School nurses are registered nurses trained to use assessment skills (including student health history, current symptoms, current trends of infectious disease) and clinical judgment to determine when students need to be sent home, referred to a medical provider, offered COVID testing, or returned to the classroom. Just as they do with all contagious illnesses, school nurses will follow clinical guidelines and evidence-based information to make these decisions.

Symptoms are only one part of the equation when nurses determine whether or not students should be sent home or referred to a medical provider. Nurses have to look at the full picture in order to make these decisions. Does this student have a known exposure to COVID? If so, they are now symptomatic and testing should be recommended, and the student should be excluded from school until they have a negative COVID test, receive a differential diagnosis, or 5 days have passed since the onset of symptoms.  When nurses are evaluating for the risk of COVID they will consider the individual’s exposure history, personal health history, current community transmission rate, current transmission rate in the school, and the symptoms the individual has. A list of possible COVID symptoms can be found at https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html It’s important to remember that symptoms alone do not determine the need for referral or offering COVID testing.