Information for Residents

Note: Updated recommendations reflect the Amended Health Directive of 12/8/2020. 

High: Red Zone

In-person learning is not recommended. If offered, it should be highly restricted and contingent on COVID-19 testing at least 25% of on-campus staff once a week. Close contacts of confirmed cases of COVID-19 must quarantine for 14 days. Special education students, at-risk students and students who lack access to resources required for learning should be prioritized for on-campus learning. It is recommended that schools utilize small, fixed pods of up to six students.

The red zone also recommends that schools not host in-person events, whether academic and/or athletic. Drive-through events are permissible. School athletes may engage in physical skill-building drills at home, alone, or with their household, under Centers for Disease Control & Prevention (CDC) guidance for youth sports. The red zone also recommends that colleges and universities conduct classes virtually.

Moderate: Yellow Zone

In-person instruction, if offered, should prioritize pre-kindergarten through elementary school students, special needs students, a larger number of at-risk students, and students who lack access to resources required for learning.

The amended directive recommends that building and room occupancy not exceed 50% and should be contingent on adequate ventilation and ability to create six feet of distance between students and staff. It is recommended that schools utilize small, fixed pods of up to 12 students.

Within the yellow zone, extracurricular and team activities should only take place if COVID-19 precautions can be enforced not only during main activities but also during breaks, meals, practices, in locker rooms and training rooms, and during bus rides.

Colleges and universities should only operate in-person if COVID-19 precautions can be enforced not only during classes and in public spaces, but also in shared housing, with support services and monitoring of students in quarantine or isolation.

Low: Green Zone

In-person instruction should take place under CDC guidance for minimal to moderate community transmission. Physical distancing by older children and adults, frequent hand hygiene and face coverings during high-contact activities are recommended in the green zone.

COVID is primarily spread person to person. Everyday actions to prevent transmission include:

• Maintaining a 6-foot distance from people outside your household.
• Frequent handwashing for at least 20 seconds.
• Using a face covering that covers the mouth and nose.
• Avoid sharing utensils, face coverings, musical instruments, drinks, or other high touch personal items.

COVID may be spread by touching a surface or object that has the virus on it and then touching your own mouth, nose, or possibly your eyes. Surfaces that people frequently touch such as doorknobs, faucets and handrails should be frequently cleaned.

A cloth face covering should have two or more layers. A face shield is not considered a face covering.

People exposed in an outdoor setting have less risk of acquiring COVID-19. Yelling, singing, and playing wind instruments can increase risk of spread.

COVID symptoms may include:

Fever is defined as 100.4 or higher (a cutoff of 100.0 is recommended for screening at workplaces).

People with these symptoms should be excluded immediately from the school environment, evaluated by a medical professional and tested to rule out COVID. Find free testing sites here.

If no test is performed, then a symptomatic person should remain in isolation until at least 10 days after symptom onset, symptom improvement, and 24 hours fever-free without the use of fever-reducing medicines.

Children can definitely get COVID-19, but we still do not know much about children and their contagiousness. We need more information about COVID-19 and the virus that causes it (SARS-CoV-2) to know how much children spread the virus. From some studies it appears that children, particularly children under 10, might be less contagious than adults.

The virus that causes COVID-19, SARS-CoV-2, can survive for between hours to days on some surfaces. It survives longer on glass, wood, plastic and stainless steel (3-5 days) than on cardboard or fabric (less than a day). The amount of virus on a surface decreases over time, so risk of infection goes down. Risk of infection from touching a surface also decreases if that surface is in the sun. The virus is easily killed by commonly used disinfectants.

The CDC recommends cleaning (with soap and water) and disinfecting high touch surfaces regularly. This list of disinfectants that work to kill SARS-CoV-2 includes many standard household disinfectants (like bleach).

All playground equipment should be cleaned regularly, according to school protocols. Children should try not to touch their eyes or mouth and wash their hands before and after playing, and hand hygiene should be used frequently. The CDC has guidance on the cleaning of outdoor spaces.

The current guidelines do not recommend testing students and staff who do not have symptoms of COVID-19 before they return to school. Anyone with symptoms of COVID-19 should be isolated and tested immediately. Find information about symptoms and how to get tested.

People who are sick with COVID-19, but not sick enough to be hospitalized, are infectious/contagious for 10 days after they start to feel ill (develop symptoms). If people are hospitalized, they are infectious/contagious for 20 days after they start to feel ill.

However, the COVID-19 test for active infection (the RT PCR, NAAT or antigen test, not the antibody test) can stay positive for longer than someone is infectious. In some cases for the RT PCR test, people have tested positive for 8 weeks after their symptoms are over and they are no longer infectious. This is why the CDC and we do not recommend re-testing to find out if someone is still infectious. The RT PCR test detects RNA fragments of the virus and not viable (living) virus.

The Texas Education Agency (TEA) offers specific guidance for this in their guidebook and in their responses to various scenarios within schools.

An overview is that, if a teacher or student tests positive:

• They should isolate themselves from others immediately and inform the school.
• The school should notify the local health authority by calling 210.207.8876.
• The school is required to notify student families, teachers, and staff in writing.
• The school should follow appropriate cleaning protocols and collaborate with the local health authority for following up potential contacts of the person with COVID-19 (case investigation and contact tracing).

Much more detail and guidance on these individual steps is available from the TEA:

• TEA website
• Public Health Guidance for School Year 2020 -2021 (PDF)

People with COVID-19 can return to work or school after it has been 10 days since their symptoms started, symptoms are better, and they haven’t had a fever for 24 hours even without taking fever reducing medicines. A negative test should not be required.

Recovered persons should not be retested for COVID-19 for at least 3 months after their initial positive test, even if exposed to COVID-19 again during those 3 months.

Within 24 hours of notification of the positive result, report to Metro Health by calling 210.207.8876. You will be asked to provide:

• Person’s Name
• Person’s Date of Birth (DOB)
• Person’s Address
• Person’s/Guardian Contact Information
• Testing Location
• Symptom Onset Date (if known)
• Grade or Job Position
• Class Schedule/Teacher’s Name(s), if the case is a student
• Last Date at School
• Extracurricular Activities 

Consider potential exposures from:

• Transportation to/from school
• Afterschool programs, extracurricular activities
• Tutoring, specialized classes
• Affiliations, close friendships, romantic relationships
• Meal times and break times

People with underlying health conditions are more likely to become seriously ill from COVID-19. This includes:

• older adults
• people of any age with
  • obesity
  • type 2 diabetes
  • chronic kidney disease
  • chronic obstructive pulmonary disease
  • cancer
  • history of a solid organ transplant
  • serious heart conditions
  • sickle cell disease

Read more here.

Please see CDC guidance here. We anticipate further TEA recommendations shortly.

NOTE: Someone who was a close contact to a person with COVID-19 should quarantine/isolate for 14 days, even with a negative test. A negative test is just a snapshot from the date the test was performed, and the virus can incubate up to 14 days.

Recommendations for school nurses caring for people with suspected COVID-19 include: a fresh, fit-tested N95 mask each day and eye protection (face shield or goggles). Fit testing is an OSHA requirement, and a user seal check should be performed each time a mask is used.

For hands-on care of a symptomatic person, gloves should be worn, and an impermeable gown if there is splash or spray risk.

Nurses should have thermometers, biohazard disposal, at least a 2-week supply of PPE and a handwashing station.

All children should be encouraged to use face masks while indoors, particularly when they are within 6 feet of others. Face shields add protection for the eyes and the rest of the face in addition to face masks. We do not know how much using a face shield without a face mask protects you.

The child should be separated as much as possible from the rest of the family. The rest of the family does not need to quarantine unless the child develops symptoms. However, one adult may need to stay home to supervise the child.

Each school should have one or more isolation care rooms, which is a designated place to safely evaluate and hold a person awaiting transportation. Students should be escorted to the isolation space. The area should be away from other students and staff, allow privacy of the evaluation, and have a clear sight line for a supervising adult. It is best for this space to include a cot that can be wiped down and cleaned easily, a dedicated bathroom, and exterior exits to prevent sick individuals from mixing with healthy staff and students. Ideally, isolation care areas are located on an exterior wall to maximize ventilation options. Anyone who enters a designated isolation care room must use appropriate PPE and should be logged to facilitate contact tracing.

Bear in mind that isolation is not a diagnosis; it is a recognition that someone is sick, and needs extra care. Take steps to reduce fear, anxiety, and stigma related to isolation.

After the individual leaves isolation care, the room must be closed and cleaned before it can be used again. The CDC recommends waiting 24 hours before cleaning; if that is not possible, then wait as long as feasible. The area where the individual was originally showing symptoms also must be cleaned and disinfected.