GOVERNMENT OF ANTIGUA AND BARBUDA

MINISTRY OF HEALTH, WELLNESS AND THE ENVIRONMENT

ADVICE ON THE MANAGEMENT OF THE SICK CHILD AND STAFF AT SCHOOL IN THE CONTEXT OF COVID-19

October 10, 2020

Daily health screening for early signs of illness can sometimes prevent a child from becoming ill
while attending school (during school hours). This screening can also eliminate problems for school
having to care for a sick child until the parent or guardian is able to come to the school to pick the
child up or exposing the other children and staff to communicable diseases.

What to look for in a Sick Child or Staff Suspected to have COVID-19

People with COVID-19 have had a wide range of symptoms reported – ranging from mild
symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus.

A sick child or staff suspected to have COVID-19 may have:

A. Acute onset of fever AND cough;
OR

B. Acute onset of ANY THREE OR MORE of the following signs or symptoms:
Fever (measured temperature of >= 100 ْF or 37.7 ْC with onset within the last 10
days), cough, general weakness/fatigue, headache, myalgia, sore throat, coryza,
dyspnea, anorexia/nausea/vomiting, diarrhea, altered mental status

C. Recent onset of anosmia (loss of smell) or ageusia (loss of taste) in the absence of any
other identified cause

Persons who are moderately to severely ill may have Emergency Warning Signs for
COVID-19.
a. If a child or staff is displaying any of these signs, they must be mentioned when calling
the EMS and the Nurse:
– Trouble breathing
– Persistent pain or pressure in the chest
– Confusion
– Inability to wake or stay awake
– Bluish lips or face

The following steps should be taken to facilitate the safe and efficient management of a sick child
or staff at school

Child:

1. If a child becomes ill during school hours, he/she must be placed in a supervised isolation
area with a clean appropriate place to lie down.
2. The child must don a medical mask (if tolerated)
3. The ill child must also be provided with the appropriate supervised attention while waiting
for their parent or guardian to arrive at the school
4. The illness must be reported immediately to:
– Parent(s) or guardian
– Designated Public Health Nurse in the community (see listed below for your school)
– Emergency Medical Services (EMS) at 562 2432 or 464 6303
5. A designated member of staff or “Point of Contact” should provide the Nurse and EMS with
a brief summary of the child’s name, age, contact of parents, address and symptoms or
signs and any underlying illness or chronic conditions
6. Parents or guardians are required to come to the school to remove the ill child within 1
hour, but after the medical assessment by the Nurse and/or EMS has taken place
7. The school and parents/guardians should make provisions for children whose
parents/guardians are unable to accompany them home from school
8. If a moderately or severely sick child requires immediate hospital assessment and
management, parents must be notified, and a responsible staff member should accompany
the child until the parent is able to do so

Sick Staff:

1. If a staff member becomes sick at school, the school must notify:
– Designated Public Health Nurse in the community (see listed below for your school)
– Emergency Medical Services (EMS) at 562 2432 or 464 6303
2. A designated member of staff or “Point of Contact” should provide the Nurse and EMS with
a brief summary of the sick staff’s name, age, contact, address and symptoms or signs and
any underlying illness or chronic conditions
3. The sick staff member, if mildly ill and not suspected to have COVID-19 infection as defined
above, may leave the school premises but should be encouraged to seek medical attention
as soon as possible
4. If the staff is moderately or severely ill, he/she must be placed in a supervised isolation area
with a clean appropriate place to lie down until the Nurse and/or EMS is able to assess
him/her
5. The sick staff must don a medical mask (if tolerated)
6. The Nurse will assess the staff, complete a COVID-19 Investigation Form and give
instructions for isolation, monitoring of signs and symptoms and follow-up as required

The Isolation Area

1. Persons supervising the isolation area should wear appropriate Personal Protection
Equipment (PPE). A surgical mask is required if they remain a distance of less than 3 to 6
feet from the sick child or staff. However, in cases where the supervisor is likely to come
into contact with or hold a sick child or staff, a surgical mask, face shield and gown should
be donned, and frequent handwashing or sanitizing is required.

2. If multiple persons are sick at the same time, they should be isolated no less than 6 feet
apart, in a well-ventilated area, adhering to the other infection control and prevention
measures mentioned for the isolation area.

3. When the sick child or staff is removed from the school, the area where the child or staff
was waiting must be cleaned and sanitized by the school.

4. It is recommended to separate the isolation area for sick staff from that for children.

5. Confidentiality should be maintained at all times, and measures should be put in place to
reduce stigmatization or bullying of child or staff member upon their return to school.

The Nurse reports to the Epidemiology and Surveillance Unit which is responsible for making
recommendations to the Chief Medical Officer (Quarantine Authority).

Any decision to be made about the Quarantine of any school must be done by the Quarantine
Authority in conjunction with the Director of Education.

Criteria for a Child or Staff to Return to School

A. A sick child or staff who does not meet the requirements of the case definition for COVID19 infection, but misses school due to an illness, must present a School Note certifying
their fitness upon their return to school.

B. A child or staff who meets the requirements of the case definition for COVID-19 infection,
must be tested and isolated for 14 days. After which, they will be retested to have 2
consecutive negative COVID-19 PCR results.
– The office of the Chief Medical Officer will then present the staff or parents/
guardian with a letter confirming the individual’s fitness to return to school

C. If a child or staff is identified as a contact of a confirmed case, the risk of exposure will be
assessed.
a. If the risk of exposure is high, the child or staff will be tested.

I. If COVID-19 PCR result is positive, they will be isolated for 14 days, after which
they will be retested to have 2 consecutive negative COVID-19 PCR results. If
COVID-19 PCR is still positive on retesting, they will have weekly retesting until 2
consecutive negative tests are obtained.
– The office of the Chief Medical Officer will then present the staff or parents/
guardian with a letter confirming the individual’s fitness to return to school

II. If COVID-19 PCR result is negative, then they will be quarantined for 14 days, after
which they will be retested to have 1 negative COVID-19 PCR result.
– The office of the Chief Medical Officer will then present the staff or parents/
guardian with a letter confirming the individual’s fitness to return to school

b. If the risk of exposure is low, the child or staff will be placed in quarantine for 14 days,
after which they will be tested to have 1 negative COVID-19 PCR result.
– The office of the Chief Medical Officer will then present the staff or parents/
guardian with a letter confirming the individual’s fitness to return to school

DESIGNATED NURSES IN NURSES’ SCHOOL DISTRICTS FOR PRIMARY AND
SECONDARY SCHOOLS AND OTHER PUBLIC INSTITUTIONS FOR LEARNING
(This list will be updated monthly to reflect any changes)

A. Eastern Area

Responsible Nurse: PHN Nurse Kay Tomlinson
Contact: 460 4270
Schools/Institutions: Parham Primary, Pares Primary, Pares Secondary, Nelvie N. Gore Primary,
Newfield Primary, Glanvilles Secondary, Freetown Primary

B. Northern Area

Responsible Nurse: Nurse Althea Georges
Contact: 462 4127
Schools/Institutions: Clare Hall Secondary, Potters Primary, Pigotts Primary, St Michaels Primary,
Antigua Grammar School, TOR Memorial, T.N Kirnon School, School for the Deaf, The Adele
School, St Anthony’s Secondary, St Andrews Primary, St Nicholas Primary, Christian Union Jr.
Academy, Gospel Light, Christ the King High School, Sunnyside Tutorial, ABICE, ABIIT, Cedar Grove
Primary, St Joseph’s Academy, Sir Novelle Richards Academy, Victory Centre, St John’s Catholic,
Foundations of Faith, Simon Bolivar Preschool, New Winthorpes Primary

C. Southern Area

Responsible Nurse: Nurse Miasha Carr
Contact: 462 6304
Schools/Institutions: Jennings Primary, Jennings Secondary, S.R Olivia David Primary, Urlings
Primary, Trinity Academy, Old Road Primary, Bendals Primary, St Mary’s Secondary School

D. Gray’s Farm Area

Responsible Nurse: Nurse Latoya Mussington and Nurse Margaret Joseph
Contact: 462 0681
Schools/Institutions: Green Bay Primary School, Five Islands Primary, Temple Academy,
Nyabinghi Theocracy

E. Bishop Gate Area

Responsible Nurse: PHN Cherise Greenaway and Nurse Edith Desilva
Contact: 462 0501
Schools/Institutions: Villa Primary, Antigua Wesleyan Jr. Academy, Grace Christian Academy,
Divine Academy, Princess Margaret School, Better Chance Primary, Antigua Girls’ High School

F. Browne’s Avenue Area

Responsible Nurse: Nurse Alden Robins and Nurse Joseanne Campbell
Contact: 562 3076
Schools/Institutions: Golden Grove Primary, Antigua State College, Ottos Comprehensive, Mary E
Pigott School, SDA Primary, SDA Secondary, Minoah Magnet, Sunny Dale, Tabernacle Academy, St
John’s Lutheran, Baptist Academy, Kids Unlimited, Sea View Academy, Grays Crescent Primary, St.
Peters Primary, Foundation Mixed School, National Public Library

G. All Saints Area

Responsible Nurse: PHN Denise Williams
Contact: 460 1003
Schools/Institutions: Sea View Farm Primary, J.T Ambrose School, All Saints Secondary,
Freemansville Primary, Liberta Primary, Irene B Williams, Cobbs Cross Primary, C.T Samuel
Primary, Post Millenial Academy, New Bethel SDA Academy, Island Academy, Buckleys Primary

H. Barbuda

Responsible Nurse: PHN Jenita Cuffy
Contact: 721 2686
Holy Trinity School, Sir McChesney George Secondary School

LIST OF PRESCHOOLS AND DAYCARE CENTERS IN NURSING AREAS

The nurses assigned to schools and public institutions of learning are also assigned to preschools
and daycares in their designated areas.

AREA                                                  NAME                               DAYCARE                               PRESCHOOL
ALL SAINTS AREA
Liberta                                                    Liberty                                  X                                                   X
Moravian                              X                                                   X
Cobbs Cross                                          11th Hour                              X                                                   X
All Saints                                               Tender Heart                       X                                                    X
Samaritan                                                                                   X
Baptist                                  X                                                    X
Sea View Farm and                             Sunshine                               X                                                    X
Freemans Village
Christian Union                  X                                                     X
Swetes                                                   Cana Moravian                                                                            X
New Adventure                   X                                                     X
SOUTHERN AREA
Jennings                                               Cedar Hall                           X                                                      X

BARBUDA                                         William Cody Kelly                                                                     X
Burnice Lewis                    X
Toddlers Paradise             X

GRAYS FARM AREA
North                                                    Baby’s Paradise                                                                           X
Greenbay                                                                                      X
Grays Green Promise
Land                                                                                               X
South                                                   Temple Academy                                                                         X
Kuddles                                                                                         X
Kiddies Haven                                                                             X

NORTHERN AREA
Potters                                                Denieces                              X
Golden Achievers              X                                                        X
La Petite Learning
Center                                                                                             X
St. Peters Primary                                                                        X
Tabernacle Academy                                                                   X
Cedar Grove                                      Tiny Treasures                   X
Learning Ladder                X
Touna World                                                                                X
Little Flower                                                                                 X

Pigotts                                               Sunnyside Primary                                                                       X
Clare Hall I                                       St. John’s Catholic            X                                                         X
Bible Believers                   X                                                         X
Little Feet Big Steps         X                                                         X
Sprout Angels                    X                                                         X
Christian Union                                                                            X
Raising the Standard
of Excellence
Academy                                                                                        X
Hundred Acre                                                                               X
Clare Hall II                                     Little Diamonds                X                                                         X
Jump for Joy                     X                                                         X
Kids Castle Learning
Center                                 X                                                         X
Children’s Academy         X                                                         X
Curious Minds                  X
Little Explorers                 X
Simon Bolivar                   X

BISHOPGATE STREET
HC
Share and Care                   X
Precious Gems                    X                                                       X
Moravian                             X                                                        X
Ethlyn Williams                 X                                                        X
Gentle Touch                      X                                                        X
Gentle Scholars                  X                                                        X
Deanery Lane                     X                                                        X
Smart Kids                          X                                                        X
Excelsior                              X                                                       X
Sandy                                   X
Montesorri                                                                                    X
Dr. Rosa Lee                                                                                 X
Villa                                                                                                X
Better Chance                                                                               X
Grace Christian                                                                            X

BROWNES AVENUE
St. John’s II                                     Baptist Academy                                                                         X
Precious Little Angels         X                                                    X
Abraham Center                  X                                                     X
Salvation Army                                                                            X
District A                                         Agape                                                                                             X
Sunnydale                                                                                     X
District B                                          Mount Zion Baptist            X                                                     X

Ministry of Education, Science and Technology (MoEST)
School Reopening Protocols
(September 2020)

INTRODUCTION

Within the ongoing climate of the COVID-19 pandemic and the many uncertainties it brings, the
Ministry of Education, Science and Technology (MoEST) seeks to ensure that teaching and
learning occur in a safe and healthy environment that is conducive to the delivery of quality
education. It is, therefore, necessary that all stakeholders play their part in limiting the
transmission of the corona virus by practising good hand and respiratory hygiene, wearing masks,
observing social/physical distancing, remaining at home when sick and cleaning high-touch
surfaces regularly.

The School Reopening Protocol document is designed to address several aspects of school life
which are affected by the effects of this pandemic. The first section identifies what is expected
of stakeholders within this COVID-19 environment. The second section presents a number of
protocols with accompanying procedures to be followed in each case. The MoEST recognises that
this is a fluid situation and the protocols may need to be revised periodically in keeping with the
decisions of the Cabinet of Antigua and Barbuda and Ministry of Health

EXPECTATIONS OF STAKEHOLDERS

All stakeholders: To be responsible for observing all COVID-19 protocols and associated practices
in the quest to preserve human health and life. Individuals who have known exposure or travel
history should declare such.

Ministry of Education, Science and Technology: To be responsive to the needs arising within the
education system as a result of COVID-19.

Board of Education: To work in harmony with the MoEST and schools in ensuring that timely and
adequate support (technical and material) is provided in the current COVID-19 pandemic.

Antigua and Barbuda Union of Teachers: To work collaboratively with all stakeholders to ensure
the health and safety of the teaching fraternity and by extension the school population.

Ministry of Health: To support and guide the MoEST for the safe and successful implementation
of COVID-19 protocols in institutions of education including facilities of higher learning.

Principals and Teachers: To communicate, implement, manage and monitor COVID-19 protocols.

Students: To be model students, by observing the requisite COVID-19 protocols.

Parents: To work in harmony with their children, schools and the various agencies to ensure that
the COVID-19 protocols are satisfactorily observed.

Other stakeholders/agencies (school bus, service organisations, visitors, external agencies,
press): To work with the MoEST and schools to enable the successful implementation and
observance of COVID-19 protocols.

PROTOCOL 1: SCHOOL ADMINISTRATION
1. School administrators should ensure that the protocols are carried out within the school
community.

2. School administrators should make available resources to the relevant personnel, as
provided by the Board of Education, in a space that can be easily accessed.

3. In addition to the daily log of attendance, schools should ensure that a record is kept of
the seating arrangements for each class to allow for contact tracing should the need
arise.

4. School administrators should ensure that classroom physical distancing spaces are upheld
for classroom instruction. Schools have the option of using larger spaces within schools,
such as auditoriums, for larger classes.

5. School administrators must identify an isolation space in case any student/school
personnel should fall ill during the school day. The isolation space is an area used as a
temporary holding area to reduce the risk of possible transmission of the disease. Hence,
care should be taken to ensure there is physical distancing, handwashing and sanitising,
wearing of masks and other prevention control measures being practised. The isolation
space must be easy to clean. After each use, it must be thoroughly cleaned and
disinfected.

6. School administrators should direct cleaners to ensure that bathrooms are supervised and
the school environment is cleaned at intervals. Further training of cleaners must be
facilitated by the Ministry of Health in collaboration with the MoEST. School
administrators should instruct cleaners to use the cleaning resources in the correct
proportions as per that training.

7. The school administration should coordinate the taking of temperature for all persons
entering the school’s compound.

PROTOCOL 2: SCREENING
1. All staff, students and visitors who arrive at the school compound are required to wear a
visibly clean mask that covers both their nose and mouth.

2. All staff, students and visitors MUST be screened (temperature check, interview when
necessary) upon entry of the school plant. The thermometer MUST be used in accordance
with the manufacturer’s instructions. Hands must then be washed or sanitized before
proceeding to any other area on the school compound.

3. Any of the following individuals may be assigned as a screener:
• school nurses (where applicable);
• parent coordinators (where applicable);
• first aiders (where applicable);
• administrative staff;
• teachers;
• security officers; and
• any other authorized staff.

4. Persons who are performing temperature checks must ensure that they wash their hands
and put on a facemask, eye protection/face shield that fully covers the front and sides of
the face. Other protective gear which may include disposable/reusable aprons and gowns
should be used if extensive contact with students is occurring (in early childhood centres
and special needs schools). The required procedure for administering temperature checks
must be followed.
• If disposable or non-contact (temporal or infrared) thermometers are used and there
is no physical contact with students, gloves do not need to be changed before the next
check.
• If there is contact at any time during the screening process, the machine should be
cleaned immediately with 70-90% alcohol solution.
• After each screening process is completed, the thermometer must be thoroughly
cleaned and properly stored.

5. Anyone (staff, student, visitor) who is found to have an elevated temperature of 100°F
(or 37.7°C) or higher must be asked to sit for 15 minutes then the temperature will be
rechecked. The screener may then ask further questions (see Appendix A) to complete the
screening process. Staff and visitors whose temperature remains elevated will not be
permitted unto the compound and should be advised to seek medical attention. A record
should be kept of the names of individuals whose temperature remains elevated. Data
collected (temperature readings and other responses to set screening questions) should
be passed on to principals for information sharing with the relevant authorities. (See
Appendix B for contact details of health care providers.)

6. Students whose temperature remains elevated should be taken to the isolation
space/room (a space as identified by the school). The school then notifies the parent/guardian for the child to be collected. The parent/guardian is expected to collect or arrange for the child to be collected within the hour of notification. The parent/guardian should be encouraged to monitor the child and immediately contact the nearest health centre/clinic or call the Education COVID-19 contact numbers: 464 6303; 464 9011 to obtain further guidance. It is the responsibility of the school to notify the Ministry of Education and the nearest health centre/clinic of such cases.

7. Visitation to the school compound by non-education personnel is discouraged at this time.
Where there are exceptions, the individuals should be interviewed and their query passed
on to the administration of the school. All visitors who do not have urgent concerns should
be encouraged to call or email the school.

PROTOCOL 3: PHYSICAL DISTANCING
The following Social Distancing guidelines are based on the Public Health Act (Dangerous
Infectious Disease) Regulations 2020:

1. Physical distancing of ideally six (6) feet but no less than three (3) feet must be maintained
on the school compound at all times during the school day. Efforts should be made for
rooms (general assembly auditoriums/halls, classrooms, staff rooms, administrative
offices, laboratories, etc.) to be adequately ventilated.

2. Signage must be displayed in classrooms, in bathrooms, in general assembly areas,
outside all offices, school libraries, where possible in entry areas to the school plant,
auditoriums, main halls, custodial staff areas, waiting areas and, above all, wash stations.

3. Schools, as far as possible, should give consideration to the scheduling of staggered
breaks and other movements on the school compound to ensure that all persons adhere
to the physical distancing protocol and hand hygiene practices.

4. Where possible, social bubbles must be maintained during break and lunch periods. Each
class must break together as an individual bubble.

5. As needed, throughout the day, teachers should allow periods for “mask breaks”, that is,
periods where students can remove their masks at safe distances.
Schools should structure times for multiple “mask breaks”.
Mask breaks may be permitted for other students who are having difficulty with keeping
on the mask.
• Mask breaks for 10 minutes at least three (3) times during the school day, help
students to better comply with wearing the mask.
• Everyone should immediately wash/sanitise hands before replacing their masks
or re-entering their classes. Wet masks should be changed as soon as possible as
it makes breathing difficult and promote the growth of micro-organisms.
• Mask breaks should only be permitted if the students are:
✓ Adequately spaced at ideally six (6) feet but no less than three (3) feet apart
✓ Outdoor for recess in small supervised groups
✓ Eating/drinking
✓ Engaged in non-contact sports, games andskill building tasks that are required
for curriculum purposes while maintaining six (6) feet distancing.

6. Whole school assemblies are not recommended. However, the following alternatives can
be considered:
• Schools with large halls/courtyards may be able to facilitate assemblies with required physical distancing for upper and lower secondary forms/primary classes on alternative days.
• One form/class level can assemble per day while the other levels participate in classroom assembly.
• Schools with smaller spaces can conduct assembly over the PA system/virtual platforms with students in classrooms, supervised by the secondary form teacher/primary class teacher and prefect.
If any of the three alternatives is chosen, it is strongly recommended that these
assemblies should last between 15 to 20 minutes and must allow for motivational
messages, COVID-19 reminders and updates, in addition to preparation for
learning (Ministry of Education, 2020). In isolated cases, the principals’ discretion can be
exercised should longer assemblies be required.

7. Where the required physical distance cannot be achieved, staff meetings/gatherings
should be held virtually.

PROTOCOL 4: PERSONAL PROTECTIVE EQUIPMENT
Personal Protective Equipment (PPE) are meant to protect the wearer and/or those nearby from
the spread of illness-causing germs such as COVID-19. See Appendices C and D for guidelines
from the Ministry of Health, Wellness and the Environment (MOHWE).

Wearing of Masks or Face Covering

1. All staff, students and visitors who enter the school compound are required to wear a
visibly clean mask that covers the mouth and nose throughout the day. However, children
between two to five years are not required to wear masks. Special consideration to wear
face shields only may be given to students and staff with an accompanying medical
documentation but six (6) feet physical distance is to be maintained. Face shields should
not be used as a replacement for masks even in asthmatics. (See Appendix D for MOHWE
guidelines for use of face shields).

2. Acceptable masks include disposable masks and cloth masks that completely cover mouth
and nose. Designs/displays on cloth masks must be age-appropriate. Bandanas,
handkerchiefs or scarves should not be used as alternative face coverings.

• Teachers are permitted to wear face shields while teaching and maintaining the six
(6) feet physical distance. Teachers who wear face shields which meet MOHWE specifications should maintain physical distance of at least 1 m (3.3 feet). See Appendix D.

• The Ministry of Education will provide a one-time supply of two cloth masks to all
staff and students.
• Teachers may consider using masks with a see-through covering over the mouth (and
nose) when teaching young students or students with disabilities for improved
communication.

Use of PPE for Staff
School nurses and delegated staff must use the requisite PPE (surgical masks, reusable face
shield, hooded face shield, gloves, and/or gowns) in specific health service situations to include
attending to or monitoring anyone exhibiting respiratory or flu-like symptoms where it is not
possible to maintain the recommended physical distance.

PROTOCOL 5: HAND HYGIENE AND RESPIRATORY ETIQUETTE

All students, staff and visitors will be required to follow proper hand hygiene and respiratory
etiquette. Signs and posters promoting proper hygiene practices should be posted throughout
the school compound in appropriate areas (such as entrances to the school compound,
administrative offices, classrooms, auditorium, cafeteria, custodial staff areas and handwashing
stations).

Hand Hygiene

1. Individuals must routinely practise proper hand hygiene to help reduce the spread of
COVID-19. Proper hand hygiene includes:
• Hand washing with soap and water, lathering for at least 20 seconds.
• Use of hand sanitisers (70-90% alcohol) only where hands are not visibly dirty and
the washing of hands is not possible. A generous amount of hand sanitiser should
be rubbed vigorously over palms, back of hands, between fingers and under
fingernails for 30 seconds. After consecutively using hand sanitiser three times,
hands must be washed with soap and water.
• Persons should refrain from touching eyes, noses and mouths.

2. Staff, students and other individuals who enter the school compound should wash their
hands with liquid soap at the following times:
• Upon entering the school compound;
• Before entering the classroom (when or if applicable);
• Before and after snack and lunch;
• Before and after using the bathroom;
• Taking a student to the bathroom / helping a student with toileting;
• After sneezing, wiping or blowing nose;
• After using shared items or surfaces (e.g. telephones, electronic devices, keyboards,
computer mice, musical instruments, tools, desks or table tops);
• When hands are visibly soiled.

3. Hand sanitizers should be used when hand washing is not possible. Hand sanitizers should
be placed in strategic locations on the school compound and monitored for refill as
necessary.

Respiratory Etiquette

The COVID-19 virus spreads mainly from person to person through respiratory droplets produced
when an infected person coughs, sneezes or even talks. Staff and students, if they must remove
their masks, should cover their mouths and noses with a tissue when coughing or sneezing and
immediately dispose of the used tissue in the nearest available bin.

• Individuals MUST wash or sanitize their hands after sneezing, coughing and handling dirty
tissues.
• If no tissue is available, using the flexed-elbow technique (that is, using the inside of the
elbow or sleeve to cover the mouth and nose) is preferable to using the hands.

Other Hygienic Practices
1. Students are encouraged to bring along a personal pouch containing an extra mask, a
small packet of hand tissue, hand sanitizer and asthma pumps where needed.

2. The sharing of school equipment and other items should be discouraged. In cases where
sharing is absolutely necessary, items must be cleaned and disinfected between uses.

PROTOCOL 6: CLEANING AND DISINFECTING

1. Cleaning schedules should be mounted in strategic places on the school compound.
Custodians are asked to supervise bathroom use (discouraging abuse of resources) and
to pay attention to the following as they exercise caution and vigilance while carrying out
their duties:

• Wear gloves and disposable aprons ensuring that they are properly disposed after
use.
• Thoroughly clean and disinfect all rooms, floor, walls, corridors, railings and other
areas of the school to be used by staff and students prior to the reopening of
school.
• Properly and regularly clean and disinfect frequently touched surfaces (e.g., desks,
chairs, stools, work stations, tools, equipment, classrooms, playrooms, door  knobs, light switches, telephones, etc.) with the appropriate disinfectant every two hours or where there is a change in groupings of students.
• Clean and disinfect bathroom facilities after use at regular intervals. Focus should
be placed on the toilet bowls and handles, faucets, and door handles.
• Ensure that the collected waste is properly disposed by securing garbage bags in
a garbage receptacle with a lid.

2. Provision should be made for adequate supplies of the following: cleaning and
disinfecting agents, gloves, aprons, rags, and mops. These must be approved products.

3. Further training should be provided for custodial staff in the proper cleaning protocols,
method for mixing and storing chemicals, and use of personal protective equipment to
carry out cleaning and disinfection tasks.

PROTOCOL 7: DEALING WITH SUSPECTED CASES

1. Students MUST stay at home when they are sick. Any student absent from class due to
suspected COVID-19 symptoms shall not return to school without a physician’s note.
COVID-19 symptoms include: fever, chills, cough, shortness of breath and sore throat.
Loss of taste or smell and headache are symptoms of interest as well, while diarrhea and
vomiting remain supplemental. Any student who is a close contact of a confirmed case,
must follow the directives of the Quarantine Authority. The school should aim to
provide the child in quarantine or isolation with online educational materials to enable
learning to continue.

2. If a student has an elevated temperature, refer to Protocol 2 (4 and 5) for actions to be
taken. A student who displays signs or symptoms of the common cold or flu while at the
school, should be taken to the isolation space/room (a space as identified by the school).
The school then notifies the parent/guardian for the child to be collected. The
parent/guardian is expected to collect or arrange for the child to be collected within the
hour of notification. The parent/guardian should be encouraged to monitor the child and
contact the nearest health facility in keeping with the national protocol guidelines for
reporting suspected cases, for example, call the COVID-19 hotline to obtain further
guidance. It is the responsibility of the school to contact the Ministry of Education and the
nearest health centre/clinic about the issue. (See Appendix C for contact details of health
care providers.)

3. Teachers, school administrators, clerical, ancillary or other staff who are sick MUST stay
at home and follow the expected protocol as per the Civil Service Regulation/Labour Code
for reporting uncertified illness. Wherever possible, and in order to reduce the burden
on schools, academic tasks should be submitted to their Principals/Head of Department
electronically, when reporting ill. Any staff who is absent from work due to suspected
COVID-19 symptoms shall not return to work without a physician’s note.

4. If a staff member is found to have an elevated temperature while at school, refer to
Protocol 2 (5) for further actions. Should a staff member display signs or symptoms of
the common cold or flu while at school, that person should immediately seek
permission to return home, following the established protocols of the school. COVID-19
symptoms include: fever, chills, cough, shortness of breath and sore throat. Loss of taste
or smell and headache are symptoms of interest as well, while diarrhea and vomiting
remain supplemental. The staff should contact the nearest health facility in keeping with
the national protocol guidelines for reporting suspected cases, for example, call the
COVID-19 hotline to obtain further guidance. It is the responsibility of the school to
contact the Ministry of Education and the nearest clinic about the issue. (See Appendix
C for contact details of health care providers.)

5. Any staff who is a close contact of a confirmed case, must follow the directives of the
Quarantine Authority. It is recommended that the person seeks professional health care,
depending on the situation/context.

6. In the event that a staff or student is found positive with COVID-19 or was exposed to a
suspected or confirmed case of COVID-19, the school MUST refer the matter to the Public
Health Department.

7. Administrators should follow the usual procedure (requesting permission to close school
from the Director of Education) when/if school closure becomes necessary. Should a
school need to close due to COVID-19 exposure, immediate attention should be given to:
• Contact tracing and notifying the relevant health authority about the matter.
• Implement its plan for remote instruction and learning, utilizing the applicable
online platforms.                                                                                                                                                                                     • Deep cleaning and sanitization of the school compound must be done (in
collaboration with the Ministry of Health) before school is reopened.

PROTOCOL 8: EMERGENCY DRILLS

The MoEST encourages schools to continue to observe their emergency drills as scheduled since
emergencies are anticipated events in life. However, such practices will necessitate schools to:
• Adjust established drills and, as far as possible, incorporate COVID-19 protocols.
Schools must be mindful that such protocols may not be fully operational in an
actual emergency response. A staggered drill practice of groups of students is
advisable but not to be followed should an actual event occur.
• Adequately notify the school body of changes in drill procedures.
• Incorporate the protocol for infection should the school be forced into high alert
for closure, and/or temporary quarantine of anyone or the entire school body.

PROTOCOL 9: FOOD SERVICES

All Cafeteria Operators and Vendors must be guided by the Education Act 2008 Division 2 Part 12
Subsection 172.

Once approval has been granted and cafeteria operators and vendors possess a valid Food
Handler’s Certificate, all school meal service providers shall resume operations effective the
beginning of the 2020/2021 academic year.

1. All Cafeteria Operators (where not run by the school) must have a valid contract as signed
by the Permanent Secretary, Ministry of Education, Science & Technology and the school.

2. All vendors must be approved by the Director of Education.

3. It is the responsibility of the Cafeteria Operators, vendors and National School Meals
personnel to ensure that the areas of operation are inspected before the resumption of
school. A certificate from the Ministry of Health confirming that the areas of operation
have been inspected and approved in accordance with the COVID-19 guidelines must be
presented to the school’s administration for submission to MoEST before permission is
granted for operation to begin.

4. It is the responsibility of the Cafeteria Operators, vendors and National School Meals
personnel to ensure that frequently-touched surfaces are regularly sanitized.

5. Each Cafeteria Operator, vendor and National School Meals personnel are responsible for
ensuring that there is a handwashing station in place for students to properly wash their
hands before receiving service.

6. The best practice for cafeterias/school meals centres is that there is one entrance and
one exit for smooth physical distancing flow of traffic when service is provided.

7. All cafeteria workers, vendors and National School Meals personnel, should follow all
hygiene protocols by frequently washing their hands during the process of serving
students. They are expected to wear their mask at all times. They should also adhere to
all other protocols in place at the school.

8. Parents are encouraged to ensure that once they provide meals for their children that all
necessary utensils are supplied so that students can consume their meals. The sharing of
utensils and food are strongly discouraged. It is strongly recommended that students are
adequately supplied with a daily supply of water, along with nutritious food, fruits and
vegetables.

9. Where appropriate, students should eat their meals at their desks/tables in class.

PROTOCOL 10: EXTRA AND CO-CURRICULAR ACTIVITIES

The Ministry of Education, Science and Technology recognizes that extra-curricular activities to
include sports, drama, dance and other forms of extra and co-curricular activities are necessary
for the holistic development of our students. However, these must be implemented in
accordance with the established protocols from the Ministry of Education, Science and
Technology, Ministry of Sports, Culture and other relevant institutions.

1. Any physical or extracurricular activity on the school’s compound should follow the
physical distancing protocol and the sanitization regimens for hands, sporting and other
equipment. Where possible, events should be held out of doors.

2. All Social and Fund-raising activities planned by the school should be sanctioned by the
Ministry of Education. Schools should detail the planned event and show how social
distancing and hygienic practices will occur.

3. There should be no fund-raising social activities planned that include the attendance of
the general public including parents (School cake sales, barbecues, fetes, Open Day, etc.).

4. School programmes, such as those produced by the Education Broadcasting Unit (EBU),
Independence programmes, Queen and King of the Forms, Christmas concerts, dance and
theatre productions and other cultural development showcases may be held via online
streaming platforms. Should a live audience be deemed necessary, it MUST be limited to
the capacity stipulated in the government social gathering protocol.

5. The use of buildings for meetings by clubs and organizations (Girl Guides, Interact, Choir,
Pan, Drama, Dance) should be limited. Such groups should meet in reduced sized groups
on the outdoors or large auditoriums if necessary. The use of face shields and/or masks
are mandatory along with hand sanitizing. Where possible, groups should also explore
online platforms to hold regular sessions/meetings.

6. The use of school environments by community organizations should receive special
discretionary consideration by the Ministry of Education, Science and Technology. There
should be a re-application process for existing arrangements.

Physical Education

Physical Education is recognized as an important experiential learning opportunity for students
as they heal, re-connect and adapt on their return to school. Teaching this discipline will not be
as it was before COVID-19. The established COVID-19 protocols will be observed along with the
following guidelines.

1. From Kindergarten to Third Form, there will be regular Physical Education lessons with
the physical distancing and other protocols being observed.

2. The offering of Physical Education at the Caribbean Advanced Proficiency Examination
(CAPE) and Caribbean Secondary Education Certificate (CSEC) levels will be further
determined after consultations with the Caribbean Examinations Council (CXC).

3. Contact activities at this time are prohibited until such times that the requisite protocols
are developed and approved by Ministry of Health.

4. All practical classes must be facilitated/held outdoors.

5. Limited equipment will be used in the classes and these equipment, when used, must be
cleaned and disinfected before and after use.

6. Students should not wear masks during practical Physical Education (PE) classes but
must observe the physical distancing guideline. Students are required to have:
• A small zip-lock bag to store masks when going to PE.
• A supply of disposable towels/tissue to wipe face and hands at the end of the
lesson.

7. The Physical Education teacher must meet the students at the class and give instructions
as to the conduct of each lesson. Lessons should conclude 10 minutes before the
scheduled end time to allow the students to prepare for their next class.

8. Coaches who are working along with any Physical Education teacher during school time
must follow the established school curriculum and protocols.

9. All after-school training programmes should continue. However, these programmes
should be conducted under the direct guidance of the Ministry of Sports. Students’
participation in the programmes is subject to approval by parents/guardians who must
communicate directly with the Ministry of Sports to make all the necessary
arrangements.

Performing Arts Subject Areas

The activities of the Performing Arts such as Music, Drama and Dance that are part of regular
sessions in school must be given specific consideration as these events are expected to be
continued as normal classroom activities in schools where Music, Theatre Arts are conducted.

1. Music

• Singing at Assembly: This may occur only with small groups of not more than 4 persons
or soloists performing the School song; the National Anthem; and hymns. Performers
would be allowed to remove masks for singing provided they maintain six (6) feet physical
distancing and wear face shield. Alternatively, the school administration may wish to
consider the use of pre-recorded music for the recognition of the National Anthem and
school song or the use of pan/piano instrumentalists for this function.

• Students must wash hands or apply hand sanitizer before entering Music rooms. Musical
instruments and other equipment must be cleaned before and after use.

• The playing of any wind instruments and singing should be done preferably on the out of
doors or within a large auditorium; where this is not possible, there should be limits to a
maximum of two students at a time performing in a room. Teachers may also utilize the
Google Classroom or other online teaching platforms to hold such practical classes.

• Other non-wind instrumental playing may occur with students wearing masks. Class
groups should be limited to allow for physical distancing.

• The involvement of teaching personnel from the Department of Culture should be
coordinated by the school administration and the Director of Culture. Such persons
should be informed about the procedures and protocols established by the Ministry of
Education, Science and Technology. This applies for other disciplines such as Dance and Drama.

2. Dance and Drama/Theatre Arts

• The use of face shields will be necessary for such practical components that require
students to interface with each other but with distances of six (6) feet apart. Enclosed
rooms should be properly ventilated when in use.

• Students MUST wash hands or apply hand sanitiser before engaging in Theatre Arts
classes.

• Where possible, class sizes should be reduced to accommodate the space in which the
classes are held. Small groups of 5-8 should be maintained for practical
components. Where there are large class sizes, a teacher’s aide or second teacher should
be engaged to assist.

• Teachers are asked to explore various drama techniques and styles with their students
that can minimize close physical/verbal contact. Where possible, activities involving voice
projection should be done outdoors or in large airy auditoriums.

PROTOCOL 11: USING THE NATIONAL SCHOOL BUS SERVICES

School bus drivers and conductors should ensure that the following protocols are followed:

1. School buses should be sanitized before and after each trip (include wiping hand rests,
door handles, rails and other hard surfaces). All buses must be equipped with supplies,
including personal protective equipment and disinfectant.

2. School bus drivers and conductors should wear face masks that cover the mouth and
nose and follow the established protocols for hand hygiene and respiratory etiquette.

3. If a student is called upon to show his/her ID, the ID should be held in a manner for the
conductor to see. School bus conductors should avoid handling the ID.

4. Students should enter and disembark the bus in an orderly fashion following the
protocols for physical distancing, coughing and sneezing. All students MUST sanitize
their hands before entering the bus. All students MUST use items from their personal
pouch to sanitize every time they cough or sneeze in the bus. As much as possible,
windows should be kept open to allow for fresh air ventilation while transporting
students. Each student MUST wear a mask on the bus.

5. No student should be left stranded or not be allowed to enter a school bus as a result
of him/her becoming ill on their way to school. Should a student become ill while on the
bus he/she should be placed in the designated holding area in the bus and the school
informed immediately upon arrival. Schools should then follow the expected protocol
for dealing with sick students.

6. All school bus personnel should exercise Positive Behaviour Management techniques in
dealing with students who use the school bus service.

7. The capacity of the school buses and scheduling will be determined by the relevant
authorities and will be communicated to all students in a timely manner.

PROTOCOL 12: COMMUNICATION

The MoEST strongly recommends that signage be displayed at strategic points clearly outlining
the expectations of all persons who enter the compound. Principals should advise all parents and
other stakeholders of the NO VISITORS policy at this time.

1. Signage is clearly visible at the entrance and other key areas of compounds to include
(bathroom, cafeterias, classrooms, etc.) Posters depicting preventative and protective
measures to be displayed in strategic areas throughout the compound. These include (but
are not limited to) office areas, staff rooms, classrooms, library, auditoriums, etc.

2. Signage should be used to remind individuals to:
• Stay at home if they are feeling unwell.
• Wear masks properly by covering the nose and mouth when unable to maintain
physical distance from others.
• Adhere to physical distancing guidelines.
• Report symptoms of COVID-19.
• Follow hand hygiene guidelines.
• Follow respiratory etiquette guidelines.

3. Visible floor markers must be placed throughout the compound in areas such as
classrooms, cafeteria, and corridors, which will indicate the physical distance to be
observed as per the guidelines from the MOHWE.

4. Signage should be placed at the front of the compound advising that persons will not be
allowed on the school compound:
• if they exhibit flu-like symptoms.
• unless wearing a mask.
• unless temperature check results in normal reading.
• unless hands are properly washed and/or sanitized.

5. Signage indicating No Unauthorized Visitors Allowed on the Compound should be visibly
displayed.

6. Signage indicating the proper technique of washing hands should be placed above all
wash basins in restrooms and at wash stations. For primary school students, age-appropriate signage is encouraged.

7. Signage must be in place in the cafeteria and school meals centre to clearly outline what
is expected of each student upon entering these spaces, receiving service and upon
leaving. Floor markers must also be in place clearly identifying the physical distance to be
observed while students utilize these services.

8. Signage outlining the protocols in effect while on the school bus should be visibly
displayed in all school buses. Markers must also be used to indicate the physical distancing
to be observed by students while using the buses.

9. Principals should ensure that all information for students and parents are up to date and
easily accessible.

10. Principals should make provisions for the sanitization of all resources being used
before and after each use. These resources include but not limited to phones, desks,
chairs, computers. Persons responsible for sanitization of these resources must be clearly
identified and this information should be communicated to the individuals.

11. Principals should clearly articulate various responsibilities to school personnel and
students.

12. Principals are asked to ensure that:
• Staff, students, and parents/guardians are aware of the following and that these are
made accessible through email, newsletters and/or other electronic means:
✓ system of timetabling and days when students are not required to be at school
✓ times for scheduled break and lunch
✓ policy for personal hygiene
• Parents and guardians are aware of the drop-off and pick-up policies of the school and
regular reminders are communicated on the method of operation in the “New
Normal”.

13. Each school should implement a communication plan utilising the checklist. (See
Appendix E). Principals should clearly articulate the official medium of accessing
information for respective schools. This ensures that parents, students and other
stakeholders can access all information pertaining to the school from the correct source.

14. In light of the NO VISITORS policy to be implemented, parents are encouraged to
communicate with the school, staff and administration during normal hours of operation
through the identified means such as email and phone.

PROTOCOL 13: STUDENT/TEACHER SUPPORT

The outbreak of the Coronavirus disease, COVID-19, has disrupted our entire lifestyle. It has
brought abrupt changes to every facet of our life. As we prepare to return to school, we must
acknowledge the profound impact that the pandemic has had on the students’ academic, social,
emotional, and life outcomes. Therefore, as students transition back to school, we must seek to
put measures in place to mitigate against a lasting impact on their development.

Administrators should make provisions for an orientation session at each class or grade level to
explain the new processes to students and the importance of adherence.

Allow students to share how COVID-19 has affected or impacted their lives and give them an
opportunity to ask questions and express concerns with the guidance of the Counselling Unit.

• Students should be reminded during home room/class prayers of measures to mitigate
against the spread of COVID-19 and their role as students. This should include
opportunities for students to demonstrate expected hygiene etiquette, practice
handwashing, etc.
• Teachers should engage students in activities to reinforce tolerance and empathy for
persons afflicted rather than stigma and discrimination against those affected.
• Teachers should conduct readiness assessments during the first two weeks of the term to
assess students’ grade level competencies. The results of the assessments should be
utilized to determine learning gaps and remediation measures.
• Teachers should also avail themselves for psychosocial support as needed.
• Teachers are encouraged to provide the grade level teacher with any relevant information
on students that would allow for interventions to enhance student performance, to
include but not limited to any areas of weakness that they had observed or had been
working with the student as well as the students’ level of interaction during the school
closure.
• Engage social services as necessary for students and their families who may be facing
undue hardships (lack of food for example).

PROTOCOL 14: CURRICULUM AND ASSESSMENT

Our response to COVID-19 caused significant disruptions to the delivery of education with
resulting teaching and learning gaps. The return to school will immediately focus on closing these
gaps through diagnostic and readiness assessments and teaching practices that will address
students’ needs at every level. Support for teachers and other educators will be provided through
ongoing professional development, monitoring and collaborative discourses, so that the teaching
and learning process can be adjusted to meet the demands of the current environment.

1. Teachers should use data captured by curriculum survey to determine students who
require immediate intervention by schools with the assistance of Education Officers,
Curriculum in an effort to address their needs.

2. Education Officers, Curriculum should collaborate with subject specialists/teachers in
schools to adjust the curriculum to ensure maximum learning is attained.

3. MoEST Support Teams will conduct diagnostic assessment of students with special needs
and address the significant gaps in their learning that would have occurred.
The Education Officers responsible for Mathematics and English will supervise the use of
diagnostic kits to identify the learning needs of students who are operating below grade
level in those areas. Various strategies will be utilized to address the needs of these
students.

4. All technical officers will rigorously monitor, evaluate and train teachers to encourage
differentiated instruction and other effective teaching strategies.

PROTOCOL 15: EXTERNAL SUPPORT SERVICES

The MoEST welcomes the partnership and assistance of our community and external service
partners in education. However, in this pandemic, we have to exercise strict measures to combat
the spread of COVID-19. Limited access will be given to concerned parties.

1. Zoom or other similar presentation modes should be considered as the first option for
hosting interactive live sessions with schools.

2. No more than two visitors should be allowed at any given time when visiting the school
compound. The usual protocol for screenings and other practices should be observed.

3. Contact details should be provided to facilitate contact tracing if necessary.

Persons who have travelled within the past two weeks MUST abide by the Travel Protocols of
Antigua and Barbuda which pertain to returning to the country.

APPENDIX A: SCREENING QUESTIONS

1. Did you travel within the past three weeks?
………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………….
2. Have you had any known contact with anyone who has COVID-19 or its
symptoms?…………………………………………………………………………………………………
3. Have you had any known contact with anyone who has been under quarantine
or isolation?
………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………….
4. Do you have any shortness of breath, sore throat, headache, loss of appetite,
smell, diarrhea, vomiting and/or body chills?
………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………….

APPENDIX B: CONTACT NUMBERS OF HEALTHCARE PROVIDERS

LIST OF COMMUNITY HEALTH CENTRES & CLINICS

HEALTH CENTERS & CLINICS    LOCATION                          TEL#                CELL #

All Saints, SVF & FMV                             All Saints Village                    460-1003            727 -3158

Bishop Gate Health Center                     Luther George Rd                  462 -0501            7297207
(Off Rowan Henry St)

Browne’s Avenue Health Center            All Saints Road                      562- 3076            729-3084

Clare Hall Health Center                         Clare Hall                                462 -4127            729- 7258

Grays Farm Health Center                      Grays Farm Main Road        462- 0861            727-3170

Jennings Health Center                            Jennings Village                    462- 6304          729-3293

Bendals Clinic                                            Bendals Village                        462-3841

Bethesda Clinic                                          Bethesda Village                      463-2810

Bolans Clinic                                              Bolans Village                          462-3606

Cedar Grove Clinic                                    Cedar Grove Village                462-1011

Five Island Clinic                                       Five Island                                562-7410

Freetown Clinic                                          Freetown Village                      462-5365

Johnsons Point Clinic                              Johnson’s Point Village          562-3753

Judges Hill Clinic                                      Judges Hill                                462-3114

Liberta & Cobbs cross Clinic                  Liberta Village                          460-3175

New Field Clinic                                        New Field Village                    460-4270

Old Road Clinic                                        Old Road Village                       462-8255

Parham, Willikies, Pares                        Parham Village                          463- 2576

Piggott’s Clinic                                          Pigotts Village                            462-1271

Potters Clinic                                            Potters Village                            462-4692              7297478

Swetes, Buckleys, John Hughes            Swetes Village                            460 -1174

Emergency COVID-19 contact numbers to be used by educational institutions: Telephone- 464 6303;
464 9011

APPENDIX C: ADVICE ON THE USE OF MASKS FOR CHILDREN IN THE COMMUNITY IN THE CONTEXT OF COVID-19

                                                     MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT
                           Advice on the use of masks for children in the community in the context of COVID-19
                                                                            September 3rd 2020

Background

Antigua and Barbuda saw its first case of COVID-19 in March 2020. In order to control the
outbreak, the government of Antigua and Barbuda implemented several public health
measures such as the wearing of facemasks, social and physical distancing and
handwashing. Compliance with all these measures including physical distancing, hand
hygiene, respiratory etiquette and adequate ventilation in indoor settings is essential for
reducing the spread of SARS-CoV-2, the virus that causes COVID-19.

Purpose of the document

This document provides guidance to decision makers to inform policy on the use of masks
for children in the context of the COVID-19 pandemic. It does not address the use of masks
for adults working with children or parents/guardians or the use of masks for children in
health-care settings.

These guidelines were adapted for Antigua and Barbuda from information from the World
Health Organization. They are based on Antigua and Barbuda’s Maternal Child and Adolescent
Health Committee’s (MCAHC) Consensus on the Advice the Use of Masks in Children. This
interim guidance will be revised and updated as new evidence emerges.

This document provides specific considerations for the use of non-medical masks, also known
as fabric masks, by children as a means for source control in the context of the current COVID19 pandemic.

For the purposes of this guidance, children are defined as anyone below the of age of 18 years.
Advice is outlined for the four following specific age groups.

• Children under two years of age.
• Children between two to five years of age
• Children between five and 11 years of age
• Children between 12 and 18 years of age

Specific Recommendations

1. Children under two years of age

Children under 2 years of age should not wear masks.

2. Children between two to five years of age

Children ages 2-5 years should not wear masks for source control This advice is motivated by a “do no harm” approach and considers:

a) childhood developmental milestones;
b) compliance challenges and;
c) autonomy required to use a mask properly.

Mask wearing in this age group may be required in special circumstances. If these
circumstances require mask wearing is expected for an extended period of time, appropriate
and consistent supervision, including direct line of sight supervision by a competent adult is
needed. This is both to ensure correct use of the mask and to prevent any potential harm
associated with mask wearing to the child.

Special circumstances include:
a). Primary school entry at 5 years, where there may be mixed age groups for example 5- and 6-
year olds in a bubble where the 6-year olds are required to wear masks. Five-year-old who are
mixing with six-year olds will be required to wear masks.
b). The presence of vulnerable persons.
c). Other medical and public health advice (medical documentation may be required).

The following public health and social measures should be prioritized to minimize the risk of
SARS -CoV -2 transmission for children five years of age and under who are not required to
wear face masks.
a). Maintaining physical distance of at least 3 feet (1 meter) where feasible. (The consensus of
MCAHC is physical distance of 6 feet or 2 meters if no masks are in use)
b). Educating children to perform frequent hand hygiene
c). Limiting the size of school classes
d). Keeping the integrity of a class “bubble”
e). Ensuring good cross ventilation or outdoor activities when possible.

Source control is a strategy for reducing disease transmission by blocking
respiratory secretions produced through speaking, coughing, or sneezing.

3. Children between six and 11 years of age

Children between the ages if six and 11 years of age should wear face masks. However, a riskbased approach however should also be applied to the decision to use of a mask. This approach
should take into consideration:

a. The child’s capacity to comply with the appropriate use of masks and availability of
appropriate adult supervision.
b. Potential impact of mask wearing on learning and psychosocial development
c. Children with disabilities or with underlying diseases

4. Children between 12 and 18 years of age

For children and adolescents 12 years and older, the MCAHC agrees that mask wearing is
required in this group and while Antigua and Barbuda’s national mask guidelines for adults
can be applied in this age category, a risk-based approach should also be applied to the
decision to use of a mask. This approach should take into consideration:

a. The child’s capacity to comply with the appropriate use of masks and availability of
appropriate adult supervision.
b. Potential impact of mask wearing on learning and psychosocial development.
c. Children with disabilities or with underlying diseases.

Special Notes

a. Masks should fit properly (completely covers mouth and nose) and comfortably.
b. Cloth masks made of cotton are more comfortable in the tropical climate, than those of
polyester.
c. Persons with asthma are at a higher risk for respiratory complications from SARS-CoV-2 and
should be encouraged to use a mask unless there is severe respiratory disease or complications
from the use of a mask.
d. Any medical contra-indication for mask use (includes severe asthma, attention deficit
hyperactivity disorder (ADHD) etc.) must be accompanied by medical
certification/documentation.
e. Special consideration to wear face shields only may be given to students with an
accompanying medical documentation but six (6) feet physical distance is to be maintained.
Face shields should not be used as a replacement for masks.
f. The use of a medical mask for immunocompromised children or children with certain
other diseases (e.g. cancer) is usually recommended but should be assessed in consultation
with the child’s medical provider.
g. In all age groups, measures should be put in place to mitigate exclusion,
stigmatization or bullying for students who are “different”.

Mask Breaks

The MOHWE agrees that mask breaks may be helpful and support the statement in the Back to
School Protocol for the Ministry of Education Science and Technology (MoEST).

As needed, throughout the day, teachers should allow periods for “mask breaks”, that is,
periods where children can remove their masks at safe distances. Schools should structure
times for multiple “mask breaks”.

• Mask breaks for 10 minutes at least 3 times during the school day, may help students to
better comply with wearing the mask.

• More frequent mask breaks may be permitted for students who are having difficulty
with keeping on their mask.

• Everyone should immediately wash/sanitize hands before replacing their masks or reentering their classes. Wet masks should be changed as soon as possible as it makes
breathing difficult and promote the growth of micro-organisms.

• Mask breaks should only be permitted if the children are:

• Adequately spaced at ideally six (6) feet apart o Outdoor for
recess in small supervised groups o Eating/drinking

• Engaged in non-contact sports, games and skill building tasks that are required for
curriculum purposes while maintaining six (6) feet distancing. Kickball and running with
enough space are generally safe. Contact sports at this time are prohibited until such
times that the requisite protocols are developed and approved by Ministry of Health.

Special Note:
Reduced physical activity in children is linked to increased childhood overweight and obesity
as well as negative impact on their mental health. Children should be permitted where
possible to engage in physical activity in school.

Additional Considerations for Children with Disabilities

Children with developmental disorders or disabilities may face additional barriers, limitations
and risks and therefore should be given alternative options to mask wearing, such as face
shields (see above). Policies on masks should be adapted for children with disabilities based on
social, cultural and environmental considerations.

Some children with disabilities require close physical contact with therapists, educators or
social workers. In this context, it is critical that all care providers adopt key infection prevention
and control (IPC) measures, including wearing masks, and that settings are adapted to
strengthen IPC.

The wearing of masks by children with hearing loss or auditory problems may present learning
barriers and further challenges, exacerbated by the need to adhere to the recommended physical
distancing. These children may miss learning opportunities because of the degraded speech signal
stemming from mask wearing, the elimination of lipreading and speaker expressions and physical
distancing. Adapted masks to allow lipreading (e.g. clear masks) or use of face shields (see above)
may be explored as an alternative to fabric masks in these situations.

Monitoring and Evaluation
The COVID-19 situation is very dynamic. The MOHWE will continue to work the MoEST to
monitor the use of face masks in school children. We should look specifically at the impact
on our children’s health, including mental health; reduction in transmission of SARS-CoV-2;
motivators and barriers to mask wearing; and secondary impacts on a child’s development
learning, attendance in school, ability to express him/herself or access school; and impact on
children with developmental delays, health conditions, disabilities or other vulnerabilities.

Data will be used to inform strategies on communication; training and support to teachers,
educators, and parents; engagement activities for children; and distribution of materials
that empower children to use masks appropriately.

APPENDIX D: ADVICE ON THE USE OF FACE SHIELDS IN THE CONTEXT OF
COVID-19

                                              MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT
                                                    Advice on the use of face shields in the context of COVID-19
                                                                                  September 4th 2020

Background

Antigua and Barbuda saw its first case of COVID-19 in March 2020. In order to control the
outbreak, the government of Antigua and Barbuda implemented several public health
measures such as the wearing of facemasks, social and physical distancing and handwashing.
Compliance with all these measures including physical distancing, hand hygiene, respiratory
etiquette and adequate ventilation in indoor settings is essential for reducing the spread of
SARS-CoV-2, the virus that causes COVID-19.

Introduction

Face shields are designed to be used provide protection from splashes of biological fluid
(particularly respiratory secretions), chemical agents and debris into the eyes. In the context of
protection from SARS-CoV-2 transmission through respiratory droplets, they are used by health
workers as personal protective equipment (PPE) for eye protection in combination with a medical
mask or a respirator.

In the context of COVID-19 in community settings, some children and adults may not be able to
wear a mask for a variety of reasons (e.g. health issues, fear of mask), and thus, face shields may
be considered as an alternative to masks as respiratory droplet protection or as source control,
based on availability, improved feasibility and better tolerability.

While a face shield may confer partial protection of the facial area against respiratory droplets
with the added benefit of ease of use, the effectiveness of face shields for source control has not
yet been adequately studied. Droplets may be exhaled or inhaled from the open gaps between
the visor and the face, which is a disadvantage inherent to its design. Other design disadvantages
include glaring, fogging, optical imperfection, and being bulkier than goggles and safety glasses.
There are many emerging face shield designs that attempt to overcome these limitations, but
current laboratory testing standards only assess face shields for their ability to provide eye
protection from chemical splashes. Further research and laboratory challenge standards are
urgently needed to investigate the effectiveness of face shields for respiratory droplet protection
and/or source control.

Purpose of the document

Some persons have been using to use face shields as a replacement of face masks. This document
provides information on the use of face shields in Antigua and Barbuda in the context of the
COVID-19 pandemic.

These guidelines were adapted for Antigua and Barbuda from information from the World Health
Organization. The MOHWE will continue to monitor emerging information on the use of face
shields for the prevention of respiratory virus transmission and update this document as new
evidence emerge

Specific Recommendations

1. At present, face shields are considered to provide a level of eye protection only and
should not be considered as an equivalent to masks with respect to respiratory
droplet protection and/or source control.

2. The Ministry of Health Wellness and the Environment advises that when physical
distance cannot be maintained, and in special situations where it is not practical to wear
a mask (for example, among children with hearing loss or other disabilities or health
conditions that limit compliance with wearing fabric or medical masks and consequently
their utility), face shields may be used while taking the following considerations into
account:

• The face shield is an incomplete physical barrier and does not provide the
filtration layers of a mask.
• The face shield should cover the entire face, be wrapped around the sides of
the face and extend to below the chin.
• Reusable face shields must be properly cleaned (with soap or a detergent and
water), disinfected (with 70-90% alcohol) and stored after each use. Face shields
that will withstand the use of disinfectants without damaging their optical
properties should be selected.
• Maintaining physical distance of at least 1 m (3.3 feet) should be maintained
where feasible, with ongoing promotion of frequent hand hygiene and
respiratory etiquette.
• Caution should be taken to avoid injury when children don, wear, and doff face
shields and they should be supervised at all times.

APPENDIX E: CHECKLIST FOR COMMUNICATIONS AND OPERATIONS

☐ All staff aware of their role in monitoring student interactions
☐ All staff aware of their revised roles as per school committees and designations
☐ Systems in place to ensure adherence to visitor’s policy (visitors wash hands before
being escorted to the office; no entry on compound without mask, etc.)
☐ Parents aware of the visitor’s policy and requirements for students
☐ Form/class teachers informed of the hand washing policy, cough and sneeze etiquette
and in turn inform and remind students
☐ Physical distance floor markers in the cafeteria, administration office, outside
washrooms and handwashing stations/sinks
☐ Schedule for staggered lunch/break time developed and shared with staff
☐ Schedule developed for cleaning classrooms and sanitization of furniture
☐ Age-appropriate signage promoting washing of hands and personal hygiene on
compound
☐ Policy for sick students on compound shared with stakeholders
☐ Updated contact information for all students and parents
☐ Schedule developed and followed for monitoring water storage and accessing
adequate supply of water daily on schools’ plant.

                                                            Work Cited
Ministry of Education. School Supervision and Management Division. (2020, July). Guidelines
for the reopening of schools. Trinidad and Tobago: http://www.news.gov.tt/

                                                          Works Consulted
Alachua County public schools continuity of operations plan. (n.d.). https://www.sbac.edu/
Association for Physical Education. (2020, May). COVID-19: Interpreting the Government
guidance in a PESSPA context: A practical self-review tool for risk assessment.
http://www.afpe.gov.uk

Center for Disease Control and Prevention. (2020, July). School and childcare programs: Plan,
prepare and respond.

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

Education Scotland. (2020, August). Covid-19: Return to educational establishments Physical Education guidelines.

https://education.gov.scot/media/pdgh1rvf/pe-guidelines-aug-2020.pdf

Global Education Cluster. (2020). Safe back to school: A practitioner’s guide.

https://resourcecentre.savethechildren.net/library/safe-back-school-practitioners-guide

Houston Independent School District. (2020). HISD reopening plan for the 2020-2021 academic
year. https://www.houstonisd.org/reopening

Ministry of Education. School Supervision and Management Division. (2020, July). Guidelines for the reopening of schools. Trinidad and Tobago: Author. http://www.news.gov.tt/

Ministry of Education, National Reconciliation and Information. (n.d.). SVG COVID-19
guidelines for prevention and controls in schools. St Vincent and the Grenadines:
Author.

Ministry of Education, Science and Technology. (2020, May). Return to school: Re CXC
preparations. Antigua and Barbuda: Author.

Ministry of Education, Youth and Information. (n.d.). Manual for the reopening of
educational institutions. Jamaica: Author.

Minnesota Department of Health. (2020, June). COVID-19 cleaning and disinfecting guidance
for schools and child care programs.

https://www.health.state.mn.us/diseases/coronavirus/schools

NC Department of Health and Human Services. (2020, July). StrongSchoolsNC: Infection
control and PPE guidance (K-12).

https://files.nc.gov/covid/documents/guidance/education/Strong-Schools-NC-Public-Health-ToolkitPPE-Guidance.pdf

New York State Education Department. (n.d.). Recovering, rebuilding, and renewing: The spirit
of New York’s schools reopening guidance. http://www.nysed.gov/

UNICEF. (2020, June). What will a return to school during the COVID-19 pandemic look like?
https://www.unicef.org/coronavirus/what-will-return-school-during-covid-19-pandemic-look

World Health Organization. (2020, July). Schools and COVID-19.
https://www.who.int/news-room/q-a-detail/q-a-schools-and-covid-19

MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT
Advice on the use of face shields in the context of COVID-19
September 4th 2020

Background

Antigua and Barbuda saw its first case of COVID-19 in March 2020. In order to control the
outbreak, the government of Antigua and Barbuda implemented several public health measures
such as the wearing of facemasks, social and physical distancing and handwashing. Compliance
with all these measures including physical distancing, hand hygiene, respiratory etiquette and
adequate ventilation in indoor settings is essential for reducing the spread of SARS-CoV-2, the
virus that causes COVID-19.

Introduction

Face shields are designed to be used provide protection from splashes of biological fluid
(particularly respiratory secretions), chemical agents and debris into the eyes. In the context of
protection from SARS-CoV-2 transmission through respiratory droplets, they are used by health
workers as personal protective equipment (PPE) for eye protection in combination with a
medical mask or a respirator.

In the context of COVID-19 in community settings, some children and adults may not be able to
wear a mask for a variety of reasons (e.g. health issues, fear of mask), and thus, face shields may
be considered as an alternative to masks as respiratory droplet protection or as source control,
based on availability, improved feasibility and better tolerability.

While a face shield may confer partial protection of the facial area against respiratory droplets
with the added benefit of ease of use, the effectiveness of face shields for source control has not
yet been adequately studied. Droplets may be exhaled or inhaled from the open gaps between the
visor and the face, which is a disadvantage inherent to its design. Other design disadvantages
include glaring, fogging, optical imperfection, and being bulkier than goggles and safety glasses.
There are many emerging face shield designs that attempt to overcome these limitations, but
current laboratory testing standards only assess face shields for their ability to provide eye
protection from chemical splashes. Further research and laboratory challenge standards are
urgently needed to investigate the effectiveness of face shields for respiratory droplet protection
and/or source control.

Purpose of the document

Some persons have been using to use face shields as a replacement of face masks. This document
provides information on the use of face shields in Antigua and Barbuda in the context of the
COVID-19 pandemic.

These guidelines were adapted for Antigua and Barbuda from information from the World
Health Organization. The MOHWE will continue to monitor emerging information on the use of
face shields for the prevention of respiratory virus transmission and update this document as new
evidence emerges.

Specific Recommendations

1. At present, face shields are considered to provide a level of eye protection only and
should not be considered as an equivalent to masks with respect to respiratory droplet
protection and/or source control.

2. The Ministry of Health Wellness and the Environment advises that when physical
distance cannot be maintained, and in special situations where it is not practical to wear a
mask (for example, among children with hearing loss or other disabilities or health
conditions that limit compliance with wearing fabric or medical masks and consequently
their utility), face shields may be used while taking the following considerations into
account:

• The face shield is an incomplete physical barrier and does not provide the
filtration layers of a mask.
• The face shield should cover the entire face, be wrapped around the sides of the
face and extend to below the chin.
• Reusable face shields must be properly cleaned (with soap or a detergent and
water), disinfected (with 70-90% alcohol) and stored after each use. Face shields
that will withstand the use of disinfectants without damaging their optical
properties should be selected.
• Maintaining physical distance of at least 1 m (3.3 feet) should be maintained
where feasible, with ongoing promotion of frequent hand hygiene and respiratory
etiquette.
• Caution should be taken to avoid injury when children don, wear, and doff face
shields and they should be supervised at all times.

MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT
Advice on the use of masks for children in the community in the context of COVID-19
September 3rd 2020

Background
Antigua and Barbuda saw its first case of COVID-19 in March 2020. In order to control the
outbreak, the government of Antigua and Barbuda implemented several public health
measures such as the wearing of facemasks, social and physical distancing and handwashing.
Compliance with all these measures including physical distancing, hand hygiene, respiratory
etiquette and adequate ventilation in indoor settings is essential for reducing the spread of
SARS-CoV-2, the virus that causes COVID-19.

Purpose of the document
This document provides guidance to decision makers to inform policy on the use of masks for
children in the context of the COVID-19 pandemic. It does not address the use of masks for
adults working with children or parents/guardians or the use of masks for children in healthcare settings.

These guidelines were adapted for Antigua and Barbuda from information from the World
Health Organization. They are based on Antigua and Barbuda’s Maternal Child and Adolescent
Health Committee’s (MCAHC) Consensus on the Advice the Use of Masks in Children. This
interim guidance will be revised and updated as new evidence emerges.

This document provides specific considerations for the use of non-medical masks, also known
as fabric masks, by children as a means for source control in the context of the current COVID19 pandemic.

For the purposes of this guidance, children are defined as anyone below the age of 18 years.
Advice is outlined for the four following specific age groups.

• Children under two years of age.
• Children between two to five years of age
• Children between five and 11 years of age
• Children between 12 and 18 years of age

Specific Recommendations
1. Children under two years of age

Children under 2 years of age should not wear masks.

2. Children between two to five years of age

Children ages 2-5 years should not wear masks for source control1. This advice is motivated by

a “do no harm” approach and considers:
a) childhood developmental milestones;
b) compliance challenges and;
c) autonomy required to use a mask properly.

Mask wearing in this age group may be required in special circumstances. If these
circumstances require mask wearing is expected for an extended period of time, appropriate
and consistent supervision, including direct line of sight supervision by a competent adult is
needed. This is both to ensure correct use of the mask and to prevent any potential harm
associated with mask wearing to the child.

Special circumstances include:

a) Primary school entry at 5 years, where there may be mixed age groups for example
5- and 6-year olds in a bubble where the 6-year olds are required to wear masks.
Five-year-old who are mixing with six-year olds will be required to wear masks.
b) The presence of vulnerable persons.
c) Other medical and public health advice (medical documentation may be required).

The following public health and social measures should be prioritized to minimize the risk of
SARS-CoV-2 transmission for children five years of age and under who are not required to
wear face masks.

a) Maintaining physical distance of at least 3 feet (1 meter) where feasible. (The consensus
of MCAHC is physical distance of 6 feet or 2 meters if no masks are in use)
b) Educating children to perform frequent hand hygiene
c) Limiting the size of school classes
d) Keeping the integrity of a class “bubble”
e) Ensuring good cross ventilation or outdoor activities when possible.

____________________
1 Source control is a strategy for reducing disease transmission by blocking respiratory
secretions produced through speaking, coughing, or sneezing.

3. Children between six and 11 years of age

Children between the ages if six and 11 years of age should wear face masks. However, a riskbased approach however should also be applied to the decision to use of a mask. This approach
should take into consideration:

a. The child’s capacity to comply with the appropriate use of masks and availability
of appropriate adult supervision
b. Potential impact of mask wearing on learning and psychosocial development
c. Children with disabilities or with underlying diseases

4. Children between 12 and 18 years of age

For children and adolescents 12 years and older, the MCAHC agrees that mask wearing is
required in this group and while Antigua and Barbuda’s national mask guidelines for adults can
be applied in this age category, a risk-based approach should also be applied to the decision to
use of a mask. This approach should take into consideration:

a. The child’s capacity to comply with the appropriate use of masks and availability
of appropriate adult supervision.
b. Potential impact of mask wearing on learning and psychosocial development.
c. Children with disabilities or with underlying diseases.

Special Notes
a. Masks should fit properly (completely covers mouth and nose) and comfortably.
b. Cloth masks made of cotton are more comfortable in the tropical climate, than
those of polyester.
c. Persons with asthma are at a higher risk for respiratory complications from SARSCoV-2 and should be encouraged to use a mask unless there is severe
respiratory disease or complications from the use of a mask.
d. Any medical contra-indication for mask use (includes severe asthma, attention
deficit hyperactivity disorder (ADHD) etc.) must be accompanied by medical
certification/documentation.
e. Special consideration to wear face shields only may be given to students with an
accompanying medical documentation but six (6) feet physical distance is to be
maintained. Face shields should not be used as a replacement for masks.
f. The use of a medical mask for immunocompromised children or children with
certain other diseases (e.g. cancer) is usually recommended but should be
assessed in consultation with the child’s medical provider.
g. In all age groups, measures should be put in place to mitigate exclusion,
stigmatization or bullying for students who are “different”.

Mask Breaks
The MOHWE agrees that mask breaks may be helpful and support the statement in the Back to
School Protocol for the Ministry of Education Science and Technology (MoEST).

As needed, throughout the day, teachers should allow periods for “mask breaks”, that is,
periods where children can remove their masks at safe distances.
Schools should structure times for multiple “mask breaks”.

• Mask breaks for 10 minutes at least 3 times during the school day, may help
students to better comply with wearing the mask

• More frequent mask breaks may be permitted for students who are having
difficulty with keeping on their mask.

• Everyone should immediately wash/sanitise hands before replacing their masks
or re-entering their classes. Wet masks should be changed as soon as possible as
it makes breathing difficult and promote the growth of micro-organisms.

• Mask breaks should only be permitted if the children are:
o Adequately spaced at ideally six (6) feet apart
o Outdoor for recess in small supervised groups
o Eating/drinking
o Engaged in non-contact sports, games and skill building tasks that are
required for curriculum purposes while maintaining six (6) feet distancing.
Kickball and running with enough space are generally safe. Contact sports
at this time are prohibited until such times that the requisite protocols are
developed and approved by Ministry of Health.

Special Note:
Reduced physical activity in children is linked to increased childhood overweight
and obesity as well as negative impact on their mental health. Children should
be permitted where possible to engage in physical activity in school.

Additional Considerations for Children with Disabilities
Children with developmental disorders or disabilities may face additional barriers, limitations
and risks and therefore should be given alternative options to mask wearing, such as face
shields (see above). Policies on masks should be adapted for children with disabilities based on
social, cultural and environmental considerations.

Some children with disabilities require close physical contact with therapists, educators or
social workers. In this context, it is critical that all care providers adopt key infection prevention
and control (IPC) measures, including wearing masks, and that settings are adapted to
strengthen IPC.

The wearing of masks by children with hearing loss or auditory problems may present learning
barriers and further challenges, exacerbated by the need to adhere to the recommended
physical distancing. These children may miss learning opportunities because of the degraded
speech signal stemming from mask wearing, the elimination of lipreading and speaker
expressions and physical distancing. Adapted masks to allow lipreading (e.g. clear masks) or use
of face shields (see above) may be explored as an alternative to fabric masks in these situations.

Monitoring and Evaluation
The COVID-19 situation is very dynamic. The MOHWE will continue to work the MoEST to
monitor the use of face masks in school children. We should look specifically at the impact on
our children’s health, including mental health; reduction in transmission of SARS-CoV-2;
motivators and barriers to mask wearing; and secondary impacts on a child’s development
learning, attendance in school, ability to express him/herself or access school; and impact on
children with developmental delays, health conditions, disabilities or other vulnerabilities.

Data will be used to inform strategies on communication; training and support to teachers,
educators, and parents; engagement activities for children; and distribution of materials that
empower children to use masks appropriately.

             Ministry of Education, Science and Technology (MoEST) School Reopening Protocols

                                                                               (August 2020)

INTRODUCTION

Within the ongoing climate of the COVID-19 pandemic and the many uncertainties it brings, the Ministry of Education, Science and Technology (MoEST) seeks to ensure that teaching and learning occur in a safe and healthy environment that is conducive for the delivery of quality education. It is therefore necessary that all stakeholders play their part in limiting the transmission of the corona virus by practising good hand and respiratory hygiene, wearing masks, observing social/physical distancing, remaining at home when sick and cleaning high-touch surfaces regularly.

The School Reopening Protocol document is designed to address several aspects of school life which are affected by the effects of this pandemic. The first section identifies the expectations of stakeholders within this COVID-19 environment. The second section presents a number of protocols with accompanying procedures to be followed in each case. The MoEST recognises that this is a fluid situation and the protocols may need to be revised periodically in keeping with the decisions of the Cabinet of Antigua and Barbuda and Ministry of Health, as the new normal takes root.

EXPECTATIONS OF STAKEHOLDERS

All stakeholders: To be responsible for observing all COVID-19 protocols and associated practices in the quest to preserve human health and life. Individuals who have known exposure or travel history should declare such. ·

Ministry of Education, Science and Technology: To be responsive to the needs within the education system, arising as a result of COVID-19.

Board of Education: To work in harmony with the MoEST and schools in ensuring that timely and adequate support (technical and material) is provided in the current COVID-19 pandemic.

Antigua and Barbuda Union of Teachers: (To be submitted)

Ministry of Health: (To be submitted)

Principals and Teachers: To communicate, implement, manage and monitor COVID-19 protocols

Students: To be model students, by observing the requisite COVID-19 protocols.

Parents: To work in harmony with their children, schools and the various agencies to ensure that the COVID-19 protocols are satisfactorily observed.

Other stakeholders/agencies (school bus, service organisations, visitors, external agencies, press): To work with the MoEST and schools to enable the successful implementation and observance of COVID-19 protocols.

PROTOCOL 1: SCHOOL ADMINISTRATION

1.    School administrators should ensure that protocols are carried out within the school community.

2.  School administrators should make available resources to the relevant personnel, as provided by the Board of Education, in a space that can be easily accessed.

3. In addition to the daily log of attendance, schools should ensure that a record is kept of the seating                                 arrangements for each class to allow for contact tracing should the need arise.

4. School administrators should ensure that classroom physical distancing spaces are upheld for classroom                        instruction.  Schools have the option of using larger spaces within schools, such as auditoriums, for larger                       classes.

5. School administrators must identify an isolation space in case any student/school personnel should fall ill                     during the school day.  The isolation space is an area used as a temporary holding area to reduce the risk of                   possible transmission of the disease. Hence, care should be taken to ensure there is physical distancing,                         handwashing and sanitizing, wearing of masks and other prevention control measures being practiced. The                   isolation space must be easy to clean. After each use, it must be thoroughly cleaned and disinfected.

6. School administrators will direct cleaners to ensure that bathrooms are supervised and the school environment is cleaned at intervals.  Further training of cleaners must be facilitated by the Ministry of Health in collaboration with the MoEST.  School administrators should instruct cleaners to use the cleaning resources in the correct proportions as per that training.

7. The school administration will coordinate the taking of temperature for all persons entering the school’s                         compound.  Any of the following individuals may be assigned as a screener:

• school nurses (where applicable);
• parent coordinators (where applicable);
• first aiders (where applicable);
• administrative staff;
• teachers;
• security; and
• any other authorised staff.

PROTOCOL 2: SCREENING

1. All staff, students and visitors who arrive at the school compound are required to wear a visibly clean mask that covers both their nose and mouth. However, children younger than age two are not required to wear a face mask.
2. All staff, students and visitors MUST be screened (temperature check, interview when necessary) upon entry of the school plant. The thermometer MUST be used in accordance with the manufacturer’s instructions.
3. Any of the following individuals may be assigned as a screener:

• school nurses (where applicable);
• parent coordinators (where applicable);
•   first aiders (where applicable);
• administrative staff;
• teachers;
• security officers; and
• any other authorised staff.

4. Anyone (staff, student, visitor) who is found to have an elevated temperature 100 degrees Fahrenheit (or 38 degrees Celsius) or higher must be asked to sit for 15 minutes then the temperature will be rechecked. The screener may then ask further questions (See Appendix A) to complete the screening process. Staff and visitors whose temperature remains elevated will not be permitted unto the compound and should be advised to seek medical attention. A record should be kept of the names of individuals whose temperature remains elevated. Data collected (temperature readings and other responses to set screening questions) should be passed on to principals for information sharing with the relevant authorities. (See Appendix C for contact details of health care providers).
5.   Students whose temperature remains elevated should be taken to the isolation space/room (a space as identified by the school). The school then notifies the parent/guardian for the child to be collected. The parent/guardian is expected to collect or arrange for the child to be collected within the hour of notification. The parent/guardian should be encouraged to monitor the child and immediately contact the nearest clinic or call the COVID-19 hotline (462-6843) to obtain further guidance. It is the responsibility of the school to notify the Ministry of Education and the nearest clinic of such cases.
6.     Visitation to the school compound by non-education personnel is discouraged at this time. Where there are exceptions, the individuals should be interviewed and their query passed on to the administration of the school. All visitors who do not have urgent concerns should be encouraged to call or email the school.

7.  Persons who are performing temperature checks must ensure that they wash their hands and put on a                           facemask, eye protection/face shield that fully covers the front and sides of the face. Other protective gear                     which may include disposable/reusable aprons and gowns should be used if extensive contact with students is            occurring (in early childhood centres and special needs schools). The required procedure for administering                  temperature checks must be followed.

• If disposable or non-contact (temporal or infrared) thermometers are used and there is no physical contact with students, gloves do not need to be changed before the next check.
• If non-contact digital or infrared thermometers are used, they should be cleaned with a minimum of 60% alcohol solution/wipe (or isopropyl alcohol on a cotton swab) between each student. The same wipe can be reused if it remains wet. If there is contact at any time the machine should be cleaned with a minimum of 60% alcohol solution.
• After each screening process is completed, the thermometer must be thoroughly cleaned and properly stored.

 PROTOCOL 3: PHYSICAL DISTANCING

The following Social Distancing guidelines are based on the Public Health Act (Dangerous Infectious Disease) Regulations 2020:

1. Physical distancing of ideally six (6) feet but no less than three (3) feet must be maintained in the general assembly, classrooms, staff rooms, administrative offices, laboratories, when standing anywhere on the school compound at all times during the school day.

2. Signage must be displayed in classrooms, in bathrooms, in general assembly areas, outside all offices, school libraries and above all wash stations, where possible in entry areas to the school plant, auditoriums, main halls, custodial staff areas and waiting areas.

3. Schools, as far as possible, should give consideration to the scheduling of staggered breaks and other movements on the school compound to ensure that all persons adhere to the physical distancing protocol and hand hygiene practices.

4. Where possible, social bubbles must be maintained during break and lunch periods. Each class must break together as an individual bubble.

5. As needed, throughout the day, teachers should allow periods for “mask breaks”, that is, periods where children can remove their masks at safe distances.

Schools should structure times for multiple “mask breaks” for young children (ages 2-6 years as defined by the WHO).

• Mask breaks may be permitted for other students who are having difficulty with keeping on the mask
• Mask breaks for 10 minutes at least 3 times during the school day, help students to better comply with wearing the mask
• Everyone should immediately wash/sanitise hands before replacing their masks or re-entering their classes. Wet masks should be changed as soon as possible as it makes breathing difficult and promote the growth of micro-organisms
• Mask breaks should only be permitted if the children are:
• Adequately spaced at ideally six (6) feet but no less than three (3) feet apart
• Outdoor for recess in small supervised groups
• Eating/drinking
• Engaged in non-contact sports, games and skill building tasks that are required for curriculum purposes while maintaining six (6) feet distancing. Kickball and running with enough space are generally safe. Contact sports at this time are prohibited until such times that the requisite protocols are developed and approved by Ministry of Health.

6. Whole school assemblies are not recommended. However, the following alternatives can be considered:

• Schools with large halls/courtyards may be able to facilitate assemblies with required physical distancing for upper and lower secondary forms/primary classes on alternative days.
• One form/class level can assemble per day while the other levels participate in classroom assembly.
• Schools with smaller spaces can conduct assembly over the PA system/virtual platforms with students in classrooms, supervised by the secondary form teacher/primary class teacher and prefect.

If any of the three alternatives is chosen, it is strongly recommended that these assemblies should last between 15-20 minutes and must allow for motivational messages, COVD-19 reminders and updates, in addition to preparation for learning. (MoE Trinidad and Tobago, July 2020). In isolated cases, the principals’ discretion can be exercised should longer assemblies be required.

7. Where the required physical distance cannot be achieved, staff meetings/gatherings should be held virtually.

PROTOCOL 4: PERSONAL PROTECTIVE EQUIPMENT

Personal Protective Equipment (PPE) are meant to protect the wearer and/or those nearby from the spread of illness-causing germs such as COVID-19.

Wearing of masks or face covering

1. All staff, students and visitors who enter the school compound are required to wear a visibly clean mask that covers the mouth and nose throughout the day.  However, children younger than age two are not required to wear masks. Special consideration to wear face shields only may be given to students and staff with an accompanying medical documentation but six (6) feet physical distance is to be maintained. Face shields should not be used as a replacement for masks even in asthmatics.
2. Acceptable masks include disposable masks and cloth masks that completely cover mouth and nose. Designs/displays on cloth masks must be age-appropriate. Bandanas, handkerchiefs or scarves should not be used as alternative face coverings.

• Teachers are permitted to wear face shields while teaching and maintaining the six (6) feet physical distance.
• The Ministry of Education will provide a one-time supply of two cloth masks to all staff and students.
• Teachers may consider using masks with a see-through covering over the mouth (and nose) when teaching young students or students with disabilities for improved communication.

Use of PPE for Staff

3.    School nurses and delegated staff must use the requisite PPE (surgical masks, reusable face shield, hooded face shield, gloves, and/or gowns) in specific health services situations to include attending to or monitoring anyone exhibiting respiratory or flu-like symptoms where it is not possible to maintain the recommended physical distance. 

PROTOCOL 5: HAND HYGIENE AND RESPIRATORY ETIQUETTE 

All students, staff and visitors will be required to follow proper hand hygiene and respiratory etiquette. Signs and posters promoting proper hygiene practices should be posted throughout the school compound in appropriate areas (such as entrance to the school compound, administrative offices, classrooms, auditorium, cafeteria, custodial staff areas and handwashing stations).

1. Hand Hygiene

Individuals must routinely practise proper hand hygiene to help reduce the spread of COVID-19. Proper hand hygiene includes:

• Hand washing with soap and water, lathering for at least 20 seconds.
• Use of hand sanitisers (60% minimum alcohol) only where hands are not visibly dirty and the washing of hands is not possible. A generous amount of hand sanitiser should be rubbed vigorously over palms, back of hands, between fingers and under fingernails for 30 seconds. After consecutively using hand sanitiser three times, hands must be washed with soap and water.
• Persons should refrain from touching eyes, noses and mouths.

1. Staff, students and other individuals who enter the school compound should wash their hands with liquid soap at the following times:

• Upon entering the school compound
• Before entering the classroom;
• Before and after snack and lunch;
• Before and after using the bathroom;
• Taking a student to the bathroom / helping a student with toileting;
• After sneezing, wiping or blowing nose;
• After using shared items or surfaces (e.g. telephones, electronic devices, keyboards, computer mice, musical instruments, tools, desks or table tops);
• When hands are visibly soiled.

III.  Hand sanitisers should be placed in strategic locations on the school compound and monitored for refill as necessary.

2. Respiratory Etiquette  

The COVID-19 virus spreads mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes or even talks. Staff and students, if they must remove their masks, should cover their mouths and noses with a tissue when coughing or sneezing and immediately dispose of the used tissue in the nearest available bin.

• Individuals MUST wash or sanitise their hands after sneezing, coughing and handling dirty tissues.
• If no tissue is available, using the flexed-elbow technique (that is, using the inside of the elbow or sleeve to cover the mouth and nose) is preferable to using the hands.

3. Other Hygienic Practices

Students are encouraged to bring along a personal pouch containing an extra mask, a small packet of hand tissue, hand sanitiser and asthma pumps where needed.

The sharing of school equipment and other items should be discouraged. In cases where sharing is absolutely necessary, items must be cleaned and disinfected between uses.

PROTOCOL 6: CLEANING AND DISINFECTING

1. Cleaning schedules should be mounted in strategic places on the school compound. Custodians are asked to supervise bathroom use (discouraging abuse of resources) and to pay attention to the following as they exercise caution and vigilance while carrying out their duties:

• Wear gloves and disposable aprons ensuring that they are properly disposed after use.
• Thoroughly clean and disinfect all rooms, floor, walls, corridors, railings and other areas of the school to be used by staff and students prior to the reopening of school.
• Properly and regularly clean and disinfect frequently touched surfaces (e.g., desks, chairs, stools, work stations, tools, equipment, classrooms, playrooms, door knobs, light switches, telephones etc.) with the appropriate disinfectant every two hours or where there is a change in groupings of students.
• Clean and disinfect bathroom facilities after use at regular intervals.  Focus should be placed on the toilet bowls and handles, faucets, and door handles.
• Ensure that the collected waste is properly disposed by securing garbage bags in a garbage receptacle with a lid.

2.     Provision should be made for adequate supplies of the following: cleaning disinfecting agents, gloves, aprons, rags, and mops. These must be approved products.
3.     Further training should be provided for custodial staff in the proper cleaning protocols, method for mixing and storing chemicals, and use of personal protective equipment to carry out cleaning and disinfection tasks.

PROTOCOL 7: DEALING WITH SUSPECTED CASES

1. Students MUST stay at home when they are sick. Any student absent from class due to suspect COVID-19 symptoms shall not return to school without a physician’s note. Covid-19 symptoms include: fever, chills, cough, shortness of breath and sore throat. Loss of taste or smell and headache are symptoms of interest as well, while diarrhea and vomiting remain supplemental. Any student who is a close contact of a confirmed case, must follow the directives of the Quarantine Authority. The school should aim to provide the child in quarantine or isolation with online educational materials to enable learning to continue.
2. If a student has an elevated temperature, refer to Protocol 2 (4 and 5) for actions to be taken. A student who displays signs or symptoms of the common cold or flu while at the school, should be taken to the isolation space/room (a space as identified by the school). The school then notifies the parent/guardian for the child to be collected. The parent/guardian is expected to collect or arrange for the child to be collected within the hour of notification. The parent/guardian should be encouraged to monitor the child and contact the nearest health facility in keeping with the national protocol guidelines for reporting suspected cases, for example, call the COVID hotline to obtain further guidance. It is the responsibility of the school to contact the Ministry of Education and the nearest clinic about the issue. (See Appendix C for contact details of health care providers)
3. Teachers, school administrators, clerical, ancillary or other staff who are sick MUST stay at home and follow the expected protocol as per the Civil Service Regulation/Labour Code for reporting uncertified illness.  Wherever possible, and in order to reduce the burden on schools, academic tasks should be submitted to their Principals/Head of Department electronically, when reporting ill. Any staff who is absent from work due to suspect COVID-19 symptoms shall not return to work without a physician’s note.
4. If a staff member is found to have an elevated temperature while at school, refer to Protocol 2 (5) for further actions. Should a staff member display signs or symptoms of the common cold or flu while at school, that person should immediately seek permission to return home, following the established protocols of the school. Covid-19 symptoms include: fever, chills, cough, shortness of breath and sore throat. Loss of taste or smell and headache are symptoms of interest as well, while diarrhea and vomiting remain supplemental. The staff should contact the nearest health facility in keeping with the national protocol guidelines for reporting suspected cases, for example, call the COVID hotline to obtain further guidance. It is the responsibility of the school to contact the Ministry of Education and the nearest clinic about the issue. (See Appendix C for contact details of health care providers)
5. Any staff who is a close contact of a confirmed case, must follow the directives of the Quarantine Authority. It is recommended that the person seeks professional health care, depending on the situation/context.
6. In the event that a staff or student is found positive with COVID-19 or was exposed to a suspected or confirmed case of COVID-19, the school MUST refer the matter to the Public Health Department.
7.   Administrators should follow the usual procedure (requesting permission to close school from the Director of Education) when/if school closure becomes necessary.  Should a school needs to close due to COVID-19 exposure, immediate attention should be given to:

• Contact tracing and notifying the relevant health authority about the matter.
• Implement its plan for remote instruction and learning, utilising the applicable online platforms.
•   Deep cleaning and sanitisation of the school compound must be done (in collaboration with the Ministry of Health) before school is reopened.

PROTOCOL 8: EMERGENCY DRILLS

The MoEST encourages schools to continue to observe their emergency drills as scheduled since emergencies are anticipated events in life. However, such practices will necessitate schools to:

• Adjust established drills and to as far as possible to incorporate COVID-19 protocols but advising school that such protocols may not be fully operational in an actual emergency response. A staggered drill practice of groups of students is advisable but not to be followed should an actual event occur.
• Adequately notify the school body of changes in drill procedures.
• Incorporate the protocol for infection should the school be forced into high alert for closure, and/or temporary quarantine of anyone or the entire school body.

PROTOCOL 9: FOOD SERVICES

All Cafeteria Operators and Vendors must be guided by the Education Act 2008 Division 2 Part 12 Subsection 172.

Once approval has been granted and cafeteria operators and vendors possess a valid Food Handler’s Certificate, all school meal service providers shall resume operations effective the beginning of the 2020/2021 academic year.

1. All Cafeteria Operators (where not run by the school) must have a valid contract as signed by the Permanent Secretary, Ministry of Education, Science & Technology and the school.
2. All vendors must be approved by the Director of Education.
3. It is the responsibility of the Cafeteria Operators, vendors and National School Meals personnel to ensure that the areas of operation are inspected before the resumption of school.  A certificate from the Ministry of Health confirming that the areas of operation have been inspected and approved in accordance with the COVID-19 guidelines must be presented to the school’s administration for submission to MoEST before permission is granted for operation to begin.
4. It is the responsibility of the Cafeteria Operators, vendors and National School Meals personnel to ensure that frequently-touched surfaces are regularly sanitised.
5. Each Cafeteria Operator, vendor and National School Meals personnel are responsible for ensuring that there is a handwashing station in place for students to properly wash their hands before receiving service.
6. The best practice for cafeterias/school meals centre is that there is one entrance and one exit for smooth physical distancing flow of traffic when service is provided.
7. All cafeteria workers, vendors and National School Meals personnel, should follow all hygiene protocols by frequently washing their hands during the process of serving students. They are expected to wear their mask at all times. They should also adhere to all other protocols in place at the school.
8. Parents are encouraged to ensure that once they provide meals for their children that all necessary utensils are supplied so that students can consume their meals. The sharing of utensils and food are strongly discouraged. It is strongly recommended that students are adequately supplied with a daily supply of water, along with nutritious food, fruits and vegetables.
9. Where appropriate, students should eat their meals at their desks/tables in class or should be given pre-packaged meals for take-away.

PROTOCOL 10: EXTRA AND CO-CURRICULAR ACTIVITIES

The Ministry of Education, Science and Technology recognises that extra-curricular activities to include sports, drama, dance and other forms of extra and co-curricular activities are necessary for the holistic development of our students.  However, these must be implemented in accordance with the established protocols from the Ministry of Education, Science and Technology, Ministry of Sports, Culture and other relevant institutions.

1. Any physical or extracurricular activity on the school’s compound should follow the physical distancing protocol and the sanitisation regimens for hands, sporting and other equipment. Where possible, events should be held out of doors.
2. All Social and Fund-raising activities planned by the school should be sanctioned by the Ministry of Education.  Schools should detail the planned event and show how social distancing and hygienic practices will occur.
3. There should be no fund-raising social activities planned that include the attendance of the general public including parents (School cake sales, barbecues, fetes, Open day etc.).
4. School programmes, such as those produced by the Education Broadcasting Unit (EBU), Independence programmes, Queen and King of the Forms, Christmas concerts, dance and theatre productions and other cultural development showcases may be held via online streaming platforms. Should a live audience be deemed necessary, it MUST be limited to the capacity stipulated in the government social gathering protocol.
5. The use of buildings for meetings by clubs and organisations (Girl Guides, Interact; Choir, Pan, Drama, Dance) should be limited.  Such groups should meet in reduced sized groups on the outdoors or large auditoriums if necessary.  The use of face shields and/or masks are mandatory along with hand sanitizing. Where possible, groups should also explore online platforms to hold regular sessions/meetings.
6. The use of school environments by community organisations should receive special discretionary consideration by the Ministry of Education, Science and Technology. There should be a re- application process for existing arrangements.

 Performing Arts Subject Areas

The activities of the Performing Arts such as Music, Drama and Dance that are part of regular sessions in school must be given specific consideration as these events are expected to be continued as normal classroom activities in schools where Music, Theatre Arts are conducted.

1. Music:

• Singing at Assembly:   This may occur only with small groups of not more than 4 persons or soloists performing the School song; the National Anthem; and hymns.  Performers would be allowed to remove masks for singing provided they maintain 6 feet physical distancing and wear face shield.  Alternatively the school administration may wish to consider the use of pre-recorded music for the recognition of the National Anthem and school song or the use of pan/piano instrumentalists for this function.
• Students must wash hands or apply hand sanitizer before entering Music rooms.  Musical instruments and other equipment must be cleaned before and after use.
• The playing of any wind instruments and singing should be done preferably on the out of doors or within a large auditorium; where this is not possible, there should be limits to a maximum of two students at a time performing in a room.   Teachers may also utilise the google classroom or other online teaching platforms to hold such practical classes.
• Other non-wind instrumental playing may occur with students wearing masks. Class groups should be limited to allow for physical distancing.
• The involvement of teaching personnel from the Department. of Culture should be coordinated  by the school administration and the Director of Culture. Such persons should be informed about the procedures and protocols established by the Ministry of Education, Science and Technology.  This applies for other disciplines such as Dance and Drama.

2. Dance and Drama/Theatre Arts

• The use of face shields will be necessary for such practical components that require students to interface with each other but with distances of 6 feet apart.  However, any enclosed room should be properly ventilated when in use.
• Students MUST wash hands or apply hand sanitiser before engaging in theatre arts classes.
• Where possible, class sizes should be reduced to accommodate the space in which the classes are held.   Small groups of 5-8 should be maintained for practical components.  Where there are large class sizes, a teacher’s aide or second teacher should be engaged to assist.
• Teachers are asked to explore various drama techniques and styles with their students that can minimise close physical/verbal contact.  Where possible, activities involving voice projection should be done outdoors or in large airy auditoriums.

PROTOCOL 11: SCHOOL BUS – BOARDING AND ALIGHTING

School bus drivers and conductors should ensure that the following protocols are followed:

1. School buses should be sanitised before and after each trip (include wiping hand rests, door handles, rails and other hard surfaces). All buses must be equipped with supplies, including personal protective equipment and disinfectant.
2. School bus drivers and conductors should wear face masks that cover the mouth and nose and follow the established protocols for hand hygiene and respiratory etiquette.
3. If a student is called upon to show his/her ID, the ID should be held in a manner for the conductor to see.  School bus conductors should avoid handling the ID.
4. Students should enter and disembark the bus in an orderly fashion following the protocols for physical distancing, coughing and sneezing.  Each student MUST sanitise their hands before entering the bus. Each student MUST use items from their personal pouch to sanitise every time they cough or sneeze in the bus. As much as possible, windows should be kept open to allow for fresh air ventilation while transporting students. Each child MUST wear a mask on the bus.
5. No student should be left stranded or not be allowed to enter a school bus as a result of him/her becoming ill on their way to school. Should a student become ill while on the bus he/she should be placed in the designated holding area in the bus and the school informed immediately upon arrival. Schools should then follow the expected protocol for dealing with sick students.
6. All school bus personnel should exercise Positive Behaviour Management techniques in dealing with students who use the school bus service.
7. The capacity of the school buses and scheduling will be determined by the relevant authorities and will be communicated to all students in a timely manner.

PROTOCOL 11: COMMUNICATION 

The MoEST strongly recommends that signage be displayed at strategic points clearly outlining the expectations of all persons who enter the compound. Principals should advise all parents and other stakeholders of the NO VISITORS policy at this time.

1. Signage is clearly visible at the entrance and other key areas of compounds to include (bathroom, cafeterias, classrooms etc.) Posters depicting preventative and protective measures to be displayed in strategic areas throughout the compound. These include (but are not limited to) office areas, staff rooms, classrooms, library, auditoriums etc.
2. Signage should be used to remind individuals to:

• Stay at home if they are feeling unwell.
• Wear masks properly by covering the nose and mouth when unable to maintain physical distance from others.
• Adhere to physical distancing guidelines.
• Report symptoms of COVID-19.
• Follow hand hygiene guidelines.
• Follow respiratory etiquette guidelines.

3.Visible floor markers must be placed throughout the compound in areas such as classrooms, cafeteria, and corridors, which will indicate the physical distance to be observed as per the guidelines from the Ministry of Health.

4. Signage should be placed at the front of the compound advising that persons will not be allowed on the school compound:

• • if they exhibit flu-like symptoms.
  • unless wearing a mask.
  • unless temperature check results in normal reading.
  • unless hands are properly washed and/or sanitised.

5. Signage indicating No Unauthorised Visitors Allowed on the Compound should be visibly displayed.

6. Signage indicating the proper technique of washing hands should be placed above all wash basins in restrooms and at wash stations. For primary school students, age-appropriate signage is encouraged.

7. Signage must be in place in the cafeteria and school meals centre to clearly outline the expectations of each student upon entering these spaces, receiving service and upon leaving. Floor markers must also be in place clearly identifying the physical distance to be observed while students utilise these services.
8. Signage outlining the protocols in effect while on the school bus should be visibly displayed in all school buses. Markers must also be used to indicate the physical distancing to be observed by students while using the buses.
9. Principals should ensure that all information for students and parents are up to date and easily accessible.
10. Principals should make provisions for the sanitisation of all resources being used before and after each use. These resources include phones, desk, chairs, computers etc. Persons responsible for sanitisation of these resources must be clearly delineated and communicated.
11. Principals should clearly articulate various responsibilities to school personnel and students.
12. Principals are asked to ensure that:

• Staff, students, and parents/guardians are aware of the following and made accessible through email, newsletters, other electronic means:
• system of timetabling and days when students are not required to be at school
• times for scheduled break and lunch
• policy for personal hygiene
• Parents and guardians are aware of the drop-off and pick-up policies of the school and regular reminders are communicated on the method of operation in the “New Normal”.

13. Each school should implement a communication plan utilising the checklist (refer to Appendix A). Principals should clearly articulate the official medium of accessing information for respective schools. This ensures that parents, students and other stakeholders can access all information pertaining to the school from the correct source.
14. In light of the NO VISITORS policy to be implemented, parents are encouraged to communicate with the school, staff and administration during normal hours of operation through the identified means such as email and phone).

PROTOCOL 12: STUDENT/TEACHER SUPPORT·  

The outbreak of the Coronavirus disease, COVID-19, has disrupted our entire lifestyle.  It has brought abrupt changes to every facet of our life.  As we prepare to return to school, we must acknowledge the profound impact that the pandemic has had on the students’ academic, social, emotional, and life outcomes. Therefore, we must seek to put measures in place to mitigate against a lasting impact on their development as students transition back to school.

Administrators should make provisions for an orientation session at each class or grade level to explain the new processes to students and the importance of adherence.

Allow students to share how COVID-19 has affected or impacted their lives and give them an opportunity to ask questions and express concerns with the guidance of the Counselling Unit.

• Students should be reminded during home room/ class prayers of measures to mitigate against the spread of COVID-19 and their role as students. This should include opportunities for students to demonstrate expected hygiene etiquette, practise handwashing, etc.
• Teachers should engage students in activities to reinforce tolerance and empathy for persons afflicted rather than stigma and discrimination against those affected.
• Teachers should conduct readiness assessments during the first two weeks of the term to assess students’ grade level competencies. The results of the assessments should be utilised to determine learning gaps and remediation measures.
• Teachers should also avail themselves for psychosocial support as needed.
• Teachers are encouraged to provide the grade level teacher with any relevant information on students that would allow for interventions to enhance student performance, to include but not limited to any areas of weakness that they had observed or had been working with the student and the students’ level of interaction during the school closure.
• Engage social services as necessary for students and their families who may facing undue hardships (lack of food for example).

PROTOCOL 14: CURRICULUM AND ASSESSMENT

Our response to COVID-19 caused significant disruptions to the delivery of education with resulting teaching and learning gaps. The return to school will immediately focus on closing these gaps through diagnostic and readiness assessments and teaching practices that will address students’ needs at every level. Support for teachers and other educators will be provided through ongoing professional development, monitoring and collaborative discourses, so that the teaching and learning process can be adjusted to meet the demands of the current environment.

1. Teachers should use data captured by curriculum survey to determine students who require immediate intervention by schools with the assistance of Education Officers, Curriculum in an effort to address their needs.
2. Education Officers, Curriculum should collaborate with subject specialists/teachers in schools to adjust the curriculum to ensure maximum learning is attained.
3. MoEST Support Teams will/should conduct diagnostic assessment of students with special needs and address the significant gaps in their learning that would have occurred as a result of remote learning.
4. The Education Officers responsible for Mathematics and English will/should utilise diagnostic tool kits to address learning needs of students who are operating below grade levels in those areas.
5. All technical officers will/should rigorously monitor, evaluate and train teachers to encourage differentiated instruction and other effective teaching strategies.

PROTOCOL 15: EXTERNAL SUPPORT SERVICES 

The MoEST welcomes the partnership and assistance of our community and external service partners in education. However, in this pandemic, we have to exercise strict measures to combat the spread of COVID-19. Limited access will be given to concerned parties.

1. Zoom or other similar presentation modes should be considered as the first option for hosting interactive live sessions with schools.
2. No more than two visitors should be allowed at any given time when visiting the school compound. The usual protocol screenings and practices should be observed.
3. Contact details should be provided to facilitate contact tracing if necessary.

Persons who have travelled within the past two weeks MUST abide by the Travel Protocols of Antigua and Barbuda which pertain to returning to the country.

APPENDIX A – SCREENING QUESTIONS

1. Did you travel within the past three weeks? ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………..
2. Have you had any known contact with anyone who has COVID-19 or its symptoms?…………………………………………………………………………………………………
3. Have you had any known contact with anyone who been under quarantine or isolation? ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………..
4. Do you have any shortness of breath, sore throat, headache, loss of appetite, smell, diarrhoea, vomiting and/or body chills? ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

APPENDIX B: CHECKLIST FOR COMMUNICATIONS AND OPERATIONS

☐ All staff aware of their role in monitoring student interactions

☐ All staff aware of their revised roles as per school committees and designations

☐ Systems in place to ensure adherence to visitor’s policy (visitors wash hands before being escorted to the office; no entry on compound without mask, etc.)

☐ Parents aware of the visitor’s policy and requirements for students

☐ Form/class teachers informed of the hand washing policy, cough and sneeze etiquette and in turn inform and remind students

☐ Physical distance floor markers in the cafeteria, administration office, outside washrooms and handwashing stations/sinks

☐ Schedule for staggered lunch/break time developed and shared with staff

☐ Schedule developed for cleaning classrooms and sanitisation of furniture

☐ Age-appropriate signage promoting washing of hands and personal hygiene on compound

☐ Policy for sick students on compound shared with stakeholders

☐ Updated contact information for all students and parents

☐ Schedule for monitoring of water stores developed and followed

APPENDIX C: CONTACT NUMBERS OF HEALTHCARE PROVIDERS

LIST OF COMMUNITY HEALTH CENTERS & CLINICS

HEALTH CENTERS & CLINICS            LOCATIONS                                   TEL #             Cell #

All Saints, SVF & FMV                     All Saints Village                             460-1003        727 -3158

Bishop Gate Health Center               Luther George Rd                       462 -0501       7297207

(Off Rowan Henry St)

Browne’s Avenue Health Center       All saints Road                            562- 3076      729-3084

Clare Hall Health Center                    Clare Hall                                      462 -4127      729- 7258

Grays Farm Health Center                 Grays Farm Main Road              462- 0861      727-3170

Jennings Health Center                      Jennings Village                           462- 6304      729-3293

Bendals Clinic                                       Bendals Village                            462-3841

Bethesda Clinic                                    Bethesda Village                         463-2810

Bolans Clinic                                         Bolans Village                              462-3606

Cedar Grove Clinic                               Cedar Grove Village                    462-1011

Five Island Clinic                                  Five Island                                     562-7410

Freetown Clinic                                    Freetown Village                         462-5365

Johnsons Point Clinic                          Johnson’s Point Village               562-3753

Judges Hill Clinic                                  Judges Hill                                     462-3114

Liberta & Cobbs cross Clinic               Liberta Village                               460-3175

New Field Clinic                                    New Field Village                        460-4270

Old Road Clinic                                     Old Road Village                          462-8255

Parham, Willikies, Pares                     Parham Village                             463- 2576

Piggott’s Clinic                                      Pigotts Village                              462-1271

Potters Clinic                                         Potters Village                             462-4692       7297478

Swetes, Buckleys, John Hughes         Swetes Village                              460 -1174

WORK CITED

Ministry of Education. School Supervision and Management Division. (2020, July). Guidelines

for the reopening of schools. Trinidad and Tobago: Author. http://www.news.gov.tt/

WORKS CONSULTED

Alachua County public schools continuity of operations plan. (n.d.). https://www.sbac.edu/

Center for Disease Control and Prevention. (2020, July). School and childcare programs: Plan,

prepare and respond.

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

Global Education Cluster. (2020). Safe back to school: A practitioner’s guide.

https://resourcecentre.savethechildren.net/library/safe-back-school-practitioners-guide

Houston Independent School District. (2020). HISD reopening plan for the 2020-2021 academic

year. https://www.houstonisd.org/reopening

Ministry of Education. School Supervision and Management Division. (2020, July). Guidelines

for the reopening of schools. Trinidad and Tobago: Author. http://www.news.gov.tt/

Ministry of Education, National Reconciliation and Information. (n.d.). SVG COVID-19

guidelines for prevention and controls in schools. St Vincent and the Grenadines:

Author.

Ministry of Education, Science and Technology. (2020, May). Return to school: Re CXC

preparations. Antigua and Barbuda: Author.

Ministry of Education, Youth and Information. (n.d.). Manual for the reopening of

educational institutions. Jamaica: Author.

Minnesota Department of Health. (2020, June). COVID-19 cleaning and disinfecting guidance

for schools and child care programs.

https://www.health.state.mn.us/diseases/coronavirus/schools

NC Department of Health and Human Services. (2020, July). StrongSchoolsNC: Infection

control and PPE guidance (K-12).

https://files.nc.gov/covid/documents/guidance/education/Strong-Schools-NC-Public-Health-Toolkit-PPE-Guidance.pdf

New York State Education Department. (n.d.). Recovering, rebuilding, and renewing: The spirit

of New York’s schools reopening guidance. http://www.nysed.gov/

UNICEF. (2020, June). What will a return to school during the COVID-19 pandemic look like?

https://www.unicef.org/coronavirus/what-will-return-school-during-covid-19-pandemic-look

World Health Organisation. (2020, July). Schools and COVID-19.

https://www.who.int/news-room/q-a-detail/q-a-schools-and-covid-19

                                                        MINISTRY OF HEALTH
                                                  CENTRAL BOARD OF HEALTH
                                          Guidelines for the Reopening of Nurseries,
                                                         Daycares & Pre-Schools

General Guidelines

• All Daycares and Preschools MUST be inspected and approved by Central
  Board of Health and the Early Childhood Development Unit before they
  can re-open.
• Employees MUST NOT report to work if they have symptoms of COVID19, including fever, respiratory symptoms such as cough, shortness of
  breath or loss of the sense of taste/smell. If in doubt call the COVID
  Hotline at 462-6843
•   If an employee is sick send them home immediately. Clean and disinfect
  surfaces in their work place. Others at the facility with close contact (i.e.
  within 6ft) of the employee during this time is considered exposed.
•  Staff and parents of students must inform the Principal/Owner about
  illness.
•  Instruct employees who are well, but know they have been exposed to
  COVID-19 to notify the Principal/Owner.
• Employees and students absent from work/school due to suspected
  COVID-19, MUST NOT return unless cleared by a Medical Practitioner.
• Inform fellow employees of their possible exposure to COVID-19 in the
  work place, if an employee is confirmed to have COVID-19, while
  maintaining confidentiality.
• Implement workplace control to reduce transmission among employees.
• Workers and students with a cough, runny nose, jaundice, diarrhea,
  vomiting, should not be permitted at work or attend school.
• Identify an isolation room/sickbay to holding sick students until their
  parents arrive. Parents must be called immediately to collect their child
  as soon as possible.
•  Isolate sick persons (teachers, staff and students) who may become ill
  while at the institution.
•  The school must use a touch less infrared thermometer to check the
  temperature of their employees and children each day before they enter.
  Any staff or child who has a temperature of 99°F and above, should not
  be allowed to enter until they have no fever and no evidence of COVID-19
  symptoms. *Follow guidelines on Taking Temperature.
•  All persons on the school compound are required to wear a face mask in
  compliance with the regulations. The face mask must cover your nose
  and mouth.
•  Each school is required to inform the parents about the measures the
  school is putting in place to allow for students to re-enter the premises
  for classes.
•  Each school is required to explain to the parents the importance and
  reasons for school-related measures being implemented.
•  Each school is required to reinforce the need for strict compliance with
  the guidelines for the return to school.
•  Each school is required to take any appropriate action to protect the
  interest of staff and students by persons who are found to be in any
  breach of the protocol while on the school compound.
•  If meals are prepare at the school, all Food Handlers MUST have a valid
  Food Handlers Badge issued by the Central Board of Health.
•  All guidelines pertaining to Food Safety MUST be followed. *Obtain a
  copy of the guidelines pertaining to Food Service Establishments.
•  Delivery personnel should wash their hands before entering.
•  There must be a backup supply of potable water in the event APUA water
  is unavailable or turned off. There should be a pump and a pressure
  tank attached.
•  There must be a residual chlorine available (both APUA and private
  source).
•  Parents must adhere to physical distancing while picking up and
  dropping off their child or children. Parents must be wearing their
  facemask.
•  Parents must cooperate, respect and be patient with Centre Management
  and staff as safety measures are implemented.
•  General visitors to the centres are discouraged. However, where there
  are exceptions, their query should be made directly to the Centre
  Administration. All visitors who do not have urgent concerns should be
  encouraged to call or email the Centre.
•  The names of all persons who visit the compound should be recorded, as
  well as the date/time of their visit.
•  Each School is advised to implement a school absenteeism monitoring
  system to track both students and staff, or to alert the Ministry of Health
  of any significant increases in absenteeism due to respiratory illnesses
  (cough, colds, fever, difficulty breathing).
•  A register must be kept of all staff and children at facility; this will
  include their names, addresses and phone number.
•  No visitor should be allowed to visit location in the centre where children
  are usually expected to occupy.
•  All Staff are encouraged to provide emotional support at the first sign or
  report of distress.
•  Until further notice, all field trips are suspended until authorised by the
  Ministry of Health and Ministry of Education.
•  Persons in need of psychosocial support should be directed to contact
  the Psychosocial Hotline for Tele counselling at 464-7421.

CLEANING OF THE WORKPLACE, WORK EQUIPMENT & FACILITIES

•  The Custodians must thoroughly clean and disinfect all rooms, floor,
  walls, corridors, railings and other areas of the school to be used by staff
  and students prior to return of the of persons to the environment.
•  Custodians must properly clean and disinfect desks, chairs, stools, work
  stations, tools, equipment, classrooms, playrooms, toys, door knobs,
  light switches, cots, diaper changing tables, and facilities prior to reopening and use by staff and students.
•  Clean and disinfect bathroom facility after use and when visibly soiled.
  Focus should be placed on the toilet bowl, the toilet handle, the faucet,
  the faucet handle and the door handle.
•  The toilet paper and the paper towel MUST be mounted.
•  A cleaning schedule MUST be posted in all bathrooms.
•  Custodians must be provided with adequate supplies of cleaning
  disinfecting agents. These must be approved products.
•  Custodians must be provided with the necessary training and the proper
  use of personal protective equipment to carry out cleaning and
  disinfection task.
•  Remove all soft toys from the centre and thoroughly clean and disinfect
  the toys after use. Discourage the sharing of toys between students.

HYGIENE AND SAFETY PRECAUTIONS

•  Custodian staff must clean and disinfect desk, chairs, workstations,
  equipment and facility on a daily basis.
•  Custodian staff must be provided with adequate supply of Personal
  Protective Equipment (PPE).
•  A daily record of the cleaning regime of critical areas outlining Where to
  clean, What to clean, When to clean and Who should do the cleaning,
  should be displayed for check and scrutiny by a Public Health Inspector
  and daily by the Principal. Areas such as the bathrooms and classrooms.
  The times of such cleaning operation should also be inserted.
•  Custodian staff must undertake daily and frequent (every 2 hours)
  cleaning of high touched/high traffic areas.
•  Staff must desist from sharing common office supplies (e.g. pens,
  staplers)
•  Custodians must wear disposable gloves to clean and disinfect.
•  Custodians must clean surfaces using soap and water, then disinfectant.
•  Use disinfectant approved to work against bacteria, fungus and virus
  (some may be certified to work against coronavirus).
•  Diluted bleach solution can also be used if appropriate for the surface.
•  Facilities for hand hygiene should be available in each classroom at the
  entrance door. A Hand Washing Station should be erected and equipped
  with Potable running water, Liquid Hand Soap to facilitate hand washing
  and a sufficient supply of paper towel for drying hands with a foot
  operated bin in which to dispose of already used napkin.

VENTILATION

All work space and classrooms must be properly ventilated
Keep all doors and windows open whenever possible

PERSONAL HYGIENE & PROTECTION

• All persons on the school compound must wear face masks at all times.
•  Face masks should not be reused and must be carefully handled and
  removed to avoid self contamination.
•  Posters demonstrating how to safely wear and remove face mask should
  be strategically displayed around the school building.
•  Hand washing stations must be placed at the entrance of the school, in
  adequate amount to prevent to prevent congestion upon arrival.
•  Staff and students must wash their hands using liquid soap and running
  water, for at least 20 seconds, especially upon arrival at the school and
  more so after using the bathroom, blowing their nose/coughing/sneezing, and before eating.
•  All staff and students must practice frequent hand washing. Signage(s)
  demonstrating the correct ways how to wash hands should be placed
  above the station in this area.
•  Students should be given clear instructions to avoid touching hands to
  face.
•  It is recommended that parents should give their child/ children a
  sample sized bottle with 70% Alcohol based sanitizing solution for
  personal use.
•  Staff and students must avoid as far as possible, contact with objects or
  surfaces used or touched by others (e.g. door handles and knobs) and
  must wash their hands after contact with such surfaces or objects.
•  Disinfect apparatus and learning materials used by teachers/students or
  other persons as appropriate or as needed.

DAILY ROUTINE BEFORE SCHOOL

All staff and students are required to maintain good hand and
respiratory hygiene before, during and after travel between school and
home.

• ON ARRIVAL AT SCHOOL
•  Teacher should carefully observe the student upon arrival and during the
  class time to identify signs of illness.
•  When parents observe their child or children looking unwell do not bring
  then to school instead take them to the Doctor.
•  Strictly enforce the wearing of a clean face mask for all persons entering
  the school.
•  Enforce the hand hygiene protocol at the point of entry (i.e. staff and
  students must wash their hands on entry to the school).
•  Ensure that temperature is taken at the entry point and assess for other
  signs and symptoms.
•  Limit the number of persons entering the compound-people who are not
  directly involved with the school’s activities should not be allowed entry.
•  Keep a register of daily attendance and note any illness of a student or
  staff.
•  Inform all staff and students about the school’s hygiene and safety
  policies before they enter the premises. Signage to this effect may be
  strategically posted.
•  Implement measures to avoid congestion at the entrance/exit of the
  school.
•  Floor markers can be placed for persons picking up and dropping off of
  children.
•  Ensure the enforcement of physical distancing by using aids such as
  floor markers, ribbons or physical barriers
•  Restrict the number of entry points into the school to control the flow
  and number of persons within the school yard. Note, All School
  compound should be fenced.
•  Footwear must be removed upon entering the centre. They may choose
  to wear socks or indoor shoes thereafter. The shoes must be of a material
  that is easy to wash and sanitize.
•  Designate separate entrance and exit routes to avoid unnecessary
  bundling up of people and to enable the practice of social distancing.

DURING SCHOOL

Children should be restricted to individual small classes. The small
classes is aimed to limit any potential spread and allow for easy contact
tracing and remediation.

•  Once placed in a class, children and the caregiver must stay within that
  class.
•  Downtime and mealtime should be conducted in the specified groups.
  The class should not be mixed.
•  Avoid assigning group work to students to ensure compliance with the
  social distancing policy.
•  Each caregiver or teacher should strictly adhere to the staff to child ratio:
  Birth to 1 year: 1:3
  1-2 years: 1:6
  2-3 years: 1:8
  3-5 years: 1:10
•  Square footage per child:
  Birth to 2 years 40 square feet
  2-3 years 30 square feet
  3-5 years 25 square feet
•  The classrooms must be of adequate size to achieve physical distancing
  and the ratio assigned. This will be observed during inspection.
•  Provide a designated area for storing personal belongings separately.
  Such as lunch bags, bottles etc in assigned cubicle.
•  Space desks to accommodate physical distancing at least 6ft apart
•  Keep open, where feasible, all doors to classrooms and other areas
  occupied by staff and students.
•  Ensure that students do not congregate while at school.
•  Strictly enforce physical distancing of 6ft apart at all time for everyone on
  the compound during school.
•  Plan activities and lessons with the physical distancing protocols as
  prerequisites to the plan for a designated group of children and ensure
  those children remain separated from other children throughout the day.
  They will perform all activities in this group to allow for easy contact
  tracing if the need arises.
•  Ensure the wearing of facemask at all times while in the classroom or
  outside on the compound.
•  Ensure regular cleaning and disinfection of desks, chairs and the general
  classroom, must be done before and after use.
•  Limit or prevent the mixing of classes while waiting to be collected.
•  Restrict/limit the switching of groups or teachers. If possible, utilize the
  same teacher for the duration of their instructional sessions.
•  Implement measures to control the movement of students into and out of
  the classroom and the school.
•  Discourage/prohibit the sharing of resources such as crayons, artwork
  etc.
•  Disinfect all desks and chairs used by students and teachers prior to the
  start of classes and at the end of classes.
•  Provide foot operated garbage containers in all classrooms and around
  the institution.
•  Garbage bins should be outfitted with disposable liner bags in each
  classroom, staffroom or speciality room.
•  Ensure that garbage liners are removed and disposed of daily and bins
  are washed at least twice a week.

Discourage outdoor play. Remove outdoor play from daily activity, that is
NO RECESS.

Ensure that the physical distancing protocols are observed in the
classroom, at meal time and any other time when the children have to
gather.

•  Reinforce good hygienic practices throughout the day. Teachers should
  always remind students of the COVID- 19 protocols by having short
  demonstrations in class.
•  Focus on good health behaviour, such as covering coughs and sneezes
  with the elbow and washing hands frequently.
•  Encourage children to sing while washing hands to practice the
  recommended 20 seconds duration.
•  Consider using puppets or dolls to demonstrate symptoms (sneeze,
  coughing, fever) and what to do if they feel sick (i.e. their head hurts,
  their stomach hurts, they feel hot or extra tied).
•  Have children sit apart for each other; have them practise stretching
  their arms out; they should keep enough space to not touch their friends

Specific to the Nursery.

•  Clean clothes must be worn to work each day.
•  Staff members should wear an apron or smock which should be cleaned
  or changed between major activities, or when soiled (major activities
  include between feeds, cleaning the environment).
•  Smocks and aprons should be laundered according to the fabric
  recommendation.
•  When babies/infants are received by the Care giver, their clothing must
  be changed before placing him/her in their personal crib/cot.
•  Each baby must he held in a clean blanket.
•  There must be no sharing of blanket, rags, bibs, or any other personal
  item.
•  Changing tables must be disinfected after each child is changed. Hands
  must be washed and not sanitized after changing a diaper.
•  Used bottles must be washed and sanitized immediately after use.
•  Facemask and face shield must be worn by caregivers or teachers during
  activities which involves caregivers or teachers to be within 3 feet or less
  of a child for long period of time, for example, when feeding, bathing or
  changing diapers.
•  All soft toys must be removed from the centre.
•  No toys from home are allowed in the centre.
•  Ensure that all cribs/cots are placed six feet apart
•  Assign a crib/cot to each child. This crib/cot should not be used or
  shared by any other child while the child is still registered with the
  centre.
•  If nap time is done on the floor, all mats should be placed a minimum of
  3 feet apart.
•  Children should be placed to sleep alternately head to toe
•  Sanitize objects and surfaces that are frequently touched during the day.
•  All cribs must be cleaned & disinfected before and at the end of each day.
•  Nurseries must have a working contact number for all parents and
  guardians.

                                            MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT
                                                                          (QUARANTINE AUTHORITY)
                                                                           QUARANTINE DIRECTIONS

Name:______________________________ Address:__________________________________
Passport: __________________________ Gender:___________________________________
Date of Arrival: _____________________ Nationality: ______________________________

Directions:

1. You have been assessed as a possible risk for the transmission of the Novel Coronavirus known as COVID19. The Chief Medical Officer of Antigua and Barbuda, who is the Quarantine Authority, in accordance with
the powers vested by section 6 of the Quarantine Act, Cap.361 and Quarantine Order No. 17 of 2020, has
directed that you be quarantined in your home or a designated facility for observation for fourteen days.

2. You are not allowed to leave your home or the designated facility during this period. Failure to comply with
these quarantine directions you will be liable on conviction to a fine of ten thousand dollars ($10,000.00) or
imprisonment for six (6) months or to both.

3. During your quarantine period, you will be in contact daily with an officer of the Quarantine Authority.

4. If you develop a fever, cough, shortness of breath or difficulty breathing you may require hospitalization and
must immediately contact the officer of the Quarantine Authority assigned to you.

I have read, understood and I am willing to comply with the instructions stated above.
______________________________                    _____________________________________
Name of Passenger                                                                 Signature of Passenger

__________________________________          ______________________________________
Name of Officer                                                                        Signature of Officer
For and on behalf of the Quarantine Authority

                                     MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT
                                             

                                              COVID-19 Guidance For Businesses and Employers
                                                                                  August 9 2020

Introduction
In January 2020 the World Health Organization (WHO) declared the outbreak of a new
coronavirus disease in Hubei Province, China to be a Public Health Emergency of International
Concern. Antigua and Barbuda saw its first case of COVID-19 in March 2020.

Getting your workplace ready for COVID-19

WHO and public health authorities around the world are taking action to contain the COVID-19
outbreak. All sections of our society, including businesses and employers, must play a role if we
are to stop the spread of this disease. This document outlines simple ways to prevent the spread
of the virus, things to consider when employees travel, and how to have your business operate
safely during a COVID-19 outbreak.

How COVID-19 spreads
When someone who has COVID-19 coughs or exhales they release droplets of infected fluid.
Most of these droplets fall on nearby surfaces and objects – such as desks, tables or telephones.
People could catch COVID-19 by touching contaminated surfaces or objects – and then touching
their eyes, nose or mouth. If they are standing within one meter of a person with COVID-19 they
can catch it by breathing in droplets coughed out or exhaled by them.

Most persons infected with COVID-19 experience mild symptoms and recover. However, some
go on to experience more serious illness and may require hospital care. Risk of serious illness
rises with age: people over 40 seem to be more vulnerable than those under 40. People with
weakened immune systems and people with conditions such as diabetes, heart and lung disease
are also more vulnerable to serious illness.

Simple ways to prevent the spread of COVID-19 in your workplace

The low-cost measures below will help prevent the spread of infections in your workplace and
protect your customers, contractors and employees.

You can reduce working days lost due to illness and stop or slow the spread of COVID-19 if it
arrives at one of your workplaces.

• Make sure your workplaces are clean and hygienic
o Avoid unnecessary touching of surfaces and areas.

                 o Surfaces (e.g. desks and tables) and objects (e.g. telephones, keyboards) need to
be wiped with disinfectants regularly because contaminated surfaces touched by
employees and customers is one of the main ways that COVID-19 spreads.

• Promote regular and thorough hand-washing by employees, contractors and customers.

o Ensure that staff, contractors and customers have access to places where they can
wash their hands with soap and running water because proper hand-washing kills
the virus on your hands and prevents the spread of COVID-19.

               o Place sanitizing hand rub dispensers in prominent places around the workplace.
Make sure these dispensers are regularly refilled.

               o Display posters promoting and demonstrating hand-washing should be
conspicuously placed in areas designated for hand-washing.

               o Combine this with other communication measures such as offering guidance from
occupational health and safety officers, briefings at meetings and information on
the internet to promote hand-washing.

              o Dry hands thoroughly with single-use paper towels or napkins and then properly
dispose of them in a covered bin.

              o Hands can also be dried using hot air if such machines are available.

• Promote good respiratory hygiene in the workplace because good respiratory hygiene
prevents the spread of COVID-19

           o Display posters promoting respiratory hygiene. Combine this with other
communication measures such as offering guidance from occupational health and
safety officers, briefing at meetings and information on the intranet etc.

o Ensure that paper tissues are available at your workplaces, for those who develop
a runny nose or cough at work, along with closed bins for hygienically disposing
of them.
o Ensure that all workers, contractors and customers wear face masks at all times.

• Ensure that there is enough space for social and physical distancing for all workers,
contractors and customers.

• Advise employees and contractors to consult national travel advisories before going on
business trips and vacations.

Things to consider when you and your employees travel
• Before traveling

                o Make sure your organization and its employees have the latest information on

                    areas where COVID-19 is spreading. You can find this at
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situationreports/.

                o Based on the latest information, your organization should assess the benefits and
risks related to upcoming travel plans.

                o Avoid sending employees who may be at higher risk of serious illness (e.g. older
employees and those with medical conditions such as diabetes, heart and lung
disease) to areas where COVID-19 is spreading.

                o Make sure all persons travelling to locations reporting COVID-19 are briefed by a
qualified professional (e.g. staff health services, health care provider or the
Ministry of Health Wellness and the Environment)

               o Consider issuing employees who are about to travel with small bottles (under 100
CL) of alcohol-based hand rub.

• While traveling:
o Encourage employees to wash their hands regularly and stay at least one meter
away from people who are coughing or sneezing

             o Ensure employees know what to do and who to contact if they feel ill while
traveling.

             o Ensure that your employees comply with instructions from local authorities where
they are traveling. If, for example, they are told by local authorities not to go
somewhere they should comply with this. Your employees should comply with
any local restrictions on travel, movement or large gatherings.

• When you or your employees return from traveling:

            o Employees who have returned from an area where COVID-19 is spreading should
monitor themselves for symptoms for 14 days and take their temperature twice a
day.

            o If they develop even a mild cough or low grade fever (i.e. a temperature of 37.3 C
or more) they should stay at home and self-isolate. This means avoiding close
contact (one meter or nearer) with other people, including family members. They
should also telephone their healthcare provider or the Ministry of Health Wellness
and the Environment, giving us details of their recent travel and symptoms.

• Implement a plan of what to do if someone becomes ill with suspected COVID-19 at one
of your workplaces.

              o The plan should cover putting the ill person in a room or area where they are
isolated from others in the workplace, limiting the number of people who have
contact with the sick person and contacting a health care provider, the Ministry of
Health Wellness and the Environment or the Emergency Medical Services.

             o Consider how to identify persons who may be at risk, and support them, without
inviting stigma and discrimination into your workplace. This could include
persons who have recently travelled to an area reporting cases, or other personnel
who have conditions that put them at higher risk of serious illness (e.g. diabetes,
heart and lung disease, older age).

• Consider promoting regular teleworking across your organization. Teleworking will help
your business keep operating while your employees stay safe.

• Develop a contingency and business continuity plan for an outbreak in the communities
where your business operates.

             o The plan will help prepare your organization for the possibility of an outbreak of
COVID19 in its workplaces or community. It may also be valid for other health
emergencies.

            o The plan should address how to keep your business running even if a significant
number of employees, contractors and suppliers cannot come to your place of
business – either due to local restrictions on travel or because they are ill.

            o Communicate to your employees and contractors about the plan and make sure
they are aware of what they need to do – or not do – under the plan. Emphasize
key points such as the importance of staying away from work even if they have
only mild symptoms or have had to take simple medications (e.g. paracetamol,
ibuprofen) which may mask the symptoms.

             o Be sure your plan addresses the mental health and social consequences of a case
of COVID-19 in the workplace or in the community and offer information and
support.

             o For small and medium-sized businesses without in-house staff health and welfare
support, develop partnerships and plans with your local health and social service
providers in advance of any emergency.

Remember:
Simple precautions and planning can make a big difference in managing COVID-19 in
your business. Action now will help protect your employees and your business.

MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT
Protocol for Safe Entry Into Antigua and Barbuda
August 1 2020

Introduction

This document provides information for persons entering Antigua and Barbuda through the
V.C. Bird International Airport (VCBIA) during the COVID-19 pandemic.

This information follows the Travel Advisory issued by the Ministry of Foreign Affairs on July
2 2020 and is subject to change as new information becomes available. It has been
developed in conjunction with Antigua and Barbuda’s national legislation, regulations and
policies.

This document supplements previously issued documents and guidelines for the operations
at Ports of Entry in Antigua and Barbuda including the V.C. Bird International Airport.

Purpose of this Protocol
The purpose of this protocol is to provide relevant persons, agencies and institutions with
information on the requirements needed when entering Antigua and Barbuda during the
CIVID-19 pandemic. It explains and outlines the public health measures that have been
implemented to reduce the risk of the introduction of COVID-19 into Antigua and Barbuda.

Coronavirus Disease 2019 (COVID-19)
Coronavirus Disease 2019 (COVID-19) is caused by a coronavirus called SARS CoV-2. A
symptomatic COVID-19 case is a person who has developed signs and symptoms suggestive
of COVID-19. Common signs of infection include respiratory symptoms, fever, cough,
shortness of breath and breathing difficulties.

COVID-19 prevention measures include regular and thorough hand hygiene, social
distancing, avoiding touching eyes, nose, and mouth, and good respiratory hygiene. In
public areas, cleaning and disinfecting frequently touched objects and surfaces can help
reduce the risk of infection.

COVID-19 in Antigua and Barbuda
Antigua and Barbuda’s outbreak of COVID-19 began in March 2020. The government of
Antigua and Barbuda implemented several measures to control the outbreak. Some of these
including the state of emergency, the mandatory wearing of face masks, social and physical
distancing remain in place.

Specific Requirements for Persons Entering Antigua and Barbuda at the VCBIA.

While in Antigua and Barbuda all persons must obey all rules, regulations, procedures and
public health measures for COVID-19 including the following:
• wear a face mask;
• practice social and physical distancing;
• practice proper respiratory (cough and sneeze) etiquette;
• sanitize their hands at sanitization stations.

Travelers must obey and follow all instructions of port health staff and officials.

All persons entering Antigua and Barbuda through the V.C. Bird International Airport will be
subject to a maximum of 14 days quarantine/surveillance/observation as outlined in the
Guidelines and Directions of the Quarantine Authority.

If persons will be in Antigua and Barbuda for less than 14 days, they will be subject to
quarantine/surveillance/observation as outlined in the Guidelines and Directions of the
Quarantine Authority for the duration of their stay.

Prior to Arrival

As outlined in the latest Travel Advisory from the Ministry of Foreign Affairs, all travelers to
Antigua and Barbuda must present a negative COVID-19 RT RNA PCR (real time polymerase
chain reaction) test upon entry. The test must have been taken at least seven days prior to
travel. Travelers must also complete a health screening questionnaire (Attachment I) that
will be reviewed by Port Health staff on arrival.

Persons who do not present a negative COVID-19 RT RNA PCR test should not be allowed to
board the aircraft.

On Arrival
All travelers must:
• wear a face mask
• practice social and physical distancing;
• have their temperature taken by thermal scanning, infrared thermometer or
any other method deemed appropriate by Port Health staff;

1 Children less than 12 years of age are exempt from a negative RNA RT PCR COVID-19 test prior to arrival
2 Children less than 2 years of age are exempt from wearing a face mask

• practice proper cough and sneeze etiquette.

Persons will also be observed for respiratory symptoms (coughing, sneezing and shortness
of breath) and fever. Persons displaying these symptoms or who look ill will be further
questioned and may be examined. They may also be required to take a COVID-19 test at the
airport and may be placed in isolation.

If passengers arrive in Antigua and Barbuda without a negative COVID-19 RT RNA PCR test
as outlined in the travel advisory they:

• will be subjected to screening and temperature checks upon arrival;
• may be repatriated to their country of origin;
• may be tested for COVID-19 based on a risk assessment (results can take up to 72-96
hours);
• may be placed in a government quarantine facility for a maximum of 14 days and;
• will be under surveillance/observation or quarantine for a maximum of 14 days.

Persons who arrive in Antigua and Barbuda with a negative COVID-19 RT RNA PCR test upon
arrival:

• will be subjected to screening and temperature checks upon arrival;
• may be able to proceed quickly to immigration, customs and onto their hotel,
guesthouse, government quarantine facility or home;
• will be under surveillance/observation or quarantine for a maximum of 14 days.

In the event that a person presents with a positive COVID-19 test or tests positive for
COVID-19 at the VCBIA, they will immediately be placed in isolation. They will be kept in
isolation for at least 14 days. Release from isolation will be based on national guidelines.

Note: The Ministry of Health Wellness and the Environment reserves the right to vary this
protocol as deemed necessary in order to ensure the health and safety of all travelers and
residents. This protocol will be updated regularly and as new information becomes
available and all updates will be provided accordingly.

APPENDIX I

MINISTRY OF HEALTH, WELLNESS AND THE ENVIRONMENT
                                    HEALTH SCREENING QUESTIONNAIRE
(to be completed by all adult passengers prior to disembarkation)

Airline: _______________________ Flight No.: _________
Name as shown in the passport: _____________________________________________
Date of Birth: ________________ Age (at last birthday): _________
Email address:______________________Contact number: _______________________
Address (overseas): _______________________________________________________
Intended address in Antigua:________________________________________________
Names and date of birth of all children travelling with you under 18 years old:
___________________________ ___________________________________
___________________________ ___________________________________
Within the past 14 days have you, or any person listed above:
1. Been diagnosed with Coronavirus disease (COVID-19)? □ Yes □ No
2. Had close contact with anyone diagnosed COVID-19? □ Yes □ No
3. Provided direct care for COVID-19 patients? □ Yes □ No
4. Visited any patient having COVID-19? □ Yes □ No
5. Worked/stayed in a closed environment with a COVID-19 patient? □ Yes □ No
6. Lived in the same household as a COVID-19 patient? □ Yes □ No
7. Experienced any of the following symptoms (check all reported symptoms):
□ Fever/chills □ Cough □ Sore throat
□ Runny nose □ Shortness of breath
Any person who answers yes to any of these questions or have any of the above symptoms will be placed
in quarantine or isolation for up to 14 days.
I, __________________________, hereby declare that the above information is correct.

…………………………                        …………………………….
Signature                                         Date

MINISTRY OF HEALTH WELLNESS AND THE ENVIRONMENT

Guidance on Coronavirus Disease (COVID- 19) for Hotels and Guesthouses in

Antigua and Barbuda

August 9, 2020

Introduction

This document provides information on the COVID-19 for hotels and guesthouses in Antigua and Barbuda.

This information is based on currently available scientific evidence and expert opinion and is subject to change as new information becomes available. It should be used in conjunction with Antigua and Barbuda’s national legislation, regulations and policies. This guidance document will be updated as more information becomes available.

Background

There is an outbreak of pneumonia globally, caused by a new coronavirus, which is a family of viruses that includes the common cold, named COVID-19. Person-to-person spread is occurring in many cities globally, increasing the risk of international spread by travellers.

Travellers from affected countries to Antigua and Barbuda will be asked questions about their health and travel history upon arrival. They may also be subjected to entrance temperature screening, quarantine or isolation.

The Ministry of Health Wellness and the Environment (MOHWE) is working closely with its international health partners to respond to this health threat and provide timely advice and assistance to businesses, organizations, institution and the general public. On January 30, 2020 the WHO declared the outbreak a Public Health Emergency of International Concern (PHEIC). On March 11, 2020 the World Health Organization (WHO) described the COVID-19 situation as a pandemic. Antigua and Barbuda recorded its first case of COVID-19 in March 2020.

What is the COVID-19?

The Novel Coronavirus belongs to the same family of coronaviruses that causes the common cold, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Syndrome (MERS-CoV), 2012. This 2019 virus is a new strain of coronavirus that has not been previously identified in humans.

Common signs and symptoms of COVID-19

A person infected may have the following symptoms:

• Fever

• Cough

• Shortness of breath

• Breathing difficulties

• Other flu like symptoms

In more severe cases there can be

• pneumonia

• kidney failure

• death

How is COVID-19 transmitted or spread?

When someone who has COVID-19 coughs or exhales they release droplets of infected fluid. Most of these droplets fall on nearby surfaces and objects – such as desks, tables or telephones. People could catch COVID-19 by touching contaminated surfaces or objects – and then touching their eyes, nose or mouth. If they are standing within one meter of a person with COVID-19 they can catch it by breathing in droplets coughed out or exhaled by them. In other words, COVID-19 spreads in a similar way to flu. Most persons infected with COVID-19 experience mild symptoms and recover. However, some go on to experience more serious illness and may require hospital care. Risk of serious illness rises with age: people over 40 seem to be more vulnerable than those under 40. People with weakened immune systems and people with conditions such as diabetes, heart and lung disease are also more vulnerable to serious illness.

What can hotels and guesthouses do to prepare for COVID-19?

Hotels and guesthouses are places where travellers from all over the globe spend time. The risk of the introduction of a case of COVID-19 into a hotel or guesthouse in Antigua and Barbuda is very high. Therefore, the following special measures must be taken to be prepared.

1. Stay informed about the COVID-19 situation in Antigua and Barbuda. Updates will regularly be released by the MOHWE. Additionally, information can be found through the CARPHA, World Health Organization (WHO) WHO or United States Centers for Disease Control (US CDC) websites.

2. Reduce exposure to and transmission of COVID-19 and a range of illnesses are as follows:

• Frequently clean hands with soap and water and using alcohol-based hand rub

• When coughing and sneezing cover mouth and nose with flexed elbow or tissue; throw tissue away immediately and wash hands

• Avoid close contact with anyone who has fever and cough

• Persons who have a fever, cough and difficulty breathing should seek medical care early and share previous travel history with your health care provider

• Stay home when you are sick to avoid the chance of infecting other people

3.Provide staff with educational materials on COVID-19 so that they are aware of the signs and symptoms, where COVID-19 is spreading, and how it is transmitted.

4. Ensure that the services of a health care provider, preferably a physician, is available at all times to attend to guests and workers. It is advisable that a nurse be available on site to provide basic health care services and advice1. The Ministry of Health Wellness and the Environment’s COVID hotline (46COVID or 462-6843).

5. Ensure that designated health care providers know that they should to contact the MOHWE in the event that there is a suspected case at your hotel or guesthouse.

6. Ensure that staff are informed about procedures for reporting guests or other staff with symptoms and exposure history compatible with COVID-19 to the relevant health authorities in Antigua and Barbuda.

1 Please provide the MOHWE with the names and contact information of the designated health care provider(s).

7. Guests or staff suspected of having been exposed to COVID-19, who have symptoms AND exposure history consistent with the disease, should call your designated healthcare provider. Be sure to inform them that you suspect you were exposed to COVID-19 and ask if they can handle such patients or recommend a specific provider.

8. Procedures should be in place at your hotel/guesthouse for separating ill guests/staff from the rest of the hotel/guesthouse population and for minimizing the exposure of guests/staff to potentially contaminated environments while Public Health authorities are called.

9. Should a suspected case be identified in the hotel/guesthouse cleaning of the room or area should be done using regular household soap or detergent first and then, after rinsing, regular household disinfectant containing 0.5% sodium hypochlorite (that is, equivalent to 5000 ppm or 1 part to 9 parts water) should be applied. Personnel who do the cleaning should feel safe to clean the environment and therefore appropriate PPE (gloves, eye protection, a face mask, and protective gown) should be provided.

10. It is important to ensure that environmental cleaning and disinfection procedures are followed consistently and correctly. Thoroughly cleaning high-touch surfaces with water and detergent and applying commonly used disinfectants (such as bleach) are effective and sufficient procedures. Medical devices and equipment, laundry and food service utensils should be managed in accordance with safe routine procedures. Medical waste, particularly waste associated with a suspected case will be disposed of according to infectious disease waste procedures.

11. Used linen, cloths, eating utensils, laundry and any other item in contact with a patient’s body fluids should be collected separately and disinfected in such a way as to avoid any contact with persons or contamination of the environment. Surfaces or objects contaminated with blood, other body fluids, secretions or excretions should be cleaned and disinfected as soon as possible using disinfectant containing 0.5% sodium hypochlorite (that is, equivalent to 5000 ppm or 1 part to 9 parts water).

• Bag or otherwise contain contaminated textiles and fabrics at the point of use

• Handle contaminated textiles and fabrics with minimum agitation to avoid contamination of air, surfaces and person

• Use leak-resistant containment for textiles and fabrics contaminated with blood or body substances

• Identify bags or containers for contaminated textiles with labels, colour coding, or other alternative means of communication as appropriate

• Don’t use laundry chutes

• If hot-water laundry cycles are used, wash with detergent in water ³ 160°F (³ 71°C) for ³ 25 minutes.

12. Laundry, food service utensils, and medical waste not associated with a case should be managed in accordance with normal safe routine procedures.

13. Wear a disposable facemask, gown, and gloves when you touch or have contact with an infected person’s blood, body fluids and/or secretions, such as sweat, saliva, sputum, nasal mucus, vomit, urine, or diarrhoea.

• Throw out disposable facemasks, gowns, and gloves after using them. Do not reuse.

• Wash your hands immediately after removing your facemask, gown, and gloves.

For Further Information visit the following websites:

• Caribbean Public Health Agency at http://carpha.org/What-We-Do/PublicHealth/Novel-Coronavirus

• World Health Organization website for the 2019-Novel Corona Virus: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

• US CDC site for the 2019-Novel Corona Virus: https://www.cdc.gov/coronavirus/2019- ncov/index.html