School Nursing

The Relentless School Nurse: Dear CDC, Your Guidelines Are As Clear As Mud

We have a skyrocketing variant that has swept across the country as schools are attempting to reopen after winter break and yet the CDC releases a series of confusing guidelines that began with a media statement on 12/27/21. Let’s review the timeline that has given those who care about public health, especially school nurses, whiplash and calls for clarity:

12/27/21 – The CDC releases their updated guidance through a media statement that talks about “general population.” The newly minted guidelines cut isolation and quarantine days in half with recommendations to wear a mask and monitor for symptoms.  CDC Updates and Shortens Recommended Isolation and Quarantine Period for General Population. Many school districts used this media statement as an opportunity to update their school guidance based on the reduced days. The only problem was that it did not specify that this included K-12 school communities. 

12/29/21 – The CDC released an update for school districts Overview of COVID-19 Quarantine for K-12 Schools that confirmed quarantine for school students and staff as 14 days for unvaccinated or not fully vaccinated people. They also released updated guidance for isolation Overview of COVID-19 Isolation for K-12 Schools that confirmed isolation for school students and staff as 10 days regardless of vaccination status. 

Or so we thought…

1/4/22 – An update appears on the CDC website: Quarantine and Isolation. But yet, when you scroll down to the bottom of the page, you will find this “clarification” for school communities:

When you click on the “additonal guidance is available here: Overview of COVID-19 Quarantine for K-12 Schools, it circles back to the 12/29/21 information that recommends 14 days of quarantine. So, dear CDC, which is it, 5 days or 14 days?

Deeper into the document there is further clarification of the rationale behind the shortening of quarantine and isolation: What We Know About Quarantine and Isolation. This paragraph stood out to me the most:

On January 4, CDC updated COVID-19 isolation and quarantine recommendations with shorter isolation (for asymptomatic and mildly ill people) and quarantine periods of 5 days to focus on the period when a person is most infectious, followed by continued masking for an additional 5 days. These updated recommendations also facilitate individual social and well-being needs, return to work, and maintenance of critical infrastructure. Preliminary data suggest that the Omicron variant is up to three times more infectious than the Delta variant [14]. With the recommended shorter isolation and quarantine periods, it is critical that people continue to wear well-fitting masks and take additional precautions for 5 days after leaving isolation or quarantine [15]. In addition, isolation should only end if a person has been fever-free for at least 24 hours without the use of fever-reducing medication and other symptoms have resolved. Modeling data from the United Kingdom reinforce the importance of mask use; after the 5th day after a positive test, an estimated 31% of persons remain infectious [16]. Mask use and layered prevention strategies, such as receiving all recommended vaccination and booster doses, physical distancing, screening testing, and improved ventilation, are key to preventing COVID-19 and decreasing transmission.

And then there is this answer in their FAQs:

So, here is where we find ourselves, mired in a raging variant that is impacting the health and well being of school staff and students, without a safety net. Welcome to 2022. Unviersal precautions are all we have left folks, be sure to order your N95 mask and try to get a fit-test to be sure you have protection, or not, because that is what it feels like. We are on our own, tasked with an impossible burden, attempting to keep school staff and students safe as we enter the third year of a global pandemic. 


Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.