4 Questions You Must Ask When Sending Your Kids Back to School During the Pandemic

Covid-19Pandemic QuestionsQuestions for child's school during Coronaviruskids' schools questions
Written By Humayra Ali
Questions to ask when sending kids back to school during Coronavirus

As a parent and a virologist, I am concerned about sending my kids back to school. That is probably the sentiment many of you have about your children as well. We all understand that virtual experience by no means is a fair substitute for in-person learning. As my husband and I navigated through this uncertainty around returning to school, we had to think through several factors before we could make the decision. Our decision hinged on 4 important questions:

  1. Are the schools in our district following the latest Centers for Disease Control and Prevention (CDC) guidelines and taking all of the necessary precautions against the risk of spreading coronavirus? 

  2. What are the risks of COVID-19 in pediatrics and young adults?

  3. What is the infection rate in our community?

  4. What is the health status of my family, including any extended family members exposed to us on a routine basis? 

Are the schools in our district following the latest Centers for Disease Control and Prevention (CDC) guidelines and taking all of the necessary precautions against the risk of spreading coronavirus? 

CDC’s recommendations are guided by 4 considerations:

  • Promoting behaviors that reduce COVID-19’s spread

  • Maintaining healthy environments

  • Maintaining healthy operations

  • Preparing for when someone gets sick

Child Face Mask

CDC assessed the risk of reopening into 5 categories: low, some, medium, high and highest risks. Low risk is limited to virtual-only classes, activities, and events. Some risk category involves a Hybrid Learning Model where some students participate in virtual learning and other students participate in an in-person setting. This consists of small, in-person classes, activities, and events around alternating and staggered schedules. There should be no mixing of groups of students and teachers throughout/across school days. Students and teachers are not to share objects. Students, teachers, and staff follow all steps to protect themselves and others at all times including proper use of face masks, social distancing, hand hygiene. Regularly scheduled (i.e., at least daily or between uses) cleaning and disinfection of frequently touched areas implemented with fidelity. The Medium risk category also involves a Hybrid Learning Model; however, it would offer larger in-person classes, activities, and events, with some mixing of groups of students and teachers. The high-risk category will involve all students and teachers to engage in in-person only learning, activities, and events. Students will minimally mix between classes and activities. Students and teachers can share some objects. The highest risk category is none than what it was pre-pandemic--full-sized classes, in-person attendance with no spacing. You can find the CDC's recommendations here, regarding ways in which schools can help protect students, teachers, administrators, and staff to slow the spread of COVID-19. In addition to CDC’s recommendations, a noninvasive, 48-hour turnaround test for COVID-19 could be meaningful before bringing kids back to school. By the way you can read about Are COVID-19 Vaccines Free? and Getting Tested for Coronavirus Before Traveling in our blog.

We have extensively reviewed our school district’s planned safety precautions. We are given an all-virtual option, along with a hybrid model of virtual combined with in-person classes on alternating weeks. It was reassuring to us that the district’s plans are mostly in line with the safest recommendations set forth by the CDC. Our school district will have hybrid and flexible options to accommodate social distancing requirements. 61% of the students have selected an all-virtual instructional model, while the remaining 39% (~3,926 students) have requested hybrid instruction. Square foot ratios and 6-feet social distancing restrictions will not cater to a “traditional” opening. The plan will allow only 11 students per 54-passenger bus; though it presents a major operational challenge, it is a safer approach. However, there are major concerns with the supply chain and receiving all Personalized Protective Equipment (PPE) that was ordered in preparation for the school year. From a CDC recommendation standpoint, there will be daily health screenings questionnaires, daily temperature checks, requirements of cloth face masks, time made available, and reinforcement for hand washing and contact tracing. Facility safety measures will include social distancing of 6 feet, availability of hand sanitizer, enhanced building/bus cleaning procedures, and staggering of classroom release, and no lunches served in the school building. Of course, it only works if the students are carefully following these practices in school. Do I think my 7-year-old will be diligent about these practices? Let’s be honest, NO. He would not only jeopardize his own risk of getting an infection, a kid his age is likely to jeopardize the health risks of his peers as well as his teachers. As for my 12-year-old, it’s a maybe!

What is the risk of COVID-19 in pediatrics?               

As we were making considerations for sending kids back to school, we also assessed the potential health risk they may face upon returning. The American Association of Pediatrics (AAP) reported that there has been a marked increase in pediatric COVID-19 incidences. According to the report, there were 179,990 new child cases reported, representing a 90% increase in child cases over a 4-week timeframe during July and August. This wasn’t so reassuring as we were approaching schools reopening in September.

The largest pediatric study out of China found that 90% of children with Covid-19 develop mild to moderate symptoms. While 4% of those were not symptomatic, 6% did become severely or critically ill. So, children aren’t entirely immune to COVID-19!

Children Studying at School

Coronavirus cases in children are on the rise, according to a recently updated report from the AAP and the Children's Hospital Association (CHA). Children account for 9.5% of the total COVID-19 cases reported in the U.S, according to this report. There have been more than 476,000 coronavirus infections reported in children through Aug. 27. An August report from the agency stated that 1 in 3 hospitalized children needed to be admitted to an intensive care unit – a rate similar to the adults’ ICU admittance rate for the coronavirus infection. By the first week of August, 90 children in the US had died of Covid-19. Pneumonia is the single leading cause of COVID-related death in children worldwide.

As of August 6, a multi-system inflammatory syndrome (MIS-C) was identified in at least 570 kids across the country, ranging in age from less than 1 to 20. About two-thirds of those children didn't have underlying conditions before being diagnosed with MIS-C.

A recent systematic review of ten studies of pediatric patients, including two case series and 8 retrospective chart reviews, altogether described a total of 2914 pediatric patients with COVID-19. Those who were tested and showed positive for infection with SARS-CoV-2 or coronavirus, patients were only asymptomatic 14.9% of the time. 27.0% of those who were hospitalized were infants under 1 year of age, but the rest were older. Then there were deaths. The death rate of children that were hospitalized with COVID-19 was 0.18%.

Even though it is true that children are less likely to get sick from COVID-19, they can significantly contribute to the spread of the virus. A widely cited study out of South Korea showed that children between the ages 10 and 19 were spreading the virus just as much as adults. Although in this study children younger than 10 did not account for a significant amount of viral spread, another study published in JAMA Pediatrics concluded younger children may carry higher quantities of the virus in their nose when compared to adults. And keep in mind that these numbers represent the statistic before the reopening of the schools. One would expect these numbers to be much higher once the children are exposed more after going to school. As an aside, if you are interested in learning about Long-Term Debilitating Risks of COVID-19 in Young Adults, read our article on it.

What is the infection rate in our community?

From the Johns Hopkins Coronavirus Resource Center, you can track trends in COVID cases and tests by regions or states. Here you would want to look at the Daily % positive of 7-day moving average to get a sense of the infection rate in your area. In NJ, where we are located, we have 1.1% daily positive cases, which is not too bad in terms of a risk factor for contracting the disease from a school setting. Compare that to Florida, which is at 12.7% daily positive cases—I wouldn’t consider sending my kids to school when the infection rate is so high. It is simply not safe. Furthermore, Google can find the number of cases in your county. 

What is the health status of my family? 

If you have family members with chronic diseases (such as diabetes, heart and lung complications, and others) or multigenerational households which include grandparents, the decision to send your kids back to school could mean life or death. It is a different scenario if your household consists of relatively healthy children and adults. Our household has elderlies with health complications. This is yet another reason why we opted for all virtual schooling.

According to a recent survey published in JAMA Pediatrics, 1 out of 3 of parents (31%) said that even if their child’s school offers in-person instruction they would probably, or definitely, keep their children at home this coming fall. Each decision for returning to school will need to be made on an individual basis, although in my opinion, better be safe than sorry. Stay up-to-date with the latest advancements in the development of COVID-19 Vaccines (this post is frequently updated in our blog).

Humayra Ali
Previous

Impacts of AstraZeneca's COVID-19 Vaccine Trial Pause
Next

Are Covid-19 tests free?