Research In Action

I have recently corresponded with owners of driving schools seeking guidance on how to safely reopen as the country continues to cope with COVID-19. Working with my Children’s Hospital of Philadelphia (CHOP) colleague Susan E. Coffin, MD, MPH, an infectious disease/infection control expert, and the American Driver & Traffic Safety Education Association (ADTSEA), we developed the following guidelines in early June for driving schools to consider. Guidance continues to change with knowledge gained about the virus and with local data regarding the virus and its spread. For professional medical advice, driving schools should contact the Centers for Disease Control and Prevention (CDC), their local health department, or their primary care provider.

These guidelines are organized around three key principles:

1. Reducing exposure through time (minimizing time in contact) and space (keeping distance)
2. Given exposure or requirement to be in person, reducing risk of infection through barriers (e.g., masks) and hygiene (e.g., cleaning and excellent hand hygiene)
3. Given known infection exposure (student or teacher is COVID‐19 positive), getting appropriate care and reducing spread through self‐monitoring and exclusion if there is a known exposure within 14 days

It’s important to note: Because COVID‐19 can involve asymptomatic spread, we (sadly) need to treat anyone outside our immediate family/co‐habitants as a potential exposure at least while the virus is actively circulating in our community. Why is family not included? We know and share an exposure history with those who are close to us.

Reduce Exposure

 Instruction

• Provide initial and ongoing/regular training on COVID-19 safety, including reminders and feedback to instructors (regarding masking, reporting, cleaning, etc.) and instruction in self‐monitoring for symptoms and following the principles of self‐isolation in the event of an exposure
• Reduce the time the instructor spends in the vehicle with the student:
  • Do what you can to teach skills remotely (e.g., through tele-coaching)
  • Do what you can to assess skills prior to lessons to be sure that you optimize the use of the in‐vehicle time (e.g., assess through interviews or via virtual testing)
• Have shorter lessons to reduce the time the student and instructor are together in the vehicle

Vehicles

These recommendations are adapted from the CDC’s guidance on EMS vehicles:

• Schedule visits to allow for adequate time to clean the vehicles between students
• Thoroughly clean vehicle surfaces at the start of the day and after each student (including airing out vehicles to reduce any potential viral particles); be sure to clean all surfaces, including passenger and driver compartments, all controls, the dashboard, and all handles:
  • Follow routine cleaning and disinfection procedures (e.g., using cleaners and water) to pre‐clean surfaces prior to applying an EPA‐approved product.
  • Although not a hard virus to kill with standard cleaning and disinfection products, some driving schools may choose to use a product that is approved by the Environment Protection Agency (EPA) against emerging viral pathogens like SARS‐CoV‐2.
  • Clean and disinfect the vehicle in accordance with standard operating procedures for the vehicle and as directed on the clean products’ labels. Be sure to pay special attention to the contact time to achieve maximal kill.
  • Clean and disinfect all vehicle surfaces that may have come in contact with students and instructors directly or via respiratory droplets. This includes cleaning at least a 6-foot circumference around the seats unless a barrier has been erected between the front and back compartments. If so, clean the barrier.

 Students

• Screen all students for symptoms right before the lesson. Ask students and their parents/guardians if they have had an exposure to a known or suspected COVID-19 case in the past 14 days. If so, reschedule. 
• Require students to report to you if they develop COVID-19 (within two weeks after a lesson).

Instructors

• Screen instructors for symptoms or exposures each day before work. Ask them if they’ve had an exposure to a known or suspected COVID‐19 case in the past 14 days. If so, they need to self‐isolate according to the CDC guidelines.
• Require instructors to report to you if they develop COVID-19 (within two weeks after a lesson)
• Consider having instructors report to you any COVID‐19 symptoms and/or exposures to someone with COVID‐19

Reduce Risk of Infection

Given the requirement of the instructor being in the vehicle with the student, here’s how to reduce the chance of infection during in-vehicle instruction:

• Allow only one student at a time
• Require masking for both the instructor and student:
  • Consider getting transparent masks to avoid any additional harm due to reduced visibility
  • Make sure there is no obstruction to breathing
  • No N95 masks: Cloth or surgical masks should be fine
• Maintain proper distancing:
  • No shaking of hands
  • No sharing of pens; use electronic payment and electronic sharing of information
  • Keep at least 6-feet of distance between the instructor and the student and continue to wear masks (both instructor and student) when giving pre‐ or after‐instruction feedback
    • Unfortunately, with the instructor in the front passenger seat, it may not be possible to maintain proper distancing. This is why reducing in-vehicle instruction time is important.

Reduce the Spread

• Contact the Health Department about a known exposure and have the instructor or student contact their primary care provider

I hope these guidelines are helpful to enable driving schools to reopen safely. Please keep in mind that these recommendations do not reflect specific, medical/professional guidance for a specific school and may change over time. This is our best guidance on June 23, 2020. For guidance for a specific school, please contact your local health department and check back over time to be sure that the guidance is current.

Thank you for keeping young drivers safe. Training is crucial to ensure that everyone is safe on the roads.