DOYLESTOWN >> Acting on new information from area hospitals, the Bucks County Health Department on August 17 revised the county’s school guidance to include a recommendation for masking of all students.
All other school guidance issued Sunday, August 15 by the county remains in effect. The statement from Health Department Director Dr. David Damsker announcing the change follows:
"From the beginning of the pandemic, the Bucks County Health Department has worked collaboratively with our schools and hospitals to gather data and develop sensible guidance for our community. The guidance issued most recently to the schools was done in partnership with the district superintendents and was designed to allow the districts to make decisions based on data provided to them by the Health Department. While our cases have increased in Bucks over the past few weeks, our hospitalizations and deaths have not risen in a corresponding way. Our hospitals have effectively handled the rise in cases.
"Just today, however, the partnership we have with our hospitals has given us new information which causes us to update our previous recommendations.
"Even under normal circumstances, hospitals in Bucks County have limited ability to treat severe pediatric cases of any type. As our hospitals must refer all serious cases to pediatric specialty hospitals in the region, many of those same specialty pediatric hospitals are already operating at close to capacity because of non-COVID illnesses and staffing issues. While our COVID-19 cases among school-aged children remain very low, hospitals are growing concerned that any pediatric COVID-19 cases could stress the system.
"Because of this, hospitals in Bucks County have recommended that schools begin the fall semester with a mask requirement.
"As a result of this new information provided by our partner hospitals, we support their recommendation to follow CDC guidance on masking in schools. This is particularly important for students who are unvaccinated, which includes all students under 12. We continue to urge, in the strongest possible sense, that everyone get vaccinated.
"The remainder of the county’s recently released guidance remains in effect. The Health Department will continue as an active partner with our schools and hospitals as we navigate through this ongoing fight."
The following guidance was released by the Bucks County Health Department on Sunday, August 16:
As the new school year approaches, the Bucks County Health Department (BCHD) wishes to provide school entities with guidance to assist in their back-to-school planning. The COVID-19 pandemic continues to be a fluid situation with ebbs, flows, and variants. Accordingly, the BCHD has and will continue to adjust its guidance and
recommendations as necessary. In Bucks County, cases have only increased modestly, and are well below their peak in December, 2020. In fact, as of the date this memo was issued, Bucks County as a whole averages 9 cases per day of school-aged children.
While some may be looking for County-wide mandates, neither the Bucks County Commissioners nor the BCHD can dictate to independently-elected school boards or school district superintendents how to manage their schools or students. Further, the BCHD cannot provide legal advice to school districts. Any BCHD school guidance is strictly advisory, though all state and federal guidelines acknowledge and recommend the importance of working in collaboration with local health authorities to create these plans.
Thankfully, all available evidence in Bucks County – and elsewhere – indicates that while serious illness in children with COVID-19 is possible, it is very rare. There is also clear consensus that students learn best while in school, and there is no substitute for the advantages that in-person learning provides. The effects of ongoing COVID-19 mitigation efforts have led to significant learning loss, mental health issues, and social adjustment difficulties in many students. Understandably, many parents are concerned about these effects in their children.
We understand that some parents also have safety concerns for children under 12 that are still unable to be vaccinated. Parents are empowered to make choices based on those concerns, including masking their children regardless of school district masking policies.
Knowing these facts about COVID-19, school boards, and their administrations have the unenviable task of making decisions about what plans to implement and what guidance to follow. During the 2020-21 school year, school districts and daycares followed guidance from multiple sources, including the BCHD, and under very difficult circumstances educated our children while keeping them safe.
In an effort to provide some clarity for the upcoming school year, the BCHD has put together the following FAQ. These responses are based on science, years of public health policy, 18 months of accumulated local experience with the pandemic, and common sense. Both the Commissioners and the BCHD are aware that a full return to school is a critically important issue for the mental health and educational development of our children.
Ultimately, the collective objective for all stakeholders is to keep our children and communities safe. The BCHD continues to be available to review health and safety plans that public-school districts, private schools, or daycares wish to submit, in order to help achieve that goal.
Frequently Asked Questions
What is the BCHD’s position on CDC guidance?
The BCHD recognizes that school districts must review guidance from federal, state and local health authorities in their decision-making process. In addition to broad CDC guidance that attempts to cover the needs of all 50 states, and guidance from the Pennsylvania Department of Health for the entire Commonwealth, schools in Bucks County have the opportunity to work collaboratively with the BCHD, as the local health authority, to incorporate specific localized guidance based on their current data. Even within Bucks County itself, factors such as population density, case counts, and vaccination rates vary, with some areas in the County more impacted by COVID-19 than others. This variability within our County further illustrates the point that a one-size-fits-all approach to disease mitigation may not always be the most prudent approach at any level. Working with the BCHD, school districts can analyze data in order make locally-informed decisions. Indeed, it was through this data-based collaboration and local perspective, which allowed for our successful return to in-person school last year. The partnership between the BCHD and school districts resulted in near daily conversations and consultations that allowed for both safe classroom environments and best practices for mitigation. This collaboration will continue throughout the upcoming school year and beyond.
What is the BCHD’s position on vaccines?
The BCHD unequivocally recommends that everyone eligible get vaccinated. The BCHD knows that vaccines are safe, effective, and the best tool we have to mitigate COVID-19. Vaccines are proven to reduce symptoms and substantially reduce death and hospitalizations due to COVID-19. The existing data, both here in Bucks County and nationally, show the overwhelming majority of people getting seriously ill from COVID-19 are those who are unvaccinated. We recommend that school districts consider mandating vaccination for all school staff and teachers, a position supported by National Education Association (NEA) and American Federation of Teachers (AFT) nationally. Similar requirements have existed, and been successful, for decades.
What is the BCHD’s position on masks/face coverings in schools?
For the start of the school year, we recommend that at a minimum, schools should adopt a “mask-optional” policy. Moving forward, the BCHD only recommends the use of Targeted Temporary Mitigation (TTM), wherein school districts consider making mitigation decisions in consultation with the BCHD based on their local data and for specific situations. “Targeted” means it’s not a one-size-fits-all approach, and instead, is in response to individual situations and needs. Mitigation measures should be crafted in order not to affect healthy, nonexposed individuals, when possible. “Temporary” means that all mitigation be time limited to meet the needs of the specific issue at hand, rather than imposed without a defined end. To help inform their TTM decisions, the BCHD will supply each school district with data, such as current COVID-19 cases broken down by zip codes. The BCHD may recommend TTM efforts that include actions such as time-limited mask/face covering requirements for children under 12 years of age, or briefly requiring masks/face coverings for individuals in elementary school classrooms in which there are known outbreaks of multiple cases. The TTM approach mirrors similar and successful mitigation efforts supported by BCDH in schools for decades in response to various diseases. While those diseases and COVID-19 present different challenges, TTM efforts remain the gold standard from a public health perspective. Public health authorities strive to limit their response to the least restrictive action for the least period of time in order to achieve the desired outcomes for public health. Additionally, the BCHD supports enhanced TTM efforts in clinical and healthcare-like school settings, and will discuss further recommendations for those situations with school entities.
What is the BCHD’s position on masks/face coverings on school buses?
The CDC has issued an order that requires masks/face coverings to be worn on all forms of public transportation. Each school district must work with their solicitor to interpret this order and its applicability.
What is the BCHD’s position on sick or symptomatic students/staff in the classroom?
The BCHD strongly recommends school districts consider that any student/staff exhibiting fever or multiple symptoms should be excluded from school until those symptoms have resolved and are fever-free for 24 hours without medication, in accordance with existing protocols and best practices. School districts may also consider utilizing TTM in other appropriate situations, such as a temporary face covering for an individual displaying symptoms while in school. The BCDH is committed to providing more detailed guidance to support school nurses on these issues throughout Bucks County schools.
What is the BCHD’s position on contact tracing and notifications?
The BCHD continues to focus its limited resources by contact tracing in the highest-risk settings that include congregate care facilities, corrections, and nursing homes. However, we strongly recommend that school districts urge parents to report their child’s confirmed case of COVID-19 to the school nurse or staff designee, and for districts to send notification to the parents of all students in that child’s classroom, specifically in schools with unvaccinated children under the age of 12. The BCHD will closely monitor COVID-19 and its variants, and TTM may include a return to additional contact tracing for a period of time if it becomes necessary.
What is the BCHD’s position on isolation and quarantine?
The BCHD strongly recommends that school districts consider requiring any symptomatic students/staff who test positive for COVID-19 be excluded from school until symptoms have resolved and they are fever-free for 24 hours. Infectiousness peaks around the time of symptom onset and declines quickly during the first several days of symptoms. Schools may then elect to require a positive individual to wear a mask/face covering upon return to school through the 7th day from symptom onset, if applicable. Individuals who test positive but are fully asymptomatic should wait at least 3 days from the test date prior to returning to school in order to ensure they are not just pre-symptomatic (about to become symptomatic.) Based on BCDH case investigations throughout the pandemic, COVID-19 transmission within a household was very unlikely from individuals who, as the first known positive case in the household, remained asymptomatic through the course of the infection. As such, the BCHD believes individuals who have not yet developed any symptoms more than 3 days from a positive test can safely return to school. Schools may then elect to require a positive individual to wear a mask/face covering upon return to school through the 7th day from the test date. Fully asymptomatic Individuals with a known non-ongoing (i.e. not in their household) exposure to COVID-19 may continue in school normally unless any symptoms develop, in which case they should either remain home, or be evaluated by a school nurse if at school. Fully asymptomatic individuals with an ongoing household exposure to COVID-19 should be required to wear a mask/face covering at school for a minimum of one week from the symptom onset of the household member. For fully asymptomatic individuals in households with multiple positives, the mask wearing period may be extended. If any symptoms develop during this timeframe, the individual should be immediately excluded.
What is the BCHD’s position on social distancing and classroom capacity limits?
The BCHD supports any school district efforts to socially distance when feasible, while still prioritizing the importance of in-person instruction. There is no need to limit classroom capacity at this time.
What is the BCHD’s position on testing?
The BCHD is committed to providing assistance, resources, and funding to support rapid testing protocols for symptomatic individuals for stakeholders to keep schools open. Where can school districts, parents, and stake holders access pertinent data?
Please visit buckscounty.gov and click on the COVID-19 button. For any data not found on the site, the BCHD will work with school districts to provide additional information they can use to establish TTM policies. The BCHD encourage school districts to share data with the community as appropriate to empower parents to make informed choices for their children.