What doctors wish parents knew about keeping kids safe at school

After more than a year of remote learning and hybrid schedules, the country has entered the sophomore year of the COVID-19 pandemic. While many parents and students are eager for going back to school, it may not look as “normal” as many had hoped. COVID-19’s dangerous Delta variant has been surging across the U.S., prompting the CDC to release new guidance on indoor masks for vaccinated Americans and school children, and leaving parents curious to know what the typical school day will look like.

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Three AMA members took time to discuss what to expect when preparing for going back to school. They are:

• Louito Edje, MD, a family physician and associate dean of graduate medical education at the University of Cincinnati Medical Center.
• Kevin Hopkins, MD, a family physician and primary care medical director for Cleveland Clinic Community Care.
• Megan Srinivas, MD, MPH, an infectious diseases specialist and translational health policy research fellow at the University of North Carolina at Chapel Hill.

Here is what these physicians had to say.

“As schools across the country get ready to reopen this fall, we are certainly in a different phase of the COVID-19 pandemic than we were a year ago,” said Dr. Hopkins. “Much has been learned, and great progress has been made in understanding the SARS-CoV-2 virus and mitigating the risks it poses.

While “the opening of school will likely look far more normal than it did last year … this virus and the illness it causes remain a significant health threat,” he explained. “Some prevention measures will still be necessary, so don’t expect the first day of this academic year to look like COVID never happened.”

“We should expect to see masks for all people in schools whether they are vaccinated or not,” said Dr. Edje. “We will likely see children being taught how to wipe down their desks and be timed washing their hands. We may also see an increase in home schooled children.”

“There is a huge loss to development and learning when we're not having children going to school and that can't be ignored,” Dr. Srinivas explained. “Which is why it was so great that we know what we can do to get people back to school safely.”

“It’s also just the interaction. Whether it’s group activities, group projects or the direct attention you can get from teacher and student when you’re in person,” she said. “You lose that when you’re virtual. It’s also much harder for people to pay attention for longer periods of time in a virtual atmosphere.”

“Altogether, we see that being in school and doing in school learning is vital to development and educational progress of kids,” Dr. Srinivas explained. “We do have the ability to do that this year if we use proper mitigation techniques.”

“Vaccination is the most effective public health prevention strategy to protect the people we love and end this pandemic,” said Dr. Hopkins, adding that “vaccines currently available for COVID-19 are approved for use in children ages 12 and older.”

That means “all children who are 12 years or older should be vaccinated unless expressly told not to by their primary care physician,” Dr. Edje said, adding that “adults in households with children should also be vaccinated.”

“If your children are eligible for getting vaccinated, that'll be the biggest step you can take to personally protect your children prior to starting schools,” Dr. Srinivas echoed.

Read about what doctors wish parents knew about keeping unvaccinated kids safe.

“The biggest thing you can do to protect your family is to mask in congregate areas, including schools, whether you're vaccinated or unvaccinated,” said Dr. Srinivas, adding that her “hope is that every child or student has the ability to go to a school where mask requirements are in place.”

“For those age 2 and above, masking will be required even if you have been vaccinated,” Dr. Edje explained. “This is because we have just recently discovered that the Delta variant is breaking through full vaccinations.

“This means that individuals who were fully vaccinated can contract COVID and can transmit it to others,” she added, noting that “this was not the case with the other variants, and this is why the guidance from the CDC changed—being a vaccinated adult helps protect the unvaccinated under 12.”

Discover why the CDC is again turning to masks to help stop COVID-19.

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“We touch our faces on average 16 times an hour,” explained Dr. Edje. “With the Delta variant being almost 1,000 times more plentiful in the upper airways than the original variant, masks help to decrease the amount we touch our noses and mouths where the virus can be living.”

While “masking in indoor public places is strongly recommended, masking outdoors in public spaces is not necessary at this time unless the location is very crowded and poorly ventilated,” she added, noting that “this guidance may change.”

“While we're focusing on masking, we still have to keep in mind, no unnecessary hugging—I've seen a lot of people start hugging and trying to go back to these close contacts,” said Dr. Srinivas. “We need to still be washing our hands. We still need to be hand sanitizing, cleaning down surfaces that have had a lot of touches, things of that nature—all of the hygiene rules still apply.”

“I recommend parents set up some routines like washing hands as soon as you come into the house,” Dr. Edje explained. For example, “timing your wash for a full 20 seconds—singing the birthday song twice gets you in the right ballpark of 20 seconds.”

Additionally, “keeping disinfectant wipes in the car so that the car is not a place where transmission happens is also a good habit to learn,” she said.

“Whenever possible and practical, the distance between people should be maximized,” said Dr. Hopkins, noting that “the current recommendation is to maintain three feet of space between students. 

“Obviously, this is more difficult with younger children,” but “having adequate physical space is just one piece of a successful strategy of layered prevention measures,” he added.

Read about what doctors wish patients knew about physical distancing.

While we can’t predict what will happen while in school, everyone should consider packing an extra mask or two in their backpack or purse. That way an extra mask is available if the one being worn becomes soiled in any way.

“I always personally actually carry around two or three masks,” said Dr. Srinivas, noting that “you never know, somebody around you will need a mask and you can be the one to whip it out and help.”

Additionally, since the start of the pandemic, masks have evolved in style, making the choice just as exciting as choosing back to school supplies for kids.

“I've met so many children who are so excited to show me their mask,” Dr. Srinivas said. “It all has to do with how the adults in their lives frame it. If you frame it as a cool thing, kids want to be a part of it.”

“Avoid unnecessary touching of others, limit contact with shared toys and sports or playground equipment, and wash hands with soap and water or use an alcohol-based hand sanitizer before and after outdoor play,” Dr. Hopkins explained.

“Definitely mask if recess is in an indoor or unventilated setting or in close quarters,” urged Dr. Edje, adding that “if recess is outdoors in a crowded location, then mask.”

Additionally, “all children and adults with compromised immune systems should remain masked at all times except for eating,” she said. “Having wipes and using those on surfaces and hands adds a layer of protection from this highly transmissible variant.”

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“There are lots of other infectious illnesses caused by viruses and bacteria besides COVID-19,” and “many of these spread in ways similar to coronavirus, and cause sicknesses like strep throat, the flu, pneumonia, and vomiting or diarrhea,” said Dr. Hopkins. “No one wants to get sick, and no one wants to be around you when you’re sick.

“Whether it’s COVID, or something different, a mild illness for you might become life-threatening for someone else if you pass it on,” he added, emphasizing that “students and teachers should stay home when they don’t feel well. This is essential for keeping COVID-19 out of our schools.”

“We saw in a study last year—and this was looking at the Alpha variant of course—that if people are properly masking, the distance does not need to be that full six feet,” Dr. Srinivas said. “It's the masking that's more effective than segregation. As long as schools implement masking, we don't need to worry as much about the distance between individuals.

“Of course, we don't want people unnecessarily hugging and unnecessarily touching, and we want to have distance when we can, but it's not as critical,” she added.

When physical distancing in classrooms is needed, “some classes may be reduced in size,” Dr. Edje explained, adding that “some classes may be staggered so one portion of the class meets on certain days of the week and the rest of the class meets on the other days of the week.”

“There are current trials underway for children 6 months and up,” said Dr. Edje who volunteered for a coronavirus vaccine trial early in the pandemic. “The FDA recently asked Moderna and Pfizer to increase the number of children in the 5–11-year-old trials to 3,000 each to help better detect the rarer side effects.

So far, “the youngest in the trial is 8 months old and is doing well,” she said, noting that “we anticipate that children ages 5–11 will be approved for the Pfizer vaccine by September and the group 2–5 years old will be shortly after that.”

It is vital that everyone is “patient, respectful and flexible,” Dr. Hopkins urged. That’s because “the situation will likely change—probably several times—throughout the course of this school year based on the circumstances in your community.

“The manner in which we complete school in the spring may be different than how we start,” he added, emphasizing the need to “exercise common sense” and not to “take unnecessary risks” while trying to put “the needs of others ahead of your own preferences.”

Learn more from the CDC about guidance for COVID-19 prevention in K-12 schools.