Returning to In-person Schooling During COVID-19

It’s been a year since our children were abruptly sent home from school to keep them safe from the COVID-19 pandemic that was quickly spreading across the United States. And while some children and teachers were able to return to in-person schooling in the fall, many more remained at home in virtual schooling.

As schools across the country work hard to return students to the classroom, experts at Children’s Hospital of Philadelphia weigh in on how to help your child safely return to in-person learning.

What we’ve learned about schools and COVID-19

We’ve learned quite a bit about the SARS-COV-2 virus in the past year, including how in-person schooling may or may not impact community transmission of the disease.

Recent school-related findings suggest:

• Community infection rates do NOT increase when schools reopen.
• School attendance can “protect” against COVID-19, as we’ve witnessed in Wisconsin and Rhode Island, where public schools returned in the fall without a spike in COVID-19 transmission rates.
• Schools can operate safely even when the community viral transmission rate is high. We’ve learned this from successful re-openings of some independent, charter and parochial schools in our area.

Reminders for a safe return to school

No matter when your child returns to in-person schooling, they will need to follow certain rules to help control the spread of COVID-19. Measures being implemented at schools include:

1. Requiring all students and staff to wear a face mask that covers both their nose and mouth, and is snug on the sides so there are no gaps.
2. Physical distancing measures to make sure each student keeps a safe distance from others – both while they’re seated in the classroom and as they navigate the halls and other shared spaces.
3. Expanded cleaning of all shared rooms and surfaces.
4. Reminders and opportunities for frequent hand cleaning/sanitizing and respiratory etiquette (i.e., cover your cough or sneeze into a tissue or elbow, not your hands).
5. Contact tracing, quarantine and isolation procedures ready to activate if any students or staff attending school in person are exposed or test positive for COVID-19.

Answers to questions parents are asking

In a recent CHOP Primary Care Town Hall, a team of four doctors from CHOP responded to questions from parents and teachers to address concerns about returning to in-person schooling. Our panel of CHOP physicians included: Susan E. Coffin, MD, MPH, Lori Handy, MD, MSCE, Katie K. Lockwood, MD, MEd, and Katie E. McPeak, MD. Here, they answer some of the most popular questions.

Q: If an individual is exposed to a known case of COVID-19 in school, when should they be tested to see if they’ve been infected?

A: If they are symptomatic, they should get tested as soon as possible. For children who don’t have symptoms, the best time to be tested is 5-7 days after the exposure risk. If the test that is obtained on day 7 post-exposure is negative, the child can resume school/activities. If no testing was performed, the CDC recommends 10 days of quarantine after exposure and before returning to in-person schooling or activities. Your local school district may require a longer period of quarantine, but generally not more than 14 days after exposure.

CHOP now has robust testing capability. You can get a COVID-19 test for your child at any one of our several drive-thru/walk-through sites, as well as at our Urgent Care locations. The testing is quick and painless and no longer requires a deep swab to the back of the nose.

Q: Are the COVID-19 vaccines safe?

A: Yes! All COVID-19 vaccines have undergone rigorous testing before being approved by the FDA. You may experience some reactions from the vaccine; this is to be expected. Your immune system is responding to the spike protein in the vaccine. Most reactions occur within the first three days, and may occur after the first or second shot – or both. The most common reactions after the vaccine for individuals younger than 55 years old include: fatigue, headache, muscle ache, fever, chills and arm pain. Reactions typically resolve in a few days. Also, remember that no COVID-19 vaccines are currently approved for use in children younger than age 16.

Q: What’s the best mask and mask advice for kids?

A: The best mask is one that fits on your child’s face, covers both their nose and mouth and is snug on the sides so it doesn’t bunch up. You don’t need KN-95 masks. Masks should include two layers of cotton. Make it fun! Let them pick the design – whether it’s superheroes, princesses or a cool pattern. And then get a bunch. Your child attending school will need multiples throughout the week to avoid laundry every night. Masks should be dry and clean. If it’s not, switch it out (safely, far from others). Most kids who are resistant to mask wearing can be gradually taught to wear them properly.

Pro Tip: Consider putting self-stick hooks by your front door with a little laundry bag or basket near it. Clean masks go on the hooks; dirty masks go in the laundry bag or basket right away!

Q: What about lunch at school? How close can kids be?

A: Whenever children take off their masks and are around others without masks, there’s a risk of COVID-19. But there are things we can do to reduce this risk. Parents and educators can help children prepare to eat at school by offering rules or guidelines including:

• Sit at least six feet away from other students while eating.
• Remove your mask only when actively eating or drinking.
• When finished eating and drinking, put your mask back on – don’t wait until the bell rings and lunch is over.
• Remind your child that having their mask off for the entire lunch break isn’t necessary, and they will be safest if they put their mask back on when they are not eating or drinking.

Parents can check in with school officials about how they plan to host lunch in school. Some schools have chosen to reduce risk by hosting lunch in larger spaces or in multiple locations (i.e., cafeteria, gym, auditorium). Other schools limited on space have chosen to install Plexiglass barriers between students, allowing them to sit a bit closer but still protected against droplets or aerosol-based viruses.

Q: How can families comfort their kids who are scared of returning to school, scared of their own infection risk or worry about passing the virus to a loved one?

A: Many children can be supported by parents and siblings to help them better understand how our masks, handwashing and physical distancing keep us healthy. However, some children will be overwhelmed or truly fearful for themselves or others.

If you are concerned about your child’s behavior or mental health, talk to your child’s pediatrician as soon as possible. They may refer you to a therapist who is experienced in helping children and teens. The transition back to school may be hard for some kids so communication between parents, teachers and pediatricians is important to identify kids who are at-risk.

Worth the challenge

Going back to school during a pandemic is challenging, but with the appropriate tools and resources, your child can return to learning with their peers – safely – and enjoy many of the social benefits of in-person education, extracurricular activities and more.

Resources

• Navigating COVID-19: Resources for Parents
• Is Your Family Putting On and Taking Off Their Mask Safely?
• COVID-19 Testing for Kids
• COVID-19 Vaccine Program: School Personnel
• Teens, Stress & COVID-19
• COVID-19 Vaccine Program FAQs

Susan E. Coffin, MD, MPH, Lori Handy, MD, MSCE, Katie K. Lockwood, MD, MEd, and Katie E. McPeak, MD, are all physicians at Children’s Hospital of Philadelphia.