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COVID-19 EDUCATION PLAN

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Guidance on Supporting Students Who Require Interventions or Supports that Must Be Delivered in Close Physical Proximity

Updated December 2020

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Acknowledgement

The Inclusion Support Branch of Manitoba Education appreciates the support of a team coordinated by the Infection Prevention and Control Consultant of Manitoba Health, Seniors and Active Living in the development of the content for this document.

 

Purpose

This document was prepared to assist school divisions and funded independent schools in keeping students and staff safe in situations where students require interventions or supports that cannot be provided from a distance of two metres.

Assumptions

All facilities providing schooling or school-related activities must continue to follow applicable health and safety legislation to ensure the safety, health, and well-being of students and staff.

Guidelines in this document are based on the underlying assumption that the necessary protocols are being followed, as established in Welcoming our Students Back: Restoring Safe Schools: COVID-19 K–12 School Settings Practice Guidance and Protocols

Schools and school divisions are following the most recent public health guidelines, such as those found in the following resources:

Before implementation, it is recommended that this content be reviewed by the Workplace Safety and Health Committee of the school division or school.

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Special Considerations

When working with students who need extra supports, additional considerations are beneficial to both students and staff members.

  • In order to avoid stigma or unintended consequences, it is important that routine practices are followed universally.
  • Consider how the environment can be engineered to support students who have difficulty following recommended protocols (e.g., students who are impulsive, students who are working to improve self-management, students for whom self-management is not yet possible).
    • Suggestions: Use tape on the floor, hoops, mats, or other items that can mark off personal space; organize activities with a visual cue about how many students should be in that area (e.g., two chairs next to an activity).
  • Review student-specific plans to determine whether interventions that require close physical proximity for longer periods of time are necessary (e.g., physically directing a student).
  • Student-specific plans may be required to address particular situations (e.g., students with ‘tics’ such as touching their face; students with mental health needs and who are upset or do not understand the need to physically distance; students who communicate in ASL and who may need to touch their face to express themselves).
  • School clinicians will review additional protocols identified by their regulatory body.
  • Consider changes in the school environment or remote learning needs when reviewing and updating student-specific plans (SSPs).
  • Create congregated classrooms as a temporary COVID-19 response measure for students with special learning needs in order to offer regular, everyday timetabling.
  • Consider additional planning for students with special learning needs, including those living with complex medical needs, to support a smoother transition to school.
  • Division-level remote learning will be in place for students who are medically advised not to return to in-class learning due to COVID-related risk factors. These situations should be rare and limited to children with compromised immune systems or other medical conditions that increase their risk.
  • Consider alternate attendance options for students, depending on their needs.

Manitoba Education continues to work with the Manitoba Department of Families and education stakeholders to further develop guidance and support for students with special needs and students at risk. For more information, please visit Resources Supporting Students with Special Needs

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Following Routine Practices

A layered approach including multiple routine practices will reduce the spread of COVID-19. Routine practices consist of many public health measures, such as the following:

  • Stay home when sick.
  • Screen for Symptoms.
  • Minimize visitor access.
  • Physical distance as much as possible.
  • Limit exposure to others by using cohorts.
  • Increase ventilation
  • Wear a non-medical mask.
  • Increase frequency of cleaning, disinfecting, and sanitizing.
  • Avoid touching your eyes, nose, and mouth with unclean hands.
  • Ensure students and staff obey the following hand hygiene guidelines. At the following times, engage in frequent hand hygiene with soap and water for at least 15 to 20 seconds, or use alcohol-based sanitizer:
    • at the start of the day and before going home
    • before and after completing any support/procedure that does not allow physical distancing (both students and staff)
    • before and after putting on and removing personal protective equipment (PPE) such as gloves, masks, and eye shields, as outlined in this document
    • after going to the washroom, wiping nose or handling dirty tissues, coughing, sneezing, or blowing nose
    • after getting hands dirty or if they have become contaminated
    • after completing cleaning tasks (staff)
    • before and after food preparation or contact with food
    • before and after snacks or meals

Note: The hand hygiene procedure takes longer than 15 to 20 seconds, as you need to turn the water on, get your hands wet, perform the lathering and mechanical actions, and then rinse them off and dry. The time spent just lathering and performing the mechanical actions is what requires 15 to 20 seconds.

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Provide Accessible Information and Direct Instruction

  • Encourage hand hygiene and make alcohol-based hand sanitizer available at all building access points.
  • Post signs in common areas, such as entrances, classrooms, restrooms, life skills area, physiotherapy area, and vocational area.
  • Provide clear, direct instructions about how to perform hand hygiene and cough etiquette.
    • Use plain language, as spoken in the community
    • Keep messages short, explaining simple steps they can take
    • Use large fonts and graphics
    • Make sure instructions are accessible (e.g., Braille, pictorial)
    • Use social stories

Review the posters and videos that have been created by the Manitoba government to define/explain hand hygiene, mask use, and cough etiquette, which can be found under Health and Safety Resources.

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Non-medical Masks

Manitoba Education will continue to work with Public Health to monitor the situation and adjust direction accordingly. For the most up-to-date information regarding mask use, please see Guidance for Mask Use in Schools (adobe pdf 225 KB).

For more information, see Welcoming Our Students Back: Restoring Safe Schools: COVID-19 K–12 School Settings Practice Guidance and Protocols

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Considerations Regarding Staff Assignments

It is important to identify which staff members can safely work with students who are considered low, medium, or high risk, based on the staff members’ individual circumstances. Staff would then be assigned accordingly and/or necessary accommodations would need to be put into place.

Vulnerable populations are described by Public Health as outlined below. These vulnerabilities need to be considered as they relate to both students and staff.

Anyone who is

  • at risk due to underlying medical conditions (e.g., heart disease, hypertension, diabetes, chronic respiratory diseases, cancer)
  • at risk due to a compromised immune system from a medical condition or treatment (e.g., chemotherapy)
  • An older adult

Anyone who has

  • difficulty reading, speaking, understanding, or communicating
  • difficulty doing preventive activities like frequent hand washing and covering coughs and sneezes
  • ongoing specialized medical care or who requires specific medical supplies
  • ongoing supervision needs or support for maintaining independence
  • difficulty accessing medical care or health advice
  • difficulty accessing transportation
  • economic barriers
  • unstable employment or inflexible working conditions
  • social or geographic isolation, like in remote and isolated communities
  • insecure, inadequate, or non-existent housing conditions
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Students Who Require Supports that Must be Delivered in Close Physical Proximity

Students may require specific interventions or supports that must be delivered in close physical proximity. Examples of these interventions or supports include

  • catheterization
  • gastrostomy and Ostomy feeding/care
  • blood-glucose monitoring
  • pre-set oxygen
  • suctioning
  • diapering
  • assistance in using the washroom
  • assistance with feeding
  • assistance with mobility
  • assistance with communication device or other teaching tools
  • administration of emergency medication by school staff (e.g., epinephrine auto-injector or “epi-pen”, asthma medication, rescue medication for seizures)
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Level of Risk

Precautions related to these types of supports will vary depending on the level of risk. Ongoing reassessment of a student’s level of risk must occur by the school team.

Low Risk

A student is considered low risk if they

  • have screened negative
  • can communicate sufficiently to follow basic directions
  • are able to perform preventative activities like frequent hand hygiene and cough etiquette, and wear a non-medical mask
  • are generally cooperative during all types of procedures

When the risk is low, following routine practices and providing accessible information and direct instruction are considered sufficient. See the information outlined previously in this document.

  • Disposable gloves need only be worn to perform close personal care that results in potential for contact with bodily fluids. Perform hand hygiene before AND after removing gloves.
  • If there is concern that there is increased risk of transmission of COVID-19 among low risk students (e.g., a cohort identified with two or more cases), use personal protective equipment (PPE) required for a medium level of risk (even if Public Health has not determined any transmission within the cohort).
  • If the student is considered low risk and is unable to wear a mask, use PPE required for a medium level of risk.

Medium Risk

A student is considered medium risk if they

  • have screened negative
  • have difficulty communicating sufficiently to follow basic directions
  • have difficulty performing preventative activities like frequent hand hygiene and cough etiquette, or are unable to wear a non-medical mask
  • are generally cooperative during all types of procedures
  • demonstrates symptoms such as running nose, coughing, sneezing, gagging, drooling, but do so normally

Medium-risk situations call for routine practices (as outlined previously in this document) to be followed at all times. Providing accessible information and direct instruction is also useful. In addition, the following precautions are recommended:

High Risk

A student is considered high risk if they

  • have screened negative
  • have difficulty communicating sufficiently to follow basic directions
  • have difficulty performing preventative activities like frequent hand hygiene and cough etiquette, or are unable to wear a non-medical mask
  • are uncooperative during most/all types of procedures
  • have vulnerabilities that include expected behaviours that increase the chance of spreading infection (e.g., spitting, biting)

High risk situations call for routine practices, as outlined previously in this document, to be followed at all times. Providing accessible information and direct instruction is also useful. In addition, the following precautions are recommended:

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Additional Notes

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