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Back to School 2020 Q&A

Published in Pediatrics, For the Health of It Author: Jill Amsberry,DO

Questions abound as parents have conversations with other parents and their children about the uncertainty of the upcoming school year. Pediatrician Dr. Jill Amsberry, DO, and mother of two, helps to answer some of those questions as parents make tough decisions and weigh what is best for their children as they head back to school, either at home or in the classroom.

How do I decide whether or not my child should be in the classroom or stay at home?

It is a difficult choice. And there is no wrong choice but finding the best choice for your family is important. The Centers for Disease Control and Prevention (CDC) provides a decision-making tool that asks straight forward questions to help you make that decision. You also can reach out to your child’s primary care provider for help in deciding between in-person and virtual learning.

There are other things to consider when making the back-to-school decision. Schools provide important services for children in addition to academics. According to the American Academy of Pediatrics (AAP), children learn social and emotional skills, get exercise and access to mental health support that cannot be provided with online learning. For many families, school is where kids get healthy meals, access to the internet and other vital services. The CDC says lack of access to these services have the potential to widen existing disparities and cause long-term effects on children’s educational outcomes, health and the economic well-being of families and communities.

What's your advice for children and parents who are fearful about the return to school?

This is a time of great uncertainty, so it is very understandable that there may be some fear from parents and children about returning to school. I recommend parents try to stick with what we know, looking to the experts from the Minnesota Department of Health (MDH), CDC and AAP for guidance.

It also is important that children know scientists are working very hard to learn more about how COVID-19 works. One thing they have learned is that wearing masks, washing our hands and keeping our distance really does help to reduce the spread of the disease. It also is important to feel as secure as possible during this time. That means it is more important than ever to maintain some structure around their days. If parents are noticing any mental health concerns in their children, I would encourage them to contact their primary care clinic. Many CentraCare clinics have immediate access to mental health services through their Integrated Behavioral Health Programs or they can send a referral to help the child get set up with a different mental health specialist.

In rapidly changing health events and outbreaks such as COVID-19, there can be a lot of incorrect or partially correct information that can add to stress and confusion for parents and caregivers. Seeking out current and accurate information can help reduce stress and fear.

Are children at lower risk of COVID-19 than adults?

The latest information from the AAP states that childhood cases are increasing in the U.S. It is more likely that children will be infected in areas with more rapid community spread. While children have generally had more mild illness, if case counts rise across the board, more children will be impacted which will also mean more children will have serious illness.

Should children with underlying health conditions (asthma, diabetes, obesity) return to school?

Some children may be at increased risk of getting COVID-19 and, in turn, are at an increased risk for severe illness from COVID-19. Parents and caregivers may need to take additional precautions when making decisions about returning to in-person classes. The CDC provides a comprehensive list of underlying conditions. If you have questions or concerns, contact your child's primary care provider.

See more information about underlying conditions: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

What is the incubation period for children with COVID-19?

Similar to adults, children may develop symptoms from two days to two weeks following exposure to the virus.

Most children recover from COVID-19 within two weeks. Children with normal immune systems can resume activities when it has been at least 10 days since symptom onset and three days fever-free without fever-reducing medication and all other symptoms improving. After someone has had COVID-19, we don’t know how long-lasting immunity against it may be, so everyone who has recovered from the virus should still wear masks and follow social distancing recommendations.

We have a high-risk adult (or newborn baby) at home and my child could potentially bring home the virus. Should he/she not attend school?

Parents and caregivers do need to consider whether other household members are at increased risk of severe illness from COVID-19 when making decisions about which activities to resume, including going back to school.

The CDC says if you, your child or a household member are at increased risk for severe illness from COVID-19, you will need to weigh the benefits, risks and ability to accommodate other educational options, if they’re available.

When school starts, should kids stay away from their grandparents?

If the grandparent is over 65, he or she is at a higher risk of COVID-19 than a younger adult. When school begins, children will come in contact with more people who could potentially share the virus. But staying away from grandparents can be difficult on both them and on children.

As with visits during the summer, it’s important to evaluate your family’s risk factors and risk tolerance. Do the grandparents have high-risk medical conditions? Chronic conditions such as lung disease, heart problems and diabetes can place people at higher risk for a more serious infection. Does potential isolation from grandkids seem more difficult than the risk of getting COVID?

What safety measure should families take once the kids return home from school each day?

The most important thing when children come home from school is that they wash their hands. It’s also a good idea to wash their masks every day.

Items such as shoes, clothes and backpacks are low risk for transmission — as long as children remember to wash their hands before eating or touching their faces.

Is it OK for children to have more screen time when it’s required for school?

Limits on screen time will probably look a lot different now than before the pandemic. With school and socializing happening online, increased screen time is unavoidable. But there are still techniques from the Child Mind Institute that you can use to maintain boundaries:

  • With so much change, unstructured screen time can be a source of comfort and entertainment for many children. Let them know that a certain portion of their screen time is theirs to do what they like.
  • Use extra screen time as an incentive for good behavior. If you go this route, be sure to let your child know exactly what is necessary to earn the extra time.
  • Brainstorm alternatives to screen time. Instead of telling your child, “don’t be on your screen, do something else,” help them decide what to do instead of screen time. Remember that with school, they are used to that structure. Try developing an “activity menu” that lists their favorite non-screen activities (like crafts, reading or playing with a pet).

Is there going to be a diminished flu season this year because of quarantine?

While it is difficult to predict the flu season, public health officials often look to Australia and other countries in the Southern Hemisphere, where they are in the winter flu season, to get an idea of what lies ahead for the U.S. According to the World Health Organization (WHO), so far, COVID-19 precautions have slowed down the pandemic in Australia while also protecting residents against the flu.

The behavioral changes people have already adopted to flatten the COVID-19 curve — such as social distancing, hand washing and mask wearing — could lessen the impact of the flu.

However, because the flu and COVID-19 can bring similar symptoms, people who think they have COVID-19 — but really have flu — could lead to more testing shortages as well.

What happens if there is an outbreak in a classroom?

Schools should have a response plan in place if someone within the school — a student, teacher or staff member — tests positive for COVID-19.

The MDH has resources available to schools and schools should communicate to parents and caregivers what will take place if this happens. According to the CDC, in most instances, a single case of COVID-19 in a school would not warrant closing the entire school. Community spread and how much contact the person with COVID-19 has had with others, as well as when such contact took place, need to be considered.

For district-specific plans, contact your district administration or visit your district’s website to view their safe learning plan for the upcoming school year.

How are we going to know if it's the flu, allergies, COVID-19? Or other viruses such as strep or the common cold?

It's always been more difficult to identify the cause of illness in children than in adults as many children don’t have the ability to communicate exactly how they are feeling. COVID-19 is particularly tricky in that it can look like many different things including the flu, allergies, strep and the common cold. Just like other years, we recommend contacting your medical provider who will help you determine the most likely cause and provide recommendations for how you can best help your child get better.