When students miss school for COVID 19, Guide to clearance, & when to keep student home


    MPS School Nurse Guidance for Families and Staff, related to COVID19 and General Illness: last updated August 26, 2022


    This School Nursing Guidance includes the following information:

    1. Massachusetts DESE/DOH Guidance for COVID-19 symptoms and school attendance

    2. Current COVID-19 Close Contact exposure Guidance for Massachusetts School settings

    3. Health Services Guidance: Illness & Dismissal

    4. References



    Current Massachusetts DESE/DOH Guidance for COVID-19 symptoms and school attendance, last updated August 26, 2022:

    Middleborough Public School Nurses follow the current State and Local Massachusetts Department of Public Health and Massachusetts Department of Education and Secondary Education (DESE) regulations and protocols with regards to all communicable diseases and infections.


    Current  Mass DPH/ Mass DESE COVID-19 Isolation and Quarantine Guidance for Children in Child Care, K-12, School Settings ( link to reference included below. 1)


    Effective August 26, 2022, children and staff in child care, K-12, out-of-school time (OST) and recreational camp settings should follow the below guidance.1 

    • A rapid antigen test, such as a self-test, is preferred to a PCR test in most situations.

    • When an individual tests positive for COVID19, to count days for isolation, Day 0 is the first day of symptoms OR the day the day positive test was taken, whichever is earlier.  

    • Contact tracing is no longer recommended or required in these settings, but schools or programs must continue to work with their Local Board of Health in the case of outbreaks.

    • The Commonwealth is not recommending universal mask requirements, surveillance testing of asymptomatic individuals, contact tracing, or test-to-stay testing in schools. While masks are not required or recommended in these settings except for in school health offices, any individual who wishes to continue to mask, including those who face higher risk from COVID-19, should be supported in that choice.  For those who need or choose to mask, masking is never required in these settings while the individual is eating, drinking, sleeping or outside.

    • All individuals are encouraged to stay up-to-date with vaccination as vaccines remain the best way to help protect yourself and others.

    Isolation and exposure guidance and protocols, for children in Pre-k and K-12 settings, in conjunction with our local MDPH Nurse Jaclyn Johnson BSN PHRN,  here is the specific guidance for quarantine after COVID19 close contact exposure, and for clearance after testing positive for COVID19:  


    ​Important update  received on August 26, 2022:

    Current COVID-19 Exposure Guidance :

    Quarantine is no longer required nor recommended for children or staff in these settings, regardless of vaccination status or where the exposure occurred. All exposed individuals may continue to attend programming as long as they remain asymptomatic.


    Those who can mask should do so until Day 10, and it is recommended that they test on Day 6 of exposure. If symptoms develop, follow the guidance for symptomatic individuals, below.


    Current COVID19 positive/COVID19 Illness Guidance:

          • Children and staff who test positive must isolate for at least 5 days.
          • If they are asymptomatic or symptoms are resolving and they have been fever free without the use of fever-reducing medicine for 24 hours, they may return to programming after Day 5 and should wear a high-quality mask through Day 10:
            • If the individual is able to mask, they are highly recommended to do so through Day 10.
              • If the individual has a negative test on Day 5 or later, they do not need to mask.
              • If the individual is unable to mask, they may return to programming with a negative test on Day 5 or later.
              • Symptomatic individuals can remain in their school or program if they have mild symptoms and have tested negative. Best practice would also include wearing a mask, if possible, until symptoms are fully resolved. For symptomatic individuals, DPH recommends a second test within 48 hours if the initial test is negative.
                • Symptomatic individuals should be sent home and allowed to return to their program or school if symptoms remain mild and they test negative, or they have been fever-free for 24 hours without the use of fever-reducing medication and their symptoms are resolving, or if a medical professional makes an alternative diagnosis. A negative test is strongly recommended for return.  


    For students with symptoms of Covid19:

    • Student will be dismissed from school by the School Nurse  

    • Student will be allowed to return to school if they test for COVID and their test result is negative and their symptoms are resolving, or if they choose not to test: they have been fever-free for 24 hours without the use of fever-reducing medication and their symptoms are resolving, or if a medical professional makes an alternative diagnosis, the MD note will be followed.

    • The MPS School Nurse’s Office has Covid 19 test kits for interested parents/ care providers to take home when they dismiss their students with symptoms that indicate a question of possible Covid-19.  The at-home test kits are completely optional.

    • Note: MD letters are no longer needed for clearance after testing positive for COVID19  and for COVID19 illness. Clearance to attend school after COVID19 is now a personal attestation of well, or recovered.    This is supported by Mass DPH/DESE and our local Middleborogh Department of Health Nurse Jaclyn Johnson BSN RNPH

    COVID-19 symptoms list:

    • Fever (100.0° Fahrenheit or higher), 

    • Chills, or shaking chills 

    • Difficulty breathing or shortness of breath 

    • New loss of taste or smell

    • Muscle aches or  body aches 

    • Cough (not due to other known cause, such as chronic cough) 

    • Sore throat, when in combination with other symptoms

    • Nausea, vomiting, or diarrhea when in combination with other symptoms

    • Headache when in combination with other symptoms 

    • Fatigue, when in combination with other symptoms 

    • Nasal congestion or runny nose (not due to other known causes, such as allergies) in combination with other symptoms 


    MPS Health Services General Guidance: Illness & Dismissal

    When your child is not feeling well during the school day, our MPS School Nurses are available in the School Health Office to assess your child. We ask parents/care providers to please have a plan in place to pick up your child in case he/she needs to be dismissed from school for illness or accidental injury. If a student has symptoms of illness needing to be dismissed, the school nurse will contact the parents/care providers as listed on your child's Emergency Contact sheet. We will contact all names you listed on the Nurse Emergency Contact sheet until someone is reached.  

    Please keep in mind that your child can be ill and contagious without the presence of a fever.

    Below is a list of common health issues for your reference.  This is a partial list as your School Nurse’s assessment determines when a student is unwell and in need of a nursing dismissal from school.  Thank you.

    • FEVER- We consider a temperature of 100 degrees or higher a fever. Children should remain at home fever-free for 24 hours without taking Tylenol or Motrin.

    • VOMITING/DIARRHEA- Children should remain at home symptom-free for 24 hours and are able to ingest fluids and food comfortably.

    • COUGHS/COLDS- If your child has discomfort from their cold symptoms, consider keeping them home. A continuous cough and/or continuous or green nasal drainage may need to be evaluated by your child’s physician.

    • CONJUNCTIVITIS- Your child may need to be on an antibiotic for 24 hours after the first dose before returning to school or a note from your student Pediatrician/MD with other guidance. Good hand-washing for the entire family is essential to prevent its spread.

    • STREP THROAT- Children cannot return to school until 24 hours after the first dose of antibiotic is taken. They should feel well enough to return to school. Some children feel ill for several days with strep infections.

    • SUSPICIOUS RASH- Children with rashes that are suspicious should have them evaluated by a physician and be cleared to return to school.

    • MONONUCLEOSIS- Please contact the school nurse if your child is diagnosed with mono. Your child’s physician will most likely place restrictions on their physical activity and temporary accommodations can be arranged at school.

    • HEAD LICE- Please refer to our link section for specific information on treating head lice. Children must be treated with a pediculosis (such as Nix) before returning to school. Please contact your child’s physician for advice on which product he recommends. You should accompany your child to school and the nurse will check them before they return to the classroom.

    • FIFTH’S DISEASE- Children are no longer contagious by the time symptoms appear with this viral illness. Fifth’s disease is of concern to pregnant women and should be reported to the school nurse.

    • CHICKENPOX- Your child should remain at home five days or until all areas are crusted over, completely dry and no new areas are breaking out.

    • IMPETIGO- Your child must remain at home until 24 hours after the first dose of antibiotics.

    • Note: prescription medications that have multiple doses per day should be given at home as much as possible: for example, antibiotics are often prescribed three times a day,  for five, seven or ten days in a row. Families should plan to administer their children's medication at home. For example, a three-times-a-day antibiotic can be given at home: before school, after school and at the students' bedtime. 



    1. current Guidance from Mass DPH/DESE:COVID-19 Isolation and Exposure Guidance for Children and Staff in Child Care, K-12




     Last reviewed Septemebr 19, 2022