New Jersey’s Health Department has halved the recommended isolation and quarantine periods for students and school staff to five days, offering districts more flexibility as COVID closes classrooms across the state.
Though the guidelines issued Monday are voluntary, they still stirred concern among some medical experts, coming amid record-high case numbers that have been driven by the highly infectious omicron variant. The department’s COVID activity reporting system currently shows all parts of New Jersey experiencing red, or “very high,” levels.
“The timing seems unsafe to me,” said Robin Cogan, a preschool nurse in Camden County and executive director of the New Jersey School Nurses Association. “I can see limiting quarantine, but both isolation and quarantine, limiting that when we’re in red, I can’t begin to understand the thought behind it.”
Health officials recommend isolation for people who are sick or have tested positive for COVID-19 and quarantines for those who have been exposed to the virus. Previous New Jersey guidelines called for a 10-day window.
Almost a third of New Jersey’s school districts were operating remotely last week as they dealt with rising cases and COVID-fueled staff shortages. Most infected children face mild symptoms. Still, the omicron surge has sent more children to the hospital in New Jersey in recent weeks than at any time in the 22 months of the pandemic.
Gov. Phil Murphy declared a new public health emergency on Tuesday, extending his authority to require masks inside schools. Murphy on Monday said students and teachers will have to wear masks for the “foreseeable future” given the “tsunami” of new COVID cases.
Why the new COVID guidelines?
The new guidelines followed recommendations issued on Jan. 4 by the federal Centers for Disease Control and Prevention, which also shortened quarantine and isolation periods.
In its new guidelines, the state Health Department cited the omicron variant’s shorter incubation period, which is the time between becoming infected and feeling symptoms, when people are most contagious. Reports suggest that omicron has an incubation period of two to four days, compared with up to 14 days for previous variants, the agency said.
“Although many people have intentions to self-isolate, both isolation and quarantine are challenging, especially in the context that many infections are asymptomatic,” the department said. “The shortened time frames for isolation and quarantine focus on the period when a person is most infectious, followed by continued masking for an additional five days.”
Under the new guidelines:
- Persons who show symptoms, whether or not they test positive for COVID-19 or are waiting for test results, should stay home and isolate for five days until their symptoms resolve. The five days start after “day zero,” when people begin showing symptoms, so most are likely to face at least six days of isolation.
- If symptoms persist, people should continue isolating until they are fever-free for 24 hours or until their symptoms improve.
- People who test positive but have no symptoms should also isolate for five days, according to the guidelines. Here, too, the day of the positive viral test is considered day zero. If symptoms develop before the isolation period ends, the clock starts over for another five days and day zero is counted as when symptoms began.
- Children and adults who complete the five-day isolation period should wear masks both at home and outside their homes from day six through 10, according to the department.
Medical experts concerned about the new guidelines
The new guidelines showed up in superintendents’ inboxes just as the state is seeing surges in COVID-19 infections that are unprecedented even compared with the earliest days of the pandemic.
In schools, positivity numbers for staff and students were relatively low last fall, between 1.4 and 3 cases per 1,000, until they began to climb in mid-November, followed by a sharp uptick of positive cases in late December. The number of positive cases in schools is now 29 for every 1,000.
“I am concerned about limiting isolation to five days and expecting that a child is going to wear a mask properly fitted the entire school day and wear a mask at home,” said Cogan, of the nurses association. Though schools are encouraged to implement more stringent guidelines, they are not allowed to do less than what is recommended, she said, based on discussions she has had with state officials.
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The new quarantine guidelines from the state do not appear to have changed, other than the halving of the number of days to five. Adults and children who have been fully vaccinated — including boosters for those age 12 and above — need not quarantine after exposure to a person who tested positive for COVID-19. Unvaccinated or partially vaccinated people, however, are still required to quarantine, but for only five days, with the day of exposure being counted as day zero.
Another significant change from existing guidelines is that parents can now decide, after five days, if their children are feeling better and ready to go back to school.
“[A] glaring change is that the guidance for returning is that your symptoms are improving. That is different for everyone; that is so subjective,” said Cogan.
As a nurse, Cogan said, she prefers to tell students to return when they are completely well. “We want to say to families to send them back to school when they’re back to themselves — when they’re acting like themselves.”
The guidelines issued by the state are premature and will result in further spread of infections from the omicron variant, if proper personal protective equipment is not used more universally, said Stanley Weiss, an epidemiologist at Rutgers School of Public Health.
The infectiousness of omicron, coupled with its airborne spread, makes it essential that people wear tight-fitting KN95 masks, Weiss said. Since these masks are not required outside of health care settings, some adults and children who return to school while still infectious after the shortened isolation periods are likely to continue spreading the virus, he said.
“This will cause further stress on our system by helping the omicron virus to further propagate,” Weiss said. “Cloth masks had utility earlier in the pandemic — but it’s a different situation now because omicron is so highly infectious.” he added.
Schools have yet to adopt the new guidelines, though some began advising parents about them. Mark Toback, superintendent of the Wayne public schools, said he would make a decision on how to move forward after consulting with the district’s Board of Education.
The new recommendations differ from guidance issued by the state in September, when schools reopened for full, in-person instruction for the first time in months. That guidance, called “The Road Forward,” was issued jointly by the state departments of education and health. This week’s update was not sent out by the Education Department. Asked why it did not issue the memo jointly, the Health Department said the guidance covered all non-health care settings, including schools.
Mary Ann Koruth covers education for NorthJersey.com. To get unlimited access to the latest news about New Jersey’s schools and how it affects your children, please subscribe or activate your digital account today.