If your child is one of the millions of kids who's going to in-person school during the novel coronavirus pandemic, you may be rotating between moments of euphoria and pure panic.
But while it's normal and expected to have concerns, you can take comfort in knowing that kids are less likely than adults to suffer serious complications of COVID-19, although it's possible that they can still transmit it to others, says Jennifer Lighter, MD, an infectious disease specialist at NYU Langone Health.
What's more, there's little evidence that schools have contributed meaningfully to increased community transmission, according to a paper published January 2021 in JAMA.
Still, it's smart to be cautious. Here's how to gauge whether it's safe to send your kids to school, and what precautions you need to take.
Get tips on how to stay healthy, safe and sane during the novel coronavirus pandemic.
1. Make Sure It's Actually Safe
One reason school districts in various parts of the country have seen outbreaks is because they returned to school when rates of COVID-19 were still high in their area, Dr. Lighter explains.
The lowest risk of transmission in schools is when there has been less than 5 per 100,000 cases within the last 14 days, as well as a positive test rate of under 3 percent, per the Centers for Disease Control and Prevention (CDC).
If it's higher than that, that doesn't necessarily mean you shouldn't send your kids, but it's probably worth having a discussion with your pediatrician about whether the benefits outweigh the risk, Dr. Lighter says.
You can get a sense of how both your state and county are doing at CovidActNow.org.
Your school should require that everyone wear masks (both students and staff) as well as social distancing as much as possible (while spacing everyone six feet apart is preferred, per the American Academy of Pediatrics, keeping everybody three feet apart is OK).
Your school district should also have a contact tracing plan set up with your town's health department, in case someone at the school tests positive. That way, they can quickly figure out who has been in close proximity to the infected person — usually defined as someone who's been within six feet of the individual for at least 15 minutes starting from two days before they got sick, per the CDC — and have them quarantine.
2. Send Your Kid to School With the Right Supplies
There's no need to go overboard with hand wipes and disinfectant sprays — a simple cloth mask (plus an extra for their backpack, in case the one they're wearing gets lost or dirty) and hand sanitizer should be plenty, Dr. Lighter says.
"We know now that the main way the virus that causes COVID-19 is spread is through aerosols — we're much less worried about infection from surfaces," she explains.
As far as a cloth mask, look for one that has double layers. When researchers at Wake Forest Baptist Medical Center compared about 400 cloth masks to surgical and N95 masks, they found that the best-performing ones were made out of two layers of heavyweight "quilter's cotton," filtering out about 78 percent of all particles compared to about 65 percent with surgical masks.
The best way to tell if your mask meets the grade is to perform what's known as the "light" test, per study author Scott Segal, MD, chair of anesthesiology at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. "Hold the cloth up to bright light or sun — if you can see light pass through the fibers, it's not as good of a filter," he explains.
Make sure your child knows how to wear a mask properly, too. That is, kids shouldn't "make mistakes like letting it slip down under their nose," Dr. Lighter says.
Hand sanitizer is also key, but just make sure it contains at least 60 percent alcohol, per the U.S. Food and Drug Administration (FDA).
Teach Kids When — and How — to Use Hand Sanitizer
Make sure kids understand that anytime they touch a commonly grabbed surface — such as doorknobs or stair railings — they should quickly sanitize their hands afterward by either washing them or using hand sanitizer.
Explain to kids how to sanitize their hands: Apply enough sanitizer to coat the whole surface, then rub until dry, per the CDC.
“Don’t talk to them about it in a scary way — explain it as they’re doing their part against COVID-19, so they can feel part of the solution,” Dr. Lighter says. “You don’t want to make them so fearful that they’re too afraid to enjoy school.”
3. Encourage a Hand-Washing Habit
As soon as your kids set foot inside your house after being at school (or anywhere else), they should head to the bathroom and wash their hands thoroughly, advises Michael Chang, MD, a pediatric infectious disease specialist at the McGovern Medical School at UTHealth in Houston.
Make sure they lather soap all over their hands, including on the backs, between their fingers, and under their nails for at least 20 seconds, or about the time it takes to sing the "Happy Birthday" song twice.
After that, they — and you — really don't need to do anything more, stresses Dr. Chang, other than wash their cloth mask in that night's laundry or in the sink. There's no need to disinfect everything they came home with.
"There's really no evidence that COVID-19 can be transmitted through items such as shoes, clothes, books and backpacks," Dr. Chang says.
Instead, a better use of your time is to do a quick symptom check.
"If they come home and complain about their throat feeling scratchy, or they have a headache or complain that their food tastes funny, you will want to watch them closely to see if it goes away after a couple hours or if it persists," Dr. Chang notes. "These can all be symptoms of COVID-19."
4. Err on the Side of Caution
If your kid shows any signs or symptoms of COVID-19 — even if it's just a mild cough or runny nose — keep them home and call your pediatrician.
"A lot of children will have runny noses and sore throats, and most of the time, it won't be COVID-19," Dr. Chang says. "But the only way to know that for sure is to get tested. It's inconvenient for parents, and it may mean your child will miss more school than you'd like, but it could save lives."
At some point, you may get the dreaded call that one of your child's classmates tested positive for COVID-19 and they need to quarantine for two weeks. While you should take it seriously, you don't need to panic: "If everyone in the classroom wore a mask and kept it on, there's lower risk of exposure," Dr. Lighter says.
Communities with a mask mandate were able to significantly slow down the growth of COVID-19 cases, per a June 2020 study in the journal Health Affairs. That's likely because masks are a highly effective way to reduce the spread of aerosolized droplets.
In one lab experiment, researchers used mannequins to get a sense of how far aerosolized droplets could travel — without any covering, respiratory droplets traveled an average of 8 feet, but a homemade cloth face mask reduced that distance to 2.5 inches, per the June 2020 findings published in Physics of Fluids.
By the way, if your child is home quarantining due to a classmate diagnosed with COVID-19, that doesn't affect siblings, who can continue to attend school. To be safe, it's a good idea to have the child who is quarantining use a separate bathroom from the rest of your family and wear a mask as much as possible around other family members.
Just because school has started doesn't mean your kid should start up with extracurriculars again.
The January 2021 JAMA paper notes that contact during both sports practices and competition, and at social gatherings associated with team sports, seems to increase the risk of COVID-19 outbreaks. Specifically, the authors note, indoor practice or competition and school-related social gatherings with limited adherence to physical distancing and other mitigation strategies could jeopardize the safe operation of in-person education.
So, it might be wise to have your child skip athletics for now, especially if they can't play outdoors and the sport requires a lot of close contact with others.
It's OK to see friends outside of school, but try to have playdates outdoors, and keep everyone six feet away from each other (and if you can't easily do that, make the kids wear masks).
It's also a good idea to be extra cautious if you plan to see grandparents. You don't have to nix a visit entirely, but try to stay outdoors, and masks and social distancing are a must.
"We're going to be living with COVID-19 for months," Dr. Chang says. "That doesn't mean kids won't be able to go back to school in some form and even possibly play certain sports, but we all have to be smart about our choices."
Is This an Emergency?
- Centers for Disease Control and Prevention: Indications for Dynamic School Decision Making
- Centers for Disease Control and Prevention: Contact Tracing for COVID-19
- Wake Forest Baptist Health: Testing Shows Type of Cloth Used in Homemade Masks Makes a Difference, Doctors Say
- CDC: "Hand Sanitizer Use Out and About"
- American Academy of Pediatrics: COVID-19 Planning Reconsiderations: Guidelines for School Re-entry
- Health Affairs: Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US
- U.S. Food and Drug Administration: "Q&A for Consumers | Hand Sanitizers and COVID-19"
- Physics of Fluids: "Visualizing the effectiveness of face masks in obstructing respiratory jets"
- JAMA: "Data and Policy to Guide Opening Schools Safely to Limit the Spread of SARS-CoV-2 Infection"