January 14, 2022

Multnomah County Public Health notified schools this week that it would change its guidance regarding isolation and quarantine periods to align with federal guidance, and a shift away from contact tracing.

“COVID-19 is spreading quickly in our community, and the emergence of the Omicron variant has forced Public Health to mount a dramatic course change in hopes of meeting this new challenge,” Chair Deborah Kafoury and Public Health Director Jessica Guernsey said in a letter sent to school superintendents Friday.

Contact Tracing

The changes in school guidance come a week after Public Health announced it has paused contact tracing and individual case investigations, except in certain high-risk environments. That’s because the sheer speed of Omicron’s transmission means people are exposed, infected and then contagious before the local health department can even identify an outbreak, much less get word to those who are exposed.

Because of that dynamic, contact tracing has become much less effective at lowering COVID-19’s risk, especially when cases are surging so high and when spending time in any indoor public space is essentially considered an exposure for anyone who isn’t up-to-date on their vaccines. 

At the same time, health officials also determined there is a real and increasing risk to kids who could be forced to miss more school. That’s why Public Health is recommending schools stop contact tracing except in certain scenarios — and then only if they have the staff and time to do it. Those scenarios are:

  • Exposures during mealtimes when masks can’t be worn. This approach will require assignment and tracking of lunch “pods.”
  • Any indoor learning or extracurricular activities that do not include masks.

While contact tracing has lost its power in the surge, three other key prevention measures continue to pack a punch: vaccines, masks and staying home when ill.

Multnomah County is recommending schools focus on educating people about when to stay home and for how long, and to make sure everyone on campus has a well-fitting mask. 

Multnomah County continues to recommend that families and school staff get booster shots as soon as they’re eligible, use well-fitting masks in indoor public places, and keep kids home when they’re sick with any illness.

“We want to acknowledge the profound pandemic fatigue people are experiencing and the concern you have for your family and school community,” Kafoury and Guernsey wrote to families on Friday. “Like you and so many others, we are adapting as the virus evolves. We appreciate your continued partnership in this fast-moving and truly unprecedented situation.”

[Read the full letter]

Isolation and Quarantine

Also this week Public Health Director Guernsey notified schools in a separate letter that Multnomah County would align its isolation and quarantine guidance with recommendations from the federal Centers for Disease Control (CDC) and Prevention. 

“The CDC’s updated recommendations for isolation and quarantine balance what is known about the risks of the virus and the need to maintain essential functions like keeping kids learning in person,” she wrote in a Jan. 11 letter. “Taking a layered approach is key: Get vaccinated, get boosted, wear a mask in public indoor settings, and consider all risks before you gather.”

Quarantine

The updated guidance means that individuals who meet certain criteria will no longer need to quarantine following an exposure. People do not need to quarantine if they meet any of the following conditions:

  • They are older than 18 and have received a booster dose
  • They are 5 to 17 and completed the primary series of a COVID-19 vaccine
  • They completed the primary series of Pfizer or Moderna within the last five months
  • They received their primary Johnson & Johnson shot within the last two months
  • A lab or antigen test administered by a provider confirms they have had COVID-19 within the past 90 days. 

Even though individuals who meet at least one of the criteria above do not need to quarantine following an exposure, they should still wear a well-fitting mask around others and monitor themselves for symptoms for 10 days.

Quarantine starts the day after the most recent exposure. Close contacts should quarantine at home, away from others, for at least five days. 

If the close contact does not develop symptoms in those five days, they can go back to school. But they must wear a well-fitting mask at all times for another five days. If a person is unable to consistently and diligently wear a well-fitting mask, they should continue to quarantine at home for a full 10 days. Similarly, if masking is not feasible during certain extracurricular activities, then the person should not participate in that activity until the 10 days is up.

Isolation

Anyone who tests positive for COVID-19, regardless of vaccination status or symptoms, must isolate. 

In alignment with CDC and Oregon Health Authority recommendations, individuals who have COVID-19 should isolate for a minimum of five full days, with day 0 being the first day of symptoms. For those who never have symptoms, day 0 is the day they took the test that came back positive. 

If a person has no symptoms or mild symptoms that are improved or gone after five days, that person may return to school if they consistently and diligently wear a well-fitting mask for an additional five days. 

If a person continues to have a fever, or if their other symptoms have not improved after five days, they should wait to end their isolation until they have been fever-free for 24 hours, without the use of fever-reducing medication, and other symptoms have improved.

[Read the full letter]