing the EOP.

  • Multiple federal agencies have developed resources on school planning principles and a 6-step processpdf iconexternal icon for creating plans to build and continually foster safe and healthy school communities before, during, and after possible emergencies.

  • The Readiness and Emergency Management for Schools (REMS) Technical Assistance Center’s websiteexternal icon contains free resources, trainings, and technical assistance (TA) for schools and their community partners, including many tools and resources on emergency planning and response to infectious disease outbreaks. Schools may find these considerations are helpful for developing high-quality emergency operations plans.

School nurses, teachers, staff, parents, student leaders, and other community stakeholders (e.g., youth service organizations, health centers, etc.) should be involved in the development of the Emergency Operations Plans (EOP). Some of the strategies school administrators should consider while developing their EOP:

• Develop a protocol for monitoring local COVID-19 data in your community to keep track of the level of community transmission, to make decisions about changes to mitigation strategies, and to help determine whether school closures may be necessary. This should include daily review of official public health data for the community surrounding the school. Contact the state, local, tribal, or territorial Public Health Department for references to local COVID-19 data.

• Develop and test information-sharing systems (e.g., school-to-parent email or texting protocols, periodic virtual meetings with parent/teachers, etc.) with school and community partners and key stakeholders. Use institutional information systems for day-to-day reporting on information that can help to detect and respond to an outbreak, such as number of cases and absenteeism or changes in the number of visits to the health center by students, teachers, and other staff.

• Adopt mitigation strategies to promote healthy behaviors that reduce the spread of COVID-19, maintain healthy school environments and operations, and plan what to do if a student, teacher, or staff member gets sick.

• Examine the accessibility of information and resources to reduce the spread of COVID-19 and maintain healthy environments and determine whether they are culturally relevant, in plain language, and available in appropriate languages and accessible formats.

• In consultation with local officials, establish transparent criteria for when the school will suspend in-person learning to stop or slow the spread of COVID-19, as well as transparent criteria for when to resume in-person learning.

• Assess students’ special needs (such as continuing education, meal programs, and other services) and develop strategies to address these needs if in-person learning is suspended or if a student needs to self-isolate as a result of a diagnosis of or exposure to COVID-19.

• Ensure the EOP takes into consideration students with disabilities, students with special healthcare needs, students experiencing homelessness, migrant students and those with English learners, etc.

Top of Page

Promote behaviors that reduce spread of COVID-19

Schools can make multiple recommended changes to encourage behaviors that reduce the spread of the virus that causes COVID-19.

Staying home when appropriate

Educate staff and families about when they/their child(ren) should stay home and when they can return to in-person school.

• Actively encourage staff and students who are sick or who have recently had close contact (less than 6 feet for a cumulative total of 15 minutes or more over a period of 24 hours or direct physical contact) with a person with COVID-19 to stay home and get tested for COVID-19. Develop policies that encourage sick employees and students to stay at home without fear of reprisal, and ensure employees, students, and students’ families are aware of these policies. Consider not assessing schools based on absenteeism, and offering virtual learning and telework options, if feasible.

• Staff and students should stay home and follow CDC recommendations if they have tested positive for or are showing symptoms of COVID-19.

• Staff and students who have recently had close contact with a person with COVID-19 should also stay home, monitor their health, and get tested for COVID-19.

• CDC’s criteria can help inform when employees should return to work:

  • If they have been sick with COVID-19

  • If they have recently had close contact with a person with COVID-19

Hand hygiene and respiratory etiquette

• Teach and reinforce handwashing with soap and water for at least 20 seconds and increase monitoring to ensure adherence among students and staff.

• Encourage staff and students to cover coughs and sneezes with a tissue. Used tissues should be thrown in the trash and hands washed immediately with soap and water for at least 20 seconds.

• If soap and water are not readily available, hand sanitizer that contains at least 60% alcohol should be used (for staff and older children who can safely use hand sanitizer).

Masks

• Teach and reinforce the consistent and correct use of masks. The use of masks is one of many important mitigation strategies to help prevent the spread of COVID-19. Masks offer some protection to the wearer and are also meant to protect others, in case the wearer is infected with the virus that causes COVID-19. Masks are not Personal Protective Equipment (PPE) (e.g., surgical masks, respirators).

• Consistent and correct use of masks is most important when students, teachers, and staff are indoors and when social distancing is difficult to implement or maintain. Individuals should be frequently reminded not to touch the face covering or mask and to wash their hands or use hand sanitizer frequently. Information should be provided to staff, students, and students’ families on proper use, removal, and washing of masks.

• Masks should not be placed on:

  • Children younger than 2 years old

  • Anyone who has trouble breathing or is unconscious

  • Anyone who is incapacitated or otherwise unable to remove the mask without assistance

• Consistent and correct use of masks may be challenging for some students, teachers, and staff, including:

  • Younger students, such as those in early elementary school (Pre-K through 3^rd grade).

  • Students, teachers, and staff with severe asthma or other breathing difficulties.

  • Students, teachers, and staff with special educational or healthcare needs, including intellectual and developmental disabilities, mental health conditions, and sensory concerns or tactile sensitivity.

• While masks are strongly encouraged to reduce the spread of COVID-19, CDC recognizes there are specific instances when wearing a mask may not be feasible. In these instances, parents, guardians, caregivers, teachers, staff, and school administrators should consider adaptations and alternatives whenever possible. They may need to consult with healthcare providers for advice about wearing masks.

• People who are deaf or hard of hearing—or those who care for or interact with a person who is hearing impaired—may be unable to wear masks if they rely on lipreading to communicate. This may be particularly relevant for faculty or staff teaching or working with students who may be deaf or hard of hearing. In this situation, consider using a clear mask that covers the nose and wraps securely around the face. If a clear mask isn’t available, consider whether faculty and staff can use written communication (including closed captioning) and decrease background noise to improve communication while wearing a mask that blocks your lips.

• Masks are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the mask coughs, sneezes, talks, or raises their voice. This is called source control.

• In addition to those who interact with people who are deaf or hard of hearing, the following groups of teachers and staff may also consider using clear masks:

  • Teachers of young students (e.g., teaching young students to read).

  • Teachers of students who are English language learners

  • Teachers of students with disabilities

• Clear masks should be determined not to cause any breathing difficulties or over heating for the wearer. Clear masks are not face shields. CDC does not recommend use of face shields for normal everyday activities or as a substitute for masks because of a lack of evidence of their effectiveness to control the spread of the virus from the source for source control.

Adequate supplies

Ensure you have accessible sinks and enough supplies for people to clean their hands and cover their coughs and sneezes. Supplies include soap, a way to dry hands (e.g., paper towels, hand dryer), tissues, hand sanitizer with at least 60% alcohol (for staff and older children who can safely use hand sanitizer), disinfectant wipes, masks (as feasible) and no-touch /foot-pedal trash cans (preferably covered).

Signs and messages

• Post signs in highly visible locations (e.g., school entrances, restrooms) that promote everyday protective measurespdf icon and describe how to stop the spreadpdf icon of germs (such as by properly washing hands and properly wearing a maskimage icon). Signs should include visual cues (such as clear, easy-to-understand pictures demonstrating the healthy behaviors) at the appropriate reading and literacy level.

• Broadcast regular announcements on reducing the spread of COVID-19 on PA systems.

• Use simple, clear, and effective language about behaviors that prevent spread of COVID-19 when communicating with staff and families (such as on school websites, in emails, and through school social media accounts). If feasible, provide communication in multiple languages.

• Use communication methods that are accessible for all students, faculty, and staff, including those with disabilities.

• Translate materials into common languages spoken by students, faculty, and staff and people in the school community.

• Find freely available CDC print and digital resources on CDC’s communications resources main page. CDC also has American Sign Language videos related to COVID-19 and other communication tools.

Top of Page

Maintaining healthy environments

School administrators can make multiple recommended changes to physical spaces to maintain a healthy environment.

Cleaning and disinfection

• Clean and disinfect frequently touched surfaces (e.g., playground equipment, door handles, sink handles, drinking fountains) within the school and on school buses regularly. Use of shared objects (e.g., gym or physical education equipment, art supplies, toys, games) should be limited when possible. If shared objects are used, students should wash hands or use hand sanitizer before and after use.

• If transport vehicles (e.g., buses) are used by the school, drivers should practice all safety actions and protocols as indicated for other staff (e.g., hand hygiene, masks). To clean school buses or other transport vehicles, see guidance for bus transit operators.

  • Develop a schedule for increased, routine cleaning.

  • Ensure safe and correct use and storage of cleaning and disinfection productsexternal icon, including storing products securely away from children. Use products that meet EPA disinfection criteriaexternal icon.

  • Cleaning products should not be used near children, and staff should ensure that there is adequate ventilation when using these products to prevent children or themselves from inhaling toxic fumes.

Shared objects

• Discourage sharing of items that are difficult to clean or disinfect.

• Keep each child’s belongings separated from others’ and in individually labeled containers, cubbies, or areas.

• Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (e.g., assigning each student their own art supplies, equipment) or limit use of supplies and equipment by one group of children at a time. Students should wash hands or use hand sanitizer before and after use.

• Avoid sharing electronic devices, toys, books, and other games or learning aids.

Ventilation

Consider ventilation system upgrades or improvements and other steps to increase the delivery of clean air and dilute potential contaminants in the school. Obtain consultation from experienced Heating, Ventilation and Air Conditioning (HVAC) professionals when considering changes to HVAC systems and equipment. Some of the recommendations below are based on the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Guidance for Building Operations During the COVID-19 Pandemicexternal icon. Review additional ASHRAE guidelines for schools and universitiespdf iconexternal icon for further information on ventilation recommendations for different types of buildings and building readiness for occupancy. Not all steps are applicable for all scenarios.

Improvement steps may include 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 (strategic fan placement 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 (DCV) controls that reduce air supply based on occupancy or temperature during occupied hours.

• Further open minimum outdoor air dampers to reduce or eliminate HVAC air recirculation. In mild weather, this will not affect thermal comfort or humidity. However, this may be difficult to do in cold, hot, or humid weather.

• Improve central air filtration:

  • Increase air filtrationexternal icon 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 2 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 (HEPA) fan/filtration systems to help enhance air cleaning (especially in higher risk areas such as the nurse’s 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 nurse’s office).

• Consider using ultraviolet germicidal irradiation (UVGI) as a supplement to help inactivate the virus that causes COVID-19, especially if options for increasing room ventilation are limited.

• Ventilation considerations are also important on school buses.

*Note: The ventilation intervention considerations listed above come with a range of initial costs and operating costs which, along with risk assessment parameters such as community incidence rates, facemask compliance expectations and classroom density, may affect considerations for which interventions are implemented. Acquisition cost estimates (per room) for the listed ventilation interventions range from $0.00 (opening a window; inspecting and maintain local exhaust ventilation; disabling DCV controls; or repositioning outdoor air dampers) to <$100 (using fans to increase effectiveness of open windows; or repositioning supply/exhaust diffusers to create directional airflow) to approx. $500 (adding portable HEPA fan/filter systems) to approx. $1500 (adding upper room UVGI).

Water systems

The temporary shutdown or reduced operation of schools and reductions in normal water use can create hazards for returning students and staff. To minimize the risk of lead or copper exposure, Legionnaire’s disease, and other diseases associated with water, take steps such as plumbing flushing to ensure that all water systems and features (e.g., sink faucets, drinking fountains, showers, decorative fountains) are safe to use after a prolonged facility shutdown, and follow EPA’s 3Ts, (Training, Testing, and Taking Action) for reducing lead in drinking waterexternal icon. It may be necessary to conduct ongoing regular flushing after reopening. For additional resources, refer to EPA’s Information on Maintaining or Restoring Water Quality in Buildings with Low or No Useexternal icon. Drinking fountains should be cleaned regularly.

Modified layouts

• Space seating/desks at least 6 feet apart when feasible.

• 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.

Physical barriers and guides

• Install physical barriers, such as sneeze guards and partitions, particularly in areas where it is difficult for individuals to remain at least 6 feet apart (e.g., reception desks).

• 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).

Communal spaces

• Close communal use shared spaces such as dining halls and playgrounds with shared playground equipment if possible; otherwise, stagger use and clean between use.

• Add physical barriers, such as plastic flexible screens, between bathroom sinks especially when they cannot be at least 6 feet apart.

Food service

• Schools are essential to meeting the nutritional needs of children with many consuming up to half their daily calories at school. Nationwide more than 30 million children participate in the National School Lunch Program and nearly 15 million participate in the School Breakfast Program. (15, 16) There are several mitigation strategies that schools may implement while providing this critical service to their students.

• Avoid offering any self-serve food or drink options, such as hot and cold food bars, salad or condiment bars, and drink stations. Serve individually plated or pre-packaged meals instead, while ensuring the safety of children with food allergiespdf icon.

• As feasible, have children eat meals outdoors or in classrooms, while maintaining social distance (at least 6 feet apart) as much as possible, instead of in a communal dining hall or cafeteria.

• Have teachers and children wash their hands with soap and water for 20 seconds or use a hand sanitizer that contains at least 60% alcohol before and after eating. Ensure children do not share food, either brought from home or from the food service.

• If communal dining halls or cafeterias will be used, ensure that children remain at least 6 feet apart in food service lines and at tables while eating. Clean tables and chairs between each use.

• Ensure children do not share food or utensils. This helps prevent the spread of COVID-19 for all students and helps ensure the safety of children with food allergiespdf icon:

  • Use disposable food service items (e.g., utensils, trays).

  • If disposable items are not feasible or desirable, ensure that all non-disposable food service items and equipment are handled by staff with gloves and washed with dish soap and hot water or in a dishwasher.

  • Individuals should wash their hands after removing their gloves or after directly handling used food service items.

• If food is offered at any event, have pre-packaged boxes or bags for each attendee instead of a buffet or family-style meal.

• Provide tissues and no-touch or foot pedal trash cans, where possible, for employees, volunteers, and students to use.

• If possible, install touchless payment methods (pay without touching money, a card, or a keypad). Provide hand sanitizer right after handling money, cards, or keypads.

• Of Note: USDA has issued the COVID-19 Nationwide Waiver to Allow Meal Pattern Flexibility in the Child Nutrition Programsexternal icon.

Pets and Other Animals in the Classroom

• While more research is needed, the information we have so far shows there is low risk of animals spreading the virus that causes COVID-19 to people. However, the virus may spread from people to animals in some situations, especially after an animal has close contact with a person with COVID-19.

• Do not allow animals that are at higher risk for infection with COVID-19 in the classroom. This includes cats, dogs, and small mammals like ferrets, hamsters, and rabbits.

• For service dogs, however, the benefits of having the dog in the classroom for a particular student or staff member can outweigh the risks for infection. Administrators can discuss with student’s parents or guardians or the staff member, as well as teachers, the school nurse and the staff or student’s healthcare provider, and make decisions to allow service dogs in the classroom on a case-by-case basis.

• For more information, see If You Have Pets and the Healthy Pets, Healthy People website.

Top of Page

Maintaining healthy operations

School administrators can make multiple recommended changes to school management to maintain healthy operations.

Protections for staff and children at higher risk for severe illness from COVID-19

• Offer options for staff at higher risk for severe illness (including older adults and people of all ages with certain underlying medical conditions or disabilities) that limit their exposure risk (e.g., telework, modified job responsibilities that limit exposure risk).

• Offer options for students at higher risk of severe illness that limit their exposure risk (e.g., virtual learning opportunities).

• Provide inclusive programming for children and youth with special healthcare needs and disabilities that allows on-site or virtual participation with appropriate accommodations, modifications, and assistance (e.g., students with disabilities may have more difficulties accessing and using technology for virtual learning).

• Consistent with applicable law, put in place policies to protect the privacy of people at higher risk for severe illness regarding underlying medical conditions.

Regulatory awareness

Be aware of local or state regulatory agency policies related to group gatherings to determine if events can be held.

Identifying small groups and keeping them together (cohorting or podding)

Dividing students and teachers into distinct groups that stay together throughout an entire school day during in-person classroom instruction. Limit mixing between groups such that there is minimal or no interaction between cohorts.

Alternating schedule

Alternate the days when cohorts physically attend school. For example, certain grades or classrooms physically attend school on Monday/Tuesday and other grades or classrooms physically attend on Thursday/Friday (and the school is thoroughly cleaned in between, on Wednesday). As another example, some schools internationally have rotated in-person attendance weekly with one group of students attending during a week, followed by a different group the next week in rotation with thorough cleaning on the weekends.

Staggered scheduling

• Stagger student arrival, drop-off, and pick-up time or locations by cohort, or put in place other protocols to limit contact between cohorts and direct contact with parents, guardians, and caregivers as much as possible.

• When possible, use flexible worksites (e.g., telework at home) and flexible work hours (e.g., staggered shifts) to help establish policies and practices for social distancing (staying at least 6 feet apart).

Mix of virtual learning and in-class learning (hybrid schedule)

Hybrid options can apply a cohort approach to the in-class education provided.

Virtual/at-home only

Students and teachers engage in virtual-only classes, activities, and events.

Gatherings, visitors, and field trips

• Pursue virtual group events, gatherings, or meetings, if possible, and promote social distancing of at least 6 feet between people if events are held. Limit group size to the extent possible.

• Pursue options to convene sporting events and participate in sports activities in ways that reduce the risk of transmission of COVID-19 to players, families, coaches, and communities.

• Limit any nonessential visitors, volunteers, and activities involving external groups or organizations as possible – especially with individuals who are not from the local geographic area (e.g., community, town, city, county).

• Limit cross-school transfer for special programs. For example, if students are brought from multiple schools for special programs (e.g., music, robotics, academic clubs, sports), consider using distance learning and virtual environments to deliver the instruction or temporarily offering duplicate programs in the participating schools. For youth sports considerations visit the FAQs for Youth Sports Programs (e.g., physical distance, wearing masks, etc.).

• Develop a plan for staff who travel between schools (e.g., school nurses, psychologists, therapists). For example, consider allowing them to have virtual meetings in place of physical school visits and revise scheduling to limit their visits to multiple campuses.

• Pursue virtual activities and events in lieu of field trips, student assemblies, special performances, school-wide parent meetings, and spirit nights, as possible.

Designated COVID-19 point of contact

Designate a staff person, such as the school nurse, to be responsible for responding to COVID-19 concerns. All school staff and families should know who this person is and how to contact them.

Travel and transit

• Consider options for limiting non-essential travel in accordance with state and local regulations and guidance.

• Consider postponing or canceling upcoming student international travel programs.

• Encourage students, faculty and staff who use public transportation or ride sharing to use forms of transportation that minimize close contact with others (e.g., biking, walking, driving or riding by car either alone or with household members).

• Ensure options for safe travel on campus for people with disabilities. For example, social distancing in designated seating areas for wheelchairs may not be possible and drivers who may need to have close contact to assist a person with disabilities.

• Encourage students, faculty and staff who use public transportation or ride sharing to follow CDC guidance on how to protect yourself when using Additionally, encourage them to commute during less busy times and clean their hands as soon as possible after their trip.

Participation in community response efforts

Consider participating with local authorities in broader COVID-19 community response efforts (e.g., sitting on community response committees).

Communication systems

Put systems in place for:

• Staff and families should self-report to the school if they or their student have symptoms of COVID-19, a positive test for COVID-19, or were exposed to someone with COVID-19 within the last 14 days. The reporting system should be consistent with the health information sharing regulations for COVID-19external icon (e.g. see “Notify Health Officials and Close Contacts” in the Preparing for When Someone Gets Sick section below) and other applicable federal and state laws and regulations relating to privacy and confidentiality, such as the Family Educational Rights and Privacy Act (FERPA). The communication methods should be accessible for all students, faculty and staff, including those with disabilities and limited English proficiency (e.g., use interpreters and translated materials)

• Notifying staff, families, and the public of school closures and any restrictions in place to limit COVID-19 exposure (e.g., limited hours of operation).

Leave (time off) policies and excused absence policies

• Implement flexible sick leave policies and practices that enable staff to stay home when they are sick, have been exposed, or caring for someone who is sick.

  • Examine and revise policies for leave, telework, and employee compensation.

  • Leave policies should be flexible and not punish people for taking time off and should allow sick employees to stay home and away from co-workers. Leave policies should also account for employees who need to stay home with their children if there are school or childcare closures, or to care for sick family members. Additional flexibilities might include giving advances on future sick leave days and allowing employees to donate sick leave to each other, for example.

• Develop policies for return-to-school after COVID-19 illness. CDC’s criteria to discontinue home isolation and quarantine can inform these policies.

Back-up staffing plan

Monitor absenteeism of students and employees, cross-train staff, and create a roster of trained back-up staff.

Staff training

• Train staff on all safety protocols.

• Conduct training virtually or ensure that social distancing is maintained during training.

Recognize signs and symptoms

We learn more about COVID-19 every day, and as more information becomes available, CDC will continue to update and share information. As our knowledge and understanding of COVID-19 evolves, this guidance may change.

Based on the best available evidence at this time:

• CDC does not currently recommend universal symptom screenings (screening all students grades K-12) be conducted by schools.

• Parents or caregivers should be strongly encouraged to monitor their children for signs of infectious illness including COVID-19 every day.

• Students who have symptoms of any infectious illness or symptoms consistent with COVID-19 should not attend school in-person.

  • The profile of symptoms associated with COVID-19 remains under study and will be updated as warranted by research findings. Further information on what symptoms may suggest infectious illness and recommended return-to-school policies is available at Screening K-12 Students for Symptoms of COVID-19: Limitations and Considerations.

  • Schools that choose to conduct symptom screening should conduct these screenings safely and respectfully, and in accordance with any applicable privacy laws and regulations (e.g., confidentiality as required by the Americans with Disabilities Act (ADA) and the Family Educational Rights and Privacy Act [FERPA]).

  • The considerations detailed here are intended only for students in K-12 school settings. For guidance related to screening of staff, please refer to CDC’s Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 and the Prevent Transmission Among Employees section of CDC’s Resuming Business Toolkitpdf icon.

Sharing facilities

Encourage any organizations that share or use the school facilities to also follow these considerations.

Support coping and resilience

• Encourage employees and students to take breaks from watching, reading, or listening to news stories about COVID-19, including social media if they are feeling overwhelmed or distressed.

• Promote employees and students eating healthy, exercising, getting sleep, and finding time to unwind.

• Encourage employees and students to talk with people they trust about their concerns and how they are feeling.

• Transparently communicate with staff, teachers, students, and families, including about mental health support services available at the school. These critical communications should be accessible to individuals with disabilities and limited English proficiency.

• Share facts about COVID-19 regularly through trusted sources of information to counter the spread of misinformation and mitigate fear.

• Consider posting signages for the national distress hotline: call or text 1-800-985-5990

• Ensure continuity of mental health services, such as offering remote counseling.

• Encourage students to call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255), 1-888-628-9454 for Spanish, or Lifeline Crisis Chatexternal icon if they are feeling overwhelmed with emotions such as sadness, depression, anxiety, or feel like wanting to harm themselves or others.

Top of Page

Prepare for when someone has COVID-19

Schools can prepare for when students, teachers, or staff have symptoms of COVID-19 or are diagnosed with COVID-19.

Advise students, teachers, staff, and families of home isolation and quarantine criteria

Students, teachers, and staff with COVID-19 should not return to in-person school until they have met CDC’s criteria to discontinue home isolation. Students, teachers, and staff who have been close contacts (within 6 feet for a cumulative total of 15 minutes or more over a period of 24 hours) of someone with COVID-19 should not return to in-person school until they have completed their quarantine.

Make sure students, teachers, staff, and families know when to stay home

Make sure that staff and families know that students, teachers, or staff with symptoms of COVID-19, with a positive test for COVID-19, or who have been in close contact with someone with COVID-19 should stay home and notify school officials (e.g., the designated COVID-19 point of contact). These critical communications should be accessible to individuals with disabilities and limited English proficiency. For detailed information on when students who have symptoms of COVID-19 can return to in-person school, visit Screening K-12 Students for Symptoms of COVID-19: Limitations and Considerations.

Isolate and transport students who develop symptoms while at school

Some students may develop symptoms of infectious illness while at school. Schools should take action to isolate students who develop these symptoms from other students and staff. Follow the school isolation protocol outlined in Screening K-12 Students for Symptoms of COVID-19: Limitations and Considerations when student develops symptoms of an infectious illness.

Clean and disinfect

• Close off areas used by a sick person and do not use these areas until after cleaning and disinfecting them. For outdoor areas (e.g., playgrounds, sitting areas, outdoor eating areas, etc.), this includes surfaces or shared objects in the area, if applicable.

• Wait at least 24 hours before cleaning and disinfecting. If 24 hours is not feasible, wait as long as possible. Ensure safe and correct use and storage of cleaning and disinfection productsexternal icon, including storing products securely away from children.

Notify health officials and close contacts

• In accordance with state and local laws and regulations, school administrators should notify local health officials, staff, and families immediately of any case of COVID-19 while maintaining confidentiality in accordance with the Americans with Disabilities Act (ADA)external icon and FERPAexternal icon or and other applicable laws and regulations.

• Inform those who have had close contact with a person diagnosed with COVID-19 to stay home and self-monitor for symptoms, get tested for COVID-19, and follow CDC guidance if symptoms develop. Maintain confidentiality as required by the Americans with Disabilities Act (ADA)external icon and Family Educational Rights and Privacy Act (FERPA) or and other applicable laws and regulations.

• A school might need to implement short-term building closure procedures if/when an infected person has been on campus during their infectious period and has close contact with others. If this happens, work with local public health officials to determine next steps. One option is an initial short-term class suspension and cancellation of events and activities (e.g., assemblies, spirit nights, field trips, and sporting events) to allow time for local health officials to gain a better understanding of the COVID-19 situation and help the school determine appropriate next steps, including whether such a suspension needs to be extended to stop or slow further spread of COVID-19. In situations where schools are cohorting students (e.g., in pods) administrators may choose to close the building in places (e.g., classrooms, common areas) where others were exposed to the infected person. In the event that local health officials do not recommend building or classroom closures, thoroughly cleaning the areas where the infected person spent significant time should be considered.

• Local health officials’ recommendations whether to suspend school or events and the duration such suspensions should be made on a case-by-case basis using the most up-to-date information about COVID-19 and taking into account local case-counts, and the degree of ongoing transmission in the community.

What to do if a Student Becomes Sick Flowchart

Information includes:

• Student negative COVID-19 test result

• Student positive COVID-19 test result

• And more

Top of Page

Students with disabilities or special healthcare needs

Plan for accommodations, modifications, and assistance for children and youth with disabilities and special healthcare needs

A customized and individualized approach for COVID-19 may be needed for children and youth with disabilities who have limited mobility; have difficulty accessing information due to visual, hearing, or other limiting factors; require close contact with direct service providers; have trouble understanding information; have difficulties with changes in routines; or have other concerns related to their disability. This approach should account for the following:

• Education should remain accessible for children in special education who have a 504 Plan or Individualized Education Program.

• Social distancing and isolating at school may be difficult for many people with disabilities.

• Wearing masks may be difficult for people with certain disabilities (e.g., visual or hearing impairments) or for those with sensory, cognitive, or behavioral issues.

• Students may require assistance or visual and verbal reminders to cover their mouth and nose with a tissue when they cough or sneeze, throw the tissue in the trash, and wash their hands afterwards.

• Where service or therapy animals are used, use guidance to protect the animal from COVID-19.

• Cleaning and disinfecting procedures may negatively affect students with sensory or respiratory issues.

• Students may require assistance or supervision washing their hands with soap and water for at least 20 seconds or using a hand sanitizer (containing at least 60% alcohol).

• Cleaning and disinfecting personal belongings, school objects, or surfaces may require assistance or supervision.

• Behavioral techniques can help all students, adjust to changes in routines and take preventive actions. These techniques may be especially beneficial for some children with disabilities and may include modeling and reinforcing desired behaviors and using picture schedules, timers, and visual cues. Organizations that support individuals with disabilities have information and resources to help schools with these behavioral techniques. In addition, behavioral therapists or local mental health or behavioral health agencies may be able to provide consultation for specific concerns.

Follow guidance for Direct Service Providers (DSPs)

Direct Service Providers (personal care attendants, direct support professionals, paraprofessionals, therapists, and others) provide a variety of home and community-based, health-related services that support individuals with disabilities. Services provided may include assistance with activities of daily living, access to health services, and more. DSPs are essential for the health and well-being of the individuals they serve.

• Ask Direct Service Providers (DSPs) before they enter school if they are experiencing any symptoms of COVID-19 or if they have been in contact with someone who has COVID-19. If DSPs provide services in other schools, ask specifically whether any of the other schools have had positive cases. For guidance related to screening of staff (to include DSPs), please refer to CDC’s Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 and the Prevent Transmission Among Employees section of CDC’s Resuming Business Toolkitpdf icon.

• If there is potential that a DSP may be splashed or sprayed by bodily fluids during their work, they should use standard precautions to avoid getting infected. They will need to wear personal protective equipment (PPE) including a facemask, eye protection, disposable gloves, and a gown.

• CDC has developed guidance for DSPs. School administrators should review the DSP guidance and ensure that DSPs needing to enter the school are aware of those preventive actions.

After reviewing the suggestions listed on this page, school administrators can use CDC’s School Considerations: Readiness and Action Planning Toolpdf icon to protect students, staff and communities.

The following guidance was created to help owners, administrators, or operators of shared (also called “congregate”) housing facilities – working together with residents, staff, and public health officials – prevent the spread of COVID-19.

For this guidance, shared housing includes a broad range of settings, such as apartments, condominiums, student or faculty housing, national and state park staff housing, transitional housing, and domestic violence and abuse shelters. Special considerations exist for the prevention of COVID-19 in shared housing situations, and some of the following guidance might not apply to your specific shared housing situation.

People living and working in this type of housing may have challenges with social distancing to prevent the spread of COVID-19. Shared housing residents often gather together closely for social, leisure, and recreational activities, shared dining, and/or use of shared equipment, such as kitchen appliances, laundry facilities, stairwells, and elevators.

Be sure to consider the unique needs of your residents, such as people with disabilities, cognitive decline, or no access to technology. This guidance does not address infection prevention and control in healthcare settings. If your facility offers healthcare services, please consult CDC Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings

There may also be specific guidance for certain types of shared housing, such as homeless shelters, that may apply to your facility.

State, territorial, local, and tribal public health departments can give you specific information on COVID-19 transmission and policies in your community, which can help you decide when and if you need to scale up or loosen prevention measures.

Plan and prepare

Review, update, and implement emergency operations plans (EOPs)

Some shared housing facilities have already experienced an outbreak of COVID-19, others have a handful of cases, and others have not yet had infection introduced. Regardless of the status of a facility, the most important thing is for all facilities to plan and prepare. No matter the level of transmission in a community, every shared housing facility should have a plan in place to protect residents, workers, volunteers, and visitors from the spread of COVID-19. This should be done in collaboration with state and local public health departments, housing authorities, local or state regulatory agencies, and other relevant partners. Focus should be on components, or annexes, of already-existing plans that address infectious disease outbreaks. If your shared housing facility does not have an emergency operations plans (EOP), now is the time to develop one.

Reference key resources while developing, reviewing, updating, and implementing the EOP

• Multiple federal agencies have developed resources on emergency preparedness, which may be helpful for administrators of shared housing facilities.

  • The National Multifamily Housing Council (NHMC)external icon provides guidance on emergency preparedness and response resources for the apartment industry. HUD also provides guidance for public health disaster readiness and preparationexternal icon.

• CDC has specific consideration for people with disabilities as they may be at higher risk of getting COVID-19 or having severe illness.

• Additionally, FEMA’s Planning Considerations for Organizations in Reconstituting Operations During the COVID-19 Pandemicexternal icon outlines key considerations for planning to resume operations while protecting the well-being and safety of employees and communities.

Planning strategies to include:

• Informing residents, workers, volunteers, and visitors about COVID-19. Develop information-sharing systems that are tailored to the needs of your setting. For instance, administrators can support residents who have no or limited access to the internet by delivering print materials to their residents. Printable materials for community-based settings are available on the CDC website.

• Promoting healthy behaviors that reduce spread, maintaining healthy environments and operations, and knowing what to do if someone gets sick.

• Taking action to prevent or slow the spread of COVID-19. This includes limiting the number of non-essential visitors to workers, volunteers, and visitors who are essential to preserving the health, including the mental health, well-being, and safety of residents.

• Consider identifying residents who have unique medical needs and behavioral health needs and encourage them to develop a plan for if they or their primary caregiver(s) become ill.

To maintain safe operations

• Review the CDC guidance for businesses and employers to identify strategies to maintain operations and a healthy working and living environment.

• Develop flexible sick leave policies. Require staff to stay home when sick, even without documentation from doctors. Use flexibility, when possible, to allow staff to stay home to care for sick family or household members or to care for children in the event of school or childcare dismissals. Make sure that employees are aware of and understand these policies.

• Create plans to protect the staff and residents from spread of COVID-19 and help them put in place personal preventive measures.

• Clean and disinfect shared areas (such as exercise room, laundry facilities, shared bathrooms, and elevators) and frequently touched surfaces using products from EPA’s List N: Disinfectants for Coronavirus (COVID-19)external icon more than once a day if possible.

• Identify services and activities (such as meal programs, religious services, and exercise rooms and programs) that might need to be limited or temporarily discontinued. Consider alternative solutions (e.g., virtual services) that will help programs continue while being safe for residents.

• Identify a list of healthcare facilities and alternative care sites where residents with COVID-19 can receive appropriate care, if needed.

Encourage staff and residents to prepare and take action to protect themselves and others

• Follow the guidance and directives on community gatherings from your state and localexternal icon health departments.

• Encourage social distancing by asking staff and residents to stay at least 6 feet (2 meters) apart from others and wear masks in any shared spaces, including spaces restricted to staff only.

• Consider any special needs or accommodations for those who need to take extra precautions, such as older adults, people with disabilities, and people of any age who have serious underlying medical conditions.

• Limit staff entering residents’ rooms or living quarters unless it is necessary. Use virtual communications and check ins (phone or video chat), as appropriate.

• Limit the presence of non-essential volunteers and visitors in shared areas, when possible.

• Use physical barriers, such as sneeze guards, or extra tables or chairs, to protect front desk/check-in staff who will have interactions with residents, visitors, and the public.

• Provide COVID-19 prevention supplies for staff and residents in common areas at your facility, such as soap, alcohol-based hand sanitizers that contain at least 60% alcohol, tissues, trash baskets, and, if possible, masks that are washed or discarded after each use.

• Consider any special communications and assistance needs of your staff and residents, including persons with disabilities.

• Suggest that residents keep up-to-date lists of medical conditions and medications, and periodically check to ensure they have a sufficient supply of their prescription and over-the-counter medications.

• If possible, help residents understand they can contact their healthcare provider to ask about getting extra necessary medications to have on hand for a longer period of time, or to consider using a mail-order option for medications.

• Make sure that residents are aware of serious symptoms of their underlying conditions and of COVID-19 symptoms that require emergency care, and that they know who to ask for help and call 911.

• Encourage residents who live alone to seek out a “buddy” in the facility who will check on and help care for them and safely make sure they are getting basic necessities, including food and household essentials.

Note: Surgical masks and N-95 respirators are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance. All staff and residents should wear a mask covering when in shared areas of the facility and maintain social distancing to slow the spread of the virus.

Communicate to staff and residents

Identify platforms such as email, websites, hotlines, automated text messaging, newsletters, and flyers to help communicate information on:

• Guidance and directives from state and local officials and state and localexternal icon health departments.

• How your facility is helping to prevent the spread of COVID-19.

• How additional information will be shared, and where to direct questions.

• How to stay healthy, including videos, fact sheets, and posters with information on COVID-19 symptoms and how to stop the spread of germs, how to wash your hands, and what to do if you are sick.

• How staff and residents can cope and manage stress and protect others from stigma and discrimination.

• Identify and address potential language, cultural, and disability barriers associated with communicating COVID-19 information. Communications may need to be framed or adapted so they are culturally appropriate for your audience and easy to understand. For example, there are resources on the CDC website that are in many languages.

Considerations for common spaces in your facility, to prevent the spread of COVID-19

• Consider how you can use multiple strategies to maintain social (physical) distance between everyone in common spaces of the facility.

• Consider cancelling all public or non-essential group activities and events.

• Offer alternative methods for activities and social interaction such as participation by phone, online, or through recorded sessions.

• Arrange seating of chairs and tables to be least 6 feet (2 meters) apart during shared meals or other events.

• Alter schedules to reduce mixing and close contact, such as staggering meal and activity times and forming small groups that regularly participate at the same times and do not mix.

• Minimize traffic in enclosed spaces, such as elevators and stairwells. Consider limiting the number of individuals in an elevator at one time and designating one directional stairwells, if possible.

• Ensure that social distancing can be maintained in shared rooms, such as television, game, or exercise rooms.

• Make sure that shared rooms in the facility have good air flow from an air conditioner or an opened window.

• Consider working with building maintenance staff to determine if the building ventilation system can be modified to increase ventilation rates or the percentage of outdoor air that circulates into the system.

• Clean and disinfect shared areas (laundry facilities, elevators, shared kitchens, exercise rooms, dining rooms) and frequently touched surfaces using products from EPA’s List N: Disinfectants for Coronavirus (COVID-19)external icon more than once a day if possible.

Considerations for specific communal rooms in your facility

Shared kitchens and dining rooms

• Restrict the number of people allowed in the kitchen and dining room at one time so that everyone can stay at least 6 feet (2 meters) apart from one another.

  • People who are sick, their roommates, and those who have higher risk of severe illness from COVID-19 should eat or be fed in their room, if possible.

• Do not share dishes, drinking glasses, cups, or eating utensils. Non-disposable food service items used should be handled with gloves and washed with dish soap and hot water or in a dishwasher. Wash hands after handling used food service items.

• Use gloves when removing garbage bags and handling and disposing of trash. Wash hands

Laundry rooms

• Maintain access and adequate supplies to laundry facilities to help prevent spread of COVID-19.

• Restrict the number of people allowed in laundry rooms at one time to ensure everyone can stay at least 6 feet (2 meters) apart.

• Provide disposable gloves, soap for washing hands, and household cleaners and products from EPA’s List N: Disinfectants for Coronavirus (COVID-19)external icon for residents and staff to clean and disinfect buttons, knobs, and handles of laundry machines, laundry baskets, and shared laundry items.

• Post guidelines for doing laundry such as washing instructions and handling of dirty laundry.

Recreational areas such as activity rooms and exercise rooms

• Consider closing activity rooms or restricting the number of people allowed in at one time to ensure everyone can stay at least 6 feet (2 meters) apart.

• Consider closing exercise rooms.

• Activities and sports (e.g., ping pong, basketball, chess) that require close contact are not recommended.

Pools and hot tubs

• Consider closing pools and hot tubs or limiting access to pools for essential activities only, such as water therapy.

  • While proper operation, maintenance, and disinfection (with chlorine or bromine) should kill COVID-19 in pools and hot tubs, they may become crowded and could easily exceed recommended guidance for gatherings. It can also be challenging to keep surfaces clean and disinfected.

  • Considerations for shared spaces (maintaining physical distance and cleaning and disinfecting surfaces) should be addressed for the pool and hot tub area and in locker rooms if they remain open.

Shared bathrooms

• Shared bathrooms should be cleaned regularly using products from EPA’s List N: Disinfectants for Coronavirus (COVID-19)external icon, at least twice per day (e.g., in the morning and evening or after times of heavy use).

• Make sure bathrooms are continuously stocked with soap and paper towels or automated hand dryers. Hand sanitizer could also be made available.

• Make sure trash cans are emptied regularly.

• Provide information on how to wash hands properly. Hang signspdf icon in bathrooms.

• Residents should be instructed that sinks could be an infection source and should avoid placing toothbrushes directly on counter surfaces. Totes could also be used for personal items to limit their contact with other surfaces in the bathroom.

If a resident in your facility has COVID-19 (suspected or confirmed)

• Have the resident seek advice by telephone from a healthcare provider to determine whether medical evaluation is needed.

• Residents are not required to notify administrators if they think they may or have a confirmed case of COVID-19. If you do receive information that someone in your facility has COVID-19, you should work with the local health departmentexternal icon to notify anyone in the building who may have been exposed (had close contact with the sick person) while maintaining the confidentiality of the sick person as required by the Americans with Disabilities Act (ADA) and, if applicable, the Health Insurance Portability and Accountability Act (HIPAA).

• Provide the ill person with information on how to care for themselves and when to seek medical attention.

• Encourage residents with COVID-19 symptoms and their roommates and close contacts to self-isolate – limit their use of shared spaces as much as possible.

• • If possible, designate a separate bathroom for residents with COVID-19 symptoms.

  • Consider reducing cleaning frequency in bedrooms and bathrooms dedicated to persons with COVID-19 symptoms to as-needed cleaning (e.g., soiled items and surfaces) to avoid unnecessary contact with the ill persons.

  • Follow guidance on when to stop isolation.

• Minimize the number of staff members who have face-to-face interactions with residents who have suspected or confirmed COVID-19.

• Encourage staff, other residents, caregivers such as outreach workers, and others who visit persons with COVID-19 symptoms to follow recommended precautions to prevent the spread.

• Staff at higher risk of severe illness from COVID-19 should not have close contact with residents who have suspected or confirmed COVID-19, if possible.

• Those who have been in close contact (i.e., less than 6 feet (2 meters) with a resident who has confirmed or suspected COVID-19 should monitor their health and call their healthcare provider if they develop symptoms suggestive of COVID-19.

• Be prepared for the potential need to transport persons with suspected or confirmed COVID-19 for testing or non-urgent medical care. Avoid using public transportation, ride-sharing, or taxis. Follow guidelines for cleaning and disinfecting any transport vehicles.

Accepting new residents at facilities that offer support services

First, review and follow the guidance and directives from your state and local officials.

If your situation is not restricted by their guidance and directives, then consider the following guidance:

• • At check-in, provide any new or potential resident with a clean mask and keep them isolated from others. Shelters can use this tool to screen for symptoms at entry.

  • Medical evaluation may be necessary depending on the symptoms.

• If your facility is full, your facility space is inadequate to maintain physical distancing (such as is recommended in the guidance for homeless shelters), or you do not have the resources (staff, prevention supplies) to accept additional residents, reach out to community- or faith-based organizations to help meet individuals’ needs, including:

  • A safe place to stay

  • Ability to obtain basic necessities, such as food, personal hygiene products, and medicine

  • Access to any needed medical or behavioral health services

  • Access to a phone or a device with internet access to seek out resources and virtual services and support

Additional CDC resources to help prevent spread of COVID-19 in shared or congregate housing settings

More detailed guidance is available for specific types of facilities. Some of the information in these guidance documents is applicable to that specific type of facility only, and some of the information would be applicable to other congregate housing facilities.

• Assisted living facilities

• Retirement communities and independent living

• Homeless shelters

• Community- and faith-based organizations

• Colleges and universities

• Households with suspected or confirmed COVID