safety measures for covid 19 essay

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How to Protect Yourself and Others

CDC’s Respiratory Virus Guidance  provides strategies you can use to help protect yourself and others from health risks caused by COVID-19 and other respiratory viruses. These actions can help you lower the risk of COVID-19 transmission (spreading or catching COVID-19) and lower the risk of severe illness if you get sick.

Core Prevention Strategies

CDC recommends that all people use core prevention strategies to protect themselves and others from COVID-19:

• Although vaccinated people sometimes get infected with the virus that causes COVID-19, staying up to date on COVID-19 vaccines significantly lowers the risk of getting very sick, being hospitalized, or dying from COVID-19.
• Practice good hygiene  (practices that improve cleanliness)
• Take steps for cleaner air

When you are sick:

• Learn when you can go back to your normal activities .
• Seek health care promptly for testing and/or treatment if you have risk factors for severe illness . Treatment may help lower your risk of severe illness, but it needs to be started within a few days of when your symptoms begin.

Additional Prevention Strategies

In addition, there are other prevention strategies that you can choose to further protect yourself and others.

• Wearing a mask and putting distance between yourself and others  can help lower the risk of COVID-19 transmission.
• Testing for COVID-19 can help you decide what to do next, like getting treatment to reduce your risk of severe illness and taking steps  to lower your chances of spreading COVID-19 to others.

Key Times for Prevention

Using these prevention strategies can be especially helpful when:

• Respiratory viruses, such as COVID-19, flu, and RSV, are causing a lot of illness in your community
• You or those around you have risk factors  for severe illness
• You or those around you were recently exposed to a respiratory virus, are sick, or are recovering

Check Your Community

Find out if respiratory viruses are causing a lot of illness in your community. Data updated weekly.

Learn more about all three of these respiratory viruses, who is most at risk, and how they are affecting your state right now. You can use some of the same strategies to protect yourself from all three viruses.

Get the Latest on COVID-19, Flu, and RSV

• COVID-19 Testing
• COVID-19 Vaccines
• COVID-19 Treatments and Medications
• Preventing Respiratory Viruses
• Protect Yourself from COVID-19, Flu, and RSV

Additional Resources

• Respirators and Masks
• Improving Ventilation in Your Home
• Improving Ventilation In Buildings

Search for and find historical COVID-19 pages and files. Please note the content on these pages and files is no longer being updated and may be out of date.

• Visit archive.cdc.gov for a historical snapshot of the COVID-19 website, capturing the end of the Federal Public Health Emergency on June 28, 2023.
• Visit the dynamic COVID-19 collection  to search the COVID-19 website as far back as July 30, 2021.

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Prevent COVID-19: How to Protect Yourself from the Coronavirus

Follow these simple precautions to reduce your chances of contracting covid-19..

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The COVID-19 pandemic has been a part of our daily lives since March 2020, but with about 151,000 new cases a day in the United States, it remains as important as ever to stay vigilant and know how to protect yourself from coronavirus.

According to the  Centers for Disease Control and Prevention (CDC) , “The best way to prevent illness is to avoid being exposed to this virus.” As the vaccines continue their roll out, here are the simple steps you can take to help prevent the spread of COVID-19 and protect yourself and others.

Know how it spreads

Scientists are still learning about COVID-19, the disease caused by the coronavirus, but according to the CDC, this highly contagious virus appears to be most commonly spread during close (within 6 feet) person-to-person contact through respiratory droplets.

“The means of transmission can be through respiratory droplets produced when a person coughs or sneezes, or by direct physical contact with an infected person, such as shaking hands,” says  Dr. David Goldberg , an internist and infectious disease specialist at NewYork-Presbyterian Medical Group Westchester and an assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons.

The CDC also notes that COVID-19 can spread by airborne transmission , although this is less common than close contact with a person. “Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours,” the CDC states. “These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space. These transmissions occurred within enclosed spaces that had inadequate ventilation.”

Finally, it’s possible for coronavirus to spread through contaminated surfaces, but this is also less likely. According to the CDC, “Based on data from lab studies on COVID-19 and what we know about similar respiratory diseases, it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this isn’t thought to be the main way the virus spreads.”

Practice social distancing

Since close person-to-person contact appears to be the main source of transmission, social distancing remains a key way to mitigate spread. The CDC recommends maintaining a distance of approximately 6 feet from others in public places. This distance will help you avoid direct contact with respiratory droplets produced by coughing or sneezing.

In addition, studies have found that outdoor settings with enough space to distance and good ventilation will reduce risk of exposure. “There is up to 80% less transmission of the virus happening outdoors versus indoors,” says Dr. Ashwin Vasan , an assistant attending physician in the Department of Medicine at NewYork-Presbyterian/Columbia University Irving Medical Center and an assistant professor at the Mailman School of Public Health and Columbia University Vagelos College of Physicians and Surgeons. “One  study  found that of 318 outbreaks that accounted for 1,245 confirmed cases in China, only one outbreak occurred outdoors. That’s significant. I recommend spending time with others outside. We’re not talking about going to a sporting event or a concert. We’re talking about going for a walk or going to the park, or even having a conversation at a safe distance with someone outside.”

Wash your hands

Practicing good hygiene is an important habit that helps prevent the spread of COVID-19. Make these CDC recommendations part of your routine:

• Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
• Before eating or preparing food
• Before touching your face
• After using the restroom
• After leaving a public place
• After blowing your nose, coughing, or sneezing
• After handling your mask
• After changing a diaper
• After caring for someone who’s sick
• After touching animals or pets
• If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands with the sanitizer and rub them together until they feel dry.
• Avoid touching your eyes, nose, and mouth with unwashed hands.

Visit the CDC website for guidelines on how to properly  wash your hands  and  use hand sanitizer . And see our video below on how soap kills the coronavirus. There’s plenty of  science  behind this basic habit. “Soap molecules disrupt the fatty layer or coat surrounding the virus, ” says Dr. Goldberg. “Once the viral coat is broken down, the virus is no longer able to function.”

In addition to hand-washing, disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.

Wear a mask

Face masks have become essential accessories in protecting yourself and others from contracting COVID-19. The CDC recommends that people wear face coverings in public settings, especially since studies have shown that individuals with the novel coronavirus could be asymptomatic or presymptomatic. (Face masks, however, do not replace  social distancing  recommendations.)

“Face masks are designed to provide a barrier between your airway and the outside world,” says  Dr. Ole Vielemeyer , medical director of Weill Cornell ID Associates and Travel Medicine in the Division of Infectious Diseases at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. “By wearing a mask that covers your mouth and nose, you will reduce the risk of serving as the source of disease spread by trapping your own droplets in the mask, and also reduce the risk of getting sick via droplets that contain the coronavirus by blocking access to your own airways.”

Restrict your travel

Traveling can increase the spread of COVID-19 and put you at risk for contracting the disease. The CDC recommends avoiding non-essential travel to many international destinations  during the pandemic. It also advises people to  weigh the risks when it comes to domestic travel: “Travel increases your chance of getting and spreading COVID-19,” states the CDC. “Staying home is the best way to protect yourself and others from COVID-19.”

“For people at risk for the complications of COVID-19, such as those with underlying medical conditions or those who are older, it’s prudent to avoid travel,” says Dr. Goldberg.

If you must travel, take safety measures,  consider your mode of transportation, and stay up to date on the  restrictions that are in place at your destination. Adhering to your state’s quarantine rules after traveling will help prevent the spread of COVID-19.

Watch for symptoms

The symptoms of infection for the coronavirus are often similar to those of other respiratory virus infections, such as influenza. Symptoms can include:

• Fever or chills
• Shortness of breath or difficulty breathing
• Muscle or body aches
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting

With the COVID-19 pandemic now coinciding with flu season, it’s important to recognize the differences in symptoms — as well as get a flu shot. “The medical community is concerned that if we have an increased number of influenza cases, it will strain the hospital system on top of what’s already going on with the COVID-19 pandemic,” says  Dr. Ting Ting Wong , an attending physician and infectious disease specialist at NewYork-Presbyterian Brooklyn Methodist Hospital.

If you think you may have been  exposed to a person with COVID-19  and have symptoms, call ahead to a doctor’s office to see if you can get tested. You can also use a virtual care platform, such as NewYork-Presbyterian’s  NYP OnDemand,  to meet with a healthcare professional by videoconference. Avoid contact with others and wear a face mask if you need to leave your home when you are sick.

How NewYork-Presbyterian is prepared

NewYork-Presbyterian continues to follow the situation closely and implement the recommendations provided by our local and state departments of health and the CDC. Our medical staff is trained to recognize patients who may have the virus and will help prevent COVID-19 from spreading.

We understand how important the support of loved ones and friends is to patients during their hospital stay. Stay up to date with NewYork-Presbyterian’s  visitor guidelines . It’s our priority to keep patients and visitors safe from infection.

For more information on the evolving situation and how to protect yourself from coronavirus, visit the  CDC  and check  NewYork-Presbyterian  for more updates.

View all of our COVID-19 outbreak articles  here .

Additional Resources

If you have concerns regarding COVID-19, please call NewYork-Presbyterian’s hotline at 646-697-4000. This hotline is available as a public service to provide information only and not diagnose, treat, or render a medical opinion.

If you are not feeling well, consider using NewYork-Presbyterian’s Virtual Urgent Care for non-life-threatening symptoms such as fever, cough, upset stomach, or nausea. Learn more by visiting nyp.org/urgentcare .

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Masks Strongly Recommended but Not Required in Maryland, Starting Immediately

Due to the downward trend in respiratory viruses in Maryland, masking is no longer required but remains strongly recommended in Johns Hopkins Medicine clinical locations in Maryland. Read more .

• Vaccines  
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Staying Safe from COVID-19

Reviewed By:

Lisa Lockerd Maragakis, M.D., M.P.H.

The coronavirus that causes COVID-19 spreads primarily from person to person through respiratory droplets. This can happen when someone with the virus coughs, sneezes, sings or talks when close to others. By closely following a few safety measures, you can help protect yourself and others from getting sick.

Lisa Maragakis , senior director of infection prevention at Johns Hopkins, shares these guidelines: 

Get vaccinated for COVID-19 and get a booster as soon as you’re eligible

Several COVID-19 vaccines have been approved or authorized by the U.S. Food and Drug Administration (FDA) for emergency use among specific age groups and recommended by the Centers for Disease Control and Prevention (CDC). Johns Hopkins Medicine views all authorized COVID-19 vaccines as highly effective at preventing serious disease, hospitalization and death from COVID-19. 

Learn more about coronavirus vaccine safety and COVID-19 boosters .

Be aware of infection rates in your area

As more people get vaccinated, the rates of infection and hospitalization will vary in your area. For the foreseeable future, it’s a good idea to be familiar with the vaccination and COVID-19 data for your area and follow the local, state and federal safety guidelines.

Practice physical distancing

The coronavirus spreads mainly from person to person. If an infected person coughs or sneezes, their droplets can infect people nearby. People, including children, may be infected and have only mild symptoms, so physical distancing (staying at least 6 feet apart from others) is an important part of coronavirus protection.

Wear a mask

Wear a face mask in crowded, indoor situations since people carrying the SARS-CoV-2 virus and unvaccinated or vulnerable people might be present. Johns Hopkins Medicine and other health care institutions require all visitors, patients and staff to wear masks in all of their hospitals, treatment centers and offices. Learn more information about how  masks  help prevent the spread of COVID-19.

Practice hand hygiene

• After being in public places and touching door handles, shopping carts, elevator buttons or handrails
• After using the bathroom
• Before preparing food or eating
• If soap and water are not available, use hand sanitizer with at least 60% alcohol.
• Avoid touching your eyes, nose or mouth, especially with unwashed hands.
• If you cough or sneeze, do so in the bend of your elbow. If you use a tissue, throw it away immediately.

Take precautions if you are living with or caring for someone who is sick

• Wear a mask if you are caring for someone who has respiratory symptoms.
• Clean counters, door knobs, phones and tablets frequently, using disinfectant cleaners or wipes.

If you feel sick, follow these guidelines:

• Stay home  if you feel sick  unless you are experiencing a medical emergency such as severe shortness of breath.
• Take measures to keep others in your home safe, and follow precautions recommended by the CDC to avoid infecting others .
• Call your doctor or urgent care facility and explain your symptoms over the phone.
• If you leave your home to get medical care, wear a mask if you have respiratory symptoms.

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Know the Facts and Get Your COVID Vaccine

DO NOT DELETE THE "EMPTY" SECTION CONTROL BELOW THIS. IT CONTAINS THE GHOST OF CLARA BARTON. 

COVID-19 is a serious public health risk. Know the facts, get your vaccine, and help your loved ones get the vaccine.

• Everyone ages 5 and up should get a COVID-19 vaccine.
• Everyone ages 12 and up should get a booster shot.

Vaccines reduce your risk of severe illness and death from COVID-19. COVID-19 vaccines are safe, effective, and free.

As viruses spread, they change. Some variants emerge and persist. Reducing the spread of infection can slow the emergence of new variants. So get vaccinated, get your booster shot, and continue to wear masks in indoor public places. 

(Para español, visite redcross.org/coronavirus-espanol )  

Vaccines will protect you from severe illness and death from the Coronavirus and its variant.

Get your vaccine, why get a vaccine.

Get a vaccine to protect yourself, your loved ones and your community. Vaccines are effective at preventing severe illness and death from the coronavirus and the Delta variant. Get a vaccine booster shot as soon as it is recommended for you to increase your protection. 

Vaccines are safe and effective. Medical experts carefully tested the vaccines among thousands of adults with diverse backgrounds.

Find a vaccine location near you

COVID-19 vaccines are free and available to anyone who wants one, regardless of their immigration or health insurance status.

There are three easy ways to find a nearby location where you can get the COVID-19 vaccine:

Search  vaccines.gov ( vacunas.gov ). 

Text your zip code to  438829 .

Call 1-800-232-0233 . 

(TTY 888-720-7489)

Wear a mask in indoor public places.

• Vaccines will protect you from severe illness and death. After you are fully vaccinated, wear a mask in indoor public places. You can still be infected and transmit the virus to others.
• If you are not vaccinated, get your vaccine, and wear a mask in indoor public places.
• Make sure your mask covers your nose and mouth and secure it under your chin.

Stay 6 feet away from others.

• Inside your home : Avoid close contact with people who are sick.
• Outside your home : Remember that some people without symptoms may spread the virus. Stay at least 6 feet (about two arm lengths) from other people.

Avoid crowds and poorly ventilated indoor spaces.

• Avoid crowded places like restaurants, bars, fitness centers, or movie theaters.
• Avoid indoor spaces that do not offer fresh air from the outdoors.
• If indoors, bring in fresh air by opening windows and doors. 

Wash your hands often.

• Wash your hands often with soap and water for at least 20 seconds.
• If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
• Avoid touching your eyes, nose, and mouth with unwashed hands.

Monitor your health daily.

• Be alert for symptoms: Watch for fever, cough, shortness of breath, or  other symptoms  of COVID-19.
• Follow  CDC guidance  if you develop symptoms.

Vaccine Facts

Get accurate information.

Know the facts about COVID-19 vaccines. Accurate vaccine information is critical and can help stop common myths and rumors.

Review these credible resources from the U.S. Centers for Disease Control and Prevention:

Your COVID-19 Vaccine

About COVID-19 Vaccines

Vaccines for COVID-19

Key Things to Know about COVID-19 Vaccines

Frequently Asked Questions about COVID-19 Vaccination

Myths and Facts about COVID-19 Vaccines

How do vaccines work?

COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. [ 4 ] 

When we get a vaccine, it activates our immune response. This helps our bodies learn to fight off the virus without the danger of an actual infection. If we are exposed to the virus in the future, our immune system “remembers” how to fight it.

All COVID-19 vaccines, authorized by the U.S. Food and Drug Administration, provide significant protection against serious illness and hospitalization due to COVID-19.  [5]

Again, it takes time for your body to build immunity after vaccination, so you won’t have full protection until 2 weeks after your final dose.

• COVID vaccines will not give you COVID-19.  [6]
• COVID-19 vaccines do not contain live virus.
• Getting vaccinated can help prevent serious illness and hospitalization with COVID-19.  [7]
• People who have gotten sick with COVID-19 may still benefit from getting vaccinated.  [8]
• COVID-19 vaccines will not cause you to test positive on COVID-19 viral tests.  [9]
• COVID-19 vaccines do not change or interact with your DNA in any way.  [10]
• There is currently no evidence that COVID-19 vaccination causes any problems with pregnancy, including the development of the placenta. In addition, there is no evidence that female or male fertility problems are a side effect of any vaccine, including COVID-19 vaccines.

What are the most common side effects?

After getting vaccinated, you might have some side effects, which are normal signs that your body is building protection. Common side effects are pain, redness and swelling in the arm where you received the shot, as well as tiredness, headache, muscle pain, chills, fever and nausea. These side effects could affect your ability to do daily activities, but they should go away in a few days. Learn more about  what to expect after getting a COVID-19 vaccine.

Are COVID-19 vaccines safe?

COVID-19 vaccines are safe and effective. COVID-19 vaccines are being held to the same safety standards as other common vaccines. Several expert and independent groups evaluate the safety of vaccines being given to people in the United States. Medical experts carefully tested the vaccines among thousands of adults with diverse backgrounds.

How do I protect my child?

• Help protect your whole family by getting yourself vaccinated as soon as you can.
• Get your children vaccinated as soon as they're eligible.
• Ensure everyone in your family wears a mask when they are indoors in public places.

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For the latest information, please visit:

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• World Health Organization

If you live outside the United States, health and safety tips can be found through the World Health Organization and by following your local Red Cross or Red Crescent society’s social media channels.

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What to Know about COVID-19 and Blood Donation

The American Red Cross has an urgent and ongoing need for blood and platelet donations to prevent another blood shortage as hospitals resume surgical procedures and patient treatments that were temporarily paused in response to the COVID-19 pandemic. In recent weeks, hospital demand for blood products has significantly increased and patients are relying on the generosity of blood and platelet donors to help ensure hospital shelves are stocked.

The safety of our donors, volunteers and staff remains a top priority. Each Red Cross blood drive and donation center follows a high standard of safety and infection control. Learn more about our COVID-19 safety protocols here .

Donating blood products is essential to community health and the need for blood products is constant. The Red Cross urgently needs the help of donors and blood drive hosts to ensure blood products are readily available for patients. If you are feeling well, please make an appointment to give by using the Red Cross Blood Donor App, visiting RedCrossBlood.org or calling 1-800-RED CROSS.

Volunteer to Help Others

Discover a new purpose by joining a lifesaving team to help support blood collections in your community. Two key volunteer opportunities are available:

As a  Blood Donor Ambassador  volunteer, you will engage donors by greeting, registering, answering questions, providing information, and supporting them through the recovery process at the refreshments table. The special attention you would provide helps create a favorable impression that encourages ongoing donor support.

As a  Transportation Specialist  volunteer, you will be the critical link between blood donors and blood recipients by delivering blood, platelets or other blood products to a hospital.

Click "Apply Now", then search for “Blood” or “Biomed” in the search bar to find positions.

*Note: Positions will vary based on location.

View other high priority volunteer positions »

Explore all volunteer opportunities »

Latest News About COVID-19

The Red Cross began working in early March to ensure the continued delivery of our lifesaving mission amid the many challenges presented by this coronavirus outbreak. This report provides an accounting of our activities during the first year under COVID-19. 

Support all the urgent humanitarian needs of the American Red Cross.

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How to Protect Yourself and Your Family from Coronavirus Disease 2019 (COVID-19)

Navigating covid-19.

Please refer to this helpful information about COVID-19 symptoms  and what to do if your child is exposed to COVID-19 .

What can I do to prevent coronavirus disease 2019 (COVID-19)?

The best strategy to protect yourself and others from COVID-19 is to continue to follow the CDC’s recommended public health guidelines to help prevent transmission of COVID-19, including getting vaccinated if you are eligible ( see the latest vaccine guidelines from the CDC ), wearing a mask, practicing physical distancing, washing your hands frequently and avoiding crowds. Read more tips below.

Prepare and protect yourself from COVID-19

Here are some more steps everyone can take to help stop the spread of COVID-19:

• Take safety precautions according to the level of COVID-19 in your community. Find out your county’s COVID-19 level here . 
• Wash your hands often with soap and clean, running water for at least 20 seconds.
• If you don’t have access to soap and water, use an alcohol-based hand sanitizer often. Make sure it has at least 60% alcohol.
• Don't touch your eyes, nose, or mouth unless you have clean hands.
• If someone in your home has tested positive for COVID-19, follow the CDC’s instructions for cleaning and disinfection .  
• Cough or sneeze into a tissue, then throw the tissue into the trash. If you don't have tissues, cough or sneeze into the bend of your elbow.
• Where community COVID-19 level is high, the CDC advises wearing a face mask in public. Your mask should have at least two layers, should fit snugly against your face and should cover both your mouth and nose.
• Stay away from people who are sick.
• Check your home supplies. Consider keeping a 2-week supply of medicines, food, and other needed household items.
• Make a plan for childcare, work, and ways to stay in touch with others. Know who will help you if you get sick.
• Don’t share eating or drinking utensils with sick people.
• Don’t kiss or hug someone who is sick.

What to do if you have been exposed to someone with COVID-19

Follow CDC guidelines for more details about what to do if you’ve been exposed to COVID-19 .

What to do if you are sick with COVID-19 symptoms

• Stay home. Call your healthcare provider and tell them you have symptoms of COVID-19. Follow your provider's instructions. You may be advised to isolate yourself at home. This is called self-isolation.
• Stay away from work, school, and public places. Limit physical contact with family members and pets. Don't kiss anyone or share eating or drinking utensils. Clean surfaces you touch with disinfectant. This is to help prevent the virus from spreading.
• Wear a face mask. This is to protect other people from your germs. If you are not able to wear a mask, your caregivers should when you are in the same room with them. Wear the mask so that it covers both the nose and mouth.
• If you need to go into a hospital or clinic, expect that the healthcare staff will wear protective equipment such as masks, gowns, gloves, and eye protection. You may be put in a separate room. This is to prevent the possible virus from spreading.
• Follow all instructions the healthcare staff give you.

COVID-19 Resources for Parents

Get details about COVID-19 and resources to help with everything from care at home to testing, vaccines, mental health resources, and more.

Division of Infectious Diseases

The Division of Infectious Diseases offers consultation and diagnosis in the management of children with any type of infectious disease.

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Work health, and well-being, related articles, the changing face of worker safety, health, and well-being in a post-pandemic future, it’s not just personal: the economic value of preventing bullying in the workplace, a healthy workplace starts in bed, how covid-19 has changed the standards of worker safety and health — and how organizations can adapt.

by Katherine J. Igoe

Ensuring health and safety in the workplace is already a critically important issue; organizations that invest in occupational safety perform better, reduce turnover, and help workers do their jobs more effectively. But COVID-19 has forced companies to act quickly and decisively to keep workers safe. As employers endeavor to slow the spread of the virus while keeping a supportive and productive work environment, they’ve had to adapt new business processes and address existing structures that are lacking.

“COVID-19 has stressed the system. All the flaws that have been in place are totally exposed and have come to the forefront of our daily conversations,” says Jack Dennerlein , adjunct professor of ergonomics and safety in the Department of Environmental Health and co-director of Work Health and Well-being: Achieving Worker Health at the Harvard T.H. Chan School of Public Health. From distancing procedures to the availability of remote work, the pandemic has metaphorically ripped off the mask covering the flaws in organizations’ working conditions. How has COVID-19 changed the standards of worker safety and health, and how can employers adapt to these changes?

Total Worker Health and Its Impact in the Workplace

Total Worker Health (TWH) aims to address, reactively and proactively, the challenges of worker safety, health, and well-being. At its core, it measures and assesses what a worker experiences, collects data to understand what to change, provides approaches on how to modify an environment, and encourages collaboration across traditional organizational boundaries to ensure a safe workplace. It’s both an acknowledgement of workers’ existing health, and initiatives to keep them healthy.

“These two general fields — protecting and promoting health — work together in a single workplace. It makes sense to think about this as an integrated effort instead of two siloed efforts that act in parallel,” says Nico Pronk , adjunct professor of social and behavioral sciences, president of the HealthPartners Institute, chief science officer at HealthPartners, Inc., and co-director of Work Health and Well-being: Achieving Worker Health .

As an example, he explains, “If you have diabetes, your eyesight might be diminished, and you might end up with an injury because your work is putting you at risk.” Critically, though, TWH focuses more on an organization’s framework rather than solely on an individual: “the conditions of work rather than on the behaviors of the work. You set the environment — physical, social, economic — which shapes how the workplace is organized. Within that, these factors start to drive the behavior of the individuals within it.”

COVID-19 has fundamentally uprooted assumptions about worker safety, health, and well-being and been an accelerant of addressing these issues. The pandemic has also highlighted classic social issues that workers face, like childcare, sick leave, and disability issues, and underlined safety concerns in health care environments where professionals need to treat patients. The absence of TWH — where workers don’t feel safe in their workplace — is also much more visible. Implementing TWH effectively helps make organizations more resilient during this time.

Even though COVID-19 can be used as a leverage point, Dennerlein notes, “We should be doing it for the good of the people, not just because of COVID-19. If we want this country to be productive, we have to invest in the health and safety of our workforce.” Adds Pronk, “What if you didn’t get sick? What if you didn’t get injured? The benefits come back in spades. You cannot be successful if you don’t have healthy workers, but that recognition is still hardly there.”

“Protecting and promoting health work together in a single workplace. It makes sense to think about this as an integrated effort instead of two siloed efforts that act in parallel.”

Applying and Adapting Total Worker Health During the COVID-19 Pandemic

While the values of TWH may not change, the implementation has evolved to protect workers against COVID-19. In a paper titled “ An Integrative Total Worker Health Framework for Keeping Workers Safe and Healthy During the COVID-19 Pandemic ,” Dennerlein, Erika Sabbath, Susan Peters, and Glorian Sorensen outlined six key characteristics that are essential for applying TWH in this context:

• Focusing on working conditions for infection control and supportive environments for increased psychological demands
• Utilizing participatory approaches involving workers in identifying daily challenges and unique solutions
• Employing comprehensive and collaborative efforts to increase system efficiencies
• Committing as leaders to supporting workers through action and communications
• Adhering to ethical and legal standards
• Using data to guide actions and evaluate progress

In this way, organizations can address the unique demands (including physical, ethical, and legal) of counteracting COVID-19 alongside the needs of workers to complete their tasks in a safe space, while using data and feedback to make changes.

According to the researchers, the most challenging aspect of using a TWH framework is getting top-level support. “Overall organization engagement towards this shared vision of a goal is critical — some key performance indicator for the institution has to include TWH or recognizing its impact. You have to think about that at the systems level,” says Dennerlein.

“If we want this country to be productive, we have to invest in the health and safety of our workforce.”

The Practical Implications of Implementing Total Worker Health in a Pandemic

The researchers have worked with companies to take these theoretical constructs and translate them to practical insights in the workplace. “It took companies as much as six months to learn how to bring health and safety together. Health is in HR, safety is in Operations, and the two don’t usually interact,” Pronk says. Not rushing the organizations and giving them up to a year to develop an implementation plan was key.

After buy-in from leadership, the next step is to test these six characteristics using data and feedback. Previous studies show that program design principles or characteristics are correlated with good health outcomes. “The business units that scored the highest had the lowest number of health risks in their populations. The more they followed these characteristics, the healthier their group was,” Pronk says. Following implementation, organizations would then be able to make changes and use a team-based approach to maintain awareness and continue to evaluate efficacy.

Thus, TWH can be effective, and not just in the short-term. Even after COVID-19 is no longer an immediate threat, the challenges of worker health and safety remain. “What are we doing to create a more resilient workforce ? When we start thinking about the work of the future, workers are going to have to continually reinvent themselves, because work is constantly changing. COVID-19 was a big slap in the face for that. How do we all adapt?” says Dennerlein.

“We rely on the human element in the workforce so much because humans are problem-solvers. TWH tries to broaden that and realize what a great resource we have here. Why aren’t we using that element better? Why aren’t we weaving it more effectively into our organizations to help them make better decisions to affect the bottom line?”

Harvard T.H. Chan School of Public Health offers Work Health and Well-being: Achieving Worker Health , which provides the full set of skills needed to improve worker health, safety, and well-being in the workplace .

Students’ Essays on Infectious Disease Prevention, COVID-19 Published Nationwide

As part of the BIO 173: Global Change and Infectious Disease course, Professor Fred Cohan assigns students to write an essay persuading others to prevent future and mitigate present infectious diseases. If students submit their essay to a news outlet—and it’s published—Cohan awards them with extra credit.

As a result of this assignment, more than 25 students have had their work published in newspapers across the United States. Many of these essays cite and applaud the University’s Keep Wes Safe campaign and its COVID-19 testing protocols.

Cohan, professor of biology and Huffington Foundation Professor in the College of the Environment (COE), began teaching the Global Change and Infectious Disease course in 2009, when the COE was established. “I wanted very much to contribute a course to what I saw as a real game-changer in Wesleyan’s interest in the environment. The course is about all the ways that human demands on the environment have brought us infectious diseases, over past millennia and in the present, and why our environmental disturbances will continue to bring us infections into the future.”

Over the years, Cohan learned that he can sustainably teach about 170 students every year without running out of interested students. This fall, he had 207. Although he didn’t change the overall structure of his course to accommodate COVID-19 topics, he did add material on the current pandemic to various sections of the course.

“I wouldn’t say that the population of the class increased tremendously as a result of COVID-19, but I think the enthusiasm of the students for the material has increased substantially,” he said.

To accommodate online learning, Cohan shaved off 15 minutes from his normal 80-minute lectures to allow for discussion sections, led by Cohan and teaching assistants. “While the lectures mostly dealt with biology, the discussions focused on how changes in behavior and policy can solve the infectious disease problems brought by human disturbance of the environment,” he said.

Based on student responses to an introspective exam question, Cohan learned that many students enjoyed a new hope that we could each contribute to fighting infectious disease. “They discovered that the solution to infectious disease is not entirely a waiting game for the right technologies to come along,” he said. “Many enjoyed learning about fighting infectious disease from a moral and social perspective. And especially, the students enjoyed learning about the ‘socialism of the microbe,’ how preventing and curing others’ infections will prevent others’ infections from becoming our own. The students enjoyed seeing how this idea can drive both domestic and international health policies.”

A sampling of the published student essays are below:

Alexander Giummo ’22 and Mike Dunderdale’s ’23  op-ed titled “ A National Testing Proposal: Let’s Fight Back Against COVID-19 ” was published in the Journal Inquirer in Manchester, Conn.

They wrote: “With an expansive and increased testing plan for U.S. citizens, those who are COVID-positive could limit the number of contacts they have, and this would also help to enable more effective contact tracing. Testing could also allow for the return of some ‘normal’ events, such as small social gatherings, sports, and in-person class and work schedules.

“We propose a national testing strategy in line with the one that has kept Wesleyan students safe this year. The plan would require a strong push by the federal government to fund the initiative, but it is vital to successful containment of the virus.

“Twice a week, all people living in the U.S. should report to a local testing site staffed with professionals where the anterior nasal swab Polymerase Chain Reaction (PCR) test, used by Wesleyan and supported by the Broad Institute, would be implemented.”

Kalyani Mohan ’22 and Kalli Jackson ’22 penned an essay titled “ Where Public Health Meets Politics: COVID-19 in the United States ,” which was published in Wesleyan’s Arcadia Political Review .

They wrote: “While the U.S. would certainly benefit from a strengthened pandemic response team and structural changes to public health systems, that alone isn’t enough, as American society is immensely stratified, socially and culturally. The politicization of the COVID-19 pandemic shows that individualism, libertarianism and capitalism are deeply ingrained in American culture, to the extent that Americans often blind to the fact community welfare can be equivalent to personal welfare. Pandemics are multifaceted, and preventing them requires not just a cultural shift but an emotional one amongst the American people, one guided by empathy—towards other people, different communities and the planet. Politics should be a tool, not a weapon against its people.”

Sydnee Goyer ’21 and Marcel Thompson’s ’22  essay “ This Flu Season Will Be Decisive in the Fight Against COVID-19 ” also was published in Arcadia Political Review .

“With winter approaching all around the Northern Hemisphere, people are preparing for what has already been named a “twindemic,” meaning the joint threat of the coronavirus and the seasonal flu,” they wrote. “While it is known that seasonal vaccinations reduce the risk of getting the flu by up to 60% and also reduce the severity of the illness after the contamination, additional research has been conducted in order to know whether or not flu shots could reduce the risk of people getting COVID-19. In addition to the flu shot, it is essential that people remain vigilant in maintaining proper social distancing, washing your hands thoroughly, and continuing to wear masks in public spaces.”

An op-ed titled “ The Pandemic Has Shown Us How Workplace Culture Needs to Change ,” written by Adam Hickey ’22 and George Fuss ’21, was published in Park City, Utah’s The Park Record .

They wrote: “One review of academic surveys (most of which were conducted in the United States) conducted in 2019 found that between 35% and 97% of respondents in those surveys reported having attended work while they were ill, often because of workplace culture or policy which generated pressure to do so. Choosing to ignore sickness and return to the workplace while one is ill puts colleagues at risk, regardless of the perceived severity of your own illness; COVID-19 is an overbearing reminder that a disease that may cause mild, even cold-like symptoms for some can still carry fatal consequences for others.

“A mandatory paid sick leave policy for every worker, ideally across the globe, would allow essential workers to return to work when necessary while still providing enough wiggle room for economically impoverished employees to take time off without going broke if they believe they’ve contracted an illness so as not to infect the rest of their workplace and the public at large.”

Women’s cross country team members and classmates Jane Hollander ’23 and Sara Greene ’23 wrote a sports-themed essay titled “ This Season, High School Winter Sports Aren’t Worth the Risk ,” which was published in Tap into Scotch Plains/Fanwood , based in Scotch Plains, N.J. Their essay focused on the risks high school sports pose on student-athletes, their families, and the greater community.

“We don’t propose cutting off sports entirely— rather, we need to be realistic about the levels at which athletes should be participating. There are ways to make practices safer,” they wrote. “At [Wesleyan], we began the season in ‘cohorts,’ so the amount of people exposed to one another would be smaller. For non-contact sports, social distancing can be easily implemented, and for others, teams can focus on drills, strength and conditioning workouts, and skill-building exercises. Racing sports such as swim and track can compete virtually, comparing times with other schools, and team sports can focus their competition on intra-team scrimmages. These changes can allow for the continuation of a sense of normalcy and team camaraderie without the exposure to students from different geographic areas in confined, indoor spaces.”

Brook Guiffre ’23 and Maddie Clarke’s ’22  op-ed titled “ On the Pandemic ” was published in Hometown Weekly,  based in Medfield, Mass.

“The first case of COVID-19 in the United States was recorded on January 20th, 2020. For the next month and a half, the U.S. continued operating normally, while many other countries began their lockdown,” they wrote. “One month later, on February 29th, 2020, the federal government approved a national testing program, but it was too little too late. The U.S. was already in pandemic mode, and completely unprepared. Frontline workers lacked access to N-95 masks, infected patients struggled to get tested, and national leaders informed the public that COVID-19 was nothing more than the common flu. Ultimately, this unpreparedness led to thousands of avoidable deaths and long-term changes to daily life. With the risk of novel infectious diseases emerging in the future being high, it is imperative that the U.S. learn from its failure and better prepare for future pandemics now. By strengthening our public health response and re-establishing government organizations specialized in disease control, we have the ability to prevent more years spent masked and six feet apart.”

In addition, their other essay, “ On Mass Extinction ,” was also published by Hometown Weekly .

“The sixth mass extinction—which scientists have coined as the Holocene Extinction—is upon us. According to the United Nations, around one million plant and animal species are currently in danger of extinction, and many more within the next decade. While other extinctions have occurred in Earth’s history, none have occurred at such a rapid rate,” they wrote. “For the sake of both biodiversity and infectious diseases, it is in our best interest to stop pushing this Holocene Extinction further.”

An essay titled “ Learning from Our Mistakes: How to Protect Ourselves and Our Communities from Diseases ,” written by Nicole Veru ’21 and Zoe Darmon ’21, was published in My Hometown Bronxville, based in Bronxville, N.Y.

“We can protect ourselves and others from future infectious diseases by ensuring that we are vaccinated,” they wrote. “Vaccines have high levels of success if enough people get them. Due to vaccines, society is no longer ravaged by childhood diseases such as mumps, rubella, measles, and smallpox. We have been able to eradicate diseases through vaccines; smallpox, one of the world’s most consequential diseases, was eradicated from the world in the 1970s.

“In 2000, the U.S. was nearly free of measles, yet, due to hesitations by anti-vaxxers, there continues to be cases. From 2000–2015 there were over 18 measles outbreaks in the U.S. This is because unless a disease is completely eradicated, there will be a new generation susceptible.

“Although vaccines are not 100% effective at preventing infection, if we continue to get vaccinated, we protect ourselves and those around us. If enough people are vaccinated, societies can develop herd immunity. The amount of people vaccinated to obtain herd immunity depends on the disease, but if this fraction is obtained, the spread of disease is contained. Through herd immunity, we protect those who may not be able to get vaccinated, such as people who are immunocompromised and the tiny portion of people for whom the vaccine is not effective.”

Dhruvi Rana ’22 and Bryce Gillis ’22 co-authored an op-ed titled “ We Must Educate Those Who Remain Skeptical of the Dangers of COVID-19 ,” which was published in Rhode Island Central .

“As Rhode Island enters the winter season, temperatures are beginning to drop and many studies have demonstrated that colder weather and lower humidity are correlated with higher transmissibility of SARS-CoV-2, the virus that causes COVID-19,” they wrote. “By simply talking or breathing, we release respiratory droplets and aerosols (tiny fluid particles which could carry the coronavirus pathogen), which can remain in the air for minutes to hours.

“In order to establish herd immunity in the US, we must educate those who remain skeptical of the dangers of COVID-19.  Whether community-driven or state-funded, educational campaigns are needed to ensure that everyone fully comprehends how severe COVID-19 is and the significance of airborne transmission. While we await a vaccine, it is necessary now more than ever that we social distance, avoid crowds, and wear masks, given that colder temperatures will likely yield increased transmission of the virus.”

Danielle Rinaldi ’21 and Verónica Matos Socorro ’21 published their op-ed titled “ Community Forum: How Mask-Wearing Demands a Cultural Reset ” in the Ewing Observer , based in Lawrence, N.J.

“In their own attempt to change personal behavior during the pandemic, Wesleyan University has mandated mask-wearing in almost every facet of campus life,” they wrote. “As members of our community, we must recognize that mask-wearing is something we are all responsible and accountable for, not only because it is a form of protection for us, but just as important for others as well. However, it seems as though both Covid fatigue and complacency are dominating the mindsets of Americans, leading to even more unwillingness to mask up. Ultimately, it is inevitable that this pandemic will not be the last in our lifespan due to global warming creating irreversible losses in biodiversity. As a result, it is imperative that we adopt the norm of mask-wearing now and undergo a culture shift of the abandonment of an individualistic mindset, and instead, create a society that prioritizes taking care of others for the benefit of all.”

Shayna Dollinger ’22 and Hayley Lipson ’21  wrote an essay titled “ My Pandemic Year in College Has Brought Pride and Purpose. ” Dollinger submitted the piece, rewritten in first person, to Jewish News of Northern California . Read more about Dollinger’s publication in this News @ Wesleyan article .

“I lay in the dead grass, a 6-by-6-foot square all to myself. I cheer for my best friend, who is on the stage constructed at the bottom of Foss hill, dancing with her Bollywood dance group. Masks cover their ordinarily smiling faces as their bodies move in sync. Looking around at friends and classmates, each in their own 6-by-6 world, I feel an overwhelming sense of normalcy.

“One of the ways in which Wesleyan has prevented outbreaks on campus is by holding safe, socially distanced events that students want to attend. By giving us places to be and things to do on the weekends, we are discouraged from breaking rules and causing outbreaks at ‘super-spreader’ events.”

An op-ed written by Luna Mac-Williams ’22 and Daëlle Coriolan ’24 titled “ Collectivist Practices to Combat COVID-19 ” was published in the Wesleyan Argus .

“We are embroiled in a global pandemic that disproportionately affects poor communities of color, and in the midst of a higher cultural consciousness of systemic inequities,” they wrote. “A cultural shift to center collectivist thought and action not only would prove helpful in disease prevention, but also belongs in conversation with the Black Lives Matter movement. Collectivist models of thinking effectively target the needs of vulnerable populations including the sick, the disenfranchised, the systematically marginalized. Collectivist systems provide care, decentering the capitalist, individualist system, and focusing on how communities can work to be self-sufficient and uplift our own neighbors.”

An essay written by Maria Noto ’21 , titled “ U.S. Individualism Has Deadly Consequences ,” is published in the Oneonta Daily Star , based in Oneonta, N.Y.

She wrote, “When analyzing the cultures of certain East Asian countries, several differences stand out. For instance, when people are sick and during the cold and flu season, many East Asian cultures, including South Korea, use mask-wearing. What is considered a threat to freedom by some Americans is a preventive action and community obligation in this example. This, along with many other cultural differences, is insightful in understanding their ability to contain the virus.

“These differences are deeply seeded in the values of a culture. However, there is hope for the U.S. and other individualistic cultures in recognizing and adopting these community-centered approaches. Our mindset needs to be revolutionized with the help of federal and local assistance: mandating masks, passing another stimulus package, contact tracing, etc… However, these measures will be unsuccessful unless everyone participates for the good of a community.”

A published op-ed by Madison Szabo ’23 , Caitlyn Ferrante ’23 ran in the Two Rivers Times . The piece is titled “ Anxiety and Aspiration: Analyzing the Politicization of the Pandemic .”

John Lee ’21 and Taylor Goodman-Leong ’21 have published their op-ed titled “ Reassessing the media’s approach to COVID-19 ” in Weekly Monday Cafe 24 (Page 2).

An essay by Eleanor Raab ’21 and Elizabeth Nefferdorf ’22 titled “ Preventing the Next Epidemic ” was published in The Almanac .

• Keep Wes Safe
• student publications
• Teaching during the pandemic

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The State of Health Care Quality Measurement in the Era of COVID-19 : The Importance of Doing Better

• 1 Johns Hopkins Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland
• 2 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, Maryland
• 3 Department of Medicine, Johns Hopkins Medicine, Baltimore, Maryland

The coronavirus disease 2019 (COVID-19) pandemic has highlighted a number of strengths and weaknesses in the US health care system. One strength is the incredible efforts and dedication of health care workers focused on providing the best care possible to patients, even in the most challenging of working conditions. But the data needed to understand the quality of the care being delivered to patients during this pandemic have proven difficult to obtain. As a result, there is a lack of information that would help clinicians improve care delivery in the moment and learn for the future. This situation highlights how the current approach to quality and safety measurement remains too labor intensive, contains significant data lags, and lacks sufficient standardization that allows for rapid sharing of data.

As preparations for the pandemic increased, it became readily apparent that many approaches for measuring quality across the US health care system were not going to be sustainable. In March 2020, the Centers for Medicare & Medicaid Services (CMS) announced the granting of wide and sweeping exceptions for the collection and submission of data for Medicare quality programs, citing the need for hospitals and clinicians to focus on preparation for a potential surge of patients. For example, CMS indicated that data from the first 6 months of 2020 will not be used in any of the current hospital-based performance or payment programs. 1 The announcement by CMS was shortly followed by similar announcements from other quality reporting organizations. 2

These decisions were undoubtedly correct, given the urgent need to focus all resources on surge preparation. But these decisions to suspend quality reporting requirements would not have been required if the approach to quality measurement in the US did not rely on so much manual abstraction and human intervention. To date, health care has approached quality measurement too much as an ancillary matter, treating it as a double-check after care is delivered, rather than information evaluated simultaneously with the provision of care. The current approach, therefore, is simply not resilient enough when attention and resources need to be focused elsewhere, such as during the current pandemic.

Another deficiency in the current approach to quality measurement is the substantial time lag between the provision of care and reporting of measurements on the quality of that care. For example, many claims-based quality measures, such as the Patient Safety Indicators, have a 12-month lag between the end of the care delivery period and the reporting to hospitals on their performance. Even non–claims-based measures, such as hospital-acquired infection measures, have long lags. Feedback loops are a vital component of any robust quality improvement framework, and they only work when the feedback is timely.

In the best of circumstances, hospitals and clinicians find delayed quality data to be less meaningful and less actionable for improvement. 3 , 4 During a health crisis, the effect of the data lag is magnified, as it translates to an absence of timely information about how the health system is performing. For example, validated data are still lacking on whether hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection developed venous thromboembolism at a different rate than those without infection or whether treatment with corticosteroids made a difference in outcomes for patients with COVID-19. By the time those data are available, significant opportunities for learning and improvement will have been missed.

The current approach to quality measurement is also challenged by the insufficient standardization of data for purposes of data sharing. When health systems provide care to patients with new types of clinical problems, or provide care in new ways for which there are no standards, it can be helpful for health systems to be able compare their performance with the performance of other health systems. This is especially important for care for which optimal performance is not fully understood and a comparison with care at other health systems would be informative, if not necessary. For example, despite the substantial increase in telehealth during this pandemic, defined performance measures that could help to understand how telehealth has affected the quality of care delivered to patients are lacking. Given the relative newness of telehealth, it is not clear what constitutes optimal quality for care delivered this way. This issue can be even more acutely apparent in the intensive care setting. For example, whether placing patients with SARS-CoV-2 infection in a prone position made a difference in oxygenation and mortality could be ascertained much more quickly if hospitals had a standardized method of collecting and sharing data. Having a rapid way to identify and disseminate a standardized way of collecting data about new types of clinical problems or new ways of delivering care, that all health systems could use, could allow a health system to understand and improve performance in relation to the performance of their peer institutions.

Lessons from this pandemic make clear a number of recommendations for improvement. First, approaches to reduce the measurement burden are needed. Priority areas include the development of data capture systems that collect data from hospitals, other health care centers, and clinicians without requiring extra effort on their part, along with data abstraction that does not require manual chart review. This would include building new data capture systems designed with quality measurement in mind and abstraction systems that can maximize the use of information technology. The government and other quality reporting organizations can play a key role in pushing the market in this direction, by insisting that all new measures be electronic and even setting a timeline for phasing out manually abstracted measures.

Second, reducing the lag in reporting quality data will require approaches to better capture and report quality simultaneously with the provision of clinical care. Measures should be less reliant on claims data, which by nature have a time lag, and focus on measures that can be generated from the electronic health record (EHR). This shift will require the development of more rapid and more efficient methods of data validation and possibly alterations in the workflows of how care is delivered. The full capabilities of the EHR will need to be harnessed to accomplish this goal, which will require more formal engagement with leading quality measurement organizations and EHR vendors.

Third, to address the lack of data standardization, a series of nimble national measurement committees or task forces should be established to quickly define measures and help guide how those measures will be abstracted. This could allow health systems, at least in the short term, to use standardized methods to better understand their performance in relation to other systems. These measurement committees could work with the EHR vendors to understand what changes are needed to EHR systems to accommodate these new measures, and then the EHR vendors could implement software changes as needed.

Quality measurement is essential during both times of stability and times of crisis. During a crisis, health care is still being delivered, and the need to understand the quality and safety of that care becomes more important as the care processes continue to rapidly change. The challenges highlighted in the current approach to quality measurement were known prior to the COVID-19 pandemic. This crisis has further demonstrated how problematic these challenges can be. Implementing the recommendations for improvement will require a higher level of planning and coordination than in the past around quality measurement, but the risk in not following these recommendations is too high. The health care system should prevent being in a situation with a poor understanding of the quality of health care being delivered, regardless of whether there is a public health crisis.

Corresponding Author: J. Matthew Austin, PhD, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Johns Hopkins Armstrong Institute for Patient Safety and Quality, 750 E Pratt St, 15th Floor, Baltimore, MD 21202 ( [email protected] ).

Published Online: June 25, 2020. doi:10.1001/jama.2020.11461

Conflict of Interest Disclosures: None reported.

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Austin JM , Kachalia A. The State of Health Care Quality Measurement in the Era of COVID-19 : The Importance of Doing Better . JAMA. 2020;324(4):333–334. doi:10.1001/jama.2020.11461

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• Safety tips for attending school during COVID-19

As the COVID-19 pandemic continues, families and caregivers might worry about their children getting the COVID-19 virus at school.

Unfortunately, COVID-19 outbreaks do happen in school settings. But global research has shown, at least with early variants, that when schools use multiple prevention strategies, the spread of the COVID-19 virus in schools can be lower than or similar to community spread.

What can you do to protect your school-aged child? Consider the strategies schools and families can follow to protect students' health.

Encouraging COVID-19 vaccination

COVID-19 vaccines are available for children age 6 months and older in the U.S. A COVID-19 vaccine and booster doses might prevent your child from getting the COVID-19 virus or becoming seriously ill or hospitalized due to COVID-19 . Getting a COVID-19 vaccine can also help keep your child in school and more safely participate in sports and other group activities too.

Wearing face masks

School policies vary when it comes to face masks. However, whether or not you're vaccinated, the Centers for Disease Control and Prevention (CDC) recommends wearing a face mask in indoor public spaces if you're in a community with a high number of new COVID-19 cases and hospitalizations. Wearing the most protective face mask that you'll wear regularly, fits well and is comfortable while indoors can limit the spread of the COVID-19 virus. The CDC recommends that students and staff who have been exposed or think they've been exposed to COVID-19 wear a mask around others for 10 days after their last exposure.

If your child wears a face mask in school, consider these tips:

• Have your child wear the most protective mask possible that fits well and is comfortable.
• Provide your child with a clean mask and a backup mask each day. Consider giving your child a clean, resealable bag to store the mask during lunch.
• Label your child's mask so it's not confused with other children's masks. Tell your child to never wear another child's used mask.

Screening test

Screening identifies people with COVID-19 who don't have symptoms and who don't have a known, suspected or reported exposure to COVID-19 . This can help keep COVID-19 from spreading further.

If COVID-19 is spreading at a high level according to the CDC , schools might screen all students and staff who participate in activities that may involve a higher risk, such as:

• Choir or band
• Soccer, football or other sports that involve close contact
• Dances or sports tournaments

Schools also may screen students and staff before and after breaks, such as a holiday or spring break.

Schools vary in their use of screening. They may change requirements based on attendance by students at high risk of severe COVID-19 . Or they may change requirements based on risk level in the community.

Proper ventilation

Improving ventilation in schools can reduce the number of COVID-19 virus particles in the air. Opening multiple windows and doors, using fans, or changing the heating, ventilation, air conditioning or air filtration systems can help. During transportation to and from school, keeping windows open a few inches also can improve air circulation.

Handwashing

Schools and parents should encourage students to frequently wash their hands with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol. Children should cover their mouths and noses with an elbow or a tissue when coughing or sneezing. Children also should avoid touching their eyes, noses and mouths. To ensure thorough handwashing, kids can be taught to keep washing their hands until they have sung the entire "Happy Birthday" song twice (about 20 seconds).

Staying home when sick and getting tested

Students who have symptoms of an infectious illness should stay home from school and get tested for COVID-19 . Possible symptoms of COVID-19 in children include:

• Cough that becomes productive
• New loss of taste or smell
• Changes in the skin, such as discolored areas on the feet and hands
• Sore throat
• Nausea, vomiting, belly pain or diarrhea
• Muscle aches and pain
• Extreme fatigue
• New severe headache
• New nasal congestion

Everyone with COVID-19 should stay home and isolate from others for at least five full days. School policies might vary on when a child who has had COVID-19 can return to school.

If you are recovering from COVID-19 , the CDC recommends wearing the most protective face mask that you'll wear regularly, fits well and is comfortable. Wear the mask while you are around other people through day 10. Children who are too young to wear a mask should be cared for in as separate a space as possible by a caregiver who is wearing a mask.

Contact tracing

Contact tracing is the process of identifying people who may have been exposed to someone with COVID-19 . During an outbreak, contact tracing to help students and staff know when to stay home can help prevent the spread of COVID-19 . Strategies such as improving ventilation or wearing a well-fitting mask also can help prevent further spread.

If your child's school does contact tracing, make sure you understand what steps your child needs to take after a COVID-19 exposure.

Cleaning and disinfecting

Cleaning once a day is usually enough to lower the risk of germs spreading from surfaces in schools. The CDC suggests schools have procedures for staff to follow after meals, after exposure to fluids such as blood or saliva, and after changing diapers.

What to do if your child gets COVID-19

Even if your family and your child's school carefully follow these prevention strategies, it's still possible for your child to get COVID-19 . If your child tests positive for COVID-19 :

• Talk to your child's health care provider. Keep your child home from school and away from others, except to get medical care.
• Focus on relieving your child's symptoms. This might include rest, plenty of fluids and use of pain relievers.
• Contact your child's school. Make sure you understand the school's policy on when your child can return to school. Find out if distance learning is an option while your child remains at home.
• Consider picking one person in your family to care for your sick child. Have that caregiver be with your child and separated from others in your home, when possible.
• Unfortunately, pets can catch COVID-19, so limit contact between your child and your pets.
• Call the health care provider if your child gets sicker. Emergency warning signs include trouble breathing, persistent pain or pressure in the chest, new confusion, inability to wake or stay awake, and pale, gray, or blue-colored skin, lips or nail beds — depending on your child's skin color.
• Schools and childcare programs. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/parent-faqs.html. Accessed Aug. 16, 2022.
• Stay up to date with your vaccines. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. Accessed April 20, 2022.
• How to protect yourself and others. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html. Accessed April 20, 2022.
• Information for pediatric healthcare providers. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html. Accessed April 28, 2022.
• Quarantine and isolation. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html. Accessed April 28, 2022.
• COVID-19 guidance for safe schools and promotion of in-person learning. American Academy of Pediatrics. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/. Accessed April 20, 2022.
• When and how to wash your hands. Centers for Disease Control and Prevention. https://www.cdc.gov/handwashing/when-how-handwashing.html. Accessed April 20, 2022.
• Caring for someone sick at home. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html. Accessed April 29, 2022.
• Use and care of masks. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html. Accessed Feb. 28, 2022.
• COVID-19 community levels. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/science/community-levels.html. Accessed Feb. 28, 2022.
• COVID-19 pandemic: Helping young children and parents transition back to school. Centers for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/features/COVID-19-helping-children-transition-back-to-school.html. Accessed April 28, 2022.
• Guidance for COVID-19 prevention in K-12 schools. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/k-12-guidance.html#anchor_1625661984621. Accessed Aug. 16, 2022.
• COVID-19 vaccines for children and teens. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html. Accessed Aug. 16, 2022.
• Use and care of masks. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html. Accessed April 28, 2022.
• AskMayoExpert. COVID-19: Outpatient and inpatient management (child). Mayo Clinic; 2021.

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