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Los Angeles County public health officials announced Thursday that they’re offering school districts the option to allow unvaccinated students who have come into contact with a positive COVID-19 case to continue attending in-person classes under strict guidelines.

The modified quarantine option for K-12 students will only be offered under certain conditions, county public health Director Barbara Ferrer said in a briefing, adding that schools and school districts are not required to offer the modified option and may choose to continue with the customary quarantine requirements.

The announcement comes as coronavirus cases declined over the last three weeks across all pediatric age groups by about 40%.

Under the modified option, an unvaccinated student who has had exposure to a confirmed COVID-19 case can continue in-person instruction at school but must restrict all activities outside of “what’s necessary for their academic instruction,” Ferrer said.

Those who qualify for modified quarantine include close contacts whose exposure took place at school or at a school-supervised activity, when both the close contact and the case were masked during the entire exposure period, and the close contacts are not part of a defined outbreak. (A defined outbreak is when three or more linked cases with a probable transmission in schools or school activities occurs.)

“You have to be super careful that you know for sure, and you’re able to verify, that close contacts to cases had only mask-on-mask exposure,” Ferrer said. “And sometimes that’s hard. Particularly in large schools, that may be very difficult to do.”

Under the original customary quarantine rule, unvaccinated students were required to isolate at home for a minimum of 10 days if exposed. Fully vaccinated students who are asymptomatic were not, and are still not, required to quarantine after exposure.

To apply a modified quarantine, several criteria must be met:

  • First, the exposed students must remain asymptomatic for the duration of the period.
  • They must stay home except for classroom educational instruction activities.
  • They need to continue to always wear a mask indoors, outdoors and on the school bus, except for when they’re eating and drinking.
  • While they’re eating and drinking, these students need to maintain at least a 6-foot distance from others, and ideally they should be eating and drinking outdoors.
  • Students in modified quarantine must also be tested twice a week during their quarantine. The first test is recommended to take place one or two days after exposure, while the second test should be five days or later.
  • Modified quarantine can end when a second test is done at least five days after the exposure and the test is negative. (That’s the same as the rule for students who are doing a customary quarantine.) An exposed student can end modified quarantine after day seven.

When deciding whether to adopt a modified quarantine protocol, school districts should consider whether or not they have the resources to fully implement the requirements, Ferrer said. If exposure only happened in a classroom setting, it’s likely that everybody had their masks on, but it gets complicated when students are doing other activities together, particularly eating lunch or enjoying recess, she said.

“So schools will need to have that resource available, whereby they can do that work and in fact verify that this was a mask-on-mask exposure,” Ferrer added.

The decision to offer the modified quarantine comes after public health officials reviewed four weeks’ worth of data related to cases of close contacts and outbreaks at schools.

“We feel comfortable that with relatively low transmission at schools, it’s appropriate to offer schools a modified quarantine option for K-12 students exposed to COVID at schools, under certain circumstances,” Ferrer said.

In total, nearly 2% of all staff and students countywide have been identified as a close contact of a case since the school year began. Data to date indicates that very few of the identified close contacts have subsequently tested positive, according to Ferrer.

As of last week, among the almost 30,000 people that ended up quarantined, 63 tested positive.

“This amounts to what we call a secondary attack rate of 0.2%,” Ferrer said, calling the figure “extraordinarily low.”

In total, 0.5% of the county’s student body and 0.7% of staff have become infected with the virus since school districts reopened. The figure is just slightly higher than the 0.4% rate of infection overall in the county.

While case rates rose among children in all age groups between mid-July and mid-August, they have since declined in all age groups, according to the public health department. Over the last three weeks, cases declined across all age groups by about 40%.

The current case rate for 12- to 17-year-olds is 132 new cases per 100,000 children; for 5- to 11-year-olds, it’s 141 new cases per 100,000 children; and for children up to 4, the case rate is 88 new cases per 100,000.

The case rate mirrors declines among the county’s adult population, the department said.

Hospitalizations are also following the declines in cases, and while pediatric hospitalization rates remain higher now than they were in the spring and early summer, they are starting to decline.

As of Sept. 12, 63% of 12- to 15-years-old in the county had received at least one dose of vaccine, and 53% are fully vaccinated. Among teens 16- to 17-years-old, 70% received at least one dose and 61% are fully vaccinated.

“I do want to note that the most effective strategy for reducing quarantine disruptions in middle and high schools is to have all eligible students and staff fully vaccinated as soon as possible,” Ferrer said.