Amid the coronavirus pandemic, a huge debate within the community is whether it’s safe to send children back to school. Parents, educators and students across the globe must weigh the coronavirus risks and make the difficult decision this fall on whether to continue their education in-person or online. 

Gary Kirkilas, DO, a clinical assistant professor in Child Health at the University of Arizona College of Medicine – Phoenix, shared his back-to-school advice and important information to help keep your child safe during the pandemic.

Is there a safe way to go back to daycare or school with cases so high?

The timing for safe return to school is complex. It involves input from infectious disease and public health experts, school boards, and what each family feels is the best for their situation. Some experts, such as the Centers for Disease Control and Prevention (CDC), have pointed to waiting until viral transmission in the community returns to mild to moderate levels. What exactly is mild and moderate levels? The World Health Organization (WHO) has used the 5 percent positive cases for two weeks as a benchmark for safe return to school. The Arizona Department of Health Services is reporting a 12.5 percent positive case as of July 31st, but this is a statewide aggregate result. Your community may be above or below this number.   

What is class cohorting and how does it help reduce viral transmission of COVID-19 in schools? 

Cohorting, when applied to the classroom, means that students in a homeroom will be kept together throughout the course of the day with minimal to no contact with other students and staff. This is an important method of keeping children safe, because the less contact with other students and staff, the less likelihood of coming in contact with COVID-19. Typically, homeroom students would be broken up multiple times through the course of the day with some going to different parts of the school for different classes. This movement of students through the school creates more interactions and close contacts, making it difficult to contain the virus should some contract it. 

Are screening strategies such as universal COVID-19 testing and temperature checks useful for schools?

While these strategies are helpful, they are not always feasible and sometimes can give a false sense of security. COVID-19 testing is just a snapshot in time. For example, if a student is tested the week before school starts, there is no assurance that they would not test positive a few days later. While universal testing could pick up many cases of asymptomatic or subclinical cases, it provides limited longitudinal information for the rest the student body that tests negative. Up to 80 percent of children with COVID-19 are asymptomatic or subclinical carriers and will never develop a temperature. Temperature checks can identify those with symptoms, but similar to COVID-19 testing, it could potentially give a false sense of security.

What tips can help kids stop the spread and stay safe during a pandemic? 

The traditional advice of hand washing, covering coughs, and staying home when sick is just as relevant now during this pandemic as in the past. Additionally, social distancing and wearing masks are proven methods to reduce viral spread, but are not always feasible with young children. Face masks on younger children (pre-K to 1st grade) may even cause them to touch their face even more, which could lead to infection.

Is it true that kids don’t spread the virus the same as adults?

There have been several smaller studies that show children are not major spreaders of the COVID-19 virus. One study showed that nine students and nine school staff with COVID-19 had 863 close contacts in their perspective schools. Of the 863 close contacts, only two students contracted the virus from them. Experts are still researching why this is, but it may be due to roughly 80 percent of children with COVID-19 are asymptomatic or have subclinical infections (symptoms so mild they may not even be noticed). In addition, often times when they are symptomatic, they only have weak coughs. Interestingly, a new South Korean study showed children 10 years and older were just as likely to spread the virus as adults. We will definitely need more research to say for sure.  

If my kid has a chronic condition, are there other precautions I should take? 

We are seeing that children with obesity and asthma, along with other chronic medical conditions, are at increased risk of having a more severe course of the illness that requires hospitalization. Parents of these children should be particularly strict on handwashing, social distancing and mask-wearing (when feasible). 

What are the developmental concerns with children learning virtually? 

We know that children of all ages learn best when they are physically present in school. School is much more than just a place to learn math, grammar and science. It is where social and emotional development takes place – where physical education, mentoring, individualized education plans, and even behavioral counseling takes place. Some students depend on food service in their schools. This cannot be accomplished virtually. In addition, the short attention spans of younger children are not conducive to learning virtually.

What should I look for or what questions should I ask to determine if my child will be safe at school?

I would encourage parents to ask what their children’s school ‘Safe Return to School’ plan includes. In particular, if the class will be cohorted together throughout the day. This is important because it is one of the best methods to limit viral exposure. I would also ask what their social distancing and mask policy is, including school staff. Lastly, I would ask what the procedure is in place when a student does become positive for COVID-19. Parents should take part in these ‘Safe Return to School’ virtual meetings if their school is offering them. 

Are there certain activities that schools and kids should stay away from? 

Each parent will need to weigh the risks and benefits from each activity for themselves. Some activities like singing/choir and contact sports (soccer/football etc.) are considered higher risk activities, as they allow for increased viral transmission. If parents choose to allow their children to participate in these activities, they should inquire about what safety measures are in place (temperature and symptoms checks before arriving for participation).  

What steps should schools and parents take before sending kids back to school?

The burden of safe return to school is on both the school and family. Schools need to have in place strategies and plans to mitigate viral transmission (cohorting, social distancing, masking, contact tracing, etc.) and decide which of these strategies are actually feasible. Even with the best school strategies in place, if families are not vigilant about screening their children for COVID-19 symptoms prior to arrival to school or they are engaging in high risk activities at home, COVID-19 cases will rise within schools. I would also encourage parents to make sure their children are fully vaccinated for other communicable diseases like measles and pertussis, which are known to affect children more severely than COVID-19.