For most parents, the ongoing COVID-19 pandemic has complicated their plans to send their kids back to school.
Going Back to School During the COVID-19 Pandemic
We can likely all agree that if it could be made safe for kids, teachers, and other support staff in schools, then kids should go back to school.
So what’s the problem?
Depending on where you live, the size of your school, and the number of cases, etc., it may not be possible to make schools that safe. After all, how much social distancing can you do in a classroom full of kids? And will kids, especially younger kids, really wear a face covering all day?
Sending Your Kids Back to School
On the other hand, if your community is doing a good job of keeping COVID-19 case counts down, then maybe it is safe, or at least, safe enough, to send most kids back to school.
Going back to school might be a good option for:
- kids who are healthy, without any high risk medical conditions, like diabetes or poorly controlled asthma
- kids who have no high risk contacts at home, keeping in mind that in addition to having a chronic medical problem, the risk increases with age, especially once you reach age 65 years.
- kids who have an IEP or get any kind of services or therapy at school that you can’t get at home
- kids who did poorly with online school last spring
- kids who are eager to go back to school
Most importantly, going back to school might be a good option for your kids if you are confident that your school has a good plan to keep your child and everyone else in the school safe.
Do they have a plan to cohort kids together, so that every kid in the school isn’t mixing with each other? What is their plan if someone gets sick? What is their plan if a lot of kids get sick?
It is also important to remember that virtual school isn’t a good option for everyone. Having a safe school to go to will be important for those kids who don’t have a parent or caregiver at home to help them with school or because they don’t have a reliable internet connection, etc.
Going to the School Nurse During the COVID-19 Pandemic
If your kids do go back to in-person school, what happens if they get sick?
“Immediately separate staff and children with COVID-19 symptoms (such as fever, cough, or shortness of breath) at school. Individuals who are sick should go home or to a healthcare facility depending on how severe their symptoms are, and follow CDC guidance for caring for oneself and others who are sick.”Operating Schools During COVID-19
Should they go see the school nurse, if your school is fortunate enough to have one?
“School nurses are essential healthcare providers in the community working on the frontlines of the COVID-19 pandemic in schools.”Considerations for School Nurses Regarding Care of Students and Staff that Become Ill at School or Arrive Sick
In addition to the problem with a bunch of contagious kids in the school nurse’s office, it is easy to see that it will difficult, if not impossible, for health care professionals at school to easily know if a sick child has COVID-19, strep throat, a cold, or the flu, etc.
“The overlap between COVID-19 symptoms with other common illnesses means that many people with symptoms of COVID-19 may actually be ill with something else. This is even more likely in young children, who typically have multiple viral illnesses each year.”Screening K-12 Students for Symptoms of COVID-19: Limitations and Considerations
There is also the fact that a child who goes to the nurse’s office with a cough, runny nose, or headache, etc., might not have a contagious disease at all, as these symptoms can also be caused by asthma, allergies, and migraines.
“Remember that schools are not expected to screen students or staff to identify cases of COVID-19. If a school has cases of COVID-19, local health officials will help identify those individuals and will follow up on next steps.”Considerations for School Nurses Regarding Care of Students and Staff that Become Ill at School or Arrive Sick
Fortunately, there are plans in place to deal with all of these scenarios.
Still, everyone should understand that most “sick kids,” whatever they have, will likely be sent home from school, just in case they have COVID-19. While that might sound drastic, the risk of getting others sick if they did have COVID-19 is too great.
“Actively encourage employees and students who are sick or who have recently had close contact with a person with COVID-19 to stay home.”Operating Schools During COVID-19
So how do these plans work?
Back to School COVID-19 Sick Policies
While each state and school district seems to have their own back to school sick policy, in general, what to do should likely depend on the child’s symptoms, the possibility of an alternative diagnosis for the symptoms, potential for exposure to someone with COVID-19, the amount of community spread in the area, and COVID-19 test results, etc.
If one thing isn’t clear in all of these guidelines, it is to your pediatrician – we typically won’t be able to simply say that your sick child doesn’t have COVID-19 and can go back to school.
“A doctor’s note or negative test should not be required to return to school. Some tests can yield false negatives if taken too soon, and individuals with confirmed COVID-19 can continue to test positive after the infectious period has passed. Antigen tests currently are not as reliable in determining a true negative.”Decision Tree Tool for School Nurses
Fortunately, many of the guidelines seem to understand this and don’t require a doctor’s note when kids have very mild symptoms.
“If the person is sent home, they can return to the school or program 24 hours after the symptom has improved.”COVID-19 Decision Tree for People in Schools, Youth, and Child Care Programs
They aren’t perfect, but hopefully we can use these guidelines to help balance keeping those kids who might have COVID-19 out of school, perhaps learning virtually, while those kids who don’t remain at their desks.
More on Back to School
- What to Do if You Have Been Exposed to COVID-19
- What to Do if You Have Been Diagnosed with COVID-19
- 5 Things You Need to Know About COVID-19
- Are Kids Spreading SARS-CoV-2?
- What is the COVID-19 Multi-System Inflammatory State?
- Are Kids Dying With COVID-19?
- The Second COVID-19 Wave Might Not Be COVID-19
- Why Are Social Distancing Kids Still Getting Sick?
- TMA – Decision Tree Tool for School Nurses
- COVID-19 Decision Tree for People in Schools, Youth, and Child Care Programs
- MAAP – For Medical Providers:Assessing for COVID-19 in children with symptoms and NO KNOWN EXPOSURE to COVID-19
- COVID-19 Before School Screening for Parents
- Breaking down back to school sick policies, pediatrician answers frequently asked questions
- CDC – School Decision-Making Tool for Parents, Caregivers, and Guardians
- CDC – FAQ for School Administrators on Reopening Schools
- AAP – COVID-19 Planning Considerations: Guidance for School Re-entry
- AAP – Return to School During COVID-19
- Heading back to school during the COVID-19 pandemic
- Safely Reopening America’s Schools and Communities
- Going Back to a Better School: NEA Issues Guidance on Reopening
- COVID-19: Preparing For Widespread Illness in Your School Community
- COVID-19: Return to School
- COVID-19 Impact on Education
- Coronavirus (COVID-19) Guidance for Schools
- Study – School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review
- CDC – Considerations for Schools
- CDC – Schools During the Covid-19 Pandemic
- CDC – Back to School Planning: Checklists to Guide Parents, Guardians, and Caregivers
- Is School Safe? Will Districts Test For COVID-19? Answering Back-To-School Questions
- Tips on Creating School Nurse Positions During COVID-19
- COVID-19 Toolkit
- Interim Guidance: Role of the School Nurse in Return to School Planning
- Considerations for School Nurses Regarding Care of Students and Staff that Become Ill at School or Arrive Sick
- CDC – Operating Schools During COVID-19
- CDC – Screening K-12 Students for Symptoms of COVID-19: Limitations and Considerations
- Returning To Play After Coronavirus Infection: Pediatric Cardiologists’ Perspective
Last Updated on September 3, 2020 by Vincent Iannelli, MD