Op-Ed: Pediatricians Urge Responsible Behavior, Universal Masking 

Parents, teachers and pediatricians all understand the vital importance  of in-person learning not only for our children’s academic development but for their social and emotional development as well. Many children receive resources from schools that they simply cannot receive at home. Others rely on school for nutritious meals. Sadly, there are also children who live in households where they may be the victims of abuse, where school may be their only outlet and where teachers often pick up on clues to children’s home life.

We all know that our children suffered without school this year. We all want the very best for our children. We all understand that many of us cannot be at work if our children are learning at home remotely.

We must also understand that we are in the midst of a pandemic, the greatest public health crisis of our generation. We must understand that at present, the vast majority of us are susceptible to SARS-CoV-2.

 
While most of us will recover, we know that this virus has taken the lives of many previously healthy adults including the parents and grandparents of young children and teens and it has left many more debilitated in some way. We know that while children thankfully do not usually succumb to the virus, some do. Hundreds of previously well children across the country have been hospitalized with very serious complications from the virus, the long-term effects of which are as yet unknown. We also know that children over nine years old can spread SARS-CoV-2 just as easily as adults. 

If our children are to return to school it is absolutely critical that certain safety guidelines be in place. If we want our children in school we must understand that we are going to have to act responsibly to keep not only our own families safe but our communities safe. Finally, we must understand that school this year will not resemble school as we know it, if we are to keep our children and families safe.Schools can only hold in-person classes if local rates of SARS-CoV-2 are low. This can only be achieved if we all act responsibly as families outside of school. This responsible behavior must apply to every single member of our household, young and old. We must wear masks  and social distance even when we are with friends. We must avoid large gatherings. We must be attentive to hand washing especially after touching shared objects. It feels unnatural to distance ourselves from our friends when we speak;  to not have physical contact. Masks can be uncomfortable and cumbersome. However, if we are not taking these simple safety measures we risk passing the virus to our children who can then pass it to classmates and their families. If our children are to return to school, we must understand that we are all responsible for each other.

While in school students and staff must social distance and wear masks at all times and schools should require universal mask wearing. http://www.ny2aap.org/pdf/AAPNY2_SchoolReopeningGuidelines_072920.pdf

 
It is widely accepted as scientific fact that mask wearing is the most important intervention we can take to prevent transmission of SARS-CoV-2. Medical contraindications to mask wearing are exceedingly rare and even younger grade school children can be trained to wear them. Periodic mask breaks can occur throughout the day. Parents should begin discussing the importance of mask wearing with children over the summer before the start of school. They should  review how to properly put on and take off a mask and have children practice wearing them for longer periods of time . https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Cloth-Face-Coverings-for-Children-During-COVID-19.aspx

Parents should have a supply of masks for their children that can be changed daily so masks can be washed between uses.

We must understand that the school our children abruptly left last spring will not be the school they return to.

 

Because staff and students must social distance, some schools will not be able to accommodate all children in school every day and may have alternate days for distance learning from home. Students will likely be in the same room all day and some will eat lunch in their classrooms. Arrival times might be staggered for different grades to prevent large groups from congregating. Parents may be encouraged to drive children to school when possible to minimize contact with a different set of children on the bus. Arrival procedures may take time. Children will be expected to wash their hands frequently throughout the course of the school day and will be discouraged from touching doorknobs or sharing supplies. While some may fear that these procedures may create some anxiety in children, the procedures are necessary to keep them safe. Children are resilient and can adjust  to new situations quickly .

Perhaps most importantly, parents will need to be extremely vigilant about monitoring their children for any medical symptoms. Parents must not send children to school if they have fevers of 100 or greater, cough, sore throat, diarrhea, vomiting or abdominal pain. Parents  must be sure to have a working thermometer at home. Parents who work will need to have provisions in place in the event that their child may have to stay home. Parents will need to cooperate with department of health contact tracing investigations and quarantine orders. They should be prepared for potential stays at home of up to two weeks should their child’s class need to be quarantined because of an exposure to SARS-CoV-2.  Parents might want to have discussions with employers before the start of school to make it understood that they might need flexibility should they need to stay at home with their children.

Parents should be encouraged to immunize their children against the flu. Over one hundred children die from the flu in the United States every year, many of them previously healthy with no underlying conditions. Even if a child contracts the flu, if they have been vaccinated they are more than half as likely to get seriously sick or die from the flu. Children are also often the vectors that spread the flu to the rest of their families. Adults who catch the flu from children sometimes require treatment or hospitalization which would overload hospitals if there are spikes in SARS-CoV-2. Physicians also worry about how severely ill patients may become if they contract both flu and SARS-CoV-2 at once. For all these reasons, this year is going to be a particularly important year for families to be immunized against the flu.

School will be anything but normal this year.  Schedules and procedures may be erratic and subject to change. There will most certainly be moments of anxiety, stress and periods of adjustment for both children and parents. Ultimately we know that our children have much to gain from attending school in person. However, if we are to have our children in school, the utmost attention must be given to their safety and to the safety of teachers and staff.  Schools must do everything they can to adhere to safety protocols . Perhaps more importantly, it is crucial that parents and families behave responsibly as well. Never has the true meaning of a school community been so clear and relevant. Our actions impact not only our own families but every other family we are in contact with both in and out of school. If we respect each other and care about one another and if we prepare ourselves to expect the unexpected at times, we will get through this challenging school year together. 

 
Eve Meltzer Krief MD, FAAP
Legislative Chair 
American Academy of Pediatrics NY Chapter 2
 
https://huntingtonnow.com/reopening-schools-questions-remain-over-a-complex-process/

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