In a sharp departure from previous guidance, CDC on Friday recommended schools prioritize remaining open for in-person education this fall—even if not all Covid-19 safety precautions can be met. 

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Guidance details

In the new guidance, CDC said despite the spread of emerging variants—and even though no Covid-19 vaccine has been authorized for use in children under 12—schools should aim to hold classes in person in the fall by implementing layered prevention strategies that are sensitive to local Covid-19 conditions. The recommendations are a marked change from prior guidance, in which CDC advised universal use of masks and physical distancing in schools.

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For instance, the latest CDC guidance said teachers and students who are vaccinated against Covid-19 do not need to wear masks in school, but unvaccinated adults and children must continue to do so. (The guidance still recommends quarantine for unvaccinated students who are exposed to the virus.)

In addition, CDC said schools should still aim to keep students at least three feet apart from each other, and that teachers should remain six feet apart from students. However, the agency noted if that isn't possible, schools should still hold classes in person alongside other prevention measures, such as ventilation and cleaning. The agency emphasized that children should not be excluded from in-person learning in the fall due to a minimum distancing requirement.

As an example, CDC said a school in an area with high transmission rates and with low student or teacher vaccination rates—but which does conduct regular screenings—could decide to keep requiring universal masking, but roll back physical distancing requirements so that everyone can attend in-person lessons. Conversely, a school in a similar area and with similar vaccination rates—but which doesn't conduct screening tests—should continue both its mask mandate and physical distancing requirements, CDC said.

Ultimately, CDC said its guidance aims only to "supplement—not replace—any federal, state, local, territorial, or tribal health and safety laws." The agency called on states and local school districts to monitor community transmission, vaccination coverage, and outbreaks to guide decisions on the level of layered prevention strategies.

Comments

CDC task force members said the rules recognized the importance of in-person education.

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"We know that in-person learning is really important for school, for children, for their educational, social and emotional well-being, and so we really want to get kids back in the classroom," said Erin Sauber-Schatz, a captain in the Public Health Service Commissioned Corps who helped lead the CDC task force that developed the guidelines.

Sauber-Schatz added while the original prevention strategies that have worked so far also appear to work against the more virulent delta variant, CDC is "keeping a close eye on it" and will update the guidance further, if needed.

However, public health experts and school officials had mixed responses, the New York Times reports.

Benjamin Linas, an infectious disease specialist at Boston University, praised the guidance. "For the first time, I really think they hit it on the nose," he said. "I think it's science-based and right on the mark."

But Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, said leaving decisions on school safety protocols to local officials could set prevention strategies up for ongoing negotiation and debate. "I really hoped they could issue very clear guidelines specifying what level of distance is required," she said, "and not sort of like a meditative journey on the relative benefits of distance."

Separately, Randi Weingarten, president of the American Federation of Teachers, said it won't be easy for teachers to ensure unvaccinated students are wearing masks. "Is it hard to operationalize? Yes, but at least it's the advice that we can now plan on and start trying to operationalize it," she said.

As virus caseloads and vaccination rates vary so greatly among local communities, CDC is pivoting from a uniform, one-size-fits-all approach and relying on states and local school districts to base more granular prevention decisions on local health data.

As Covid-19 vaccines are authorized for children over the age of 12, many middle and high schools will be able to reference this new guidance. (CDC, Guidance for Covid-19 Prevention in K-12 Schools, 7/9; Stolberg et al., New York Times, 7/9; Wernau/Campa, Wall Street Journal, 7/9; Foster, HealthDay/MedicineNet, 7/9).