COVID-19: Management for K-12 Schools with In-Person Learning

Posted September 10, 2020. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.


With expected increases of COVID-19 transmission in the fall and with many local schools resuming in-person learning despite public health recommendations, Spokane Regional Health District (SRHD) is expecting additional burden on primary care providers with families seeking additional clinical care and testing for their children.  

Regardless of known exposure, children with an acute onset of one or more COVID-19 symptoms (to include cough, shortness of breath, fever, sore throat, chills, loss of taste or smell, muscle/body aches, nausea/vomiting/diarrhea, congestion, unusual fatigue, and/or headache) will not be allowed to attend school until the following conditions are met:

  • In the absence of testing and/or healthcare provider evaluation, the child can return to in-person instruction at least 10 days after symptom onset provided that their symptoms are improving and they have been fever-free for 24 hours without taking fever-reducing medications, OR
  • If the child tests negative for COVID-19 with a PCR test AND their symptoms are improving and they have been fever-free for 24 hours without taking fever-reducing medications, OR
  • If the child has a note from their healthcare provider with a different diagnosis and the approval to return to school.

We realize the significant strain and burden that these requirements will place on the healthcare system. Unfortunately, with limited data on COVID-19 presentation in children and transmission dynamics within schools, a conservative approach is necessary to avoid COVID-19 outbreaks within K-12 school settings.  

Children with known close contact exposure to a COVID-19 case will be required to stay home, regardless of symptoms, for 14 days after their last known exposure to the case while infectious. In households with one or more COVID-19 cases, the quarantine period lasts for 24 days from the symptom onset of the most recent case unless the case isolates completely away from other household members while infectious. (Cases are infectious for 10 days, thus a household member’s last exposure to a case while infectious is on the 10th day, and the quarantine continues 14 days beyond the 10th day).  

The Washington State Department of Health and SRHD continue to recommend that exposed individuals be tested for COVID-19, regardless of presence or absence of symptoms. Specimen collection should ideally occur five to seven days after exposure, and no sooner than 48 hours after exposure.  A negative test does not negate the need for an exposed individual to continue their quarantine period.  

We are including an example letter that will be provided to parents of children sent home from school with symptoms. Families may also bring you letters that 1) identify children as close contacts of cases at school; 2) identify COVID-19 case(s) in a child’s classroom, or 3) that identify a COVID-19 case in a school’s broader community. All may prompt healthcare evaluation and COVID-19 testing.