Parents, teachers, pediatricians and local government officials across the country are facing a dilemma: How do we keep schools safe in the midst of the coronavirus disease 2019 (COVID-19) pandemic? Should children return to classrooms?
Unfortunately, even health experts don’t have answers to this dilemma, but they have provided guidance.
Children learn best in person, and returning to in-person school should be the goal, but local health officials need to be consulted about the safety of opening individual schools, according to the American Academy of Pediatrics.
“We know that the school environment provides more than academic instruction about math, science or English,” says Stephanie D. Davis, MD, physician-in-chief at N.C. Children’s Hospital and chair of the Department of Pediatrics at the UNC School of Medicine.
This includes social development, free or reduced meals for children who are food insecure, access to the internet, mental health support, and other vital services such as physical, occupational and speech therapy.
Nationwide, about 20 percent of children are living in poverty and don’t have access to the resources they need for online schooling, and 30 million children rely on school programs for food, Dr. Davis says.
Another potential plus for in-person schooling? So far, experts think that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from COVID-19 infection.
“It currently appears that younger children may be less likely than teenagers or adults to become infected and to spread infection,” says UNC Health pulmonologist Terry Noah, MD. “But new data about COVID-19 emerges daily, so this is a fluid situation that prevents us from being too specific.”
That said, opening schools in areas with high community spread still potentially threatens the health of students, as well as the health of teachers and staff who work at schools. Not every parent will be willing to accept the risks of in-person schooling, and many school systems are planning remote or hybrid schedules.
“Remote learning can be done effectively if there is a parent or caregiver who can take care of the child and assist with online learning,” says UNC Health pediatrician Elizabeth Blyth, MD. “If you have access to the internet and food and don’t need the services physically provided at school, remote learning can work.”
Questions to Answer Before Sending Your Child Back to School
- How widespread is the COVID-19 outbreak in your community? Are the infection rates and hospitalizations rising? If so, can your family and school become flexible with plans for in-person versus remote learning?
There is evidence from other countries that reopening schools can increase the spread of the virus. If schools open with a high incidence of COVID-19 in the community, children and teachers are more likely to carry the virus into schools.
“If you have an increased rate right now, that’s a problem,” says UNC Health pediatric infectious diseases specialist Thomas H. Belhorn, MD, PhD.
- Does does anybody in your house have a risk factor for COVID-19? This group includes people older than 65 and anyone with a serious underlying medical condition, such as diabetes or heart disease.
The Centers for Disease Control and Prevention advises that children who are medically complex, who have neurologic, genetic or metabolic conditions, or who have congenital heart disease are at higher risk of severe illness from COVID-19 than other children, Dr. Noah says. “Decisions about school for individual children who fall into these risk groups should be made in consultation with their doctors.”
- What safety precautions and plans does your child’s school have in place?
“Find out what the structure of the classroom will be. Will all the children come back at once, or will there be a staggered schedule?” says Emily Sickbert-Bennett, PhD, director of UNC Medical Center Infection Prevention. “It would be a safer environment to have fewer kids in the classroom together.”
Classrooms should be set up to keep students at least 3 feet apart.
“Three feet apart can have similar benefits to being 6 feet apart, and 3 feet is more likely to be possible than 6 feet apart,” Dr. Blyth says. “If possible, children in elementary and middle schools should stay in the classroom while teachers rotate, to reduce the number of people everyone is exposed to.”
Also, schools should have plans in place to discourage groups of children from congregating. This can be accomplished with measures such as avoiding locker use and taping directional arrows in hallways to reduce traffic flow, Dr. Blyth says.
How to Send Your Child to School Safely
“Depending on the age of the child, more practice might be necessary,” Dr. Sickbert-Bennett says. “Find a mask that’s comfortable, easy for them to put on and take off, and get them used to that feeling so they are able to wear a mask while in the classroom.”
Dr. Blyth says to make sure your child understands that the mask should cover the mouth and nose and how to take it off using the ear loops.
“I personally like the pleated face masks because they can cover a wider range of face shapes and sizes,” Dr. Blyth says. “Many masks have an adjustable piece at the ears, which I think is particularly helpful for children because masks and children are not one-size-fits-all.”
Encourage frequent hand-washing now, so it is a habit by the time your child goes back to school.
“Make sure they have good hand hygiene when they arrive to school—especially washing hands before they eat and after going to the bathroom,” Dr. Sickbert-Bennett says.
If possible, avoid having your child ride the bus, Dr. Blyth says.
“It is going to be hard to be distanced from other children on the bus,” she says. “There are children who have no other mode of transportation to school, so those kids really need to be on the bus,” but the fewer riders, the better.
Don’t be afraid to continue to ask how your child’s school is keeping spaces clean and disinfected—another area in which you can start training early.
“Kids can be pretty good at cleaning, so parents could start teaching their kids this summer,” Dr. Sickbert-Bennett says. “Get out cleaners and teach them to clean their space. That’s something that could help the teachers if kids wipe down their desk and their workspace at the beginning and end of each day.”
Do not send your child to school if he or she is sick, especially with signs of COVID-19. And make sure your school regularly screens all children and staff for COVID-19 and has a plan for what it will do if a child or teacher gets it.
“What’s the plan if someone tests positive? Do they have arrangements for testing, which ideally should come back quickly for contact investigation?” Dr. Belhorn says. “Their plan needs to be transparent. They may not have all the details, but you want to be sure they’re thinking about what will help decrease transmission in the school.”
Trying to decide if you should send your child back to school? Talk to your doctor. Need a doctor? Find one near you.