General FAQ

A person is said to have a “case” of COVID-19 if their SARS-CoV-2 infection has been confirmed by a laboratory test.

Close contact is defined as being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period OR having exposure of any duration to the person’s respiratory secretions (for example, coughed or sneezed on; shared a drinking glass or utensils; kissing) while they were contagious. A person with COVID-19 is considered to be contagious starting from 2 days before they became sick, or 2 days before they tested positive if they never had symptoms. Exception: In K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students are wearing well-fitting masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. This exception does not apply to teachers, staff, or other adults.

To be considered exposed to COVID-19, you have to have had close contact with someone who is suspected or confirmed to have COVID-19. Close contact includes:

• Being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period, OR
• Having exposure to respiratory secretions from a person with COVID-19 (e.g., being coughed or sneezed on, sharing a drinking glass or utensils, kissing), OR
• Caring for a person who has COVID-19, OR
• Living with a person who has COVID-19 

Exception: In K-12 settings, a student who is within 3-6 feet from an infected student is not considered a close contact as long as both students are wearing well-fitted masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. NOTE: This exception does not apply to teachers, staff, or other adults.  

A person with COVID-19 is considered to be contagious starting two (2) days before they became sick (or 2 days before they tested positive if they never had symptoms) until they meet the criteria to discontinue isolation.

COVID-19 spreads through close contact with an infected person. This can be either by being within 6 feet of a person with COVID-19 for a total of 15 minutes or more over a 24-hour period or having exposure to the person’s respiratory secretions (for example, coughed or sneezed on; shared a drinking glass or utensils; kissing) while they were contagious, caring for a person who has COVID-19, or living with a person who has COVID-19. Your local health department will reach out to you with more recommendations if you are identified as a close contact during contact tracing. Using COVIDWISE can help keep track of exposure. COVIDWISE is an early notification tool that individuals can use to notify contacts, or be notified themselves of an exposure.

•  Quarantine. VDH recommends that you self-quarantine (stay home) for 14 days after the last time you had contact with that person and practice physical distancing. Do not go to work or school during this time period. Avoid all public spaces, public activities, and group gatherings and do not take public transportation. If necessary, your local health department can ensure that your basic needs (for example, food and medication) are being met while you have to be in quarantine. 

• Monitor your health closely during this 14-day time period. When monitoring your health, be aware of the most common signs of COVID-19 (fever, cough, shortness of breath). Other signs of COVID-19 include chills, muscle pain, headache, sore throat and a new loss of taste or smell. Not everyone with COVID-19 will have all symptoms and fever might not be present. 
• Get tested. VDH recommends getting tested as soon as you know you were exposed and again 5 to 7 days after your exposure if your first test was negative. You might not need to get tested even if you have close contact with someone with COVID-19 and if you have recovered from COVID-19 in the past 3 months and do not have new symptoms. Fully vaccinated people should be tested 3-5 days following a known exposure to someone with suspected or confirmed COVID-19, even if you don’t have symptoms. Fully vaccinated people with ongoing COVID-19 exposure (i.e. household contact) should get tested 3-5 days after their first exposure and again get tested 3-5 days after the end of isolation for the person with COVID-19. More information can be found on the VDH COVID-19 Testing page here. For easy to read information on COVID-19 testing, click here.
• Answer the phone call. Your local health department will reach out to you with more recommendations if you are identified as a close contact during contact tracing. If you know you were a close contact to someone with COVID-19 while they were contagious, stay home and monitor your health, even if the health department does not call you.
• Respond to notifications. If you use the COVIDWISE app and receive a notice that you have been exposed, stay home, self-quarantine, and monitor your health after the potential exposure.

Certain people are not required to stay home (quarantine) after exposure. This includes people who: 

• People who have had COVID-19 within the past 3 months as long as they do not develop new symptoms*.
• People who have been fully vaccinated for COVID-19 as long as they have no symptoms. However, fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should isolate if they test positive.
• Healthcare personnel (HCP) who are fully vaccinated for COVID-19 do not need to stay home (quarantine) after a workplace or community-associated exposure or be restricted from work as long as they do not have any symptoms and do not have any conditions that weaken the immune system (e.g., organ transplantation, cancer treatment). HCP should continue to follow quarantine recommendations after close contact and follow all travel recommendations. For additional details, see here.
• People who have been fully vaccinated for COVID-19 and who have either traveled in the United States or arrived back in the United States after traveling internationally. Visit VDH’s Travelers website for information about testing requirements and recommendations for travelers.
• People who have had close contact with a person who was a close contact to someone with COVID-19 (“contact of a contact”). If your contact person tests positive for COVID-19, then you should stay home (quarantine).

*It is very important that people who are not fully vaccinated, but who are not required to stay home (quarantine) because they have had COVID-19 in the past 3 months, monitor their health for 14 days after their last exposure and continue following all recommendations (e.g., wear a mask, stay at least 6 feet away from others, avoid crowds and poorly ventilated areas, and wash hands often). Even if you are fully vaccinated, to maximize protection from the Delta variant and prevent possibly spreading it to others, wear a mask indoors in public if you are in an area of substantial or high transmission.

People who are not required to stay home (quarantine) after exposure must still watch for symptoms of COVID-19 for 14 days and continue to wear a mask, stay at least 6 feet away from others, avoid crowds, and wash hands often.

It can take up to 14 days after an exposure for you to develop COVID-19. It is safest to stay home (quarantine) for 14 days. If you are not able to stay home for 14 days after your last exposure and you do not have symptoms, you have 2 options*:

• Counting your date of last exposure as Day 0, you may leave home after Day 10; or

• If viral PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. Even if you receive a negative test result before Day 7, you should not leave home yet. 

Even if you do not stay home for the recommended 14 days, it is very important to continue monitoring for symptoms and follow all recommendations (e.g., wear a mask, stay at least 6 feet away from others, wash hands frequently, and avoid crowds) for the full 14 days after the last exposure. 

*These options to leave home (end quarantine) earlier than 14 days after exposure do not currently apply to healthcare workers or people in healthcare settings. People with certain jobs (e.g., critical infrastructure workers other than education sector workers) should stay home (quarantine) if they have been exposed, but they may be allowed to go to work if the business cannot operate without them. They can only go to work if they do not have any symptoms and if additional precautions are taken to protect them and the community. Learn more about VDH's recommendations for potential exposures for critical infrastructure workers.

If you are identified as a close contact of a person with COVID-19 and are unvaccinated, VDH recommends being tested immediately and then tested again in 5-7 days after last exposure if the initial test is negative or immediately if symptoms develop during quarantine.

Fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should self-isolate if they test positive. Fully vaccinated people with ongoing COVID-19 exposure (i.e. household contact) should get tested 3-5 days after their first exposure and again get tested 3-5 days after the end of isolation for the person with COVID-19. They should wear a mask when in contact with the person with COVID-19 throughout the infected person’s isolation period and also wear a mask indoors in public until 14 days after the infected person’s isolation period ends or until the fully vaccinated close contact receives their final test result.

More information can be found on the VDH COVID-19 Testing website here.

It can take up to 14 days after an exposure for you to develop COVID-19. This is why VDH and the Centers for Disease Control and Prevention (CDC) advise people to stay home (quarantine) for 14 days after their last contact. It is safest to stay home for 14 days. If you are not able to stay home for 14 days after your last exposure and you do not have symptoms, you have 2 options*:

• Counting your date of last exposure as Day 0, you may leave home after Day 10; or

• If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet. 

*These options to leave home (end quarantine) earlier than 14 days after exposure do not currently apply to healthcare workers or people in healthcare settings. People with certain jobs (e.g., critical infrastructure workers other than education sector workers) should stay home (quarantine) if they have been exposed, but they may be allowed to go to work if the business cannot operate without them. They can only go to work if they do not have any symptoms and if additional precautions are taken to protect them and the community. Learn more about VDH's recommendations for potential exposures for critical infrastructure workers.

Additionally, for unvaccinated individuals CDC recommends being tested immediately after being identified as a close contact and tested again in 5-7 days after last exposure if the initial test is negative or tested immediately if symptoms develop during quarantine. Fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. They should isolate if they test positive. If you have tested positive for COVID-19 in the past 3 months, you may not need to be tested.

More information can be found on the VDH COVID-19 Testing website here.

If you had or continue to have close contact with a contact of someone with COVID-19, you do not need to be tested or stay home (quarantine) just because you are a contact of a contact. But stay in touch with that contact person. If your contact person tests positive for COVID-19, then you become a true close contact and should stay home (quarantine) if unvaccinated.

Yes. You can lower your risk by having the person with COVID-19 wear a mask, staying at least 6 feet away, wearing a mask yourself, and limiting the amount of time you spend in the room. Having good ventilation in the room, such as by opening windows, can help, too. 

Fully vaccinated people who have come into close contact with someone with COVID-19 should be tested 3-5 days following the date of their exposure and wear a mask in public indoor settings for 14 days or until they receive a negative test result. More information can be found on the VDH COVID-19 Testing website here.  

If you have been identified as a close contact and are not fully vaccinated,you should be tested immediately. If you test negative, you should be tested again 5-7 days after your last exposure or immediately if symptoms develop. If you have tested positive for COVID-19 in the past 3 months, you may not need to be tested. 

If you are NOT fully vaccinated, you should continue to take COVID-19 precautions (e.g., wear a mask, practice physical distancing, avoid crowds and poorly ventilated areas, and wash your hands often). If you have had close contact with someone with COVID-19, and even if you don’t have symptoms, it is important to stay at home for 14 days since your last exposure if you are able to. This is the safest option, as opposed to shortened quarantine options.  It can take up to 14 days after exposure to the virus for a person to develop COVID-19 symptoms. By staying home and away from others for 14 days, you lower the chance of passing COVID-19 to others in case you do get sick. 

If you are not able to stay home for 14 days after your last exposure and you do not have symptoms, you have 2 slightly less safe options*:

• Counting your date of last exposure as Day 0, you may leave home after Day 10; or

• If PCR or antigen testing is available, you can get tested. You may leave home after Day 7 if the PCR or antigen test performed on or after Day 5 is negative. If you receive a negative test result before Day 7, you should not leave home yet. 

*These options to leave home (end quarantine) earlier than 14 days after exposure do not currently apply to healthcare workers or people in healthcare settings. People with certain jobs (e.g., critical infrastructure workers other than education sector workers) should stay home (quarantine) if they have been exposed, but they may be allowed to go to work if the business cannot operate without them. They can only go to work if they do not have any symptoms and if additional precautions are taken to protect them and the community. Learn more about VDH's recommendations for potential exposures for critical infrastructure workers.

 If you have been in close contact with a person with COVID-19, you should take your temperature twice daily* and remain alert for signs of illness, including fever, cough, chills, muscle or body aches, headache, sore throat, new loss of taste or smell, shortness of breath or difficulty breathing, congestion or runny nose, nausea or vomiting and diarrhea. 

*NOTE: It is important to not eat, drink, or exercise for at least 30 minutes before taking your temperature.

It may take up to 14 days after an exposure for you to develop COVID-19, which is why it is important to stay home during this time period. Some people with COVID-19 will be asymptomatic (have no symptoms), or have very mild symptoms but even these people with no or mild symptoms can still spread the disease. 

You can download VDH’s Daily Symptom Monitoring Log to help keep track of your symptoms. The health department might also use an electronic symptom monitoring program for those who have been assessed as exposed to COVID-19.

For more information on what you should do if you have been exposed to COVID-19

VDH Exposure to COVID-19 Website

People with COVID-19 might not have any symptoms. If they do have symptoms, these can range from mild to severe illness. Symptoms can include fever, chills, cough, shortness of breath or difficulty breathing, fatigue (feeling very tired), muscle or body aches, headache, sore throat, or new loss of taste or smell, stuffy or runny nose, nausea or vomiting, and diarrhea. Not everyone with COVID-19 will have all symptoms and fever might not be present. These symptoms may appear 2-14 days after exposure. This list does not include all possible symptoms and will be updated as we learn more about COVID-19. See the list of symptoms here. 

Because the symptoms of COVID-19 can look different in different people, it is important to get tested and/or speak to your healthcare provider if you have any concern.

You can use the Coronavirus Self-Checker to help determine when to seek testing or medical care.

Yes. It is possible to test positive for the flu (as well as other respiratory infections) and COVID-19 at the same time. It is important to get vaccinated against both COVID-19 and influenza this year.

Both influenza (flu) and COVID-19 are contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by the SARS-COV-2 virus and flu is caused by influenza viruses. Symptoms of flu and COVID-19 can be similar, so testing will likely be needed during flu season to know which disease you have.

Both the flu and COVID-19 can cause symptoms such as fever or feeling feverish/chills, cough, shortness of breath or difficulty breathing, fatigue (tiredness), sore throat, runny or stuffy nose, muscle pain or body aches, and headache among others. Change in or loss of taste or smell is sometimes seen in COVID-19 but is not seen with flu.

If you have any of these symptoms, you should contact your Healthcare Provider for evaluation, treatment and possible testing. Since both the flu and COVID-19 are contagious and can lead to serious illness, it is important to stay home while sick and for the recommended length of time after symptoms improve.   

For more information regarding similarities and differences between flu and COVID-19, click here.

VDH has created a chart comparing the symptoms of seasonal allergies, the common cold, strep throat, flu, and COVID-19. Please click here. 

If you have concerning symptoms, you should contact your healthcare provider for evaluation, treatment and possible testing.

If you think you might have COVID-19, it is important for you to stay home and away from others as much as possible. Rest and take care of yourself. If you are concerned about the symptoms you are having or they get worse, call your healthcare provider.  If symptoms are severe, such as if you are having trouble breathing, call 9-1-1 and get emergency care. The recommendations provided here apply to anyone who is sick or tests positive for COVID-19, even if they are fully vaccinated. 

Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive. By letting your close contacts know they may have been exposed to COVID-19, you are helping to protect everyone. Visit Exposure to COVID-19 to learn more about how to monitor your health and protect your community if you’ve been exposed to a person with COVID-19.  

Call 9-1-1 if you have a medical emergency: If you have a medical emergency and need to call 9-1-1, notify the dispatch personnel that you might have COVID-19. If possible, put on a mask before emergency medical services arrive. Emergency warning signs include (but are not limited to): trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse a person, or pale, gray or blue-colored skin, lips or nail beds, depending on skin tone. This list does not include all possible symptoms. Please consult your healthcare provider for any symptoms that are severe or concerning.

If you have symptoms or a positive test for COVID-19, follow COVID-19 prevention steps to help prevent the disease from spreading to people in your home and community. Find more details on VDH’s What to do if You are Sick webpage.

You can use the Coronavirus Self-Checker to help determine when to seek testing or medical care.

If you have symptoms or a positive test for COVID-19, follow the steps below to help prevent the disease from spreading to people in your home and community:

• Stay home except to get medical care. Do not go to work, school, or public areas. Avoid using public transportation, ride-shares, or taxis. Stay in touch with your doctor. Be sure to get care if you feel worse or think it is a medical emergency. 

• Separate yourself from other people and animals in your home as much as possible and avoid contact with other household members, including pets. This is known as home isolation.

• Call ahead before visiting your healthcare provider if you think you might have COVID-19, so the healthcare provider’s office can take steps to keep other people from getting infected or exposed.

• Get tested if you have symptoms, even if you are fully vaccinated. 

• Wear a mask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office. Make sure to remove your mask correctly, wash or store your mask properly and wash your hands after touching a used mask.

• Cover your coughs and sneezes and dispose of any tissues in a lined trash can. If you are able, wash your hands with soap or use an alcohol-based hand sanitizer that contains at least 60% alcohol right away.

• Clean your hands often. Avoid touching your eyes, nose, and mouth. Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.

• Avoid sharing personal household items (e.g., dishes, drinking glasses, towels, etc.)

• Clean all “high-touch” surfaces every day and your “sick room.” Let someone else clean and disinfect common areas but not your bedroom and bathroom. Clean and disinfect any surfaces that may have blood, stool, or body fluids on them. Follow the instructions on the label to ensure safe and effective use of the product. 

• • Tell your close contacts that they may have been exposed to COVID-19. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive. Visit Exposure to COVID-19 to learn more about how to monitor your health and protect your community if you’ve been exposed to a person with COVID-19.  

• Call 9-1-1 if you have a medical emergency. Emergency warning signs include (but are not limited to): trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse a person, or pale, gray or blue-colored skin, lips or nail beds, depending on skin tone. Please consult your healthcare provider for any symptoms that are severe or concerning.

Find more details about what to do if you are sick at: What to do if you are Sick

Clean high touch surfaces everyday. Practice routine cleaning of high touch surfaces and your “sick room.” Let someone else clean and disinfect common areas but not your bedroom and bathroom. High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Clean the area or item with soap and water or another detergent if it is dirty. Then use a household disinfectant.

If a caregiver or other person needs to clean and disinfect a sick person’s bedroom or bathroom, they should do so on an as-needed basis. The caregiver should wear a mask and wait as long as possible after the person has used the bathroom. The caregiver/other person should wear a mask and disposable gloves while cleaning. Do not touch your face while cleaning and be sure to wash your hands with soap and water after cleaning. If possible, open doors and windows to increase air circulation.

Clean and disinfect  any surfaces that may have blood, stool, or body fluids on them. Visitors, other than caregivers, are not recommended. See CDC’s Caring for Someone Sick at Home for more advice for caregivers.

Be sure to follow the instructions on the label to ensure safe and effective use of the product. Many products recommend keeping the surface wet for several minutes to ensure germs are killed. Many also recommend precautions such as wearing gloves and making sure you have good ventilation during use of the product. Most EPA-registered household disinfectants should be effective.

For more information, visit CDC’s Cleaning and Disinfecting Your Home.

 Older people (≥65 years of age) and persons living in a nursing home or long-term care facility are at greater risk for serious illness. 

 People of any age with certain medical conditions and disabilities are at increased risk of severe illness from COVID-19. A list of specific medical conditions can be found here.

Systemic health and social inequities have put many people from racial and ethnic minority groups at increased risk of getting very sick and dying from COVID-19. See CDC’s website for steps you can take to reduce the risk of COVID-19.

  Most people with COVID-19 can be ‘released’ from isolation and can be around others after: 

• At least 10 days have passed since your symptoms first appeared AND
• At least 24 hours with no fever without fever-reducing medication AND
• Other symptoms have improved (Note: the loss of taste or smell might last for weeks or months after recovery. This should not delay the end of isolation)

If you tested positive for COVID-19 but never had any symptoms, you can be around others after 10 days have passed since the first positive diagnostic test.

For more information, see: 

What to do if you have confirmed or suspected coronavirus disease (COVID-19)? 

CDC Interim Guidance on Home Isolation 

With certain diseases, including sometimes with COVID-19, the amount of oxygen in our blood can sometimes fall below normal levels. When oxygen levels are too low, we may need to take extra oxygen in a process called oxygen therapy. An oxygen concentrator is a medical oxygen therapy device that can sometimes help get extra oxygen into the body but it should only be sold and used with a
doctor’s prescription.

Because there are risks involved in both getting too much oxygen and not enough oxygen, using an oxygen concentrator to get extra oxygen without talking with a doctor first can do more harm than good. On one hand, getting oxygen concentrations that are too high can damage your lungs. On the other hand, if you really do have COVID-19, using an oxygen concentrator on your own can lead to a delay in receiving the best available treatment.

Sometimes oxygen concentrators are sold online but buying or using any of these without a prescription is not approved by the FDA. Using an oxygen concentrator on your own should not replace staying alert for early COVID-19 symptoms such as fever and cough or seeking medical help when you need it.

The FDA provides information here.

A pulse oximeter is a device used by healthcare professionals to measure the oxygen level (oxygen saturation) of the blood. Low blood oxygen levels can be a sign of COVID-19, but it is only one of many signs and symptoms that may be present during illness. Use of a pulse oximeter should only be used under the direction and supervision of a physician. A pulse oximeter should not replace being alert for early COVID-19 symptoms such as fever and cough.

Any private medical information should be shared only at the discretion of the individual and with healthcare providers who need the information to provide necessary medical care services. In addition, a person suspected or confirmed to have COVID-19 should notify people who they have been in close contact with so that the contacts can follow public health recommendations and should follow any reporting policies set up where they work to help prevent the spread of disease. 

If you have a confirmed positive lab result, both the lab and your healthcare provider are required by state regulation to report your status to the local health department. Someone from the health department may get in touch with you.

Reinfection means a person was infected (got sick) once, recovered, and then later became infected again. Cases of reinfection with COVID-19 have been reported, but remain rare​.​ Based on what we know from similar viruses, some reinfections are expected. We are still learning more about COVID-19. At this time, whether you have had COVID-19 or not, the best way to prevent infection is to take steps to protect yourself.

A CDC MMWR highlighted the fact that being unvaccinated was associated with 2.34 times the odds of reinfection compared with being fully vaccinated.

For more information on reinfection, click here.

A breakthrough infection is an infection with the virus that causes COVID-19 even after you have been vaccinated. This is an expected occurrence for a small percentage of those receiving any vaccine, since no vaccine for any disease is 100% effective in preventing infection in every person who receives it. If breakthrough infections occur, they appear to be mild. The COVID-19 vaccines continue to be highly protective against severe illness.

Although most people with COVID-19 get better within weeks to months of illness, some do not. CDC and experts around the world are working to learn more about short- and long-term health effects associated with COVID-19, who gets them, and why. CDC uses the term post-COVID conditions to describe health issues that persist more than four weeks after first being infected with the virus that causes COVID-19.

Experts do not know why or how often some people experience post-COVID conditions. Other infectious diseases can also cause longer-term symptoms for a variety of reasons. Some post-COVID conditions are likely to be similar to those seen in other infectious diseases, but others may be more specific to COVID-19.  Some post-COVID conditions involve symptoms similar to those caused by other health problems. Scientists are actively investigating the causes of post-COVID conditions.

More information on long-term effects of SARS-CoV-2 infection and COVID-19 illness can be found here.

Long COVID is also known as post-COVID conditions. Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. Long COVID can happen to anyone who has had COVID-19, even if the illness was mild, or they had no symptoms. People with long COVID report experiencing different combinations of the following symptoms:

• Tiredness or fatigue
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Headache
• Loss of smell or taste
• Dizziness on standing
• Fast-beating or pounding heart (also known as heart palpitations)
• Chest pain
• Difficulty breathing or shortness of breath
• Cough
• Joint or muscle pain
• Depression or anxiety
• Fever
• Symptoms that get worse after physical or mental activities

More information on long-term effects of COVID-19 illness can be found here.

Most post-COVID conditions can be diagnosed and managed by primary care providers, and if needed specialty care providers and support services (e.g., occupational therapy, physical therapy, social work) to maximize functional improvement and rehabilitation efforts. Healthcare professionals may also consider referral to multidisciplinary post-COVID care centers, where available, for additional care considerations. 

There are a number of post-COVID care centers (PCCC) in Virginia. The following list may not include all centers. VDH does not recommend or endorse specific clinics.

INOVA Post COVID-19 Recovery and Rehabilitation (Northern Virginia)

UVA Post COVID clinic (Charlottesville, VA)

Sheltering Arms Post-COVID-19 (coronavirus) rehabilitation (Mechanicsville, VA)

Centra Health Post-COVID Recovery Care Program (Lynchburg, VA)

Sentara Heart Hospital Post-COVID Clinic (Norfolk, VA)

The VCU Health Long COVID-19 Clinic (Richmond, VA)

Check out the following website(s):

VDH What to do if you have confirmed or suspected coronavirus disease (COVID-19)?

CDC COVID-19 Symptoms Website

CDC also provides easy to read materials: 

Things to Know about COVID-19

10 Things to Know When You Have COVID-19

Staying Away from People When You Have COVID-19

Virginia law requires that school boards provide in-person instruction in the 2021-2022 school year in adherence, to the maximum extent practicable, with applicable CDC mitigation strategies.

Virginia schools should select appropriate, layered prevention strategies to decrease the transmission of COVID-19 in schools. School officials, together with public health officials, need to consider multiple factors when making decisions about layered prevention strategies. In addition to important context about local communities, vulnerable populations, and equity concerns, the primary factors to consider are the level of community transmission, vaccination coverage, trends in school-related outbreaks or increasing cases, data from school screening testing programs, and the ages of the children served in a given school. Key prevention strategies include: promoting vaccination; consistent and correct use of masks; physical distancing; screening testing; ventilation; handwashing and respiratory etiquette; cleaning and maintaining healthy facilities; staying home when sick and getting tested; and contact tracing in combination with isolation and quarantine.

As of August 12, 2021, a Public Health Order requires all individuals aged two and older to wear masks when indoors at public and private K-12 schools, regardless of vaccination status. The Order also applies to Pre-K if the program is at a K-12 school. The Order does not apply to outdoor school settings. VDH recommends those who are not fully vaccinated wear masks in crowded outdoor settings or during outdoor K-12 settings or during outdoor activities that involve close contact with other people, but it is not a requirement.

For additional details, please see VDH Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools. 

Yes. On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. Senate Bill 1303 requires schools to provide in-school instruction in accordance, to the maximum extent practicable, with the mitigation strategies provided by the CDC. These mitigation strategies include mask wearing indoors for all students, staff, and visitors regardless of vaccination status.

In Virginia’s 2021 legislative session, Senate Bill 1303 passed which requires:

Each school board shall offer in-person instruction to each student enrolled in the local school division in a public elementary and secondary school for at least the minimum number of required instructional hours and to each student enrolled in the local school division in a public school-based early childhood care and education program for the entirety of the instructional time provided pursuant to such program. For the purposes of this act, each school board shall (i) adopt, implement, and, when appropriate, update specific parameters for the provision of in-person instruction and (ii) provide such in-person instruction in a manner in which it adheres, to the maximum extent practicable, to any currently applicable mitigation strategies for early childhood care and education programs and elementary and secondary schools to reduce the transmission of COVID-19 that have been provided by the federal Centers for Disease Control and Prevention.

• Key reasons for the issuance of the Order include:
• Keeping students in school for in-person learning remains a priority of the

Commonwealth. Consistent masking in schools will help reduce the chances of

students becoming exposed to COVID-19 while at school, and will reduce the

 overall number of students having to remain at home for quarantine.

• CDC recommends universal indoor masking for all teachers, staff, students, and

visitors to schools, regardless of vaccination status.

• Vaccination of those who are eligible remains the most important strategy to

combat COVID-19.

• While cases in Virginia have increased rapidly since mid-June 2021,

masks are a proven tool to reduce in-school transmission, even in communities

with low vaccination rates and high levels of spread.

• Delta is more contagious than earlier forms of the virus and likely causes more

infections. Preliminary evidence suggests some fully vaccinated people who

become infected with this variant can spread the virus to others.

• Children younger than 12 years old are not yet eligible to receive the COVID-19 vaccine.
• A large proportion of older students remain unvaccinated. 
• Outbreaks can and have occurred in K-12 schools in Virginia. While fewer children have been sick with COVID-19 compared with adults, children can be infected with the virus that causes COVID-19, can get sick, can spread the virus to others, and can have severe outcomes. Masks are a proven tool to reduce in-school transmission.
• The Order does not apply to outdoor school settings. VDH recommends those who are not fully vaccinated wear masks in crowded outdoor settings or during outdoor activities that involve sustained close contact with other people, but it is not a requirement.

For additional information, see VDH Information on Mask Webpage and Interim Guidance for the 2021-2022 school year. 

Additional FAQs on the Public Health order can be found here. 

Please see the Department of Education FAQs for additional information. 

Yes. On January 29, 2021, CDC issued an Order that required face masks to be worn by all people while on public transportation. This included the requirement for all individuals aged two and older to wear a mask on a school bus. Bus drivers are not required to wear a mask when alone on a bus. VDH should encourage and promote awareness of the federal order, but the federal order is not enforceable by VDH.

Keeping students in school for in-person learning remains a priority of the Commonwealth. While cases in Virginia have increased rapidly since mid-June 2021, masks are a proven tool to reduce in-school transmission, even in communities with low vaccination rates and high levels of spread. In many cases, wearing a mask in school can help prevent a child from having to quarantine when classmates test positive for COVID-19. Delta is more contagious than earlier forms of the virus and causes more infections. Children younger than 12 years old are not yet eligible to receive the COVID-19 vaccine. A large proportion of older students remain unvaccinated.

Outbreaks can and have occurred in K-12 schools in Virginia. While fewer children have been sick with COVID-19 compared with adults, children can be infected with the virus that causes COVID-19, can get sick, can spread the virus to others, and can have severe outcomes. Virginia’s hospitalization and fatality data by age group and locality can be found here.

COVID-19 related hospitalizations have been increasing since July 2021. CDC provides a tool to view weekly case trends by age group here. The default setting depicts data for the entire United States, but state data can be selected and viewed individually. The VDH outbreak dashboard provides information about reported outbreaks across the state and can be sorted by locality and exposure setting. VDH uses the national outbreak definition which can be found here. There is concern that these numbers may continue to increase as school-aged children return to classroom settings if prevention measures are not implemented. Furthermore, although many young children may not have severe symptoms of illness from the virus that causes COVID-19, they may pass it to immunocompromised people or people who cannot get vaccinated in their household or community.

Additional FAQs on the Public Health order can be found here.

The Order states that This Order shall be effective August 12, 2021, and shall remain in full force and effect until the CDC guidelines for K-12 schools change, unless this Order is sooner amended or rescinded. Several factors may also be considered, including the level of community transmission, health system capacity, and vaccine eligibility. The Order is a temporary but necessary measure, and until CDC guidelines change or trends are more favorable, the Order will remain in place.

If you would like to report a violation of the Public Health Order, contact your local health department. Contact information for your local health department can be found here: https://www.vdh.virginia.gov/local-health-districts/.

VDH fully expects all individuals to comply with this Public Health Order. Orders of the Commissioner or the Board of Health may be enforced pursuant to Virginia Code §32.1-27 which provides, in part, that any person not obeying an order of the Commissioner may be compelled in a proceeding instituted in an appropriate court by the Board or Commissioner to obey such order. Any parent or guardian of a student aggrieved by a school board action should consult with an attorney as to how to proceed.

Each school division is deciding how to safely teach children by applying everyday prevention measures in the school setting. Many decisions involve ways to minimize interactions and maximize distance between people within the school. Please contact your local school division for more information regarding reopening of schools. Frequently asked questions are available at Virginia Department of Education FAQs.  

CDC provides additional FAQs here: Parents and Caregivers – What Is Your School Doing to Protect Your Child from COVID-19?

If your child is identified as a close contact of someone with COVID-19, your child needs to follow testing and quarantine guidance from your school. A representative from the local health department may also call parents of close contacts to provide quarantine guidance.

People who have had close contact with someone who has COVID-19 need to stay home and away from others. This is called quarantine. CDC and VDH recommend a 14-day quarantine for unvaccinated close contacts before returning to normal activities, including in-person school and school activities. A 14-day quarantine is the safest option. This is because your child can become infected with COVID-19 but may not develop the infection for up to 14 days. In fact, some data show that a person may spread COVID-19 before they show symptoms or even without symptoms.

However, VDH and CDC recognize that the 14-day quarantine duration can cause substantial personal burden and might lead to low compliance. Therefore, VDH allows for shorter quarantine durations as acceptable alternatives, including for teachers, staff, and students of K12 schools.

If your child develops symptoms at any point during quarantine (even if they are fully vaccinated), they need to get tested and isolate immediately. Be sure to notify your school if this happens and reach out to your healthcare provider.

If your child is fully vaccinated, CDC and VDH recommend that they get tested 3-5 days after being exposed and monitor for any symptoms for 14 days. Your fully vaccinated child does not need to quarantine as long as they do not have symptoms.

There are options for a shorter quarantine. A full 14-day quarantine period might be required by your school, daycare, or workplace. Contact your school, daycare, or workplace to learn more and follow its quarantine recommendations.

Information for schools and parents about contact tracing and quarantine is available on the VDH K-12 page. VDH’s Exposed to COVID-19 webpage also provides the most updated information: vdh.virginia.gov/coronavirus/local-exposure/. Your local health department continues to be the best resource and point of contact for guidance regarding your specific potential exposure. Large exposure events require extensive resources from local health departments, so response times may be slower as they follow up with people identified as close contacts.

VDH has a data dashboard called COVID-19 Outbreaks by Selected Exposure Settings that is available here. VDH posts information about reported COVID-19 outbreaks, including those in K-12 public and private schools with 30 or more students and staff members, on this dashboard. This dashboard is updated weekly. You can look at all the outbreaks reported to VDH across all exposure settings or you can use the filter to look at only the outbreaks in the K-12 settings (select “K-12” in the Facility Type drop-down menu). There will be no identifiable information in the data presented.

CDC and VDH do not recommend requiring a negative COVID-19 test in order for students or staff to return to school, instead only those who have met the CDC criteria for return to school should do so. VDH created a release from isolation or quarantine guide to determine when those exposed to or diagnosed with COVID-19 can return to work or school.  However, some school divisions may require a note from a provider to return to school or work. Please check with your local school division for guidance.

Schools should avoid offering any self-serve food or drink options, such as hot and cold food bars, salad or condiment bars, and drink stations and serve individually plated or pre-packaged meals, while ensuring the safety of children with food allergies.

As feasible, schools should encourage physical distancing in food service lines and at tables while eating. Students and staff should wash their hands with soap and water for 20 seconds or use a hand sanitizer that contains at least 60% alcohol before and after eating. Schools should clean and disinfect food line areas, tables, and chairs between uses. CDC guidance and CDC FAQs.  Your individual school will decide how school lunches will be provided to students. VDOE has provided guidance to schools. Please discuss any concern you may have with your local school division.

For more information, see DOE reopening FAQ (under School Nutrition)

Make sure that you provide the school with health care provider documentation (HCP) of the child’s food allergy and treatment protocols. This includes HCP authorization and parental consent to administer medication to students in the event of anaphylaxis or illness due to exposure. Meet with school staff, including teachers, school nurses and administrators, to discuss safety measures and establish/update a Section 504 plan.  Please discuss any concern you may have with your local school division.

Make sure that you provide the school with health care provider documentation (HCP) of the child’s healthcare needs and treatment protocols. This includes HCP authorization and parental consent to administer medication or administer treatments to students. The CDC offers guidance for families of children needing extra precautions during COVID. Families are encouraged to meet with school staff, including teachers, school nurses and administrators, to discuss safety measures and establish/update a Section 504 plan.  Please discuss any concern you may have with your local school division.

The Virginia Department of Health is encouraging students and their families to prepare for attending school in person. Information for parents is available on the VDH Back to School Website. Many students will need updated immunizations, physicals for enrollment, medication administration, documentation for health conditions and emergency action plans for chronic conditions (asthma, allergy, diabetes and seizures). The AAP offers guidance to families and their children returning Back to School in the fall. Please contact your child’s health care provider to discuss your child’s medical needs.

Children need to continue to get the recommended vaccines on schedule. Vaccines provide individual and community immunity. The Virginia Department of Education is requiring all public school students to have required immunizations to be enrolled in school. Please continue to focus on your child’s immunization.

The Code of Virginia requires that children be adequately immunized (§ 22.1-271.2) and receive a school entrance physical (22.1-270) within the 12 months prior to entering public kindergarten or elementary school. Other required immunizations include Human Papillomavirus (HPV) for girls and boys entering the seventh grade   Diphtheria, Tetanus, and Pertussis (Tdap) booster for entry into seventh grade and Meningococcal  Conjugate Vaccine (MenACWY) for entry into seventh and 12th grade. 

Information for parents is available on the VDH Back to School Website.  

Some COVID-19 vaccines are available in the United States for use in those 12 years of age and older. We are constantly monitoring the vaccine guidelines, and this information will be updated as needed. Information for parents is available on the VDH Back to School Website. If your child is eligible to receive the COVID-19 vaccine, please discuss this vaccine with your healthcare provider.

Currently, the COVID-19 vaccine is not mandatory to return to school. The vaccine is one of the critical tools needed to reduce the spread of this virus. Vaccinating teachers, school staff, and students when eligible for vaccination is a critical layer of prevention and protection for all. Achieving high levels of vaccination among eligible students, teachers and staff is one of the most critical strategies to help schools safely operate. We encourage you to have a conversation with your child’s healthcare provider.  

For those that are eligible (12 years and older) to receive the COVID-19 vaccine and other vaccines may now be administered without regard to timing. This includes simultaneous administration of COVID-19 and other vaccines on the same day, as well as co-administration within 14 days. Testing for TB infection with one of the immune-based methods, either the tuberculin skin test (TST) or an interferon release assay (IGRA), can be done before, after, or during the same encounter as COVID-19 vaccination. Information for parents is available on the VDH Back to School Website.

The state does not require COVID-19 vaccines for students or staff; but local divisions may choose to require the vaccine of school staff as a matter of employment. Additionally, Virginia school division staff may be covered under forthcoming federal vaccination requirements. This requirement is not yet in place and additional information is forthcoming.

But vaccination is the leading public health prevention strategy to end the COVID-19 pandemic. Vaccinating teachers, school staff, and students when eligible for vaccination is a critical layer of prevention and protection for all. Achieving high levels of vaccination among eligible students, teachers and staff is one of the most critical strategies to help schools safely operate.

For more about the COVID-19 vaccine, and where to find a free one near you, please visit https://www.vdh.virginia.gov/covid-19-vaccine/

School divisions are subject to the Standard for Infectious Disease Prevention of the SARS-CoV-2 Virus That Causes COVID-19, issued by the Virginia Safety and Health Codes Board. The most recent version became effective September 8, 2021.

The amended Department of Labor and Industry (DOLI) Standard includes requirements for all employers as well as specific requirements for higher-risk workplaces (16VAC25-220-60, page 37), which includes school divisions. The Standard also requires employers with higher-risk workplaces to create a written Infectious Disease Preparedness and Response Plan (16VAC25-220-70, page 44) and requires training (16VAC25-220-80, page 47) of certain employees as well.

Students enrolled in school for the 2021-2022 school year will need to be up to date on their school required immunizations. Please consult with your healthcare provider for school required vaccine guidance. Information for parents is available on the VDH Back to School Website.

The Virginia Department of Health has issued guidance related to recreational and school-based athletics, available online here. With regard to masks, they recommend the following:

Indoors: If tolerable, wear a mask while playing indoor sports, especially any sport that involves close contact. At K-12 schools, masks are not required when exercising, but should still be worn if possible when engaging in active sports play. Anyone (age 2 and up) should wear a mask on the sideline, in the locker room, or in the stands when in a school or when transmission levels are substantial or high. 

Outdoors: Playing outdoor sports is generally safer than indoors. Unvaccinated athletes, coaches, officials, and spectators should strongly consider wearing masks, especially if close contact is likely to occur. Fully vaccinated people might also consider wearing a mask in crowded outdoor spaces if they or someone in their household is immunocompromised.

However, the Virginia High School League governs athletic competitions and local school divisions may have their own policies in place (such as vaccine requirements for athletes or mask mandates for outdoor spectators).

Students enrolled in school for the 2021-2022 school year will need to be up to date on their school required immunizations. Please consult with your healthcare provider for school required vaccine guidance. Information for parents is available on the VDH Back to School Website.

The risk of disease is lower when your child is outdoors compared to indoors, where there is less fresh air. School divisions have the ability to implement local mask policies based on community level conditions and public health recommendations. VDH recommends that individuals aged two and older who are not fully vaccinated wear a mask in crowded outdoor settings.

Ventilation is one component of maintaining healthy environments, and is an important COVID-19 prevention strategy for schools and childcare programs. Wearing a well-fitting, multi-layer mask helps prevent virus particles from entering the air or being breathed in by the person wearing a mask. Good ventilation is another step that can reduce the number of virus particles in the air. The risk of disease is lower when your child is outdoors compared to  indoors, where there is less fresh air.  Along with other preventive actions, ventilation can reduce the likelihood of spreading disease. The CDC has published guidance for schools on ventilation and can be found here:  ventilation in the school setting   

Drinking fountains should be cleaned and sanitized, but encourage staff and students to bring their own water to minimize use and touching of water fountains. For more information, click here.

Watch for signs of stress in your child. Some common changes to watch for include excessive worry or sadness, unhealthy eating or sleeping habits, and difficulty with attention and concentration. For more information, see the “For Parents” section on CDC’s website, Manage Anxiety and Stress. Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share facts about COVID-19 in a way that your child or teen can understand. Go to CDC’s Helping Children Cope with Emergencies or Talking with Children About COVID-19 for more information. The Virginia Department of education has resources for families: VDOE Support for Families. Schools are working to support mental health needs of students and staff.  Contact your local school division if you have questions or concerns. Information for parents is available on the VDH Back to School Website and Social Emotional Learning Resources for Parents.

COVID-19 spreads most often when attached to respiratory droplets produced when people cough, sneeze, sing, talk (especially loud talking), or breathe.

Masks act as a physical barrier to the spread of those droplets - and as a barrier to spread of COVID-19 - to uninfected people from already infected people. NOTE: Many infected people are unaware of their infection because they have not developed symptoms. 

Masks are protective in both directions. First, they reduce the amount of COVID-19 virus that infected people – even those who are infected but still without symptoms – shed into their environment. Second, when masks are properly designed and worn, they can also directly protect uninfected people by reducing the chance that they will breathe in enough virus particles shed by infected people to actually become infected themselves. An individual's benefit increases with increasing community mask use.

The CDC has also released several reports that highlight the importance of mask wearing specifically in schools. A summary of those findings can be found here. To mention a few:

• Schools without a mask requirement were 3.5 times more likely to have COVID-19 outbreaks compared to schools that started the year with a mask requirement. (Link)
• Increases in pediatric COVID-19 case rates during the start of the 2021–22 school year were smaller in U.S. counties with school mask requirements than in those without school mask requirements. (Link) 

Available data also shows that improving mask fit improves protection for the person wearing the mask.

However, it’s important to remember that the COVID-19 protection provided by masks is not absolute. Schools should follow the Interim Guidance for COVID-19 Prevention in Virginia PreK-12 Schools. This guidance emphasizes several key prevention strategies, including vaccination, masking, physical distancing, screening testing, ventilation, hand hygiene, cleaning, staying home when sick, and prompt contact tracing once any cases are identified. Of all available prevention strategies, vaccination, masking, and physical distancing should be prioritized.

Additional information on masks and mask use can be found here and here.

Masks are a key public health measure to decrease viral spread. There is no evidence to show that masks made for public use lower oxygen levels. Cloth and medical (or surgical) masks have breathable layers that will not cause your child to retain carbon dioxide or block the oxygen they need.

Most children, including children with most medical conditions, aged 2 or older can safely wear face masks for extended periods of time- including an entire school day.

Mask wearing for children at risk of COVID-19 exposure is also recommended as a safe practice by the American Academy of Pediatrics and by the American Lung Association.

There is no evidence that mask wearing weakens the immune system. Also, mask wearing does not interfere with lung development. Wearing a mask in class does not keep children from breathing properly or make their heart work harder, and also does not affect their emotional state or make it harder for them to remember class material. Teachers can learn from what doctors and nurses have done to help them communicate with children while wearing a mask, and use more gestures while speaking, like pointing to help focus children’s attention and waving hello. Posting pictures of the teacher without a mask in the classroom can also help students connect with their teacher.

N-95 masks provide a higher level of protection, but are typically reserved for medical professionals. There is some evidence that prolonged use of an N-95 mask can lead to some build-up of carbon dioxide levels in the body. However, these levels are still below short term acceptable levels. Children with lung conditions who may require higher levels of protection from their mask, should speak with their healthcare provider regarding these concerns.

Children with mental health issues that are exacerbated by mask wearing, should speak with their healthcare provider about alternatives and accommodations if needed.

To address parents and caregivers' concerns on the emotional toll the pandemic continues to have on children’s well-being and development, the AAP provides answers to some common questions about young children’s speech and language development with mask use and the physical impact of mask wearing on children. CDC has a resource toolkit designed to support parents in supporting their child’s mental health

The American Academy of Pediatrics offers advice about helping children get accustomed to masks. The A.A.P.’s suggestions include putting a mask on a child’s favorite stuffed animal, decorating masks so they’re more personalized and drawing a mask on your child’s favorite book character.

On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. For additional information, see VDH Information on Mask Webpage.  

Masks are not recommended for those under 2 years old, and anyone unable to remove the mask on their own. According to the A.A.P., children with “severe cognitive or respiratory impairments” might not be able to tolerate a mask. On the other hand, children who are at high risk for severe COVID-19, including those who are immunocompromised, might need more protection than cloth face coverings offer, and N95 masks are recommended for them. The AAP offers guidance to families and their children returning Back to School in the fall.

Wearing masks during physical activity may be considered. Some people may have a difficult time wearing a mask while exercising or playing a sport, and decisions to wear masks during play should be made on a case-by-case basis. Considerations may include the intensity of the sport and the likelihood of the mask getting caught on equipment or getting wet, and the vaccination status of participants.

The CDC states that “people who are engaged in high intensity activities, like running, may not be able to wear a mask if it causes difficulty breathing.  

On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status.The Order does allow for exemptions when students are exercising or using exercise equipment, but masks are still strongly encouraged. For additional information, see VDH Information on Mask Webpage

A person may play a wind or brass instrument without a mask as long as 6 feet of physical distance can be maintained from other people. Maintain at least 6 feet of distance during activities when increased exhalation occurs such as when singing, shouting, or playing wind/brass instruments. Consider increasing distance even more (10 feet apart) during these activities if the room size allows for it. Covers may also be used on wind and brass instruments to reduce droplet spread while playing. Limit activities that require close contact between performers (e.g., lifting a dancer, scenes in a play that require very close contact between actors), especially when indoors.  

For additional information, see VDH Information on Mask Webpage and VDH Guidance for Performing Arts.

On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This Order reinforces current state law, which requires Virginia schools to adhere to mitigation strategies outlined by the Centers for Disease Control and Prevention. The order applies to all individuals aged two and older. 

• This is based on the observation that COVID-19 infection rates are rapidly increasing across the Commonwealth, the Delta variant is more contagious than previous strains of the virus and can be spread by even those that are vaccinated, and face masks have been scientifically proven to be effective, well-tolerated and safe. For additional information, see Interim Guidance for the 2021-2022 school year. Masks must be worn on school buses, per a federal order.
• For additional information, see VDH Information on Mask Webpage

 CDC Guidance clarifies that child care providers should remove masks “before sleeping, napping, [and] when they may fall asleep (such as in a car seat or stroller).” Sleeping children may be unable to remove their masks if their breathing is obstructed, and children should not wear masks during nap time. For additional information, see VDH Information on Mask Webpage

Camps may follow CDC Guidance for Operating Youth Camps. 

At overnight camps taking place at K-12 schools, camps should follow CDC guidance for overnight camps.   

On August 12, 2021, the State Health Commissioner reissued a Public Health Order requiring all students, teachers, staff, and visitors in K-12 schools to wear masks indoors, regardless of vaccination status. This order applies to all activities on the grounds of private and public schools grounds during instruction, extra curriculars, social gatherings, etc.

The state recommends that schools follow CDC guidance on best practices for preventing the spread of COVID-19. To help school divisions decide how to best serve their communities, VDH and the Department of Education (VDOE) have updated Interim Guidance for K-12 School Reopening. The VDOE also advises local school divisions to work with local health officials and school board counsel on appropriate health and safety practices.

The CDC does not currently recommend universal symptom screening for K-12 schools. Parents or caregivers are strongly encouraged to monitor their children for signs of infectious illness every day and keep them home when they are sick. Screening procedures are available for students and staff who arrive with or develop symptoms during the course of the day.  The VDH has developed guidance for parents and school staff When Should a Child Stay Home From School and/or Child Care?.

Please discuss any concern you may have with your local school division.

• Parents or caregivers are strongly encouraged to monitor their children for signs of infectious illness every day. Students who are sick should not attend school in-person.
• CDC does not currently recommend universal symptom screenings (screening all students grades K-12) be conducted by schools.
  For more information, the VDH has developed guidance for parents and school staff When Should a Child Stay Home From School and/or Child Care? 

If a student or employee Experiences Symptoms of COVID-19 While at School, move the individual out of the classroom or group setting, isolate in a predetermined location, and inform the school nurse or school health staff member. School health staff must wear personal protective equipment (PPE), including a N-95 or surgical mask, goggles and gloves before entering into the room to evaluate the individual. Call the parent or family member of the employee to pick up and take home the ill person. If symptoms persist or worsen, or if laboratory testing might be warranted, they should contact their healthcare provider. If COVID-19 is suspected or confirmed, the ill person must stay home and be isolated from others for at least 10 days and until fever-free for at least 24 hours and others symptoms have improved. The VDH has developed guidance for parents and school staff When Should a Child Stay Home From School and/or Child Care? 

 If there is a confirmed case of COVID 19 in school, the local health department will work closely with school administrators to determine a course of action for their schools. Temporary school closures should only be necessary in the context of controlling spread associated with increased impact to school such as increased cases or outbreaks. The Virginia Department of Health (VDH) recommends that schools start by reviewing the Centers for Disease Control and Prevention (CDC) Guidance for COVID-19 Prevention in K-12 Schools. The CDC Guidance is best used together with Virginia’s Interim Guidance for COVID-19 Prevention in PreK-12 Schools and COVID-19 Resources provided by the U.S. Department of Education. The VDH will work closely with the school to make environmental cleaning recommendations, conduct contact tracing, and investigate any potential exposures. Please discuss any concern you may have with your local school division.

Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19. Parents of children who are medically fragile or have one or more chronic conditions should check with their healthcare provider about school attendance. In addition, employees that meet the criteria listed for ‘higher risk’ populations should check with their healthcare provider before returning to work. Schools should provide remote learning exceptions and teleworking options for students and staff who are at high risk of severe illness (as defined by the CDC). People who have a condition or are taking medications that weaken their immune system may not be fully protected even if they are fully vaccinated. Please discuss any concern you may have with your local school division.

People who are not fully vaccinated who have had close contact with someone with COVID-19 need to stay home and distanced from others (quarantine) for 14 days from the date of last exposure and monitor their health status closely. Close contact means being within about 6 feet for a total of 15 minutes or more over a 24-hour period. In indoor K-12 settings, a student who is within 3-6 feet of an infected student is not considered a close contact as long as both students wore well-fitting masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor. This exception does not apply to teachers, staff, or other adults in indoor K-12 settings. The VDH document Clarification of VDH K-12 Close Contact Definitions and Quarantine Periods provides clarification on how close contacts are assessed in K-12 schools. These unvaccinated individuals who are close contacts of persons with COVID-19 should be tested immediately after being identified, and if negative, tested again in 5–7 days after last exposure or immediately if symptoms develop during quarantine. They can leave quarantine after 10 days if no symptoms develop or after 7 days, if a COVID-19 test conducted on or after Day 5 is negative. VDH recommends a 14 day quarantine, as it is the safest option. 

The CDC provides guidance and a toolkit for people exposed to people with known or suspected COVID-19. VDH has developed algorithms to help guide schools: VDH Algorithm for Evaluating Non-Critical Infrastructure Workers with COVID-19 Symptoms or Exposures and  When Should a Child Stay Home From School and/or Child Care? Please discuss any concern you may have with your local school division.

CDC and VDH do not recommend requiring a negative COVID-19 test in order for unvaccinated students or staff to return to school. Unvaccinated individuals with suspected or confirmed COVID-19 should stay home and physically distance from others for at least 10 days and until at least 24 hours fever-free without the use of fever-reducing medicine and other symptoms have improved. More information is available in the CDC criteria for return to school  and the VDH guide for release from isolation or quarantine.  

Once the child meets the criteria to be released from isolation, the child may return to school and does not need to enter quarantine or be tested for a new exposure that occurs within the next 90 days.

 An individual diagnosed with COVID-19 should not return to work or school until they meet all criteria to end isolation:

• At least 10 days have passed since symptoms first appeared and
• At least 24 hours have passed with no fever without the use of fever-reducing medication, and
• Other symptoms have improved.

 VDH has developed algorithms to help guide schools When Should a Child Stay Home From School and/or Child Care?

VDH staff might need information about who was in different areas within the school or child care setting at a given time or contact information for children or staff associated with the facility and considered potentially exposed to a person with COVID-19. Staff of the school or child care facility will play an important role in supporting health department efforts to obtain this information. Similar collaboration occurs routinely for case and contact investigations of other communicable diseases and would be expected to continue seamlessly for COVID-19 investigations.  

Contact Tracing for COVID-19 in K-12 Schools: How to Prepare and What to Expect Infographic 

The CDC has developed a toolkit to help schools respond to COVID cases.

During the COVID-19 pandemic, asthma treatments using inhalers with spacers (with or without a face mask, according to each student’s individualized treatment plan) are preferred over nebulizer treatments whenever possible in the school setting. The use of asthma inhalers (with or without spacers or face masks) is not considered an aerosol-generating procedure.

CDC recommends that nebulizers in school should be reserved for instances where children cannot use inhalers, do not have access to an inhaler or for children who are in significant respiratory distress while awaiting emergency transport. 

 Suctioning and nebulizer treatments should be performed in a space that limits exposure to others and with minimal staff present, limited to the student and staff member performing the treatment.  The staff member should put on  proper personal protective equipment  (N95 mask, goggles or face shield, gloves and gown).  Rooms should be well ventilated or the treatment should be performed outside. After the student receives treatment, the room should undergo routine cleaning and disinfection. Routine cleaning and disinfecting of the room is adequate and the room does not need to be vacated for any period of  time. A list of EPA-approved disinfectants can be found here: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

Reducing the risk of exposure to COVID-19 by cleaning and disinfection is an important part of  school operations. The CDC has developed reopening guidance for cleaning and disinfecting schools, Cleaning and disinfection, and an infographic on cleaning your facility when someone has been diagnosed with COVID-19.

Being within 6 feet of a person who has COVID-19 for a total of 15 minutes or more over a 24-hour period, or having direct exposure to respiratory secretions (e.g., being coughed or sneezed on, sharing a drinking glass or utensils, kissing), or caring for a person who has COVID-19, or living with a person who has COVID-19. Exception: In indoor and outdoor K-12 settings, a student who was within 3 to 6 feet of an infected student is not considered a close contact as long as both students wore well-fitting masks the entire time. This exception may also be applied to school buses when the following criteria are met: 1.) Documented seating charts and 2.) Assurance that masks are worn and students remain in assigned seats, either via video monitoring if available, or attestation from the bus driver or monitor..  Students who were less than 3 feet apart for a total of 15 minutes or more are considered close contacts, even if both students wore masks. The K-12 exception does not apply to teachers, staff, or other adults. This means that the standard close contact definition is applied when assessing exposure in a K-12 setting that involves a student with an infected adult or an exposed adult. The VDH document Clarification of VDH K-12 Close Contact Definitions and Quarantine Periods provides clarification on how close contacts are assessed in K-12 schools.  The CDC has developed a toolkit to help schools respond to COVID cases. 

Diagnostic tests are used to identify current COVID-19 infection and should be used if your child has any symptoms. Screening tests are used regularly to identify unknown cases or cases without symptoms so that actions can be taken to quickly prevent further spread of COVID-19.The CDC provides FAQS for Parents and for additional information from VDH, see Interim Guidance for the 2021-2022 school year and K-12 Testing in schools. Contact your local school division for additional information.

Screening testing can help promptly identify and isolate cases, quarantine those who may have been exposed to COVID-19 and are not fully vaccinated, and identify clusters. This can help reduce the risk to students, teachers and staff, and controlling outbreaks before they expand can help limit any disruption to in-person education. Any screening test performed in the school setting is voluntary and requires parental consent prior to testing. Contact your local school division for additional information. The CDC provides FAQS for Parents and for additional information from VDH, see Interim Guidance for the 2021-2022 school year and  K-12 Testing in schools.

Screening testing can help promptly identify and isolate cases, quarantine those who may have been exposed to COVID-19 and are not fully vaccinated, and identify clusters. This can help reduce the risk to students, teachers and staff, and controlling outbreaks before they expand can help limit any disruption to in-person education. Screening testing can also be used to help evaluate and adjust prevention strategies and provide added protection for schools that are not able to provide optimal physical distance between students. Screening testing should be offered to students who have not been fully vaccinated when community transmission is at moderate, substantial, or high levels; at any level of community transmission, screening testing should be offered to all teachers and staff who have not been fully vaccinated. If screening testing is not feasible, schools can adopt a referral-based diagnostic testing approach. VDH has a testing site locator which may be helpful for schools to use for testing referrals.  

Pooled testing is a form of screening testing that may be used in schools. Pooled testing involves mixing several individuals’ test samples together into one “pool” and then testing the pooled sample for COVID-19. This approach increases the number of individuals that can be tested at one time and allows regular testing in the school for COVID-19.   

Any screening testing performed in the school setting is voluntary and requires parental consent prior to testing. Contact your local school division for additional information. 

Diagnostic testing is intended to identify current infection in individuals and should be performed on anyone that has signs and symptoms consistent with COVID-19.

Additional information about antigen testing is available.

While generic messaging may be shared with the school community regarding a positive test in the school, neither the student’s name or any other information that could potentially identify the ill person can be shared. The local health department will work with the student and their family to determine which individuals meet the close contact definition. The local health department will notify those individuals and provide information about disease prevention steps they should take, without disclosing personal identities.

This information helps school administrations and Local Health Departments make decisions based on the level of COVID-19 transmission rates in the community as well as the school's ability to implement prevention strategies. 

School administration and the local health department will work together to discuss the potential impact on in-person learning in the school setting.  Schools may need to make necessary changes to their individual school division educational plan depending on the level of transmission and the ability of a school to implement preventative measures.