Author: COVID-19 NEWS

As some casinos and gaming operations resume in some areas of the United States, CDC offers the following considerations for ways in which casino and gaming operators can help protect staff and customers and slow the spread of COVID-19.  Casinos and gaming operations can determine, in collaboration with local, state, territorial, federal, or tribal health officials, whether and how to implement these considerations, making adjustments to meet the 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. For more information on bars and restaurants within casinos, please see CDC’s Considerations for Restaurants and Bars. These considerations are meant to supplement—not replace—any local, state, territorial, federal, or tribal safety laws, rules, or regulations with which businesses must comply.
Guiding Principles to Keep in Mind
The more an individual interacts with others, and the longer that interaction, the higher the risk of COVID-19 spread. The risk of COVID-19 spread increases in a casino or gaming setting as follows:

Lowest Risk

Even More Risk

Highest Risk

Lowest Risk

Gaming activities are only available in virtual or online format.

Casinos are open but with limitations to allow social distancing and disinfection of machines between uses.
Activities are limited to gaming machines and equipment that do not require a dealer and that can be played by one customer at a time and disinfected between uses.
Individuals remain spaced at least 6 feet apart (2 arms’ length) while seated or standing.
Sharing of gaming materials and equipment is not allowed.

Even More Risk

Casinos are open but with limitations to allow social distancing.
Games that require a dealer and that allow multiple players at the same time are offered, but the number of players is limited.
Individuals remain spaced at least 6 feet apart while seated or standing.
When possible, casino limits customers’ sharing of objects such as dice, card shoes, shufflers, and roulette wheels, Pai Gow tiles, pit podiums, blackjack discard holders, and toke boxes. Casino cleans and disinfects these objects between uses as much as possible.
When possible, casino limits sharing of items that are difficult to clean and disinfect, such as cards, and holds items for 72 hours before reuse of these items.

Highest Risk

Casino and gaming operations are open at full capacity.
Games that require a dealer and that allow multiple players at the same time are offered.
Individuals are not spaced apart while seated or standing.
Sharing of gaming materials and equipment is permitted with no restrictions.

Know How the Virus Spreads
The virus that causes COVID-19 is mostly spread by respiratory droplets released when an infected person talks, coughs, or sneezes. These droplets can land in the mouths or noses people who are nearby or possibly be inhaled into the lungs. It is thought that the virus may spread to hands from a contaminated surface and then to the nose or mouth, causing infection. Infected people can spread the virus whether or not they have symptoms. Therefore, personal prevention practices (such as handwashing, staying home when sick) and environmental cleaning and disinfection are important principles that are covered in this document.
Fortunately, there are a number of actions operators of casinos and gaming operations can take to help lower the risk of COVID-19 exposure and spread.
Promoting Behaviors that Reduce Spread
Casinos and gaming operations may consider implementing strategies to encourage behaviors that reduce the spread of COVID-19 among staff and customers.
Staying Home when Appropriate
Educate staff and customers about when they should stay home.
Actively encourage staff and customers to stay home if they have symptoms of COVID-19 or have tested positive for COVID-19.
Encourage staff and customers who have been exposed to someone with COVID-19 within the last 14 days to stay home and monitor their health.
Consult CDC criteria to inform policies on when staff can return to work and when customers can return to the casino if they had symptoms of COVID-19, tested positive for COVID-19, or were exposed to someone with COVID-19.

Develop policies that encourage sick staff to stay at home without fear of being punished or losing their jobs, and ensure staff are aware of these policies. Educate staff when they can return to work.

Hand Hygiene and Respiratory Etiquette
Recommend and reinforce frequent staff and customer hand hygiene behaviors (e.g., before, during, and after touching gaming tokens, cards, and other frequently touched surfaces). Encourage handwashing with soap and water for at least 20 seconds. If soap and water are not readily available, provide hand sanitizer that contains at least 60% alcohol.
Remind staff and customers to avoid touching their eyes, nose, and mouth.
Encourage staff and customers to cover coughs and sneezes with a tissue or to use the inside of their elbow. 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, provide hand sanitizer that contains at least 60% alcohol.

Masks
Recommend and reinforce the use of masks among staff and customers. Masks should be worn as feasible and are most essential in times when social distancing is difficult. Individuals should be frequently reminded not to touch the mask and to wash their hands frequently. Provide information to staff and customers on proper use, removal, and washing of masks.
Note: Masks should not be placed on:
Babies and 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

Masks are meant to protect other people in case the wearer is unknowingly infected and does not have symptoms.

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 and water, a way to dry hands (e.g., paper towels, hand dryer), tissues, no-touch/foot pedal trash cans (preferably covered), masks (as feasible), and hand sanitizer containing at least 60% alcohol (placed adjacent to every card table or table game, if supplies allow).

Signs and Messages
Post signs in highly visible locations (e.g., at entrances, in restrooms, on televisions) that promote everyday protective measures and describe how to stop the spread of germs, such as by properly washing hands and properly wearing a mask. Provide signs and messages in multiple languages.
Broadcast regular announcements about reducing the spread of COVID-19 on PA systems. Include messages (for example, videos) about behaviors that prevent spread of COVID-19 when communicating with staff and customers (such as on business websites, in emails, and on social media). Ensure messages are culturally appropriate.
Find free CDC print and digital resources in a variety of languages on CDC’s communications resources main page.

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Maintaining Healthy Environments
Casinos and gaming operations may consider implementing several strategies to maintain healthy environments.
Cleaning and Disinfection
Clean and disinfect frequently touched surfaces (e.g., ATMs, door handles, cash registers, workstations, sink handles, bathroom stalls, table rails, chairs, buttons or touch points on gaming machines) within facilities at least daily and between uses as much as possible. Use disinfectants from EPA’s List N: Disinfectants for Use Against SARS-CoV-2external icon.
Limit customers’ sharing of objects (e.g., items used in table games, dice, card shoes, shufflers, roulette wheels, Pai Gow tiles, pit podiums, blackjack discard holders, toke boxes) when possible, and clean and disinfect these objects between uses as much as possible.
Clean and disinfect electronic gaming machines (e.g., slots, touch screen games) at least daily and between uses as much as possible.
Consider placing wipeable covers over electronics.
Follow the equipment manufacturer’s instructions for appropriate cleaning and disinfection procedures for machines and associated electronics.
If no manufacturer guidance is available, consider the use of alcohol-based wipes or spray containing at least 70% alcohol to disinfect machine buttons and touch screens. Dry surfaces thoroughly to avoid pooling of liquids.

Develop a schedule for increased, routine cleaning and disinfection.
Designate staff to clean and disinfect frequently touched surfaces for table games, gaming machines, and equipment.
Ensure safe and correct use and storage of disinfectants, including storing products securely away from children. Use gloves when removing garbage bags or handling and disposing of trash. Wash hands after removing gloves.
Ensure there is adequate ventilation when using cleaning products to prevent customers or staff from inhaling toxic fumes.

Shared Objects
Discourage sharing of items that are difficult to clean or disinfect.
When possible, dealers should instruct customers not to touch cards or deal cards face up.
For items that are not easily cleaned and disinfected (e.g., cards), place in a designated separate area for at least 72 hours before using these items again.

Avoid sharing gaming items that are reusable, such as cards, dice, or gaming pieces. Clean and disinfect or replace items after a staff member or new customer comes into contact with them.
Ensure staff have adequate supplies to minimize sharing of high-touch gaming equipment.
Account for the frequent replacement of shared objects (e.g., dice, cards, chips) during table games to ensure there are enough gaming supplies.

Use touchless payment options as much as possible, if available. Ask customers to exchange cash or card payments by placing payment on a receipt tray or on the counter rather than by hand to avoid direct hand to hand contact. Disinfect frequently touched surfaces such as pens, counters, or hard surfaces between use.
Use disposable drink service items (e.g., utensils, cups, napkins). If disposable items are not feasible or desirable, ensure that all non-disposable food service items are handled with gloves and washed with dish soap and hot water, or in a dishwasher. Staff should wash their hands after removing their gloves or after handling used drink service items.

Ventilation
Consider taking steps to improve ventilation in the building, in consultation with a HVAC professional, to increase total airflow supply occupied spaces, if possible.
Consider increasing the percentage of outdoor air (e.g., using economizer modes of HVAC operations) potentially as high as 100% (first verify compatibility with HVAC system capabilities for both temperature and humidity control as well as compatibility with outdoor/indoor air quality considerations).
Ensure that ventilation systems operate properly and increase circulation of outdoor air as much as possible, for example by opening windows and doors and prioritizing outdoor seating.
Do not open windows and doors if doing so poses a safety or health risk to customers or staff (e.g., risk of falling or triggering asthma symptoms).

Water Systems
To minimize the risk of Legionnaires’ disease and other diseases associated with water, take steps to ensure that all water systems and features (e.g., sink faucets, decorative fountains, drinking fountains) are safe to use after a prolonged facility shutdown.
Drinking fountains should be cleaned and disinfected frequently or closed if this is not possible.

Modified Layouts and Procedures
Change gaming layouts to ensure that staff and customers remain at least 6 feet apart, when feasible.
Limit seating capacity to allow for social distancing. Limit the number of customers at gaming tables based on type of game to maintain at least 6 feet between customers.
Limit seating by removing chairs to visually enforce maximum capacity at table games.
Provide visual cues on the floor for where chairs should be placed to ensure 6 feet of distance between customers and the dealer.

Discourage eating at game tables.
Discourage customers from congregating around gaming and food service areas.

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., cash registers, gaming machines, between dealer and customer).
Provide physical guides, such as tape on floors or sidewalks and signage, to encourage individuals to remain at least 6 feet apart (e.g., at gaming tables, entrances, in purchase lines).

Communal Spaces
Close shared spaces such as staff break rooms, if possible; otherwise stagger their use and restrict the number of people allowed in at one time to ensure everyone can stay at least 6 feet apart, and clean and disinfect between staff.
Provide outdoor options for staff areas and meetings.
Provide hand sanitizer containing at least 60% alcohol at designated eating staff areas.

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Maintaining Healthy Operations
Casinos and gaming operations may consider implementing strategies to maintain healthy operations.
Protections for Staff 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) that limit their risk of exposure (e.g., telework and modified job responsibilities).
Consistent with applicable local, state, territorial, federal, or tribal privacy and confidentiality laws and regulations, put in place policies to protect the privacy of people at higher risk for severe illness.

Regulatory Awareness
Be aware of local, state, territorial, federal, or tribal policies and recommendations related to group gatherings to determine if events can be held.

Gatherings
Avoid scheduling group events (e.g., large concerts, shows), gatherings, or meetings where social distancing of at least 6 feet between people cannot be maintained.

Staggered or Rotated Shifts
Stagger or rotate shifts to limit the number of staff on the floor at the same time.
Stagger and limit playing times to minimize the number of customers in the establishment.

Travel and Transit
Encourage staff who use mass transit to consider using other transportation options (e.g., walking or biking, driving or riding by car alone or with household members only), if feasible.
Encourage staff who use public transportation or ride sharing to follow CDC guidance on how to protect yourself when using transportation. Additionally, encourage staff to commute during less busy times and clean their hands as soon as possible after their trip.

Designated COVID-19 Point of Contact
Designate a staff member for each shift to be responsible for responding to COVID-19 concerns. All staff should know who this person is and how to contact them.

Communication Systems
Consistent with applicable local, state, territorial, federal, or tribal privacy and confidentiality laws and regulations, put systems in place for:
Having staff and customers report to the establishment’s point of contact if they have symptoms of COVID-19, have tested positive for COVID-19, or were exposed to someone with COVID-19 within the last 14 days.
Notifying local, state, territorial, federal, or tribal health authorities of COVID-19 cases.
Notifying staff, customers, and the public of business closures, and restrictions in place to limit COVID-19 exposure (e.g., limited hours of operation).

Telework and Virtual Meetings
Encourage telework for as many staff as possible (e.g., accountants, engineers), especially staff at higher risk for severe illness from COVID-19.
Replace in-person meetings with video- or tele-conference calls when possible.

Leave (Time Off) Policies
Implement flexible sick leave policies and practices that enable staff to stay home or self-isolate when they have symptoms of COVID-19, have tested positive for COVID-19, have recently have been exposed to someone with COVID-19 within the last 14 days, or have to care for someone who is sick.
Examine and revise policies for leave, telework, and staff compensation.
Leave policies should be flexible and not punish people for taking time off and should allow sick staff to stay home and away from co-workers. Leave policies should also account for staff who need to stay home with their children if there are school or childcare closures.

Develop policies for return-to-work after COVID-19 illness. CDC’s criteria to end home isolation can inform these policies.

Back-Up Staffing Plan
Monitor absenteeism of staff, cross-train staff, and create a roster of trained back-up staff.

Staff Training
Train all staff in COVID safety protocols.
Conduct training virtually, or ensure that social distancing is maintained during training.

Recognize Signs and Symptoms
If feasible, conduct daily health checks or ask staff and customers to conduct self-checks (e.g., temperature screening and/or or symptom checking). Consider using examples of screening methods in CDC’s General Business FAQs as a guide.
Health checks should be done for staff and customers safely and respectfully, and in accordance with any applicable federal or state privacy and confidentiality laws and regulations.

Support Coping and Resilience 
Encourage staff to eat a healthy diet, exercise, get adequate sleep, and find time to unwind.
Encourage staff to talk with people they trust about their concerns and how they are feeling.
Consider posting signs for the national distress hotline: 1-800-985-5990, or text TalkWithUs to 66746

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Preparing for When Someone Gets Sick
Casinos and gaming operations may consider implementing strategies to prepare for when someone gets sick.
Advise Sick Staff of Home Isolation Criteria

Isolate and Transport Those Who are Sick
Make sure that staff know they should not come to work and should notify their manager or other designated COVID-19 point of contact if they have symptoms of COVID-19, have tested positive for COVID-19, or have been exposed to someone with COVID-19 within the last 14 days.
Identify an isolation room or area to separate anyone who has COVID-19 symptoms.
Immediately separate staff or customers with COVID-19 symptoms. Individuals who are sick should go home or to a healthcare facility and follow CDC guidance for caring for oneself.
Establish procedures for safely transporting anyone who is sick to their home or to a healthcare facility. If you are calling an ambulance, alert them that the person may have COVID-19.

Clean and Disinfect

Notify Health Officials and Close Contacts
In accordance with local, state, territorial, federal, or tribal laws, casino and gaming operators should notify local, state, territorial, federal, or tribal health officials, staff, and customers immediately of any person who has COVID-19 at the establishment while maintaining that person’s confidentiality in accordance with the Americans with Disabilities Act (ADA)external icon and other local, state, territorial, federal, or tribal privacy and confidentiality laws and regulations.
Inform those who have been exposed to someone with COVID-19 within the last 14 days to stay home and self-monitor for symptoms, and follow CDC guidance if symptoms develop.

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Lowest risk: Staff and beach visitors stay at least 6 feet away from people they don’t live with. Staff and beach visitors do not share food, equipment, toys, or supplies with people they don’t live with.
More risk: Staff and beach visitors get closer — less than 6 feet away from people they don’t live with but who live in the same local area*. Staff and beach visitors limit their sharing of food, equipment, toys, or supplies with others — for example, they share only with a next-door neighbor.
Highest risk: Staff and beach visitors get closer — less than 6 feet away from people who live in a different area** where the spread of the virus might be greater. Staff and beach visitors freely share their food, equipment, toys, or supplies with others, even people they don’t know.
* Local area could be a town, city, or county.
** Different area could be another town, city, or county.

Guiding Principles to Keep in Mind
The more a person interacts with others, and the longer that interaction lasts, the higher the risk of COVID-19 spread in the community. Risk is also affected by factors such as background rates of infection in the community and individuals’ compliance with mitigation strategies, such as use of masking, social distancing, and hand hygiene. IHEs should communicate their selected level of risk so that people can make more informed decisions about attendance, especially those with disabilities and people who are at higher risk of severe illness from COVID. The risk of COVID-19 spread increases in IHE non-residential (i.e., off-campus housing) and residential (i.e., on-campus housing) settings with the level of COVID activity in the community and as follows:
IHE General Settings
Lowest Risk
Faculty and students engage in virtual-only learning options, activities, and events.
Some Risk
Students, faculty, and staff follow all steps to protect themselves and others at all times, including proper use of face masks, social distancing, and hand hygiene.
Hybrid learning model: Students participate in virtual learning, and in-person learning is limited to courses and laboratory instruction that cannot be delivered remotely.
Students, faculty, and staff participate in small, in-person classes, activities, and events that allow individuals to remain spaced at least 6 feet apart (e.g., lecture room with individual seating spaced 6 feet apart).
Students avoid out-of-class social gatherings and events and communications and policies discouraged these activities.
Apply and support strict adherence to cohorting, alternating schedules, and staggered schedules in residence halls, dining areas, and recreational areas on campus to create small groups of students and minimize their contact with others (e.g., small cohorts of freshmen who live and learn together).
Students, faculty, and staff do not share objects (e.g., laboratory, art, or recreational equipment and supplies).
Regularly scheduled (e.g., at least daily or between uses) cleaning and disinfection of frequently touched areas occur as planned (i.e., on-time and consistently).
Medium Risk
Students, faculty, and staff follow all steps to protect themselves and others such as proper use of face masks, social distancing, and hand hygiene.
Hybrid learning model: Students participate in a mix of virtual learning and in-person learning for all courses (in-person learning is not limited to specific courses).
Students, faculty, and staff participate in larger in-person classes, activities, and events that allow people to remain spaced at least 6 feet apart (e.g., classroom with marked seating or seating removed to encourage sitting 6 feet apart).
Apply cohorting, alternating schedules, and staggered schedules with some exceptions in residence halls, dining areas, and recreational areas on campus.
Students, faculty, and staff participate in limited, small out-of-class social gatherings and events.
Students, faculty, and staff dine outside whenever possible, or in well ventilated rooms with social distancing applied.
Students and faculty share objects minimally (e.g., sharing of objects is limited to one person at a time for laboratory, art, or recreational equipment and supplies that cannot be purchased or assigned individually and that are wiped down with disinfectant, as possible, between uses).
Regularly scheduled cleaning and disinfection of frequently touched areas occur as planned with few exceptions.
Higher Risk
Students, faculty, and staff follow some steps to protect themselves and others at all times such as proper use of face masks, social distancing, and hand hygiene.
Students and faculty engage in in-person only learning, activities, and events.
Students, faculty, and staff attend several small out-of-class social gatherings and events.
Students, faculty, and staff dine in indoor dining rooms while maintaining social distancing.
Students and faculty share some objects (e.g., sharing of objects is limited to one group of students at a time for laboratory, art, or recreational equipment and supplies that cannot be purchased or assigned individually and that are wiped down with disinfectant, as possible, between uses).
Irregularly scheduled cleaning and disinfection of frequently touched areas.
Highest Risk
Use of public buses, campus buses/shuttles or other high occupancy enclosed vehicles with limited ventilation and/or that require students, faculty, or staff to have sustained close contract with others. CDC’s Protect Yourself When Using Transportation provides tips for minimizing your risk when using public transportation.
Students, faculty, and staff do not/are not required to follow steps such as proper use of face masks, social distancing, hand hygiene to protect themselves and others.
Students and faculty regularly engage in in-person learning, activities, and events.
Students, faculty, and staff attend large out-of-class social gatherings and events.
Students and faculty freely share objects.
Students, faculty, and staff dine in indoor dining rooms without social distancing.
Irregularly scheduled cleaning and disinfection of frequently touched areas.
COVID-19 is thought to spread mainly by respiratory droplets released when people talk, cough, or sneeze. It is thought that the virus may spread to hands from a contaminated surface and then to the nose or mouth, causing infection. Therefore, personal prevention practices (such as handwashing, staying home when sick) and environmental prevention practices (such as cleaning and disinfection) are important principles that are covered in this document. Fortunately, there are a number of actions IHE administrators can take to help lower the risk of COVID-19 exposure and spread.
Plan and Prepare
Review, update, and implement emergency operations plans (EOPs)
Most importantly, IHE administrators need to plan and prepare for reopening or keeping IHEs open. Regardless of the number of current cases in a community, every IHE should have a plan in place to protect staff and students from the spread of COVID-19. This should be done in collaboration with state, local, tribal, and territorial public health departments, the IHE’s university system (if applicable), and other relevant partners. IHEs should prioritize EOP components that address infectious disease outbreaks and related 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.
Readiness and Emergency Management for Schools (REMS) Technical Assistance (TA) Center’s websiteexternal icon has free resources, trainings, and TA for schools, including IHEs, and their community partners. Resources include those on emergency planning and response to infectious disease outbreaks. IHEs might find this guidance for developing a high-quality EOP helpful.
Workers (faculty and other school staff), students, and other community members should be involved in developing the EOP because broad worker and community involvement is needed.
Planning and strategies should include
Daily review of official public health data for the community surrounding the IHE to keep track of the current state of COVID-19 spread.
Development of information-sharing systems with school and community partners. Institutional information systems can be used for day-to-day reporting on number of cases and information, such as absenteeism or changes in student and staff health center traffic to detect and respond to an outbreak.
Ways to promote healthy behaviors that reduce the spread of COVID-19, maintain healthy campus environments and operations, and outline what to do if someone gets sick.
Ways to enforce or ensure compliance of healthy behaviors that reduce the spread of COVID-19.
Assessment of the accessibility of information and resources to reduce the spread of COVID-19 and maintain healthy environments.
Criteria for IHE suspension of in-person learning to stop or slow the spread of COVID-19, as well as criteria for determining when to resume in-person learning.
Strategies that ensure residents and staff use practices to reduce the risk of COVID-19 in the event of IHE suspension or need to self-quarantine for the following:
Continuing education
Meal programs
Continuity of housing
Other services

Considerations for students, faculty, and staff with disabilities and people who are at higher risk of severe illness from COVID.
Considerations for students, faculty, and staff with disabilities, including effective communication of the IHE’s COVID-related plans and accessibility of the IHE’s services.
Considerations for Limited English Proficient (LEP) students, faculty, and staff to ensure meaningful communication with them regarding the IHE’s practices to reduce the risk of COVID-19 and how to continue education, meals, other services, etc. (e.g., use of interpreters and translated materials).

Elections Toolkit
Resources to help reduce the risk of COVID-19 transmissions at polling locations.

Guiding Principles to Keep in Mind
The more an individual interacts with others, and the longer that interaction, the higher the risk of COVID-19 spread. Elections with only in-person voting on a single day are higher risk for COVID-19 spread because there will be larger crowds and longer wait times. Lower risk election polling settings include those with:
a wide variety of voting options
longer voting periods (more days and/or more hours)
any other feasible options for reducing the number of voters who congregate indoors in polling locations at the same time
The virus that causes COVID-19, is mostly spread by respiratory droplets released when people talk, cough, or sneeze. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. Personal prevention practices (such as handwashing, staying home when sick) and environmental cleaning and disinfection are important actions election officials, poll workers, and voters can take to help lower the risk of COVID-19 spread.

As public aquatic venues open in some areas, CDC offers the following considerations for the safety of those who operate, manage, and use public pools, hot tubs, and water playgrounds.

Public aquatic venues can be operated and managed by:
City or county governments
Apartment complexes
Membership clubs (for example, gyms)
Schools
Waterparks
Homeowners’ associations
All decisions about implementing these considerations should be made locally, in collaboration with local health officials. Operators of public aquatic venues can consult with local officials to determine if and how to implement these considerations while adjusting them to meet the unique needs and circumstances of the local jurisdiction. Their implementation should also be informed by what is feasible, practical, and acceptable.
Promoting behaviors that prevent the spread of COVID-19
Public aquatic venues can consider different strategies to encourage healthy hygiene, including:
Hand hygiene and respiratory etiquette
Encouraging all staff, patrons, and swimmers to wash their hands often and cover their coughs and sneezes.
Masks
Encouraging the use of masks as feasible. Masks are most essential in times when physical distancing is difficult.
Advise those wearing masks to not wear them in the water. Masks can be difficult to breathe through when they’re wet.

Staying home
Educating staff, patrons, and swimmers about when to stay home (for example, if they have symptoms of COVID-19, have tested positive for COVID-19, or were exposed to someone with COVID-19 within the last 14 days) and when they can safely end their home isolation.
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 percent alcohol (for staff and older children who can safely use hand sanitizer), and no-touch/foot pedal trash cans (preferably covered).
Signs and messages
Maintaining healthy environments
To maintain healthy environments, operators of public aquatic venues may consider:
Cleaning and disinfection
Cleaning and disinfecting frequently touched surfaces at least daily and shared objects each time they are used. For example:

Handrails, slides, and structures for climbing or playing
Lounge chairs, tabletops, pool noodles, and kickboards
Door handles and surfaces of restrooms, handwashing stations, diaper-changing stations, and showers

Consulting with the company or engineer that designed the aquatic venue to decide which List N disinfectants approved by the U.S. Environmental Protection Agencyexternal icon (EPA) are best for your aquatic venue.
Setting up a system so that furniture (for example, lounge chairs) that needs to be cleaned and disinfected is kept separate from already cleaned and disinfected furniture.
Labeling containers for used equipment that has not yet been cleaned and disinfected and containers for cleaned and disinfected equipment.
Laundering towels and clothing according to the manufacturer’s instructions. Use the warmest appropriate water temperature and dry items completely.
Protecting shared furniture, equipment, towels, and clothing that has been cleaned and disinfected from becoming contaminated before use.
Ensuring safe and correct use and storage of disinfectants, including storing products securely away from children.
Ventilation
Ensuring that ventilation systems of indoor spaces operate properly.
Increasing introduction and circulation of outdoor air as much as possible by opening windows and doors, using fans, or other methods. However, do not open windows and doors if doing so poses a safety risk to staff, patrons, or swimmers.
Water systems
Taking steps to ensure that all water systems (for example, drinking fountains, decorative fountains, hot tubs) are safe to use after a prolonged facility shutdown to minimize the risk of Legionnaires’ disease and other diseases associated with water.
Modified layouts
Changing deck layouts to ensure that in the standing and seating areas, individuals can remain at least 6 feet apart from those they don’t live with.
Physical barriers and guides
Ensuring staff, patrons, and swimmers stay at least 6 feet apart from those they don’t live with, both in and out of the water, by providing:
Physical cues or guides, such as lane lines in the water or chairs and tables on the deck
Visual cues, such as tape on the decks, floors, or sidewalks
Signs

Communal spaces
Staggering use of communal spaces (for example, in the water or breakroom), if possible, and cleaning and disinfecting frequently touched surfaces at least daily and shared objects each time they are used.
Shared objects
Discouraging people from sharing items that are difficult to clean, sanitize, or disinfect or that are meant to come in contact with the face (for example, goggles, nose clips, and snorkels).
Discouraging the sharing of items such as food, equipment, toys, and supplies with those they don’t live with.
Ensuring adequate equipment for patrons and swimmers, such as kick boards and pool noodles, to minimize sharing to the extent possible, or limiting use of equipment by one group of users at a time and cleaning and disinfecting between use. 
Maintaining healthy operations
To maintain healthy operations, operators of public aquatic venues may consider:
Protections for vulnerable staff
Offering options such as telework or modified job responsibilities that reduce their risk of getting infected.
Limiting aquatic venue use to only staff, patrons, and swimmers who live in the local area, if feasible.
Lifeguards and water safety
Ensuring that lifeguards who are actively lifeguarding are not also expected to monitor handwashing, use of masks, or social distancing of others. Assign this monitoring responsibility to another staff member.
Alterations of public aquatic venues
Consulting the company or engineer that designed the aquatic venue before altering aquatic features (for example, slides and structures designed for climbing or playing).
Regulatory awareness
Being aware of local or state regulatory agency policies on gathering requirements or recommendations to determine if events, such as aquatic fitness classes, swim lessons, swim team practice, swim meets, or pool parties can be held.
Staggered or rotated shifts
Staggering or rotating shifts to limit the number of staff present at the aquatic venue at the same time.
Designated COVID-19 point of contact
Designating a staff member to be responsible for responding to COVID-19 concerns. All staff should know who this person is and how to contact him or her.
Gatherings
Avoiding group events, gatherings, or meetings both in and out of the water if social distancing of at least 6 feet between people who don’t live together cannot be maintained. Exceptions to the social distancing guidance include:

Anyone rescuing a distressed swimmer, providing first aid, or performing cardiopulmonary resuscitation, with or without an automated external defibrillator.
Individuals in the process of evacuating an aquatic venue or entire facility due to an emergency.

If planned events must be conducted, staggering drop-off and pick-up times, as much as possible, to maintain distance of at least 6 feet between people who don’t live together.
Asking parents to consider if their children are capable of staying at least 6 feet apart from people they don’t live with before taking them to a public aquatic venue.
Limiting any nonessential visitors, volunteers, and activities involving external groups or organizations.
Communication systems
Putting systems in place for:

Having staff, patrons, and swimmers self-report if they have symptoms of COVID-19, a positive test for COVID-19, or were exposed to someone with COVID-19 within the last 14 days.
Notifying local health authorities of COVID-19 cases.
Notifying staff, patrons, and swimmers (as feasible) of potential COVID-19 exposures while maintaining confidentiality in accordance with the Americans with Disabilities Act (ADA)external icon.
Notifying staff, patrons, and swimmers of aquatic venue closures.

Leave policies
Implementing sick leave (time off) policies and practices for staff that are flexible and non-punitive.
Developing return-to-work policies aligned with CDC’s criteria to discontinue home isolation.
Back-up staffing plan
Monitoring absenteeism of staff and creating a roster of trained back-up staff.
Staff training
Training staff on all safety protocols.
Conducting training virtually or ensuring that social distancing is maintained during in-person training.
Recognize signs and symptoms
Conducting daily health checks (for example, temperature screening or symptom checking) of staff. Ensure safe and respectful implementation that is aligned with any applicable privacy laws and regulations.

Preparing for when someone gets sick
To prepare for when someone gets sick, operators of public aquatic venues may consider:
Isolating and transporting those who are sick to their home or a healthcare provider
Immediately separating staff, patrons, or swimmers with COVID-19 symptoms (for example, fever, cough, or shortness of breath).
Establishing procedures for safely transporting anyone sick to their home or to a healthcare provider.
Notifying health officials and close contacts
Cleaning and disinfection
Closing off areas used by a sick person and not using the areas until after cleaning and disinfecting them.
Waiting more than 24 hours before cleaning and disinfecting these areas. Ensuring safe and correct use and storage of EPA-approved List N disinfectantsexternal icon, including storing products securely away from children. 
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Conduct a thorough COVID-19 hazard assessmentexternal icon of the workplace to identify scenarios where workers cannot stay at least 6 feet from each other or customers. Follow the hierarchy of controls to address these situations, including engineering controls, workplace administrative policies, and the use of personal protective equipment (PPE).
Create a COVID-19 Workplace Health and Safety Plan
Start by reviewing the CDC Interim Guidance for Businesses and Employers, which provides guidelines and recommendations that all employers can use to protect their employees and customers. Actions taken should be based on analysis of ongoing community transmission, local factors, and bank-specific conditions.
Identify where and how employees might be exposed to COVID-19Employers are responsible for providing a safe and healthy workplaceexternal icon.
Conduct a thorough hazard assessmentexternal icon in the bank to identify potential workplace hazards related to COVID-19.
In addition to the main public areas where employees interact with customers, identify other areas that may lead to close contact (within 6 feet) among employees (e.g., conference rooms, offices, cubicles, safe deposit vaults, break rooms, entrances, and exits).
Follow CDC guidance and work with local and/or state public health authorities and occupational safety and health professionals to decide if and how you will test employees and do workplace contact tracing of those who test positive for COVID-19.
Develop hazard controls using the hierarchy of controls to prevent infection among employees. Include a combination of controls noted below
Isolate people from the hazards (Engineering controls)
Adjust workstations, if needed, to help employees stay at least 6 feet away from each other and customers (social distancing).
Install transparent shields or other barriers where social distancing is not an option (e.g., teller counters).
Shields should be able to withstand frequent cleaning.

Separate employees from each other and from customers in all other areas of the bank, such as public counters, conference rooms, offices, cubicles, safe deposit vaults, break rooms, parking lots, entrances, and exits.
Use visual cues such as floor markings and signs to encourage social distancing.
Close or limit access to common areas where employees are likely to gather and interact.

Remove or strategically space chairs in waiting areas to discourage social gathering and maintain social distancing.
Only allow the number of customers in the bank for stations that are open. A door greeter can assist by managing the flow of customers.

Bank managers should work with their facility manager to adjust the ventilation so the maximum amount of fresh air is delivered to occupied spaces and the humidity is 40%-60%. If possible, increase filter efficiency of HVAC units to highest level.
Portable high efficiency particulate air (HEPA) filtration units may be considered to remove contaminants in the air.
More considerations for improving the building ventilation system can be found in the CDC Interim Guidance for Businesses.
Change the way people work (Administrative controls)
Consider conducting daily health checks of employees before they enter the facility.
Screening options could include taking employees’ temperature and assessing potential symptoms before they start work.
Employees should stay at least 6 feet apart while waiting for screening.
For customers with appointments, consider screening them by telephone for symptoms of COVID-19 before their appointment. If the customer reports symptoms of a respiratory illness, recommend they reschedule their appointment.
During times of known community transmission, consider allowing only customers with an appointment to enter the building.

Stagger shifts, start times, and break times as feasible to reduce crowding and ensure employees can stay least 6 feet away from each other.
Implement flexible worksites (e.g., telework) for positions where in-person contact is not required.
Encourage customers to use drive-thru banking services, automated teller machines (ATMs), online banking, or the mobile banking app for routine transactions that do not require personal assistance.
Avoid in-person meetings when possible. Consider using teleconferencing or videoconferencing instead.
When teleconferencing or videoconferencing is not possible, hold meetings in open, well-ventilated spaces, stay at least 6 feet apart, and wear cloth face coverings.

Consider discontinuing the use of customer deposit/withdrawal slip stations.
Consider providing disposable pens.
Clean and disinfect high-touch surfaces.
For high-touch surfaces, use products that are EPA-registeredexternal icon, diluted household bleach solutions, or alcohol solutions with at least 70% alcohol, appropriate for surface disinfection.
If surfaces are dirty, clean them using a detergent or soap and water before you disinfect them.

Provide sanitizing materials so high-touch surfaces (e.g., ATMs, drive-thru equipment, pens, cash drawers, time clocks, break room tables and chairs, vending machines, railings, door handles, customer deposit/withdrawal slip stations) can be properly wiped down before each use. Place posters or signspdf icon to remind employees to disinfect workspaces and equipment after use.
Conduct targeted and more frequent cleaning of high-touch surfaces.

Give employees enough time to wash and dry their hands, and provide accessible sinks, soap, water, and a way to dry their hands (e.g., paper towels, hand dryer).
Remind employees to wash their hands often with soap and water for at least 20 seconds. If soap and water are not available, they should use hand sanitizer with at least 60% alcohol between different customer transactions.
Provide hand sanitizer, tissues, and no-touch waste baskets at teller stations and desks.
Encourage employees to avoid touching their eyes, nose, and mouth with unwashed hands.

Post signs and reminders at entrances and in strategic places listing the signs and symptoms of infection, the importance of handwashing, and how to cover coughs and sneezes. This should include alternative formats for non-English speakers and populations with disabilities, including signs in braille and larger prints, as needed.
When exchanging currency or coins, employees should:
Wipe the counter between each customer.
Avoid touching their face.
Clean their hands often after touching money or paperwork handled by customers.

Remind employees that some people can spread COVID-19 even if they do not have symptoms. Consider all close contact (within 6 feet) with employees, customers, and others as a potential source of exposure.
Remind employees to cover their mouth and nose with a tissue when they cough or sneeze, or use the inside of their elbow. Throw away used tissues into no-touch trash cans and immediately wash hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer containing at least 60% alcohol. Learn more about coughing and sneezing etiquette on the CDC website.
Use cloth face coverings as appropriate
Recommend that workers wear a cloth face covering. Cloth face coverings are intended to protect other people—not the wearer. They are not considered to be PPE, which protects the wearer.
Make sure employees know how to put on and take off a cloth face covering safely.
Cloth face coverings should be washed after each use.
Cloth face coverings should not be worn if they create a new risk (e.g., if they interfere with driving or vision, or contribute to heat-related illness).

Consider requiring visitors to the workplace (service personnel, customers) to also wear cloth face coverings when social distancing cannot be maintained.
Protect Employees with Personal Protective Equipment (PPE)
The Occupational Safety and Health Administration (OSHA) has created Guidance on Preparing Workplaces for COVID-19pdf iconexternal icon to reduce worker exposure to COVID-19 based on the OSHA occupational risk pyramidpdf iconexternal icon. OSHA has divided job tasks into four levels (low, medium, high, and very high) of exposure risks to COVID-19 on the job.
For most bank employees, an OSHA exposure risk level of “low” is appropriate.
PPE is not recommended for employees in the lower exposure risk group.
The hazard assessment may determine that some employees have a higher risk level and need PPE.

Whether you test positive or negative for COVID-19 on a viral or an antibody test, you still should take steps to protect yourself and others.
We do not know how much protection (immunity) antibodies to the virus might provide against getting infected again. Confirmed and suspected cases of reinfection have been reported, but remain rare. Scientists are working to understand this.  

Updates have been made to align with the new school resources and tools that were released on July 23rd and 24th and the latest COVID-19 information.
Changes to the considerations as of August 21, 2020:
Expanded considerations on planning and preparing schools before opening
Updated considerations on ventilation
Updated considerations on food service
Updated considerations for students who may be unable to wear masks
Updated considerations for students with special healthcare needs and disabilities
Updated considerations on cohorting, staggering, and alternating strategies
Updated considerations on recognizing signs and symptoms of COVID-19 and screening
Updated considerations on coping and support
Updated considerations on making plans for accommodations
Updated considerations for Direct Service Providers (DSPs)

Considerations for schools
As communities in the United States consider how to safely re-open K-12 school buildings and in-person services, CDC offers updated considerations for mitigation strategies that K-12 school administrators can use to help protect students, teachers, and staff and slow the spread of 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:
Promoting behaviors that reduce COVID-19’s spread
Maintaining healthy environments
Maintaining healthy operations
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 and done with close communication with state and/or local public health authorities and 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).
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.

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Guiding principles to keep in mind
Everyone’s goal is to prioritize the reopening of schools as safely and as quickly as possible given the many known and established benefits of in-person learning. In order to enable this and assist schools with their day-to-day operations, it is important to adopt and diligently implement actions to slow the spread of COVID-19 inside the school and out in the community. Vigilance to these actions will moderate the risk of in-school transmission regardless of the underlying community burden – with risk being the lowest if community transmission is low and there is fidelity to implementing proven mitigation strategies.
The statement The Importance of Reopening America’s Schools this Fall highlights that parents and school leaders are very eager for schools to reopen, but understandably concerned about the health and safety of their children during the COVID-19 pandemic.
Children and COVID-19
In general, children with COVID-19 are less likely to have severe symptoms than adults or experience an asymptomatic infection – meaning they do not have any signs or symptoms of disease (1-7).
Analysis of pediatric COVID-19 hospitalization data from 14 states from early March to late July 2020 found the cumulative rate of COVID-19–associated hospitalization among children was over 20 times lower compared to adults (8.0 versus 164.5 per 100,000 population) (8). Although the cumulative rate is low, one in three children hospitalized with COVID-19 was admitted to an intensive care unit so the risk is not negligible (8). Similarly, the death rate among school-aged children is much lower than the rate among adults (9, 10). Also, the comparatively low risk for hospitalization and death among children themselves must be contextualized to the risk posed to teachers, school administrators, and other staff in the school environment. The risk of teachers, school administrators, and other staff in the school is expected to mirror that of other adults in the community if they contract COVID-19.
To be sure, the best available evidence from countries that have reopened schools indicates that COVID-19 poses low risks to school-aged children – at least in areas with low community transmission. That said, the body of evidence is growing that children of all ages are susceptible to SARS-CoV-2 infection (3-7) and, contrary to early reports (11, 12), might play a role in transmission (7, 13, 14).
The many benefits of in-person schooling should be weighed against the risks posed by COVID-19 spread. Of key significance, in-person learning is in the best interest of students, when compared to virtual learning. Application and adherence to mitigation measures provided in this document and similar to those implemented at essential workplaces can help schools reopen and stay open safely for in-person learning.
Deciding how to reopen
School officials should make decisions about school reopening based on available data including levels of community transmission and their capacity to implement appropriate mitigation measures in schools to protect students, teachers, administrators, and other staff. Schools should also consider other aspects of students’ risk and wellbeing that arise when schools do not reopen for in-person classes. This includes the potential adverse impacts on students’ social-emotional, behavioral, and mental health, as well as the critical services provided to students to help mitigate health disparities and serve children in need, such as school lunch programs, special education services, after-school programs and mental health services.
The unique and critical role that schools play makes them a priority for reopening and remaining open, enabling students to receive both academic instruction and enable the provision of other critical services and supports. By strictly implementing mitigation strategies, schools will be able to meet the needs of their students and community, while reducing the risk of COVID-19 spread.
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Taking actions to lower the risk of COVID-19 spread
COVID-19 is mostly spread by respiratory droplets released when people talk, cough, or sneeze. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own eyes, nose, or mouth. 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 model of learning and implementation of proven mitigation strategies
In general, the risk of COVID-19 spread in schools increases across the continuum of virtual, hybrid, to in-person learning with the risk moderated for hybrid and in-person learning based upon the range of mitigation strategies put in place and the extent they are conscientiously 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, activities, and events
Some risk:
Hybrid Learning Model: Some students participate in virtual learning and other students participate in in-person learning
Small, in-person classes, activities, and events
Cohorting, alternating schedules, and staggered schedules are applied rigorously
No mixing of groups of students and teachers throughout/across school days
Students and teachers do not share objects
Students, teachers, and staff follow all steps to protect themselves and others at all times including proper use of face masks, social distancing, hand hygiene
Regularly scheduled (i.e., at least daily or between uses) cleaning and disinfection of frequently touched areas implemented with fidelity
Medium risk:
Hybrid Learning Model: Most students participate in in-person learning, some students participate in virtual learning
Larger in-person classes, activities, and events
Cohorting, alternating schedules, and staggered schedules are applied with some exceptions
Some mixing of groups of students and teachers throughout/across school days
Students and teachers minimally share objects
Students, teachers, and staff follow all steps to protect themselves and others such as proper use of face masks, social distancing, hand hygiene
Regularly scheduled cleaning and disinfection of frequently touched areas largely implemented with fidelity
Higher risk:
Students and teachers engage in in-person only learning, activities, and events
Students minimally mix between classes and activities
Students and teachers share some objects
Students, teachers, and staff follow some steps to protect themselves and others at all times such as proper use of face masks, social distancing, hand hygiene
Irregular cleaning and disinfection of frequently touched areas
Highest risk:
Students and teachers engage in in-person only learning, activities, and events
Students mix freely between classes and activities
Students and teachers freely share objects
Students, teachers, and staff do not/are not required to follow steps to protect themselves and others such as proper use of face masks, social distancing, hand hygiene
Irregular cleaning and disinfection of frequently touched areas
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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 contract symptoms consistent 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.

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.
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Promote behaviors that reduce spread of COVID-19

Schools may consider implementing several strategies to encourage behaviors that reduce the spread of 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 school.
Actively encourage employees and students who are sick or who have recently had close contact (less than 6 feet for fifteen minutes or more) with a person with COVID-19 to stay home. 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 if they have tested positive for or are showing COVID-19 symptoms.
Staff and students who have recently had close contact with a person with COVID-19 should also stay home and monitor their health.
CDC’s criteria can help inform when employees should return to work:
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 use of masks. The use of masks is one of many important mitigation strategies to help prevent the spread of COVID-19. Masks are meant to protect other people in case the wearer is unknowingly infected but does not have symptoms. Masks are not Personal Protective Equipment (PPE) (e.g., surgical masks, respirators).
Appropriate and consistent 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

Younger students, such as those in early elementary school (Pre-K through 3rd 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 percent 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.
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Maintaining healthy environments

School administrators may consider implementing several strategies to maintain healthy environments.
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 at least daily or between use as much as possible. Use of shared objects (e.g., gym or physical education equipment, art supplies, toys, games) should be limited when possible, or cleaned between use.
Develop a schedule for increased frequency of routine cleaning and disinfection.
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 and disinfect school buses or other transport vehicles, see guidance for bus transit operators.
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 and clean and disinfect between 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 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 window fan placement in exhaust mode can help draw fresh air into room via other open windows and doors without generating strong room air currents).
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).
Inspect and maintain local exhaust ventilation in areas such as bathrooms, 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 nurse’s office and special education classrooms).
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 SARS-CoV-2, 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

Whether you test positive or negative for COVID-19 on a viral or an antibody test, you still should take steps to protect yourself and others.
We do not know how much protection (immunity) antibodies to the virus might provide against getting infected again. Confirmed and suspected cases of reinfection have been reported, but remain rare. Scientists are working to understand this.  

The guide compares the District Health Information Software (DHIS2), the Surveillance, Outbreak Response Management and Analysis System (SORMAS), Go.Data, Open Data Kit (ODK), Epi Info, CommCare, KoboToolbox, Excel, and paper.  Each has been deployed in various countries for contact tracing, investigations, and/or, in the case of DHIS2 and SORMAS, national surveillance. Paper is also included because it continues to be used and there are a number of resources available online for the COVID-19 response.​​
This guide is not meant to be an all encompassing guide to all available tools or features. Rather is it  focused on the primary tools that are being reported to CDC and the functions that are commonly asked about. It  is meant to be a dynamic resource that will be updated as additional tools are reported from the field offices and as additional questions about the functional elements arise.