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Can You Protect Kids from COVID-19 at School?

photo of coronavirus book bag and masks

This story was updated Aug. 10, 2020. 

Aug. 6, 2020 -- The first week back to school in the COVID-19 era brought alarming scenes from Georgia, one of the first states to reopen schools.

  • A photo of a high school hallway packed with teenagers -- most not wearing masks -- went viral. Nine students and staff members later tested positive and the school switched to an virtual model temporarily. 
  • More than 200 teachers and staff at another metro Atlanta school district tested positive or might have had exposure.
  • A second-grader tested positive after attending the first day of school.

“It’s scary, and I’m not a fear-mongering type of person,” said Candice Jones, MD, a pediatrician based in Orlando, FL, of the Georgia news -- particularly the hallway photo that left her “speechless.”

She said, “My mouth fell open. I questioned whether it was a real photo.”

It was. But, she said, it didn’t have to happen. Schools should require students to wear masks. And Jones and others have advocated that students remain in one classroom all day, rather than changing en masse several times a day, to lower the risk of exposure.

School officials said the crowded hallways were OK because the students were in the hallway for only a few minutes. CDC guidelines say you need to be exposed for 15 minutes or more to contract the virus. The district does not require masks.

“This isn’t the time to find loopholes in the guidelines,” said Taylor Heald-Sargent, MD, assistant professor of pediatrics at Northwestern University’s Feinberg School of Medicine outside Chicago.

 “The CDC guidelines are just that, they’re guidelines, and it’s really the nuances that make the difference.”

With more schools opening in the next weeks, administrators, teachers, parents, and students will be paying attention to what happens in Georgia, experts say.

“Those are things that people are going to have to look at across the country,” said Marybeth Sexton, MD, assistant professor, Emory University School of Medicine in Atlanta. “And the experiences here (in Georgia) where we go back fairly early may help inform that.”

Differences Among Ages

Some experts say children under 10 are probably less at risk than older children and teenagers -- but it is still possible and does occur. In school, young ones might not be able to understand what’s going on or the need for social distancing. And getting a kindergartner to wear a mask all day brings its own challenges.

A new study from JAMA Pediatrics reports that kids under 5 with mild to moderate symptoms “have much higher levels of genetic material for the virus in the nose than older children and adults,” according to  statement from the Northwestern University about the study. “It adds to mounting evidence children of all ages could play an important role in transmission.”

“It supports the idea that they definitely can get infected and can replicate virus in their noses even when they’re not that sick,” said Heald-Sargent, a co-author of the JAMA study. “It seems possible that they are able to spread coronavirus. Kids are frequent drivers of respiratory infections.

“We need to be careful and safe, and the assumption that kids are immune or resistant to infection might be a flawed assumption. It’s better to err on the side of safety.”

Adolescents often behave impulsively or against their own interests, Sexton said. “Kids also do tend to have a strong sense of wanting to protect their families, their friends, and of wanting  to do the right thing. … How do we explain it to them? How do we model it for them? And there probably does have to be some insistence” on wearing masks.

Remember the Basics

By remembering the basics and modeling good behavior, adults can help kids at school remember to wash their hands, use sanitizer, practice social distancing, and wear face coverings.

“We can’t just let them walk into school like it’s October 2019,” Jones said. “Nothing is going to be 100% risk free. But the goal here is to lower the risk as much as we can and prevent the spread.”

For starters, the usual back-to-school supplies will include new additions for fall 2020. Experts are advising face masks, hand sanitizer, and disinfecting wipes go into backpacks along with pencils and paper.

And students will be enlarging their vocabularies because of the pandemic, too. If they don’t know “pods,” “hybrid” and “symptoms,” they will soon.

Before School

The CDC and other experts advise that before school starts for the year and before school every day:

  • Talk with your kids about the virus, hygiene (like washing their hands), and wearing masks. Listen to their concerns.
  • Practice mask wearing with little ones, praising their behavior to encourage it while at school.
  • Check for high temps and other signs of illness each morning.
  • Load backpacks with hand sanitizer and other cleaning products -- as well as water bottles, so kids don’t need to use fountains.
  • Consider how they’re getting to school. Some districts are limiting bus capacity to one child per seat, halving the number of students who attend each day, and requiring masks on buses.

During School

The CDC and other experts advise that before school starts for the year and before school every day:

  • Talk with your kids about the virus, hygiene (like washing their hands), and wearing masks. Listen to their concerns.
  • Practice mask wearing with little ones, praising their behavior to encourage it while at school.
  • Check for high temps and other signs of illness each morning.
  • Load backpacks with hand sanitizer and other cleaning products -- as well as water bottles, so kids don’t need to use fountains.
  • Consider how they’re getting to school. Some districts are limiting bus capacity to one child per seat, halving the number of students who attend each day, and requiring masks on buses.

After School

At the end of each day, consider a household protocol for when the kids come home:

  • You might want them to remove their shoes and clothes before coming inside.
  • Have them wash their hands immediately.
  • Wash the face masks they’ve worn.
  • Talk with your child about how school is going, interactions, and their feelings.

Where schools aren’t open yet, Sexton urges everyone to do what they can to lower community transmission rates as much as possible: wear masks, stay home except when necessary, socially distance, etc.

“One of the best ways to get kids back to school is doing things that are going to protect all of us, no matter what,” Sexton said. “If you make the communities safer, the schools are going to be safer.”

WebMD Health News Reviewed by Brunilda Nazario, MD on August 06, 2020

Sources

Taylor Heald-Sargent, MD, assistant professor of pediatrics, Northwestern’s Feinberg School of Medicine.

Candice Jones, MD, pediatrician, Orlando, FL.

Marybeth Sexton, MD, assistant professor, Emory University School of Medicine in Atlanta.

CDC.

CNN.

Northwestern University.

NBC’s “Today” show.

Journal of the American Medical Association Pediatrics: “Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in Patients With Mild to Moderate Coronavirus Disease 2019 (COVID-19).

The Atlanta Journal-Constitution: “Images of Student Crowds Raise Questions in Georgia Schools.”

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