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COVID-19 (Disease caused by SARS-CoV-2

What is COVID-19 (Disease caused by SARS-CoV-2)?

COVID-19 is a respiratory disease caused by SARS-CoV-2, a coronavirus discovered in 2019 that caused a worldwide pandemic. Different variants of the virus have emerged over time. 

Signs and symptoms

The signs and symptoms of COVID-19 can vary based on the variant that is causing the illness and based on vaccination status.

  • Fever (100.4°F or higher)
  • Fatigue
  • Headache
  • Myalgia
  • Cough
  • Nasal congestion or rhinorrhea
  • New loss of taste or smell
  • Sore throat
  • Shortness of breath or difficulty breathing
  • Diarrhea
  • Nausea or vomiting
  • Poor appetite or poor feeding
  • Children infected with SARS-CoV-2 may have many of these nonspecific symptoms, only have a few (such as only upper respiratory symptoms or only gastrointestinal symptoms), or may be asymptomatic. The most common symptoms in children are cough and/or fever.

Incubation period

Thought to extend to 14 days, with a median time of onset of 3-5 days. The incubation period may be shorter or longer depending on the variant that is circulating. 

Contagious period and spread

  • A person is assumed to be contagious two days before they start having symptoms and for 10 days after symptoms start regardless of vaccination status.
  • In children too young or unable to reliably report their symptoms, parent/guardians, caregivers and teachers should monitor for symptoms and other age-appropriate signs of disease, including decreased appetite or activity. 
  • Symptomatic individuals should be tested as soon as possible after symptoms develop and seek clinical evaluation if symptoms become severe or concerning (such as trouble breathing).

Public health reporting requirements

  • Schools are able to disclose case information to public health without prior written consent under FERPA’s health or safety emergency exception, because a person with COVID-19 represents a potential threat to the health and safety of others at the school. This is true even if there is not an outbreak.  
  • Outbreaks of COVID-19 can cause significant increases in absenteeism among staff and students. Outbreak thresholds may be difficult to determine in school or child care settings. However, significant increases in school or child care absenteeism resulting from COVID-19-like illness should be reported to local public health agencies within four hours, per 6 CCR 1009-1.
  • Generally speaking, a situation is considered an outbreak if there is an increase in the number of ill children and/or staff members at the school or child care center. 
  • More information on reportability of respiratory illnesses in schools and child care are on CDPHE’s website under the link titled “Guidance for Prevention and Control of Viral Respiratory Illnesses in School and Childcare Settings.”
  • Schools and child care providers can report outbreaks by:

Control of spread

  • The virus spreads mainly from person-to-person through respiratory droplets produced when an infected person coughs, sneezes, or talks. Some people who are infected may not have symptoms.
  • The state continues to recommend a layered approach of best practices to prevent COVID-19 outbreaks. These best practices to prevent the spread of COVID-19 and other respiratory viruses include vaccination, staying home when sick (exclusion), increased ventilation, handwashing, cleaning, and disinfection. 

Vaccination

Routine child/adolescent recommendations:

  • COVID-19 vaccination is recommended for everyone ages 6 months and older, based on age and status of a person’s immune system. People with weakened immune systems may need additional or more frequent vaccine doses. 

Colorado school-required vaccines:

  • There is no school vaccine requirement for COVID-19 vaccine.

Routine adult/other recommendations:

Additional strategies can be used in response to increases in cases and when outbreaks are detected, including  maximization of outdoor activities, mask-wearing, testing, and limiting large and crowded gatherings and mixing between grades, classrooms and other groups. These strategies continue to be important for preventing the transmission of many infectious diseases in schools.

Consult with local public health for assistance with implementation of control measures.

Treatment

Treatment of COVID-19 in hospitalized patients remains largely supportive and includes management of complications For certain children, especially with underlying medical conditions, treatment may be recommended.

Exclusion

  • Ensuring people who are ill stay home is critical to preventing the spread of COVID-19 and other respiratory illnesses. 
  • Students and staff with symptoms or respiratory illness should refer to the guidance and exclusion criteria for respiratory illness symptoms and stay home until they are fever free for at least 24 hours without the use of fever-reducing medications (fever defined as a temperature of 100.4oF or higher) and all other symptoms of respiratory illness, including cough, are resolved or improved for at least 24 hours. 
  • Separate children and students who are ill from others until they can be picked up by a parent or guardian.

Additional precautions are recommended for at least five days following the return of anyone recovering from respiratory symptoms, including increased hand and respiratory hygiene, improved ventilation, masking, physical distancing, and testing. 

Additional exclusion criteria are listed in a previous section: Exclusion Guidelines for Children and Staff.

Role of teachers, caregivers, and families

  • Get COVID-19 vaccines as soon as recommended, based on age and immunocompromised status.
  • Encourage students and staff to stay home when sick or potentially contagious.
  • Provide adequate ventilation to occupied spaces. Increase filtration of indoor air through HVAC and/or with HEPA portable air cleaners.
  • When symptomatic or after a recent exposure, consider wearing a mask indoors and around others.
  • Practice good hand and respiratory hygiene. Some people may choose to wear a mask for added protection, and it is important to respect everyone’s choice.
  • Clean shared spaces and objects appropriately. Increase frequency of disinfection when cases increase. 
  • Notify students, staff, and parents/guardians of known outbreaks so all individuals are appropriately informed, will monitor closely for symptoms, and may choose to increase personal mitigation measures as necessary. 

Resources