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How safe is it to send your kids to school?

August 09, 2020

Parents across western Massachusetts are faced with a difficult question. Should children be returning to the classroom this fall?
It’s a national debate, and there isn’t much time left to decide.

The latest American Academy of Pediatrics (AAP) advice says children learn best when they are in school. However, returning to school in person needs careful steps in place to keep students and staff safe.

Back to School: How to weigh the benefits vs. the risks?

Dr. John O’Reilly, chief of General Pediatrics at Baystate Children’s Hospital, and a member of AAP, answers important questions about keeping children safe in school this fall.

Q: What questions should parents be asking their elementary/high schools about safety at the school before returning to the classroom?

A: There are many questions to consider, such as:

  • How will social distancing be observed?
  • Will there be handwashing stations or hand sanitizer available?
  • How and when will masks be required?
  • How will the use of shared surfaces be limited?
  • What about the ventilation system?

The Harvard School of Public Health has put together a great site with 15 additional questions and associated answers to consider.

Q: What are the biggest risks to those returning to school, including students, parents and teachers?

A: The biggest risk is getting COVID-19, especially for someone with underlying medical conditions such as cancer, Type II diabetes, and asthma.

The CDC offers a full list of those conditions.

If a child, parent/caretaker, teacher or school staff has one of those conditions, then they should talk to their medical provider about their medical condition and discuss their individual risk for COVID-19. For the most part, pediatric illness is mild, but parents should discuss their concerns with their pediatrician.

Q: What extra items should parents consider sending their children off to school with in their backpacks?

A: All of the necessary COVID protection gear:

  • Extra masks
  • Hand sanitizer
  • Disinfectant wipes

I don’t think schools will be able to provide every child personal supplies.

Q: What would you advise a parent of a child with other chronic health conditions to do?

A: It depends on a number of factors.

How severe is the child’s illness, and how sick would that child get if they were to contract COVID? What is the community prevalence? If <5% there is less risk. If community spread is >5% they should do online schooling.

What services/benefits does the child get in school, and how can the parent replace those benefits if the child does not go to school? Some of our patients with severe disabilities get many of their vital services, such as occupational, physical and speech therapy, as well as general nursing at school. We need to balance the benefit of those services with the risk for COVID in their specific school setting.

My biggest advice is for parents to talk to their pediatrician and their school administrators to find the safest way to get their child in school, and if that is not possible, then how to ensure we maximize their online learning.

Q: Should parents drive their children to school instead of taking the bus?

A: If possible, yes.

Q: Should students play sports? Can they do it safely?

A: I don’t think we currently have the safety protocols in place that will allow for school sports.

If we cannot do it for the Florida Marlins with their million dollar budgets, I don’t think we can do it on a limited budget for schools.

Q: Other than social distancing, hand washing, masks, etc., what do you think are some of the most important things a parent can do to protect their child?

A: Vaccination to prevent other illnesses is the most important thing beyond the basics that parents can do to protect their children. We do not know what the “double whammy” impact of a child getting both the flu and COVID simultaneously or back-to-back will be, and we don’t want to find out.

I believe school systems have to add on the next layers of protection to keep our kids safe. Strategies such as:

  • Staggering start/end times and class change times during the school day (lunch, recess, etc.), so there are not large numbers of students congregating in any one spot at any one time.
  • Cohort students into small groups. This prevents the spread to large numbers of students when one student gets sick and allows for faster testing and contact tracing in that cohort when there is an exposure.
  • Work on healthy school buildings/air quality
  • And more suggestions detailed in a Harvard Schools for health report

Q: Are shared bathrooms in schools safe?

A: Schools will have to adjust their cleaning regimens to meet the COVID requirements.

It is important for parents to teach their kids about the personal hygiene regimen that will help them be safe in any public restroom, whether that is a school or a restaurant, including handwashing.

Q: What about mask wearing for children?

A: Mask wearing is a critical part of illness prevention and should be mandatory in schools for students in second grade and above per the American Academy of Pediatrics.

Parents should be modeling mask wearing, teaching the importance of mask wearing, and practicing mask wearing at home, so kids are ready to do it in a school setting. The younger the child can wear a mask, then the better for the student and the school teachers and staff.

Learn more about kids and masks

Q: What can kids who can’t wear a mask for health reasons do?

A: The number of those kids will be very low, but if they can’t, it becomes a health risk for classmates and school teachers and staff.

In those rare circumstances (kids with traches, neuromuscular disease, etc.), the school should provide PPE for the school staff interacting with those students.

The rationale for that comes from the science of masks. If a single-layer cloth mask reduces spread 60%, a double-layer mask (well-constructed and worn appropriately, of course) may increase that to ~80%. When 2 people with double-layered masks interact at an appropriate distance, that may increase to ~90%. If only one person in the interaction is wearing a mask, you are back to using a surgical mask or an N-95 mask, which will filter out ~95% of viral particles.

Q: Emotionally, do you think children will find what they know about the pandemic to be frightening? How can parents reassure their children?

A: I think everyone has a degree of fear and stress around COVID.

Sometimes kids pick up on a parent’s stress and fears and that makes the child’s anxiety worse.

I think we can use a younger kid’s imagination to make masks a part of their superhero costume to fight the virus, and empower them in mask use by letting them decorate their masks, or have multiple masks to match multiple outfits and have the child choose their “mask of the day.”

For older students, parents can frame it as a way to protect classmates, their family and relatives with other medical conditions putting them at risk for COVID-19.

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