Dive Brief:

• Schools with a full-time nurse or school-based health center were more likely to use several COVID-19 prevention strategies early in the 2021-22 school year, according to a school survey and analysis from the Centers for Disease Control and Prevention. 
• The study examined 21 school-level prevention strategies, including cleaning, mask requirements, COVID screening, quarantining, contact tracing and more. Findings show the most common mitigation strategy was a system to report COVID outcomes (95%) and the least common action was to offer COVID screening testing to students and staff (9%).
• As the public health emergency, which began in the spring of 2020, created the largest disruption to K-12 in-person learning in modern schooling, the research into schools' responses can help education leaders plan for future prevention measures of infectious diseases and identify schools to prioritize for resources, the study said.

Dive Insight:

The study, which will be published in the May journal of Emerging Infectious Diseases, looked at the prevalence of mitigation strategies but didn't examine the effectiveness of schools’ COVID actions. The nationally representative survey, which was answered primarily by principals and school nurses in 437 public schools, was conducted Oct. 1-Nov 19, 2021.

Throughout the pandemic, the CDC provided updated guidance to schools on COVID mitigation strategies, as well as reports on impacts of those precautions. States, districts and schools, however, could adopt their own guidance and weren't mandated to follow CDC recommendations.

After the largest school shutdown ever, in spring 2020, many schools attempted to open to in-person learning during the 2020-21 school year. Schooling, however, remained disjointed that year. According to the National Center for Education Statistics, in February 2021, 43% of 4th and 8th grade students were attending schools remotely and 35% of students in those grades were learning in-person.

A CDC report from December 2020 had estimated that COVID mitigation strategies for the 2020-21 school year could range from $55 to $442 per student, or as much as $22 billion, for the nearly 51 million K-12 students enrolled in public schools.

By February 2022, 99% of schools were open for in-person learning, according to NCES. But even as schools kept campuses open, many students and staff were temporarily absent due to illness from the virus spread and being quarantined for being close contacts. NCES data showed that in February 2022, 74% of public schools had to quarantine any students.

The recent CDC study on mitigation strategies showed that initiatives requiring less resources were more commonly used than those needing more funding and time. For instance, 66% of schools required masking but only 31% offered on-campus COVID vaccinations to staff and students.

The study's authors said its finding that schools with a full-time school nurse were more likely to have several prevention strategies aligns with other research that links nurses with health-promoting practices and positive student health outcomes.

Of the schools that responded to the CDC survey, 60% had a full-time school nurse and 17% had a school-based health center. According to the National Association of School Nurses, 35% of schools employ part-time school nurses and 39% employ a full-time school nurse.

Boosting the school nurse workforce and investing in school health programs "could provide immediate benefits for COVID-19 prevention in schools and also lead to long-term gains in emergency preparedness for schools, as well as positive downstream effects for other student health-related outcomes," the study said.