Protocol and guidelines for suspected/confirmed cases of COVID-19 for faculty members and students

*Updated by the National Public Health Organization (EODY) on 05/17/2021*

1. PERSON IN CHARGE OF HANDLING CASES OF COVID-19 IN THE SCHOOL.

The Head Nurse (Ms. Athina Gargali) is assigned to be in charge of handling cases of COVID-19 in the school. If she is not available, the School Nurse (Mr. Konstantinos Kontos) will replace her.

2. SELF TESTING

Self-testing is mandatory and must be performed once a week (Mondays), 24 hours prior to arrival on campus. For more information regarding self-testing, please visit: https://www.acs.gr/self_testing_information/ 

3. COVID-19 CASE(S) MANAGEMENT

3 A) Student management in children with symptoms compatible to COVID-19 infection.

If a student experiences symptoms compatible with COVID-19 infection outside of school hours, the parents/guardians must keep the student home, seek medical evaluation and inform the Health Center and Citizenship Office.

  • If a student experiences symptoms compatible with COVID-19 infection during school hours, he/she MUST come to the Health Center. The parents will be notified to pick the student up from school. In case he/she needs to stay for a short period of time at school, the student will be requested to wear a medical mask and will be escorted to the assigned room for suspected cases that is equipped with all of the appropriate equipment. 
  • The Nurse who will supervise the assigned room will be wearing the appropriate protective equipment (medical mask, gloves, face shield and a disposable gown).
  • The assigned room will be disinfected after the student leaves school.
  • The parents will be requested to seek medical evaluation immediately. Upon physician’s evaluation, if the symptoms are deemed compatible with COVID-19 infection, the COVID-19 test (rapid or PCR) must be considered a priority and done immediately. It is noted that in this case the self-test is NOT recommended. 
  • While waiting for the results, the student should be quarantined at home, in a well-ventilated room. The school will continue to operate as normal. 
  • If the physician considers the symptoms NOT to be compatible with COVID-19 infection and has a different diagnosis, the student may return to school 24 hours after the fever has subsided (without the use of fever reducing medication) and when the symptoms are in remission or the health issue (not COVID-19 related) is gone. A doctor’s note is not required in order to return to school. For the student’s return to school, the self-testing procedure must be followed as is.
  • A student with symptoms that qualify as clinical criteria for the classification of a child as a COVID-19 suspected case and that therefore is suggested to take the diagnostic test (rapid or PCR), but for any reason did not get tested despite the recommendations, must not attend school for 10 days since the onset of the symptoms and until 3 fever free days have passed (without the use of fever reducing medication) and his/her symptoms are in remission.

3.B) Faculty member management in case the inpidual develops symptoms that are compatible with a COVID-19 infection

  • If a faculty member experiences symptoms compatible with a COVID-19 infection outside of school hours, he/she MUST inform the supervisor, the Health Center and stay home.
  • If a faculty member experiences symptoms compatible with COVID-19 infection during school hours, he/she MUST come to the Health Center, inform the supervisor and leave school. In case he/she needs to stay for a short period of time at school, the faculty member will be requested to wear a medical mask and will be escorted to the assigned room for suspected cases that is equipped with all of the appropriate equipment. The faculty member follows the same procedures for students as described above, in section 3A.
  • The staff member(s) will be requested to seek medical evaluation immediately. Upon physician’s evaluation, if the symptoms are deemed compatible with COVID-19 infection, the COVID-19 test (rapid or PCR) must be considered a priority and done immediately. 
  • While waiting for the results, the staff member should be quarantined at home, in a well-ventilated room. The school will continue to operate as normal.

3C) In case the COVID-19 test of the suspected case is POSITIVE:

  • The parent/guardian or the faculty member informs the School Nurse, Principal/Supervisor and the Hellenic National Public Health Organization (NPHO/EODY) immediately.
  • The person in charge of handling COVID-19 cases will inform the families and the appropriate departments (School Task Force, Public Health Office, Civil Protection and Primary/Secondary Education Office).
  • The public health office will be in communication with EODY (NPHO) in order to start the tracing process and perform a risk assessment in order to make the final decision for a possible grade level or school closure.

Guidelines for COVID-19 confirmed cases

The student or faculty member MUST leave school and practice home isolation for at least 10 days. The student/faculty member will isolate at home unless he/she needs to be hospitalized. During the self-isolation period, the student or faculty member who tested positive must:

  1. Refrain from any after school activities or other unnecessary out-of-home movements or having contact with people from outside of their home (i.e. walks, meeting friends etc.)
  2. Strictly avoid any contact with vulnerable people who belong to high risk groups and are susceptible to getting seriously sick.
  3. Take all protective measures during contact with other family members. Remain in a separate room and use a different bathroom (if possible) and must strictly have 1.5 meters distance from one another and all family members must wear masks. Hand hygiene, good ventilation and thorough cleaning with detergent in communal spaces must be practiced for all family members.

Return to school: inpiduals with confirmed COVID-19 infection (quarantine period)

  • The student/faculty member may return to school 3 days after the fever has subsided (without the use of fever reducing medication) AND at least 10 days after the onset of his/her symptoms AND after the remission of his/her symptoms. In cases where the student/faculty member suffers from a severe illness or is immunosuppressed, the required time from the onset of the symptoms can be up to 20 days, depending on the physician’s evaluation. It is stated that the student/faculty member will return to school if the class/grade level is operating.
  • A second test or a doctor’s note is NOT required in order to return to school.
  • If the parent or faculty member chooses to have a second test and the student/faculty member is found positive again, the child/faculty member may return to school only if the above mentioned requirements are met. (10 days after the onset of the symptoms, three (3) days fever free without the use of medication and symptoms MUST be in remission). (This may happen because the virus can be detected with the molecular test for a long period of time after recovery, regardless of the fact that the person is not considered contagious).
  • The confirmed case isolation period is connected with the “transmission period”, meaning the time that a person is considered contagious and can transmit the virus to others. For typical COVID-19 cases, a person is considered contagious 48 hours PRIOR to the onset of the symptoms and up to 10 days after that.
  • After the recommended isolation period for the confirmed case is over, the exemption of the inpidual to the self-testing procedure is recommended, for 90 days (3 months) after the diagnose.

Guidelines regarding CLOSE CONTACTS of a confirmed case

  • Contact tracing will be done immediately by the person in charge of handing COVID-19 cases.
  • All faculty members and students that are considered close contacts will be requested to leave school grounds and required to practice a 10-day quarantine at home. During the 10-day quarantine, ALL close contacts must:
    • Refrain from any activities or other unnecessary out-of-home movements or having contact with people from outside of their home (i.e. walks, meeting friends etc.)
    • Strictly avoid any contact with vulnerable people who belong to high risk groups and are susceptible to getting seriously sick.
    • Take all protective measures during contact with other family members. Remain in a separate room and use a different bathroom (if possible) and must strictly have 1.5 meters distance from one another and all family members must wear masks. Hand hygiene, good ventilation and thorough cleaning with detergent in communal spaces must be practiced for all family members.
  • Close contacts (students or faculty members) may return to school after 10 days from their last contact with the confirmed case, only IF they are asymptomatic and IF a self-test is performed on the estimated return day and the result of the self-test is NEGATIVE. Specifically:
    • The day of the last contact with the confirmed case is considered day zero (0).
    • The self-test must be performed on day ten (10).
    • The return day to school will be day eleven (11), the self-test result (performed on day 10), must be NEGATIVE.
  • If during the 10-day quarantine, a person who is considered a close contact of a confirmed case is asymptomatic, but has a positive self-test: remains at home in isolation and follows the current procedure ( repeat test at a public or private clinic).
  • If during the 10-day quarantine period, a person who is a close contact of a confirmed case, develops any symptoms that are compatible with COVID-19 infection, a COVID-19 test (rapid or PCR) must be done. It is noted that in this case the self-test is NOT recommended.

    - If the test is positive: the confirmed case protocol must be followed.

    - If the test is negative: the person will continue to quarantine until the 10-day period is over, the self-testing procedures will be followed and its case is handled depending on the clinical diagnosis and in communication with the physician.

  • Upon return to school and until the end of a 14-day period from the last contact with the COVID-19 confirmed case, increased alertness should be present for a possible onset of symptoms that meet the criteria for a suspected COVID-19 case. In this case, the person who has been considered a close contact of a confirmed case should be subjected to a diagnostic laboratory test (rapid or PCR). It is noted that in this case the self-test is NOT recommended.

    - If the test is positive: the confirmed case protocol must be followed.

    - If the test is negative: the person will continue to quarantine until the 10-day period is over. The self-testing procedures will be followed and its case is handled depending on the clinical diagnosis and in communication with the physician.

  • Close contacts of close contacts of a confirmed case are not recommended to refrain from school or get laboratory tested, they will continue to perform the self-testing procedures as usual.

Inpiduals(students/faculty members) who are exempted of the 10-day quarantine are:

  • Fully vaccinated inpiduals (inpiduals are considered fully vaccinated 2 weeks after their second dose in a 2-dose series and 2 weeks after a single-dose vaccine) ONLY if the close contact with the confirmed case happened within 6 months from the completion of their vaccination and IF they remain ASYMPTOMATIC.
  • Inpiduals with a confirmed COVID-19 infection in the past 6 months who had a high risk exposure (close contact) to a COVID-19 confirmed case and remain asymptomatic do NOT need to be quarantined because the risk of infection is very low.
  • These inpiduals must self-monitor their health closely (daily temperature measurements, being alert for symptoms) for 14 days after their last exposure with the confirmed case and must comply with all the necessary health and safety measures that are in place (i.e. masks, self-test, social distancing etc.).

Definition of "close contact" of a confirmed COVID-19 case in school

The key to determine the close contacts of a confirmed case is the transmission period of the virus, meaning the time period consisting of 48 hours PRIOR to the onset of the symptoms and up to 10 days AFTER the onset of the symptoms. Generally, close contacts in school are:

  • Students who were in the same class with the student that tested positive for 2 academic hours (90 minutes) in total (not necessarily consecutive) that was found positive with the virus, during the transmission period (48 hours). (If they were present in class during the transmission period).
  • Students who are in a different grade but were in the same class during the transmission period of the positive case.

a) Students who were in the same class with a teacher for 2 academic hours (90 minutes) in total (not necessarily consecutive) that was found positive with the virus, during the transmission period (48 hours).

b) Students who sat in adjacent desks or in desks located directly front or back in case the lesson lasted for one academic hour (45 minutes).

  • Teachers who were in the same class with a student for 2 academic hours (90 minutes) in total (not necessarily consecutive) that was found positive with the virus, during the transmission period (48 hours).
  • Students, teachers or faculty members who had face to face contact with a confirmed case (during the transmission period), meaning they had contact within less than 1.5 meters, for more than 15 minutes AND without the proper use of a face mask (for one or both of them) 48 hours PRIOR to the onset of the symptoms and 10 days after in an indoor or outdoor space in the school, including recess, physical education or any other activity in school.
  • People who had direct physical contact with a confirmed case of COVID-19 (with or without symptoms) during the transmission period.
  • People who had unprotected direct contact with respiratory or other infectious secretions of a confirmed case (with or without symptoms) during the transmission period without taking the appropriate precautionary measures.
  • Close contact of a confirmed case (student or faculty member) who uses the school bus:

c) If the confirmed case was wearing the face mask properly during the 48 hours prior of the onset of the symptoms (and 10 days after the onset of the symptoms), close contact - typically- is considered every person who is seating in the next, front or back seat of the confirmed case

d) If the confirmed case did not use the face mask properly, risk assessment must be done in cooperation with EODY in order for the close contacts to be defined

  • Students or faculty members who during the 48 hours prior to the onset of the symptoms (and  10 days after) were transported to or from school together in the same taxi or similar private vehicle.

3.D) IN CASE THE COVID-19 TEST OF THE SUSPECTED CASE IS NEGATIVE:

  • If the test result is NEGATIVE, the student/faculty member may return to school 24 hours after the fever has subsided, without the use of fever reducing medication and his/hers other symptoms are in remission as this is the appropriate period of recovering from common respiratory infections. 
  • A doctor’s note is not required in order to return to school.

3.E) WHILE WAITING FOR THE COVID-19 TEST RESULTS:

  • The suspected case remains at home in self-isolation.
  • Close contacts of the suspected case can come to school under the instruction to closely monitor their health. The class/grade level operates normally.

4 .WHEN THERE ARE THREE OR MORE CONFIRMED CASES IN THE SCHOOL WITHIN 14 DAYS

  • The person in charge of COVID-19 will immediately inform the Public Health office, the Office of Primary/Secondary Education, the Civil Protection, School Task Force and the families via email.
  • An epidemiological investigation will be conducted and risk assessment will be done by the authorities who will later decide if they will close the school or classes/grades of the school.

5 . WHEN THERE ARE FOUR OR MORE CONFIRMED CASES IN THE SCHOOL WITHIN 14 DAYS

  • The person in charge of COVID-19 will immediately inform the Public Health office, the Office of Primary/Secondary Education, the Civil Protection, School Task Force and the families via email.
  • An epidemiological investigation will be conducted and risk assessment will be done by the authorities who will later decide if they will close the school or classes/grades of the school.

» Four or more confirmed cases does not mean "automatic" school closure; proper "investigation" will be needed in order to determine closure.

Children with underlying health conditions who should refrain from coming to school and practice virtual learning according to the national health organization of Greece

*The guidelines are established by the National Public Health Organization of Greece (EODY)*

Scientific data regarding the risk children with underlying health conditions face from contracting the new coronavirus are limited as this is a newly discovered virus. The following guidelines might be modified in the future as the knowledge of SARS-Cov-2 infection increases depending on the epidemiological data. In any case, the decision on long-term absenteeism from school, should be made individually with careful weighing of each child's health status by their treating physician and in collaboration with the family.

  1. Children receiving chemotherapy for malignancy or after hematopoietic cell transplantation if less than 6 months have passed after the treatment’s completion.
  2. Children after allogeneic hematopoietic stem cell transplantation if less than 12 months have passed.
  3. Children after a solid organ transplant if less than 24 months have passed. 
  4. Children with sickle cell disease.
  5. Children with severe congenital or acquired immunodeficiency (HIV and CD4<500).
  6. Children under chronic cortisone therapy (prednisolone> 20mg / day).
  7. Children with severe chronic kidney disease or kidney failure.
  8. Children with hemodynamically significant congenital heart disease or known cardiomyopathy.
  9. Children with chronic and severe lung disease, such as cystic fibrosis with respiratory failure or children with severe and uncontrolled asthma.
  10. Children with metabolic or neurologic disorders. 
 

** A doctor's note is required in order to excuse the child's physical absence in the school. *

Guidance on self-isolation at home

People who had contact with a confirmed case of COVID-19 (i.e. family members, friends, colleagues, healthcare professionals) should monitor their health status (temperature measurement twice a day) from the day of last contact with the case and 14 days onwards. People who had contact with a suspected case should practice self-isolation for 5-7 days. Regular (daily) communication with a healthcare professional is advised throughout the monitoring period.

You should take the following measures throughout the monitoring period (14 days):
  1. Stay isolated in a well-ventilated room.
  2. Only a few people should take care of you; ideally, only one person who is not considered high-risk (i.e. not an elderly person or someone with an underlying health condition).
  3. No visitors allowed.
  4. All other family members must stay in a different room; if this is not possible, they must keep at least a 2-meter distance from you.
  5. You should avoid moving around the house, to the extent possible.
  6. All common areas must be well ventilated.
  7. Anyone coming into your room or touching your personal items must wash their hands thoroughly before and after contact, before and after food preparation, before eating and after using the toilet (hand washing with soap and water or a disinfectant).
  8. Always cover your mouth and nose when coughing or sneezing.
  9. Any materials you have used for covering your nose and mouth must be carefully disposed or thoroughly washed if they’re not disposable.
  10. Caregivers must avoid direct contact with body fluids, particularly saliva, sputum or other respiratory secretions and feces should not be handled with naked hands. Disposable gloves must always be used. A hand hygiene routine must be followed.
  11. Caregivers must avoid touching potentially contaminated items of the patient, such as plates, glasses, cutlery, towels, bed linen; all such items must be thoroughly washed before being used again.
  12. All surfaces and items in the patient’s room must be cleaned and disinfected daily with detergent or soap and water followed by disinfection with household chlorine solution (1:50 dilution, if 5% active chlorine is used).
  13. Daily cleaning of bathrooms and toilets, as described above.
  14. If you show respiratory infection symptoms (e.g. fever, cough, sore throat, difficulty breathing) you must immediately call your doctor and/or the National Public Health Organization (NPHO) (tel: 1135), for further instructions.

Reference: National Public Health Organization

Daily Symptoms Screening Questionnaire for Quarantine

Please download the file (pdf).