Back to School? Consider These Safety Precautions

As another school year begins, the flurry of excitement about new shoes, freshly sharpened pencils and pristine boxes of crayons has been overshadowed by worries about everything from the need for face masks to social distancing among children while they’re walking the halls or mingling with other kids—many for the first time in weeks or even months.

As the pandemic wears on, school administrators are facing a number of competing pressures. On one hand, some experts insist that kids’ need for socialization outweighs the risks of possible exposure to COVID-19—assuming the number of newly confirmed cases in their communities remains relatively low.

Meanwhile, other experts are telling a more cautionary tale, noting that having students convene in the classroom could result in a dramatic uptick in cases, particularly if certain safety measures aren’t implemented or enforced.

Children who are more likely to have mild cases of COVID-19 than adults may unknowingly pass the virus on to their more vulnerable parents, grandparents or caregivers at home. An August 2020 study, which examined nationally representative survey data from 2018, revealed that some 69.7 million adults were living with school-aged children. Of these adults, 54 percent had definite or possible risk factors for COVID-19. The study also showed that more than 50 percent of teachers also had definite or possible risk factors, such as cancer, a heart condition or obesity.

If that wasn’t enough, flu season is fast approaching.

More parents are opting for homeschool
Unsurprisingly, there’s been a boom in home schooling due to these unique circumstances. In the United States last year, there were about 2.5 million homeschool students in grades K through 12. This number is slated to increase by at least 10 percent during the 2020-2021 school year, according to the National Home Educators Research Institute.

The decision to homeschool may have far-reaching implications, siphoning money away from school systems and widening educational disparities in certain communities, according to Sharecare’s Community Well-Being Index (CWBI).

Based on two generations of social determinants of health indices, the CWBI suggests that the impact of COVID-19 could be particularly dire for students who rely on critical school-supported resources, such as lunch and after school programs, special education services and counseling—all factors that help shape individual and community well-being.

Assessing your school’s safety
Certain school districts have decided to keep their schools closed and resume remote learning while others have invited students back into the classroom. Some districts are offering a combination of these options, which allows some students to attend class in-person either full- or part-time while others can learn from home.

The logistical hurdles and complex new schedules—which may or may not be revised as the pandemic evolves—are enough to make parents’ heads spin. Perhaps more importantly, many families, teachers and students may be wondering if it’s even safe to head back into the classroom.

Daily cleaning protocols should also be clear. This includes at least daily cleaning of high-touch areas, such as desks, doorknobs, railings and bathrooms. Teachers may also switch classrooms instead of having students move from place to place to avoid crowded hallways where germs can be transmitted more easily.

Some schools have enough outdoor space to hold classes. This helped slow the spread of the tuberculous epidemic and the Spanish flu of 1918.

Learning about your school’s COVID-19 protocols can help you understand how your child’s return to the classroom will affect your family’s risk for COVID-19. Some key issues to consider include:

The air students breathe. About half of all U.S. school districts need to update or replace multiple systems like heating, ventilation and air conditioning (HVAC) or plumbing, according to a 2020 report from the U.S. Government Accountability Office.

“Many school buildings have older heat and ventilation systems so the filtration may not do as good of a job at capturing virus particles,” says Nathaniel Beers, MD, MPA, FAAP, member of the American Academy of Pediatrics’ Council on School Health. “Opening classroom doors and windows can help improve the flow of clean air.”

The Centers for Disease Control and Prevention suggests that schools consider portable air filtration systems, fans and ultraviolet lights that could knock out the virus in rooms with poor air circulation. “Parents should not purchase these items individually,” adds Dr. Beers, who is also President and CEO of the HSC Health Care System, a nonprofit health care organization in Washington, DC.

Face mask enforcement. Cloth face coverings should be front and center on back-to-school supply lists, and schools should have a surplus to dispense as needed. Face masks can protect other people if your child is unknowingly infected. Still, wearing a face covering may be easier said than done for some students.

“Creating clear expectations for when school-aged children will have to wear masks and how to wear them (over the nose and mouth) is essential and starts even before school is in session,” Beers says.

Class size. Social distancing is another important way to reduce transmission of COVID-19. This is defined as keeping at least 6 feet of distance between yourself and other people in both indoor and outdoor settings. In some schools, it may only be possible with smaller class sizes.

“Pods are easier in elementary schools whereas in high school, kids walk around more freely and may not be appropriately social distancing,” Beers says. There is no magic number of students that is shown to dramatically reduce transmission, but the CDC notes that the smaller the pod, the lower the risk.

Community space safety. Certain areas in schools are high-traffic locations, such as lockers in hallways. “Some schools may eliminate lockers this year, which will be harder in colder months when kids have jackets and hats,” Beers says. Others are allowing a small number of people at lockers at one time to decrease hallway congestion. Some schools have added physical barriers between bathroom sinks to keep people a safe distance apart, while others are allowing only one student in the bathroom at a time.

Bus safety. School bus drivers should seat one student per row, facing forward and skip rows between students, according to the CDC. Siblings should sit together to save space and create distance between children from other households. Staggered pickup and drop-off times can also decrease crowding, as can additional bus routes. The bus driver should have extra face coverings and keep windows open to increase the circulation of outdoor air.

Lunchtime rules. Each school will handle lunch and snacks differently. Familiarize yourself with your school’s plans. In many areas, students are eating in the classroom or other spaces at desks rather than large communal lunch tables. Some schools may be able to allow children to eat outdoors when the weather permits it. As in all common areas, social distancing should be maintained at all times.

As a general rule, school cafeterias should replace self-serve options with pre-packaged meals. In many schools, however, students are being urged to bring packed lunched from home. There should be no sharing or trading of food, and hand-washing before and after eating should be strongly encouraged.

Protocols for positive test results. Universal symptom screening by schools is not recommended by the CDC. This is something parents and guardians should monitor closely at home and discuss with their child’s healthcare provider (HCP).

Schools should be notified about any students who do test positive for COVID-19. Any students who develop cold or flu-like symptoms should stay home. Students or staff who have had recent contact with anyone with COVID-19 should also stay home and closely monitor their health for any symptoms.

It’s not if some students test positive, it’s when, Beers predicts. Understand how quickly your school plans to notify parents of a positive test result at school and what disinfecting procedures will entail.

The CDC suggests closing off the area and leaving it vacant for 24 hours and then disinfecting it with products known to destroy SARS-CoV-2, the coronavirus that causes COVID-19.

Remain informed about your school’s plans
Don’t skim. Thoroughly read all of the emails and attend video conference meetings offered by your school’s administration to find out what they are doing to mitigate the spread of COVID-19, advises Marietta Vázquez, MD, FAAP, professor of pediatrics at the Yale School of Medicine Section of Pediatric Infectious Diseases and Global Health and General Pediatrics in New Haven, Connecticut.

In most cases, children develop only mild cases of the disease. Some children, however, may develop more severe infections or complications related to COVID-19, including a very rare condition called multisystem inflammatory syndrome (MIS-C).

Children with history of cancers or weakened immune systems due to stem cell or organ transplants, heart disease or an inherited immune deficiency condition are more likely to develop more serious illness, says Dr. Vázquez, who is also director of Yale’s Children’s Hispanic Clinic. Kids who take medications for certain autoimmune diseases, such as rheumatoid arthritis or lupus, are also at higher risk as these medications affect their immune systems, Vázquez explains. These factors also increase their risk for a severe course of the flu, she points out.

Have an open discussion with your child’s pediatrician about your concerns as you navigate this school year. “Make sure that all vaccinations are up to date, as this will keep all children’s immune systems functioning optimally,” Vázquez advises. This includes making sure everyone in your household older than 6 months of age gets a flu shot.

Medically reviewed in September 2020.

Sources:
American Academy of Pediatrics. “Return to School During COVID-19.” August 2020.
Centers for Disease Control and Prevention. “Coronavirus Disease 2019 (COVID-19): Information for Pediatric Healthcare Providers.” August 2020.
Adam W. Gaffney, MD, MPH, David Himmelstein, MD, Steffie Woolhandler, MD, MPH. “Risk for Severe COVID-19 Illness Among Teachers and Adults Living With School-Aged Children.” Annals of Internal Medicine. August 2020.
National Home Education Research Institute. “Big Growth in Homeschooling Indicated This “School Year.” August 2020.
Hobday RA, Cason JW. “The open-air treatment of pandemic influenza.” American Journal of Public Health. 2009;99 Suppl 2(Suppl 2):S236-S242.
U.S. Government Accountability Office. “K-12 EDUCATION: School Districts Frequently Identified Multiple Building Systems Needing Updates or Replacement.” June 2020.
U.S. Environmental Protection Agency. “EPA Supports Healthy Indoor Environments in Schools During COVID-19 Pandemic.”
Centers for Disease Control and Prevention. “Operating schools during COVID-19: CDC’s Considerations.” September 2020.
American Academy of Pediatrics. “COVID-19 Planning Considerations: Guidance for School Re-entry.” August 2020.
Centers for Disease Control and Prevention. “Health Department-Reported Cases of Multisystem Inflammatory Syndrome in Children (MIS-C) in the United States.” August 2020.
Centers for Disease Control and Prevention. “COVID-19 Planning Considerations: People with Certain Medical Conditions.” August 2020.