COVID-19 Technical Assistance for Schools

April 1, 2021

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Webinar housekeeping

• All participants will be muted throughout the webinar• Please type questions into the chat box for the Q & A portion of the

webinar• Questions should be directed to “everyone” in the chat

• The webinar will be recorded and available at the following link:https://coronavirus.maryland.gov/pages/school-resources

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Webinar Agenda

• Guidance Updates• Hearing and Vision Screening During the COVID-19 Pandemic• In-Person Learning: Fine Arts • Social Emotional Learning through the Arts• Q and A

Next webinar will be held on April 15th at 1:00 pm

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CDC School COVID-19 Guidance- March 19, 2021• Revised physical distancing

recommendations to reflect at least 3 feet between students in classrooms and provide clearer guidance when a greater distance (such as 6 feet) is recommended.

• Clarified that ventilation is a component of strategies to clean and maintain healthy facilities.

• Removed recommendation for physical barriers.

• Clarified the role of community transmission levels in decision-making.

• Added guidance on interventions when clusters occur.

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https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/operation-strategy.html

New CDC School Distancing Guidance

• Between students in classrooms• In elementary schools, students should be at least 3 feet apart.• In middle schools and high schools, students should be at least 3 feet

apart unless there is high community transmission where middle and high school students should be 6 feet apart if cohorting is not possible.

• Maintain 6 feet of distance in the following settings:• Between adults (teachers and staff), and between adults and

students, at all times in the school building.• When masks cannot be worn, such as when eating.• During activities when increased exhalation occurs, such as singing,

shouting, band, or sports and exercise. Move these activities outdoors or to large, well-ventilated space, when possible.

• In common areas such as school lobbies and auditoriums.

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New CDC School Distancing Guidance (Cont)

• Use cohorting, and maintain 6 feet of distance between cohorts where possible.

• Limit contact between cohorts.

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Research of Interest• Association of Children’s Mode of School Instruction with Child and

Parent Experiences and Well-Being During the COVID-19 Pandemic —COVID Experiences Survey, United States, October 8–November 13, 2020. MMWR, March 19, 2021

https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7011a1-H.pdf• Minimal SARS-CoV-2 Transmission After Implementation of a

Comprehensive Mitigation Strategy at a School — New Jersey, August 20–November 27, 2020. MMWR, March 19, 2021

https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7011a2-H.pdf

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Research of Interest• Notes from the Field: SARS-CoV-2 Transmission Associated with High

School Football Team Members — Florida, September–October 2020. MMWR, March 19, 2021

https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7011a3-H.pdf

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April 1, 2021

Hearing and Vision Screening During the COVID-19 Pandemic:

An Overview

School Health COVID-19 Technical Assistance Webinars

Introduction: Hearing/Vision Screenings

Why is Hearing and Vision Screening important?– Detection of hearing and vision problems in school-age children.– Timely identification/management is important

• Serves to minimize risk of negative academic consequences

DateHearing and Vision Screening during COVID-1910

Mandated School Hearing and Vision Screenings

• Annotated Code of Maryland, Education Article §7-404– Mandated grades– Public and Nonpublic schools

• Code of Maryland Regulations (COMAR) 13A.05.05.07

April 1, 2021Hearing and Vision Screening during COVID-1911

Modifications for Conducting Safe Screening during COVID-19

Abbreviated Vision Screening– Photoscreener allows for performing screening from a safe distance

(at least 3 feet for all ages)– Distance visual acuity Test (use Snellen Chart) when photoscreener is

not available or • If a student cannot successfully cooperate for photoscreening• Minimize screening duration time

– Screenings not recommended at this time: • Color vision deficiency• Stereoacuity screening

April 1, 2021Hearing and Vision Screening during COVID-1912

Modifications for Safe Screening during COVID-19

Hearing Screening– Pure tone audiometry– Play audiometry

April 1, 2021Hearing and Vision Screening during COVID-1913

Planning/Scheduling Screenings• Choice of Screening area(s) –

– Vision screening may occur in a large open space– Hearing screening – “quiet space” or low ambient

noise area

• Other factors include:– Ventilation– Hand hygiene– Regulate flow and number of students– Physical barriers

April 1, 2021Hearing and Vision Screening during COVID-1914

Screening Notification Information

• Parent/guardian notification form for– LSS COVID-19 protocols including prevention information for

screening– LSS protocols to be followed related to COVID-19 symptoms

• Symptom screening conducted before entering screening area/space

April 1, 2021Hearing and Vision Screening during COVID-1915

Preventive Measures for ScreeningResources for Safe Screening

• Disposable masks/face coverings• Disposable gloves• Hand sanitizers – at least 60%• Cleaning/disinfecting supplies*• Face shields/eye protection • Disposable screening

accessories/items • Training for Screeners

Additional Training for Screeners

• Guidance on scheduling appointments• Process for conducting screening of

students – both in person and virtual • Screening students with special

healthcare needs• Time management and appointment

scheduling

April 1, 2021Hearing and Vision Screening during COVID-1916

Resuming Standard Screenings

Full resumption of in-person school schedules – Rescreen all students who received abbreviated screening

Link to guidance: https://phpa.health.maryland.gov/Documents/Hearing%20and%20Vision%20Screening%20COVID-19%20FINAL_3.25.21.pdf

April 1, 2021Hearing and Vision Screening during COVID-1917

Alysia Lee, Coordinator of Fine Arts

In-Person Learning: Fine Arts

April 1, 2021

Fine Arts

Music, Theatre, Dance, Visual Art, and Media Arts

Grades Prekindergarten-8: Instructional program in fine arts each year for all students.

Grades 9-12: enable 1 graduation credit and to select electives from all five disciplines

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MSDE Fine Arts Office

Arts Together:Planning Guidance for Arts Educators in Maryland Public Schools

June 1, 2020

Arts Together Panel Discussions

ARTS TOGETHER

Teaching & LearningMaintaining DistanceAccomodations for Reduced Class SizesMaterials and SuppliesSanitizationStaffingSchedulingLarge Group GatheringsProfessional Learning

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CDC Recommendations

CDC:K-12 Schools COVID-19 Mitigation Toolkit

CDC, 3/19 Updates

NEW CDC Guidelines from 3/19 Update1. Maintain 6 feet of distance . . . during activities when increased exhalation occurs, such as singing, shouting, band, or sports and exercise. Move these activities outdoors or to large, well-ventilated space, when possible.

2. Consistently adhere to universal masking of all students and educators.

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Aerosol Study

Recommendations from the International Performing Arts Aerosol Study

“These results are preliminary and will be further defined as the study continues. We are providing these preliminary results to assist in the safer return to performing arts activities. This study focuses strictly on the distribution of respiratory aerosol that is generated while playing wind instruments, singing, acting, speaking, dancing, and in a simulated aerobic activity, which may potentially contain virus.

This study did not use a live virus and therefore cannot be used to determine specific infection rates. However, this study is based on previous research that shows the virus which causes COVID-19 can travel in respiratory aerosol. This study then was designed to identify performing arts activities that generate respiratory aerosol including volume, direction, density, and mitigation strategies.”

Month 5 of 6 month study, using two independent labs at the University of Colorado-Boulder and University of Maryland.

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Aerosol Study: General Procedures

o Masks must be worn at all times. Multi-layered bell covers must be used by all wind instruments o CDC guidelines for social distancing of 6x6 feet, with 9x6 for trombone players.

o Indoors limited to 30 minutes followed by a minimum of one air exchange rate (ACH), preferably 3 ACH, to change the air indoors with outside air.

o Increase ACH to HVAC maximum, add HEPA Filtration designed for the size of the room.

o Practice good hygiene by washing hands, using sanitizers, and preventing uncontrolled spit valve release

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Aerosol Study: Wind Instruments

• Wind instruments and singing produce aerosol, which vary by instrument as well as intensity. The produced aerosol amount is, on average, similar across all instrument types and singing with the exception of the oboe. Most aerosol is being expelled from the bell of the instruments and from the mouth of the performers.

• At this time, it appears that if players wear surgical style masks with a slit for mouthpiece AND bell covers, aerosol emission is reduced between 60% and 90%.

• Flutes and recorders create a minimal amount of aerosol and it is recommended to play flute with the headjoint between their mouth and mask . Recorder should use the slitted mask used with woodwinds. Both the flute and recorder should use a cloth “mask” at the end of the barrel.

• Bell covers for woodwinds and brass should be made with a multi-layer cover with the center layer being made of MERV-13 filter material, or a 3-layer surgical style mask using a standard such as GB/T32310.

o CDC guidelines for social distancing of 6x6 feet, with 9x6 for trombone players.

Practice good hygiene by washing hands, using sanitizers, and preventing uncontrolled spit valve release.

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Aerosol Study: Singing

• Singers produce aerosol at similar rates as woodwinds and brass. The amount of aerosol varies depending on consonants, vowels, intensity, and pitch. Singers wearing a well fit 3-layer surgical style mask reduces aerosol emission. • Singers produce aerosol at similar rates as woodwinds and brass. The amount of aerosol varies depending on consonants, vowels, intensity, and pitch. Singers wearing a well fit 3-layer surgical style mask that meets the ASTM F2100 or GB/T32610 standard reduces aerosol emission. • Face shields are only effective at close range to stop large droplets; they do not prevent aerosol from being inhaled or released unless a mask is also worn.

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Aerosol Study: Partitions

Plexiglass partitions or barriers between musicians are not recommended due to room HVAC system design limitations. "Dead zones" or areas where aerosol can build-up are a concern of plexiglass partitions are used. ** addressed in CDC update

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Aerosol Study: Reduced Time

• Reduced time in performing arts activities: o Indoors - 30-minute restriction followed by a minimum of one (1) air

exchange o Outdoors – 60-minute restriction followed by a five (5) minute break (New 3/19/21)

• Practice good hygiene by washing hands, using sanitizers, and preventing uncontrolled spit valve release.

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Aerosol Study: Rehearsal Space

• Rehearsal space recommendations in order of preference: o Outdoor rehearsals, using individual mitigation

techniques described above. o Indoors with elevated outdoor air exchange rate from HVAC.

o Indoors with typical outdoor air exchange rate from HVAC plus recirculation air through MERV 13 filters or addition of appropriately sized HEPA air cleaners.

o Indoors with outdoor air exchange rate from open windows supplemented with appropriately sized HEPA air cleaners when airflow is reduced under certain outdoor wind conditions.

Please refer to the Association for Heating, Ventilating and Air-Conditioning Engineers (ASHRAE) guidance on ventilation

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Tools

Risk Assessment Tools: University of Colorado Boulder risk assessment tool

Harvard-UC Boulder Portable Air Cleaner Calculator for Schools.v1.1

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Aerosol Overview1. Bell covers should be used for all woodwinds and brass and should be made with a multi-layer cover with the center layer being made of MERV-13 filter material, or a 3-layer surgical style mask using an ASTM F2100 or GB/T32610 standard.2. Singers and instrumentalists should wear a well-fitted 3-layer surgical-style mask that meets the ASTM F2100 or GB/T32610 standard to reduce aerosol emission. Instrumental players may have a slit in their mask to allow the insertion of their mouthpiece. The slitted mask does not replace the instrumentalist’s usual mask and is only used when actively playing their instrument.3. Performing arts activities should happen on a reduced schedule:

● Indoors – 30-minute restriction followed by a minimum of one (1) air exchange● Outdoors – 60-minute restriction followed by a five (5) minute break (NEW 3/19/21)

4. Practice good hygiene by washing hands, using sanitizers, and preventing uncontrolled spit valve release.5. Rehearsal space recommendations in order of preference:

● Outdoor rehearsals, using individual mitigation techniques described above.● Indoors with elevated outdoor air exchange rate from HVAC.● Indoors with typical outdoor air exchange rate from HVAC plus recirculation air through MERV 13 filters or

addition of appropriately sized HEPA air cleaners.● Indoors with outdoor air exchange rate from open windows supplemented with appropriately sized HEPA

air cleaners when airflow is reduced under certain outdoor wind conditions.

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Large Group Gatherings

Large Group Gatherings

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Suggestions for In-Person Performances

Consider the following suggestions for planning in-person performances from the 2020-2021 Season Planning Guide by Chorus Connection: ● Reduced performance times. ● E-tickets and online ticket sales only. ● Staggered check-in times. ● Earlier open of house. ● Virtual performance options for in-person events. ● Share information about the precautions you are taking. ● Ask them to take precautions. ● Always follow the advice of your local government and health professionals when it comes to social distancing.

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Questions from the Field

URGENT Questions to Address Aerosols, Wind Instruments: Bags vs. Bell Covers; Indoor Playing

• Woodwind instruments currently require bags but recent studies from Colorado and U of MD are suggesting the bags are not required because the aerosols that are released from the keyholes is insubstantial. The use of only a bell cover would greatly improve student performance because they would be able to see their finger placement. What is the current guidance on this?Declining enrollment for next year's classes due to no being able to play or sing inside.

Aerosols, Singing: Indoor Singing• Declining enrollment for next year's classes due to no being able to play or sing inside.• What determines when it is safe to sing again (indoors and outside) with masks and all remediation practices?

Outdoor RehearsalsCan you provide updated guidance for outdoor rehearsals (band/chorus/theatre)?

Audiences/Large Gatherings/Performances• How/what is the guidance for making determinations about spectator seating at fine arts events such as concerts, plays, musicals, arts

festivals, etc?Looking at sports and sporting events - link the ties to arts events.

• What are the parameters for outdoor performances? If there's social distancing on stage, can performers (e.g., actors, singers) go without masks?

• In either case - indoor or outdoor - how many audience members are allowed to attend and what are the guidelines for seating?• Any guidance with live audience protocols? Mirroring sports for inside/outside?

Materials• What is the current guidance on sharing of materials particularly wet or sticky materials such as clay. It is typical a art practice to recycle

and reuse clay is there any guidance on resuming this practice.

PPE• Funding sources for arts-specific PPE in subsequent school years (e.g., 2021-2022) after the grants stimulus go away

Cleaning• Do UV lights kill the Covid-19 virus? How do we determine how long it takes?• What cleaner can best be used to sanitize supplies? (i.e. paint brush, drum sticks, cello finger board/necks, etc)

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CURRENT RESOURCES

● CDC:○ Operation Strategy for K-12, 3/19○ K-12 Schools COVID-19 Mitigation

Toolkit ● Aerosol Report: 3rd Review● COVID-19: Impact on the Musician and Returning

to Singing; A Literature Review● ASHRAE

Contact:

Alysia LeeCoordinator of Fine ArtsDivision of Curriculum, Instructional Improvement, and Professional LearningMaryland State Department of Educationalysia.lee@maryland.gov

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