Guidance for K-12 School Administrators on the Use of Cloth Face Coverings in Schools

Updated Aug. 11, 2020

CDC suggests that all school reopening plans address adherence to behaviors that prevent the spread of COVID-19. When used consistently and correctly, along with important mitigation strategies, cloth face coverings are important to help slow the spread of COVID-19. Other important mitigation strategies include social distancing, washing hands, and regular cleaning and disinfecting frequently touched surfaces in schools and buses. CDC provides considerations for wearing cloth face coverings and recommends that people wear cloth face coverings in public settings and when around people who live outside of their household. The use of cloth face coverings is especially important when social distancing is difficult to maintain.

Cloth face coverings are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the cloth face covering coughs, sneezes, talks, or raises their voice. Cloth face coverings are an example of source control. Several studies^1-13 have documented asymptomatic and pre-symptomatic SARS-CoV-2 transmission; meaning that people with COVID-19 who never develop symptoms (asymptomatic) and those who are not yet showing symptoms (pre-symptomatic) can still transmit the virus to other people. Cloth face coverings are meant to protect other people in case the wearer is unknowingly infected. Cloth face coverings are not personal protective equipment, such as surgical masks or respirators.

The use of cloth face coverings in educational settings may present challenges, particularly for younger students and students with special healthcare or educational needs. This document provides guidance to help school administrators decide how to best implement the wearing of cloth face coverings ― in their school settings and facilities, including but not limited to buses and other shared transportation.

Education and promotion of positive and supportive relationships should remain the primary focus of school administrators, teachers, and staff. This guidance provides K-12 school administrators with strategies to encourage students to wear face coverings, consistent with CDC guidance, while maintaining a positive learning environment.

General Considerations

COVID-19 can be spread to others even if you do not feel sick. A cloth face covering helps prevent a person who is sick from spreading the virus to others. Appropriate and consistent use of cloth face coverings is most important when students, teachers, and staff are indoors and when social distancing of at least 6 feet is difficult to implement or maintain.

Cloth face coverings should not be placed on:

Children younger than 2 years old.
Anyone who has trouble breathing or is unconscious.
Anyone who is incapacitated or otherwise unable to remove the cloth face covering without assistance.

Appropriate and consistent use of cloth face coverings may be challenging for some students, teachers, and staff, including:

Younger students, such as those in early elementary school.
Students, teachers, and staff with severe asthma or other breathing difficulties.
Students, teachers, and staff with special educational or healthcare needs, including intellectual and developmental disabilities, mental health conditions, and sensory concerns or tactile sensitivity.

While cloth face coverings are strongly encouraged to reduce the spread of COVID-19, CDC recognizes there are specific instances when wearing a cloth face covering may not be feasible. In these instances, parents, guardians, caregivers, teachers, and school administrators should consider adaptations and alternatives whenever possible. They may need to consult with healthcare providers for advice about wearing cloth face coverings.

Consider use of clear face coverings that cover the nose and wrap securely around the face by some teachers and staff. Clear face coverings should be determined not to cause any breathing difficulties or over heating for the wearer. Teachers and staff who may consider using clear face coverings include:

Those who interact with students or staff who are deaf or hard of hearing, per the Individuals with Disabilities Education Actexternal icon
Teachers of young students learning to read
Teachers of students in English as a second language classes
Teachers of students with disabilities

Clear face coverings are not face shields. CDC does not recommend use of face shields for normal everyday activities or as a substitute for cloth face coverings because of a lack of evidence of their effectiveness for source control.

Unintended Consequences

Stigma, discrimination, or bullying may arise due to wearing or not wearing a cloth face covering. Schools should have a plan to prevent and address harmful or inappropriate behavior.
Not all families will agree with school policies about cloth face coverings. Schools should have a plan to address challenges that may arise and refer parents, caregivers, and guardians to CDC’s guidance on cloth face coverings.

Practical Recommendations

Include cloth face coverings on school supply lists and provide cloth face coverings as needed to students, teachers, staff, or visitors who do not have them available.
Include clear face coverings on school supply lists for teachers and staff who regularly interact with students who are deaf or hard of hearing, students learning to read, students with disabilities, and those who rely on lip reading as a part of learning, such as students who are English Language Learners.
Ensure that students and staff are aware of the correct use of cloth face coverings, including wearing cloth face coverings over the nose and mouth and securely around the face.
Ensure that students, teachers and staff are aware that they should wash or sanitize their hands (using a hand sanitizer that contains at least 60% alcohol) before putting on a cloth face covering.
Ensure that students, teachers, and staff are aware that they should not touch their cloth face coverings while wearing them and, if they do, they should wash their hands before and after with soap and water or sanitize hands (using a hand sanitizer that contains at least 60% alcohol).
Ensure teachers and staff are aware that they should wash or sanitize hands (using a hand sanitizer that contains at least 60% alcohol) before and after helping a student put on or adjust a cloth face covering.
Ensure that all students and staff are aware that cloth face coverings should not be worn if they are wet. A wet cloth face covering may make it difficult to breathe.
Ensure that all students and staff are aware that they should never share or swap cloth face coverings.
Students’ cloth face coverings should be clearly identified with their names or initials, to avoid confusion or swapping. Students’ face coverings may also be labeled to indicate top/bottom and front/back.
Cloth face coverings should be stored in a space designated for each student that is separate from others when not being worn (e.g., in individually labeled containers or bags, personal lockers, or cubbies).
Cloth face coverings should be washed after every day of use and/or before being used again, or if visibly soiled.
Students and schools should consider having additional cloth face coverings available for students, teachers, and staff in case a back-up cloth face covering is needed during the day and to facilitate every day washing of cloth face coverings.

Additional Considerations for the Use of Cloth Face Coverings among K-12 Students

CDC recommends that people, including teachers, staff, and students, wear cloth face coverings in public settings as able when around people who live outside of their household, especially when other social distancing measures are difficult to maintain.

The following table contains examples of some, but not all, situations schools might encounter.

Cloth face coverings in schoolspdf icon

Additional Considerations for the Use of Cloth Face Coverings among K-12 Students
Possible Student Scenario	Cloth face coverings recommended	Cloth face coverings may be considered	Additional considerations
Students are seated less than 6 feet apart while riding a bus or carpooling	check solid icon		Cloth face coverings should always be worn by bus and carpool drivers as able*
Students are less than 6 feet apart while entering or exiting school (e.g., carpool drop off/pick up) or while transitioning to/from other activities	check solid icon		Consider having staff monitor students during transitions to encourage correct use and distribute cloth face coverings as needed. Teachers and staff should wash or sanitize hands (using a hand sanitizer that contains at least 60% alcohol) before and after helping a student put on or adjust a cloth face covering.
Students are seated at least 6 feet apart in the classroom		check solid icon	Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading.
Students are seated less than 6 feet apart in the classroom, or are engaging in learning stations or circle time that require close contact	check solid icon		Schools may consider keeping students in “cohorts.” Cohorts are groups of students that do not mix with other cohorts/groups of students throughout the school day. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading.
Students are less than 6 feet apart while transitioning between classes or to other activities during the school day	check solid icon		Schools may consider staggering classroom transition times and allow only one-way pathways/hallways. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading.
Students are at recess or in physical education class.		check solid icon	Vigorous exercise in a confined space (e.g., indoors) may contribute to transmission of COVID-19 and should be limited. Social distancing helps protect students at recess or in physical education class. Consider conducting activities in an area with greater ventilation or air exchange (e.g., outdoors). See CDC’s guidance on youth sports for more information. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading.
Students are in band, choir, or music class.		check solid icon	When students are not singing or playing an instrument that requires the use of their mouth, they should wear a cloth face covering in music class (unless class is outdoors and distance can be maintained). Social distancing helps protect students in music class. While students are singing or playing an instrument, use visual cues to keep them at least 6 feet apart. If it’s safe and weather permits, consider moving class outdoors where air circulation is better than indoors and maintain at least 6 feet distance between students.
Students are at least 6 feet apart during mealtimes in a common area.		check solid icon	Cloth face coverings are recommended when transitioning to and from mealtimes if outside of the classroom. Schools may be able to stagger mealtimes to ensure 6 feet distance between students in a cafeteria or lunchroom. Schools can serve meals in classrooms if students are able to maintain 6 feet of distance between one another in the classroom. Consider allowing students to eat meals outside, if weather permits.
Students participating in an assembly or event that requires close contact.	check solid icon		Large assemblies of students should be discontinued, unless necessary. When necessary, consider having the assemblies outdoors, plan for social distancing, and encourage use of cloth face coverings according to CDC guidance. Cloth face coverings should be worn by teachers and staff at all times* and are especially important at times when social distancing is difficult to maintain.
Student has severe asthma or breathing problems.		check solid icon	Cloth face coverings should NOT be worn by children under the age of 2 or anyone who has trouble breathing, is unconscious, incapacitated, or otherwise unable to remove the cloth face covering without assistance. Administrators and/or teachers should consult with parents, caregivers, or guardians about strategies to protect these students and those around them. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading.
Student is deaf or hard of hearing, or relies on lip reading to communicate.		check solid icon	Clear face coverings may be considered for teachers or staff who interact with students who are deaf and hard of hearing. Face shields are not considered clear face coverings. It is not known if face shields provide any benefit as source control to protect others from the spray of respiratory particles. CDC does not recommend use of face shields for normal everyday activities or as a substitute for cloth face coverings. Some people may choose to use a face shield when sustained close contact with other people is expected. If face shields are used without a mask, they should wrap around the sides of the wearer’s face and extend to below the chin.
Student has a disability, childhood mental health conditions, sensory concern/tactile sensitivity.	check solid icon		Administrators and/or teachers should consult with parents, caregivers, or guardians about strategies to protect these students and those around them. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading.
Student is receiving one-on-one services or instruction.	check solid icon		Students and service providers should wear a face covering as much as possible during service delivery.* Administrators and/or teachers should consult with parents, caregivers, or guardians about strategies to protect these students and those around them. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading. Cloth face coverings should be worn by teachers and staff at all times* and are especially important at times when social distancing is difficult to maintain. Students and service providers may need additional protective equipment depending on the individual characteristics of the student. See CDC’s Guidance for Direct Service Providers for additional information.

* CDC recognizes that wearing cloth face coverings may not be possible in every situation or for some people. In some situations, wearing a cloth face covering may exacerbate a physical or mental health condition, lead to a medical emergency, or introduce significant safety concerns. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a cloth face covering or to reduce the risk of COVID-19 spreading if it is not possible to wear one. Learn more.

Strategies to Support Students’ Wearing Cloth Face Coverings in Schools

All Students

Encourage parents, caregivers, and guardians to practice wearing cloth face coverings with students at home before the first day of school. If parents, caregivers, and guardians model appropriate use of face coverings and help students get used to wearing them, students may be more comfortable using them.
Introduce students with sensory concerns/tactile sensitivities to face coverings with a variety of materials, prints, and textures, and allow them to choose which face covering is most comfortable.
Use behavioral techniques such as positive reinforcement to increase the likelihood that students will comply with face covering guidance and other prevention practices.
Encourage parents, caregivers, and guardians to include students in the selection of their cloth face covering and/or the material that is used to make it. This might increase a child’s acceptance of wearing the cloth face covering.
Display age appropriate posters and materials with visual cues that show the proper way to wear a face covering in classrooms and hallways. Consider incorporating images of popular influencers promoting or modeling use of cloth face coverings.
Include reminders about face coverings in daily announcements, school newspapers, and other materials. All communication should be in an appropriate format, literacy level, and language. Consider including how to properly use, take off, and wash cloth face coverings in back-to-school communications educational materials.

Elementary School Settings

Ensure that teachers and school staff are available to help students put on and adjust face coverings as needed and that teachers and staff wash or sanitize their hands with hand sanitizer that includes at least 60% alcohol before and after doing so.
Play games or engage in other fun activities that teach students how to wear a face covering.
Consider using some art materials or other creative outlets to help students understand why face coverings help reduce the spread of COVID-19.
Share social stories about face coverings with students so they know what to expect at school. A social story is similar to a simple picture book that teaches students what to expect in social settings.
Use behavioral techniques, such as positive reinforcement, to increase the likelihood that students will comply with face covering guidance.

Middle School Settings

Show short videos or incorporate short lessons (less than 10 minutes) that teach students how to wear a face covering. Consider including videos with celebrities, musicians, athletes or other influencers popular among this age group.
Follow videos with verbal instructions that demonstrate the correct ways to wear a face covering.
Engage the class in discussions about why face coverings help reduce the spread of COVID-19.
Incorporate a lesson into the science curriculum on how respiratory droplets spread infectious disease.
Create a school competition for the best health communication strategy to highlight the importance of wearing a cloth face covering to middle school students.

High School Settings

Show videos or incorporate lessons that teach students how to wear a face covering, including the correct and incorrect ways to wear a face covering. Consider including videos with celebrities, musicians, athletes, or other influencers popular among this age group.
Ask students to write a short paper on the science behind the use of cloth face coverings as a form of source control.
Create a school competition for the best health communication strategy to highlight the importance of wearing cloth face coverings to high school students.

Students with Special Healthcare Needs

Ask parents, caregivers, and guardians to practice wearing face coverings at home before the student returns to school.
Share social stories about face coverings with students so they know what to expect at school. A social story is similar to a simple picture book that teaches students about what to expect in social settings.
Introduce students with sensory concerns or tactile sensitivities to face coverings with a variety of materials, prints, and textures, and allow them to choose which face covering is most comfortable.
Use behavioral techniques such as positive reinforcement to increase the likelihood that students will comply with face covering guidance and other prevention practices.

References

Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Students. N Engl J Med 2020;382:1663-5.
Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020;395:514-23.
Wang Y, Liu Y, Liu L, Wang X, Luo N, Ling L. Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China. J Infect Dis
Pan X, Chen D, Xia Y, et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. Lancet Infect Dis 2020;20:410-1.
Bai Y, Yao L, Wei T, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA 2020; 323(14):1406-1407.
Kam KQ, Yung CF, Cui L, et al. A Well Infant with Coronavirus Disease 2019 (COVID-19) with High Viral Load. Clin Infect Dis
McMichael TM, Clark S, Pogosjans S, et al. COVID-19 in a Long-Term Care Facility – King County, Washington, February 27-March 9, 2020. MMWR Morb Mortal Wkly Rep 2020;69:339-42.
Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility – King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep 2020;69:377-81.
Roxby AC, Greninger AL, Hatfield KM, et al. Detection of SARS-CoV-2 Among Residents and Staff Members of an Independent and Assisted Living Community for Older Adults – Seattle, Washington, 2020. MMWR Morb Mortal Wkly Rep 2020;69:416-8.
Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020;25.
Hoehl S, Rabenau H, Berger A, et al. Evidence of SARS-CoV-2 Infection in Returning Travelers from Wuhan, China. N Engl J Med 2020;382:1278-80.
Wei WE, Li Z, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 – Singapore, January 23-March 16, 2020. MMWR Morb Mortal Wkly Rep 2020;69:411-5.
Tong ZD, Tang A, Li KF, et al. Potential Presymptomatic Transmission of SARS-CoV-2, Zhejiang Province, China, 2020. Emerg Infect Dis 2020;26:1052-4.

Last Updated Aug. 11, 2020

Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases