OBJECTIVES: With layered mitigation strategies, there are low rates of secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); therefore, quarantine following close contact exposure to SARS-CoV-2 in the kindergarten through 12th grade (K–12) setting further disrupts in-person learning with uncertain benefit. We explored the impact of eliminating quarantine for students with mask-on-mask exposures to coronavirus 2019 (COVID-19) on associated secondary transmission in schools.

METHODS: This observational study was conducted in a large K–12 public school district in Omaha, Nebraska (08/01/2020–03/15/2021). We assessed primary and secondary COVID-19 infections in teachers and staff, frequency of quarantine for students and staff, and the impact of eliminating quarantine on secondary transmission in mask-on-mask exposure settings.

RESULTS: 18,632–19,604 students and 2855 staff attended in-person learning; 1856 primary infections were among students and staff. Despite 3947 student quarantines in the fall and 1689 student quarantines in the first 10 weeks of spring semester instruction, there were only two cases of secondary transmission. A local policy change removed quarantine requirements for students with mask-on-mask exposure to COVID-19 cases. Required quarantines in the spring semester reduced by 41% per primary infection compared to the fall; no student who qualified to avoid quarantine developed a secondary infection.

CONCLUSIONS: School-based COVID-19 transmission was exceptionally low in this large K–12 Nebraska school district. Elimination of student quarantine following masked exposure to COVID-19 within school was not associated with secondary transmission. Unnecessary quarantine elimination may help maximize in-person learning in the 2021–2022 school year.

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