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Symptom screening will fail to identify some students who have the virus that causes COVID-19. Symptom screening cannot identify people with the virus that causes COVID-19 who are asymptomatic (do not have symptoms) or pre-symptomatic (have not developed signs or symptoms yet but will later). Others might have symptoms that are so mild that they might not notice them. Children infected with the virus that causes COVID-19 are more likely than adults to be asymptomatic or to have only mild symptoms.

Limit contact between cohorts. In areas of substantial (orange) and high (red) levels of community transmission, schools that use less than 6 feet between students in classrooms, cohorting is recommended, with at least 6 feet maintained between cohorts.

Some students might develop symptoms of infectious illness while at school. Schools that identify symptomatic students during the school day should follow the steps of CDC s Student Becomes Sick on what to do next. This includes notifying the student s caregiver and recommending an evaluation by a healthcare provider and testing or initiating school-based testing, if available. Schools should work with students and their caregivers to base school exclusion and return decisions on the same criteria detailed for home-based screening above.

Quarantine should be used for students, teachers, and staff who might have been exposed to COVID-19. Close contacts, identified through contact tracing, should quarantine unless they are fully vaccinated, or have tested positive in the last 3 months, and do not have any symptoms.

The effectiveness of COVID-19 symptom screening in schools is not well known. A recent study found that symptom screening that evaluated for all known COVID-19 symptoms and was conducted by health professionals in a hospital setting failed to identify nearly half (45%) of all pediatric patients infected with the virus that causes COVID-19, and 40% of those with COVID-19 symptoms did not have the virus that causes it.

Limit contact between cohorts. In areas of substantial (orange) and high (red) levels of community transmission, schools that use less than 6 feet between students in classrooms, cohorting is recommended, with at least 6 feet maintained between cohorts.