Sending kids to school during the COVID-19 pandemic

We all know that kids need school. But who would have thought that doing the “back to school” stuff would include preparing our kids to stay safe in a pandemic? While the discussion of whether kids should go back to school right now has waxed too political and is beyond the scope of this post, I am discussing a few points to help parents send their kids back to school as safely as possible should their local district be offering in-person school. For more on the science behind school openings, click here and here.

1. Keep kids home if they are sick.

We are on the cusp of a big culture change when it comes to kids (not) going to school sick. Gone are the days that we send kids to school with the sniffles. The school will be sending them right back to you if they have any runny nose, cough, congestion, fever, body aches or chills, vomiting or diarrhea. While kids are getting COVID less frequently than adults, their symptoms, if they do get it, are more minimal and can look exactly like any other viral illness. Even if it ends up being one of those other viruses, passing it to other kids during this pandemic is not cool. Federal funds are available for parents who have to take time off work to care for a sick child.

2. Get them tested if they are sick.

While all children should stay home whether it’s COVID or not, a positive or negative test will make a difference in how long they need to be out of school- 10 days after they test positive (as long as they are better) vs. 24 hours after fever is gone and symptoms are better in the case of a negative. Getting a nasal swab is not fun, but saliva tests are also available. You should not have to pay for a test if it’s ordered by a doctor. According to the Utah Department of Health website, if you are insured, you should be covered 100%. If your child is not insured, they likely qualify for government funding.

3. Kids usually get used to wearing masks, few exemptions.

There are vanishingly few known medical reasons a child would not be able to wear a mask. Contrary to what people claim, masks due not lower oxygen, increase carbon dioxide, or trigger asthma attacks. In fact, they are especially important for kids with asthma to wear. Learning to wear a mask is an important life skill for a kid to learn. It’s a skill they will likely need for the foreseeable future, for as long as it takes until this pandemic ends. For some tips on helping kids get used to wearing masks, click here. It’s not wise to attempt to opt your kid out of learning this skill if they are able to learn as most kids are.

4. Not all masks are created equal

Masks made of tight woven cotton fabric with two or three layers that fold/pleat are the best. Stretchy or thin material does less to stop transmission of respiratory particles. Neck gaiters and bandanas perform the worst all around. Never use a valved mask because they are designed to keep particles out but not keep them in, making them useless for preventing transmission from the person wearing them. Surgical masks and N95s work well but are in short supply and should be saved for healthcare workers. Face shields are not an alternative to face masks. The state of Utah has mandated that all teachers and students wear an actual face mask made of cloth, not a face shield. Try several different kinds and fits so your child can switch off from day to day. See more about each type of mask here.

5. Beware of choir and band.

Singing has been identified as a super-spreader activity that’s just as bad as coughing or sneezing, if not worse, since it continuously pumps respiratory droplets into the room while everyone present is taking big deep inhalations. A single person with COVID infected 52 people at a choir practice in Washington state, one of whom died. And anyone who has played in a marching band knows the amount of saliva involved. A study of band instruments, singing and theatre found significant rates of aerosolizing of droplets that decreased but was not eliminating with using a bell cover over the instrument and using a mask for singing and stage performance.

6. School is not for everyone.

The decision to send our kids to school should not be a political one and there is no one-siz-fits all, all-or-nothing, blanket, across-the-board answer. It is ideally done when community transmission is low. Kids with higher risk conditions such as immunosuppression may not want to go back at first. Other factors that should be considered are how good your kid is at wearing a mask, whether your child needs special services provided by the school, and whether the student’s household members have high risk conditions. A decision guide from Primary Children’s hospital helps parents think through the factors that should be considered when making the decision.

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