Returning to School (12 years)

The preventive guidance to returning to school during COVID-19

Introduction

Creating healthy learning environment has always been a priority at all educational institutions and this will be achieved by preventing infectious disease transmission inside the educational institutions and between teaching staff and students. The basic structure of the educational institutions including the huge number of staff and students required creating guidance and instructions that help in reducing the transmission of any infectious diseases in general and COVID-19 disease in particular.

The Purpose of this Guidelines:

With the sustained increase in COVID-19 cases and the different prevalence rates between the regions of the Kingdom, this guidance was developed to achieve the following objectives:

Ensure a safe return to schools and creating a healthy environment.
Reduce the spread of COVID-19 in schools.
Protect students and staff.

Targeted group:

Educational and administrative cadres and school workers.
health workers.

About The New Corona Virus (COVID-19)

Novel coronavirus (COVID-19) belongs to a large family of viruses that cause diseases ranging from common colds to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV).

Symptoms of infection:

Fever (above 38°C)
Dry cough
shortness of breath
sometimes symptoms can develop into pneumonia
Some may loss sense of smell or taste
It is possible for the patient to develop digestive problems – diarrhea.

COVID-19 symptoms may change according to the age groups, as some studies indicated that some children do not show symptoms of fever, and some children have difficulty in expressing the symptoms and may show some signs of confusion or crying.

How does (COVID-19) spreads:

Schools considered as a source of infection and outbreak between students and staff.
By direct contact through droplets from those infected during coughing, sneezing or talking: if the person is standing one meter or less away from the person infected with (COVID-19).
Indirect contact: Touching surfaces and tools or shaking hands with the patient and then touching the eyes, nose, or mouth.

School’s preparations for a safe return:

The school administration must prepare a plan under the supervision of the School Health Affairs Department at the Ministry of Education and includes the following:

Distribute the training package for the (Basic of Infection Prevention and Control) that prepared by the School Health Department at the Ministry of Health and The school administration must conduct training courses to the educational and administrative staff on that training package.
The plan should cover all the activities that the teacher or student goes through during the school day (transportation – classrooms – gathering places – the cafeteria – toilets – school clinics … etc.).
Social distancing must be observed by students in crowded places such as classrooms and other facilities.
The communication mechanisms for employees, parents and the healthcare center are as follows:

A clear communication mechanism between the school, the responsible healthcare center, and the responsible authorities, and reporting the emergency cases in the school as soon as possible.
A clear mechanism to deal with suspected cases and isolate them from the rest of the contacts to stop the infection.
A clear mechanism for dealing with positive cases that may exist in the school and tracing the contacts and suspension of the educational process as determined by the local health authorities.

School must prepare the plan in cooperation with the healthcare center to provide the necessary support to complete the plan in order to raise the schools’ readiness.

Vaccination according to the students age group

In person learning requires the following:

Resume the in person learning for the age group younger than 12 years and they are not required to complete the vaccine doses, but they are encouraged to.
With complying to observe the preventive measures (wearing mask and social distancing) during in person learning, regardless of the immunization status.
Students exempted from the in-person learning: students who are not complete the vaccine doses and more vulnerable to become sick according to the appendix. (For high risk group younger than 12 years).

Family Role:

School and family must communicate with each other and share information and instructions about the following:

Promote the general health of their children, including healthy food such as fruits and vegetables, adequate sleep, especially at night, reducing sugars and encouraging them to do physical activity.
Parents should provide their children with personal protective equipment: such as (masks and hand sanitizer) according to the child’s age and his/her ability to use them and understand their importance.
Parents should provide their children personal supplies such as food, water bottles, and all school supplies, so they would not use shared tools in school.
Isolation and reporting: parents should not allow their sick children until he recovers (according to the health status in Tawakklna).
Student must return to school after he/ she recovers, with verifying the student health status in Tawakkalna application.
Educate students of the importance of preventive measures against respiratory diseases especially physical distancing, washing hands with soap and water, safe disposal of used tissues, and sneezing etiquette.

* The recovery period is according to the health status in Tawakkalna application.

Transportation:

A lot of students ride buses to school, which may consider as an environment for disease transmission, so the following measures must be taken:

Hand hygiene and sneezing etiquette:

Clean hands before and after getting off from the bus, by using hand sanitizers contain at least 60% from alcohol.
Provide buses with hand sanitizers.
The bus driver or escort shall encourage student to use the hand sanitizers.
Cover nose and mouth when coughing and sneezing with a tissue or use elbow by bending the arm, then dispose of the used tissue in the trash.
Urge students to wash their hands with water and soap for at least 40 seconds or using hand sanitizer that contain 60% of alcohol.
Avoid touching eyes, nose and mouth with unwashed hands.

Social distancing:

Students must adhere to the same seat.
Students are not allowed to stand inside the bus.
Adhere to social distancing of one and a half meters while waiting the bus.
Leave at least a seat space between each student in the same row, and it is not necessary to leave a seat behind or in front of the student.

Wearing a medical or cloth mask:

Parents must provide their children with a mask before leaving the house to help prevent infection.
The bus driver or the escort shall make sure that all students wearing masks.

Avoid touching surfaces:

Avoid touching surfaces that frequently touched by others inside the bus such as door handle and windows.
Ensure good ventilation inside the bus and open the windows.

Disinfection of buses:

The bus must be disinfected after students left, especially frequently touched surfaces such as windows and door handles, according to the disinfection and sterilization guide issued by the Public Health Authority, in the following link:

https://covid19.cdc.gov.sa/ar/community-public-ar/a-guide-to-environmental-cleaning-and-disinfection-for-the-prevention-of-covid-19-disease-in-non-health-care-settings-ar/.

Drivers and escorts:

Drivers and escorts must always wear face masks while working.
Drivers and escorts must be fully vaccinated according to the health status in the Tawakkalna application.
Directing employees to follow the instructions of the Ministry of Health and relevant authorities regarding COVID-19 regarding allowing any employees to resume work, including employees returning from travel.
Oblige all employees (driver and escort) to apply self-isolation if they develop any symptoms.

Attendance and leaving:

Organize the entry and exit process in a way that prevents crowding and ensure social distancing of one and a half meters between students.
Prepare a sufficient place to monitor students and staff before entering the school, making sure they are wearing mask, and checking the health status in Tawakkalna application.
No student or employee is allowed to enter without wearing a medical or cloth mask.
Place visible signs or stickers on the floor to identify the standing places (one and a half meters).
If any student shows symptoms, the department should isolate him /her quietly without embarrassing him /her in front of other students.
Use separate door for entry and other for exit if there is more than one gate in the school.

Morning assembly:

Cancel morning assembly and direct students to their classes directly, to achieve social distancing.

Classrooms:

Rearranging classrooms so that the distance between tables or between the table and the chair in front of is not less than 60 cm.
Ensure good ventilation inside the classrooms and open windows.
Using labs and resource rooms and converting them to classrooms for students.
Preventing the sharing special tools such as pens.

School facilities:

Ensure periodic disinfection and sterilization of school facilities and places that used by more than one person, such as toilets.
Consider disinfecting frequently touched surfaces such as door handles, light buttons, and shelves.
Set a periodic schedule for cleaning the classrooms and other facilities with appropriate disinfectants (according to Weqaya Guide), on the following link:
https://covid19.cdc.gov.sa/ar/community-public-ar/a-guide-to-environmental-cleaning-and-disinfection-for-the-prevention-of-covid-19-disease-in-non-health-care-settings-ar
Provide the cleaning and disinfection supplies and the necessary workers.
Ensure good ventilation and open windows.
Safe disposal of waste.
Disable water coolers and oblige students, educational and administrative staff, to bring their own water bottle.

The educational and administrative staff and other workers:

All educational and administrative staff and the other workers must be vaccinated with two doses of approved vaccines.
Oblige all workers to observe the preventive measures (wearing masks – social distancing – avoid sharing tools – washing hands regularly – avoid shaking hands).
The educational staff is obligated to wear the mask all the time, and if they want to clarify the pronunciation of letters when explaining, the mask can be replaced with a protective mask.
Emphasis on cleaning and disinfecting facilities that are used by educational and administrative staff (teachers’ room – administrative offices).
Prevent sharing meals and group meals in teacher rooms and breakroom.

Cafeteria and lunches:

Allow student to leave the classroom during the break, while adhering to the following precautionary measures:

Divide students inside the classroom into groups and allow them to take the break in a different period (for example: group A and B in the first period, group C and D in the second period).
The school yard must be divided according to classrooms, so that each area is designated for a specific classroom, making sure that the groups did not come in contact with other group, while providing waste bin near each group.
Prevent the direct sales from the cafeteria and allow them to distribute meals to students inside the classrooms.
Allow eating breakfast inside the classroom.

Extracurricular Activities:

Prevent any extracurricular activities that does not meet social distancing standards.
If there are sports activities, it should be in a spacious and well-ventilated place, considering the social distancing, with avoiding sharing tools.
Adhering the social distancing when performing prayers to ensure that there is no crowding at places of ablution.

Visitors:

The school should limit visiting from outside the school, except for very important visits, with an emphasis on following the preventive measures, such as: (measuring temperature, wearing a mask) and also it must be limited to the vaccinated only according to the health status in Tawakkalna.
Allocate a suitable place to receive visitors, such as parents.

Educate students on the infection control standards:

Activate the role of the health counselor in supervising the application of infection control standards in the school
Educate students on hand hygiene and the etiquette of coughing and sneezing.

Isolation rooms:

Allocate an appropriate room to isolate suspected cases or prepare a suitable place if there is no empty room.
Provide the protective equipment such as hand sanitizers and masks.

Health awareness with cooperation with Ministry of Health:

Determine the target groups (students / educational and administrative staff / families).
Identification of priority topics which include:

About the virus, its symptoms, and ways of transmission.
Healthy personal behaviors to follow, for example: hand washing and etiquette for coughing and sneezing.
Raise awareness of the importance of taking the vaccine to prevent the virus transition.
The preventive measures that should be applied in the school.
Educate parents about the chronic diseases that may increase the risk of complications in the event of infection with COVID-19.

The school health department in the health affairs directorates or health clusters in the region or governorate should prepare a school health awareness plan in the education departments for implementation by the health counselor inside the school.
The school health supervisor in the Education Department conducts field visits to ensure the implementation of preventive measures in the school.

Establish a mechanism for communication between the healthcare center and the school:

Communication between the school and the supervising healthcare center according to the approved linkage process.
Fill out the communication forms between the school and the healthcare center (according to the attached forms).
Increase school health awareness activities related to infection control in coordination between the healthcare center and the school.
Follow-up and ensure the provision of protective equipment in schools that recommended by the Public Health Authority.
Set a reporting mechanism for suspected and cases in contact with confirmed case in the school and submit it from the Education Department in the region to the School Health Department in the Health Affairs/Assembly in the region.

Monitoring and reporting of suspected cases and cases in contact:

Monitor respiratory symptoms:

The school must monitor the daily attendance and in case of the absence increased resulting from flu symptoms.
Monitor the appearance of respiratory symptoms among students.
If any student shows respiratory symptoms (fever, cough, runny nose, shortness of breath) record his name on the monitoring sheet and dealing with him/ her according to the suspected case protocols.
Prepare a list of absent students due to respiratory symptoms for the purpose of investigation.
Keep a record of absences due to diseases or respiratory symptoms in case they are needed for the purposes of epidemiological investigation of confirmed cases.

Mechanism for dealing with suspected cases:

Oblige students and educational or administrative staff who have symptoms (fever, cough, or shortness of breath) to inform the school and stay at home.
Educate parents to prevent their children from attending the school if they show respiratory symptoms.

Mechanism for dealing with suspected cases:

Isolate suspected cases in a well-ventilated room.
Suspected cases must avoid touching surfaces.
Urge suspected cases to cover the nose and mouth with a tissue while sneezing and to dispose of the tissue directly into the waste bin.
If the paper tissue is not available, it is recommended to use elbow by bending the arm.
If the suspected case needs a toilet while waiting for the medical team, it is recommended to use a separate toilet, and if it is not available, the bathroom must be disinfected well with the recommended sterilizers.
If the case is stable the case’s guardian will take him to the hospital or calling the ambulance if the case is an emergency.
Dealing with those cases according to the mechanism for dealing with suspected and confirmed cases within the school.

Parents:

Reassure the parents of their child’s condition and that the measures that will be taken in favor of the suspected case and those in contact with him.
Educate parents about the virus transition ways and the need to treat the case as a positive case until the result of the test become negative.
Ask parents about the data recorded from the suspected case about the date and method of exposure.
Give the parents the name of the health facility in which the suspected case was directed.

Mechanism for dealing with confirmed cases and those in contact with confirmed cases outside and inside the school:

Confirmed cases and contacts outside the school are dealt with according to the updated guide for that.

Institute and program of special education:

Special procedures should be allocated to special educational programs and institutes, in addition to general protocols and guidelines, because of the many challenges that this category faces.
special categories include:

learning disabilities
Blind, visually impaired
deaf, limited hearing
intellectual disability
autism spectrum disorder
Attention deficit hyperactivity disorder
multiple handicapped
Physical and health handicap
speech disorders
slow learning

Because the needs differ according to the disability, special precautions must be set for each category:

The precautions measures for students with autism spectrum disorder and attention deficit hyperactivity disorder:

Prevent student from leaving the classroom unless necessary and under the supervision of the teacher.
Use toys to explain the symptoms (cough, cold, fever) and what the student should do if he/she feels ill (e.g. headache, stomach ache, fever or fatigue) and how they can calm a sick person (e.g. showing sympathy but without neglecting the necessary precautions to prevent infection).
Encourage student to wash hands frequently for 40 seconds, without making him/her feel afraid by doing something he/she loves such as sing songs.
Ensure that students’ complaints are heard, and their questions answered in an age-appropriate manner.
Allocate some activity classes on the school day and show simplified scientific content about the respiratory infections, how to prevent them, and the correct practices for personal care and hygiene.

Precautionary measures for students with visual impairment:

Provide teaching aids on the necessary precautions such as hand washing and social distancing via Braille.
Ensure to sanitize the teaching aids in Braille, because student with visual impairment use and touch those aids frequently.
Clean and disinfect the places, facilities and helping equipment used by the mentioned category, such as handrail, which the student needs to reach the different places.
Oblige students with visual impairment to use the white cane when moving because it gives them a space and they can avoid touching others, provided that they take them home and sterilize it.

Precautionary measures for students with hearing impairment:

Provide teaching aids about the precautionary measures with sign language or educational videos.

Precautionary measures for students with intellectual disabilities:

Design the instructions using cartoon characters or pictures that are attractive to students.

Precautionary measures for students with sensory disabilities:

Providing appropriate means about the precautionary measures in (Braille language) for students with the visual impairment and in (sign language) for students with Hearing impairment.

Precautionary measures for students with physical handicap:

Creating and adapting the environment, through: Providing sterilizers and gloves next to the slopes and in places around them.

Precautionary measures for students with learning disabilities:

Provide the instructions in the form of posters and symbolic instructions.

The approved recovery period:

Students can return to schools after he completely recovers by bringing proof of his recovery from the health facility or by verifying his health status in Tawakkalna application.
If the case admitted to the hospital due to COVID-19, the decision of his return to school depends on the report of the treating physician according to the COVID-19 guidance.

Appendix (1): Groups at higher risk of infection