School Exclusion Protocols
This guidance document provides additional guidance for schools and local health departments (LHDs) for when students, faculty, or staff must be excluded from school consistent with Executive Order 2021-24 (as amended by Executive Order 2021-25) and the Communicable Disease Code, 77 Ill. Admin. Code 690.361 and 690.30(c).
“School personnel” means any person who (1) is employed by, volunteers for, or is contracted to provide services for, any public and nonpublic school in Illinois serving pre-kindergarten through 12th grade students, or is employed by an entity contracted to provide services for any public and nonpublic school in Illinois serving pre-kindergarten through 12th grade students, and (2) is in close contact (fewer than 6 feet) with other persons on the campus or in a campus-affiliated building or location for more than 15 minutes at least once a week on a regular basis. The term “School personnel” does not include any person who is present on the campus or at an affiliated off-campus location for only a short period of time and whose moments of close physical proximity to others on site are fleeting (e.g., contractors making deliveries to a site where they remain physically distanced from others or briefly enter a site to pick up a shipment).
“Student” means an adolescent or child enrolled in a school.
“Confirmed case” means a person with a positive result on a COVID-19 molecular amplification diagnostic test (e.g. polymerase chain reaction [PCR] test), irrespective of clinical signs and symptoms.
“Close contact” means an unvaccinated individual who was within 6 feet for at least 15 minutes with a confirmed or probable case in a 24-hour period. The term close contact does not include a student who was within 3-6 feet in a classroom setting for least 15 minutes with a confirmed case or probable case if both case and contact were consistently masked for the entire exposure period. Close contact does not include individuals who are fully vaccinated or who tested positive for COVID-19 within prior 90 days and are currently asymptomatic.
“Probable case” means a person with a positive result on a COVID-19 antigen diagnostic test, irrespective of clinical signs and symptoms, or with COVID-19-like symptoms who was exposed to a confirmed or probable Case.
Situation #1 - Students, Faculty or Staff Tests Positive (Confirmed Case): Exclude from In-Person Instruction
If a COVID-19 test is performed at the school or the individual self-reports a positive test, the school should report the case immediately by phone to the LHD. 77 Ill. Admin. Code 690.200(a)(1)(J).
Schools must gather information about the individual’s activity in school to provide such information to the LHD. Notification should include all available information about the individual’s movements and potential exposures to others within the school beginning with the 48 hours prior to the positive test result or symptom onset. This includes:
- Total number of students/school personnel at the school and total number of classrooms
- Total number of classrooms impacted
- Total number of students and staff potentially exposed
- The COVID-19-positive individual’s reported/observed onset date of symptoms
- The COVID-19-positive individual’s last day at the school
School Next Steps
Exclude student or school personnel who are Confirmed Cases from the school consistent with the flow chart #1 below or as otherwise recommended by the LHD.
If the COVID-19-positive individual was in the school during their infectious period (48 hours prior to symptom onset for a symptomatic person or 48 hours before specimen collection for an asymptomatic person through the date of last attendance), areas used by the individual should be cleaned and disinfected thoroughly according to CDC guidelines and as described below.
Notify families, teachers, and support staff that a confirmed case was identified in the school while maintaining confidentiality as required by the Americans with Disabilities Act (ACA) and the Family Educational Rights and Privacy Act. The notification should be sent as soon as possible and include information on symptom monitoring, what to do if symptoms develop, COVID-19 prevention strategies, and information on what the school is doing in response to the positive case. Such notification shall also specify that exclusion from school is separate from any isolation or quarantine order that may be entered by the LHD.
Exclude students and school personnel identified as close contacts by school or LHD consistent with flowchart #3 or as otherwise recommended by the LHD.
LHD Next Steps
Contact the COVID-19-positive school personnel or the parents/guardians of the COVID-19-positive student to complete the investigation and issue an order for isolation, if necessary.
Conduct contact tracing to identify close contacts to the case and to advise close contacts to remain in home away from others consistent with the flow chart #3.
Issue orders for quarantine for close contacts to the case as necessary per the Communicable Disease Code, 77 Ill. Admin Code 690, Subpart I. Orders of quarantine do not supplant the school’s authority in excluding students/staff determined to be close contacts pursuant to the executive order or the Communicable Disease Code, 77 Ill. Admin. Code 690.
Criteria for Returning to School
Consistent with the CDC’s Discontinuation of Isolation schools should permit students and school personnel who are confirmed or probable cases to return to in-person instruction if at least 10 days have passed since symptom onset date (or date of test if asymptomatic) and they have been fever-free for 24 hours without fever-reducing medication and their symptoms have improved.
The LHD may supply alternative dates as to when a student or staff member can return to school; otherwise schools should permit return consistent with this guidance unless an isolation or quarantine order is still in effect.
A letter from LHD releasing the student or staff member from isolation or quarantine is not required for a school to permit a student or school member to return.
Situation #2 - Students and School Personnel Exhibiting COVID-19-like Symptoms at School: Exclude or Refuse Admission While Acute Symptoms are Present
Students or school personnel who exhibit COVID-19-like symptom(s) should be immediately masked, if they are not already, and sent to a designated separation room that can be used for symptom evaluation, including testing if available, or while waiting until they can leave the school
COVID-19-like symptoms include the following: Fever (100.4°F or higher), new onset of moderate to severe headache, shortness of breath, new cough, sore throat, vomiting, diarrhea, new loss of sense of taste or smell, fatigue from unknown cause, muscle or body aches from unknown cause
Students and school personnel exhibiting COVID-19 like symptoms should be:
- safely transported home by parent or guardian as soon as possible, or
- safely transported by parent or guardian to a healthcare facility for clinical evaluation and testing, if necessary.
On-Site Screening (if school health personnel available)
Any school health personnel conducting a screening of a symptomatic student should be wearing fit tested N95 mask, eye protection with face shield or googles, gown, and gloves. The user should be trained on the type of PPE required, and how to don (put on) and doff (remove) it correctly and safely. Respirators, such as N95s, 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. Schools should contact their LHD to determine where fit testing can be obtained in their area.
If a fit-tested N95 respirator is not available, the next safest levels of respiratory protection include, in the following order: a non-fit-tested N95 respirator, a KN95 respirator on the FDA-approved list, or a surgical mask.
When possible, the sick individual should be tested on-site at the school for COVID-19 and other respiratory viruses, where indicated.
Individuals who have had COVID-19 with a lab confirmed test within the past three months who are now symptomatic do not need to be tested for COVID-19 and should be assessed for other illnesses.
Individuals who have tested positive for COVID-19 in past 90 days should be assessed for other illnesses and excluded or refused admittance from school consistent with the IDPH Communicable Disease in Schools guidance.
Schools must exclude or refuse to admit students and school personnel, on the school premises, with COVID-19-like illness:
- If COVID-19-negative, the student or school personnel should remain out of school until they have been fever-free for 24 hours without fever-reducing medication, 48 hours after diarrhea/vomiting have ceased, and symptoms have improved.
- If the student or school personnel test COVID-19-positive, refer to the section, “Situation #1 - Procedures for Students and School Personnel who Test Positive.”
- If testing is not performed, the child must remain out of school for 10 calendar days after symptom onset and until they have been fever free for 24 hours without fever-reducing medication, 48 hours after diarrhea/vomiting have ceased, and symptoms have improved.
Schools must exclude unvaccinated household members, who also attend or work at the school, of the symptomatic student or school personnel unless the sick individual was tested within 24 hours of onset of symptoms. If the ill individual was tested within 24 hours of onset of symptoms, household members do not need to be sent home unless there is a high suspicion the ill person has COVID-19 (e.g., they are a known close contact, they have lost sense of taste and smell). Pending test results (if test performed within first 24 hours), household members can remain in school with consistent use of well-fitting masks both indoors and outdoors. If the ill household member tests positive for COVID-19, then any unvaccinated household members should be excluded from the school immediately and treated as a close contact (refer to Situation #3). Asymptomatic household members who previously tested positive for COVID-19 do not need to be excluded if it has been fewer than 90 days since the date symptoms began or the date of specimen collection (if they were asymptomatic). Fully vaccinated household members need not quarantine but should get tested 3-5 days after exposure. If exposure is ongoing i.e. unable to isolate from their sick contact, they should get tested again 3-5 days after last day of infectious period for their sick contact i.e. 10 days from illness onset/test positive date.
All areas used by the sick individual should be cleaned and disinfected thoroughly according to CDC guidelines and as described below.
Situation #3 - Students and School Personnel who are Close Contacts to a Confirmed COVID-19 Case
Identifying Close Contacts
Schools shall investigate confirmed and suspect cases of COVID-19 in schools to identify close contacts.
Districts and schools, as well as students and families, must work with their LHD to facilitate contact tracing of infectious students and school personnel.
Upon notification or identification of a confirmed case in the school, schools should prepare and provide information and records to the LHD to aid in the identification of potential close contacts, exposure sites, and mitigation recommendations.
School personnel should inform the LHDs immediately about possible exposures within the school, including in transportation settings, classrooms, common areas and extracurricular activities. Schools should designate a person or persons for this role and have them available after hours.
LHDs should collaborate with pre-K-12 school administration to obtain contact information of unvaccinated individuals who were in rooms, classes, meals, and extracurricular activities with the confirmed case.
The LHD will conduct contact tracing to identify close contacts to the case outside of the school, and may recommend exclusion pursuant to 77 Ill. Admin. Code 690.30 or issuing orders for voluntary quarantine per the Communicable Disease Code, 77 Ill. Admin Code 690, Subpart I.
Factors that may be considered when identifying close contacts include proximity, the duration of exposure (e.g., longer exposure time likely increases exposure risk), and whether the exposure was to a person with symptoms (e.g., coughing likely increases exposure risk). Brief interactions are less likely to result in transmission; however, symptoms and the type of interaction (e.g., did the infected person cough directly into the face of the exposed individual) remain important. Schools should work with the LHD for additional guidance in particular situations if needed.
Schools Must Exclude Close Contacts
Schools must exclude close contacts as required by 77 Ill. Admin. Code 690.361.
Schools must exclude students or school personnel identified as close contacts consistent with flowchart #3 unless directed otherwise by the LHD.
Schools should exclude students even if an isolation or quarantine order has not been issued or has expired.
Individuals who do not need to be excluded
Asymptomatic individuals with prior COVID-19 disease if it has been fewer than 90 days since the date symptoms began or the date of specimen collection if they were asymptomatic.
Students and staff who are fully vaccinated with no COVID-19-like symptoms. However, CDC recommends that fully vaccinated individuals test 3 to 5 days after a close contact exposure to someone with suspected or confirmed COVID-19.
LHDs should interview the parents/guardians of a COVID-19-positive student or COVID-19-positive school personnel. The purpose for the interview is to identify everyone with whom the COVID-19-positive individual had close contact (within 6 feet for a cumulative 15 minutes or more while the individual was infectious) to identify additional individuals who should be excluded from school and/or subject to an order for isolation or quarantine.
- The infectious period begins 2 days before the onset of symptoms (for a symptomatic person) or 2 days before the positive sample was obtained (for an asymptomatic person) and ends when the COVID-19-positive individual was placed in isolation.
Parents/guardians and staff must cooperate with the LHD for purposes of conducting contact tracing or investigating any outbreak pursuant to the Control of Communicable Disease Code, 77 Illinois Administrative Code 690.
Return to school criteria
If the close contact develops symptoms, COVID-19 diagnostic testing is recommended, regardless of vaccination status, and the school should follow protocols for excluding symptomatic individuals from school for 14 days (Situation #2).
If the close contact is not tested, they are treated as a probable case (Situation #2).
If the close contact tests positive, they should be treated as a confirmed case (Situation #1).
If the close contact tests positive but remains asymptomatic, all unvaccinated close contacts are recommended to be tested between 5-7 days after exposure to a positive case.
The LHD may supply dates as to when a student or staff member identified as a close contact can return to school, otherwise schools should permit return consistent with this guidance (14 days).
A letter from LHD releasing the student or staff member from isolation or quarantine, or specifying the student is permitted to return is not required.
Situation #4 - Outbreak Response and Consideration for Closure
Identifying an outbreak
CDC and IDPH recommend using the following definitions of a school-associated outbreak: (A) multiple cases comprising at least 10% of students, teachers, or staff within a specified core group (e.g., extracurricular activity, cohort group, classroom, before/after school care, etc.) or (B) at least three cases within a specified core group meeting criteria for a probable or confirmed school--associated COVID-19 case with symptom onset or positive test result within 14 days of each other; who were not identified as close contacts of each other in another setting (i.e., household) outside of the school setting; and that are epidemiologically linked in the school setting or a school-sanctioned extracurricular activity . In other words, the cases have shared close contacts and location at school a school-sanctioned activity and have onsets within 14 calendar days of each other. Conversely, cases that occurred in different timeframes (at least calendar 15 days apart), separate locations or locations outside of school, and having no common source of exposure would not constitute an outbreak.
Once an outbreak is identified, the LHD will further investigate to determine the extent of exposures at the school and what control measures are needed to mitigate the outbreak. Such strategies might include:
- Quarantine orders from the LHD for all individuals present in the affected classroom, especially for infant and toddler classrooms where masking is not achievable and social distancing is challenging
- Temporarily suspending in-person learning only for classrooms exposed to COVID-19 cases
- Closing playgrounds
- Canceling non-essential activities and meetings
- Keeping students in stable class groups or classrooms and moving teachers between classes, if necessary
- Increasing spacing between students in classes
- Shortening the in-person school week
- Staggering school start and lunch/break times across year groups or classes
When a school is in outbreak status (as defined and established by public health authorities), outbreak testing is strongly recommended for students and required for unvaccinated school personnel who are included in the outbreak.
Outbreak testing should begin as soon as possible from the date the outbreak is declared by the LHD and at least within three days.
IDPH recommends schools acquire parental consent for student testing at the beginning of the school year to quickly accommodate outbreak testing should the need arise.
Testing for close contacts should occur as previously recommended. In addition, schools should conduct twice weekly testing of unvaccinated students during an outbreak 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.
Schools must conduct twice weekly testing of unvaccinated school personnel who are included in the outbreak definition established by public health authorities.
Testing should continue until the school has gone two incubation periods, or 28 days, without identifying any new cases.
Schools should make plans to deploy outbreak testing when needed. A listing of free testing sites is available at http://dph.illinois.gov/testing.
Decisions about taking an adaptive pause in response to an outbreak should be made in consultation with the LHD. Schools and LHDs should consider vaccination levels, number of students in quarantine, ability of the LHD and school to effectively contact trace, adherence to all layers of mitigations (in particular exclusion, isolation, universal masking, and testing), and availability of staff to conduct in-person learning.