School Nursing

The Relentless School Nurse: Universal Pandemic Precautions are COVID Guardrails – How are We Doing Anything Less in Schools?



Would you drive on this highway if the guardrails were missing? Well, that is what is happening in schools that are barring our protective guardrails like masks, physical distancing & vaccination requirements. Hospital systems across the country have implemented Universal Pandemic Precautions (UPP). Why are school districts doing anything less?

Universal Pandemic Precautions (UPP) are used in hospital settings to reduce the risk of COVID-19 transmissions from asymptomatic, pre-symptomatic or symptomatic COVID-19 positive individuals. – Hackensack Meridian Health (HMH) Universal Pandemic Precautions

UPP is an extension of Universal Precautions that were first instituted in the early 1980s during the HIV epidemic. Universal Precautions were considered an infection control paradigm shift (Weber, Babcock, et al., 2020). The presence of HIV which was also infecting healthcare workers gave rise to more vigilant infection control procedures. How are we doing anything less in schools than taking all available and necessary pandemic precautions? They are our guardrails, yet governors and boards of education in this country are purposefully removing these known protections. 

The only guardrails we can use at school are universal masking regardless of vaccination status, COVID vaccine for those eligible, handwashing, proper ventilation, and surface cleaning. I am not including physical distancing because most schools are not limiting class sizes and giving direction that we should maintain physical distancing if feasible. However, we know that many school districts have made masking optional or banned altogether, eliminated or diluted contact tracing, and limited involvement from school nursing staff from directly communicating with local health departments. 

Guidance around school reopening for the 2021-2022 school year does not specifically address the highly transmissible Delta variant. It feels like we are still working from last school year’s guidance, creating more confusion and concern. But this variant is impacting our children. There is no excuse for schools not using every single protective measure we can to limit transmission of the Delta variant. To do anything less is unconscionable. 


Weber, D., Babcock, H., Hayden, M., Wright, S., Murthy, A., Guzman-Cottrill, J., . . . Henderson, D. (2020). Universal pandemic precautions—An idea ripe for the times. Infection Control & Hospital Epidemiology, 41(11), 1321-1322. doi:10.1017/ice.2020.327

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