Written by: Alanna Higgins Joyce, MD, MPH, MST
Ah, childhood - the lazy days of summer... and winter, spring, and … fall? Stay-at-home orders during COVID-19 allowed many parents to rediscover the joy of being with their children more often and see the proven benefits of long stretches of unstructured play. For the fortunate few able to access and manage virtual homeschool, remote classroom contact provided a temporary routine. However, for many it has been near impossible. As the days of isolation continue, parents around the globe have found themselves juggling managing a household and navigating unemployment or virtual changes to their career while simultaneously caring for their children.
So, how do we get our children back to school safely? And why should we?
The American Academy of Pediatrics (AAP) just published re-entry guidelines “that foster the overall health of children, adolescents, staff, and communities and are based on available evidence.” I think they are feasible, rational and detailed enough to bring children back where they belong – to a safe daily routine with their teachers, friends and support staff. The AAP “strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.” They note that the negative impacts of school closures include not only loss of learning but social isolation, which may prevent identification of children with learning challenges, mental health concerns, food insecurity or unsafe home environments.
Not enough to convince you? Worried about COVID and your newborn, grandparent, ill household member or school-aged child themselves? There is also good data to support that children are at much lower risk for severe illness and are less likely to transmit the virus to others. In fact, early metrics from countries who have safely reopened schools indicate that “transmission in schools may be less important in community transmission than initially feared.”
My former co-resident and Ahimsa Founder, Dr. Manasa Mantravadi and I were discussing the responsible re-opening strategy outlined by the AAP. Both now parents, we agreed on the importance of setting and managing expectations to prepare our children to return to a new school experience. Here are some things to try:
- Wearing a Mask: Try a wear-at-home schedule to help ease them into the physical and emotional feeling of the mask. You may be pretty surprised - if you make it fun and “normal,” they too will see it that way. Teach and practice using a mask (cover nose and mouth, only touch ear loop holes and not the mask itself). You can even have them participate in choosing their masks or decorate paper bags they can store it in with stickers/names/pom poms.
- Temperature Checks: Make it fun! Explain to them that it’s like a magic wand - there are no ouchies here. You can help explain to older kids why we care about the actual number and how fever is a sign our body is working to fight infection.
- Social distancing: Use hula hoops or chalk to make 6 foot circles and practice playing/conversing in your circle so they get the concept of "distance." You can also play shadow tag instead of regular tag. By catching each other’s shadows, you can demonstrate that distancing doesn’t mean the fun has to go away!
- Hand washing: Most of us have now heard of teaching our kids to sing Happy Birthday twice while washing to ensure adequate cleaning time (20 seconds). For more fun, try ink-stamping little hands with a favorite character and challenging your kids to scrub with soap until the stamp disappears.
- School Transportation: Try lining up rows of chairs to practice getting on and off a “bus” and sitting in assigned seats for rides to school. If your child will be using a different mode of transportation than they have before, be sure to take some time to talk about that change.
As a mom, a pediatrician, child advocate and former teacher, I know there are significant risks to keeping children at home and huge benefits to in-person learning. For many children, school isn’t just about the ABC’s and 123’s - kids may rely completely on their school for developmental support, food security, a safe climate-controlled facility or watchful protection during working hours. The American Academy of Pediatrics (AAP) states “schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits. Beyond supporting the educational development of children and adolescents, schools play a critical role in addressing racial and social inequity.”
Former Indiana AAP President, Tony Giaquinta, MD FAAP, Pediatrician and someone who has been integral in the advocacy and policy of children’s health says, “The consensus is clear: children need to be in school this fall. Our worries about children spreading coronavirus MUST be weighed against the many deleterious consequences of school closure. We can take practical steps to greatly mitigate the spread of the disease, while still ensuring an effective learning environment that affords all the other important benefits schools provide for a child's overall health.” He also points out that state/federal funding and media attention should be diverted to our school systems just like they diverted it to healthcare systems during the initial stages of the pandemic. “That was what we had to do then and this is what we have to do now."
I believe my kids need their school. I see them becoming frustrated and angry more easily, testing boundaries and even showing sleep and appetite changes. My little one isn’t old enough to say he misses his artwork or morning circle time, but I know he does. My older son doesn't realize he was so close to reading in March and now has taken steps back. But both boys notice the fatigue of the adults around them, question the looming threat of “the virus,” and mourn cancelled visits to grandparents and off-limits playgrounds and public pools.
So take a look at the COVID-19 Planning Considerations policy and its realistic guidelines for children in each age group, and review their thoughtful statements on masks, daily screening and testing. And then if you agree, share with your local schools and governments. I will join you!
Alanna Higgins Joyce, MD, MPH, MST, is a hospital-based pediatrician in Chicago, a former public middle-school teacher, and a mother of two growing boys.
Manasa Mantravadi, MD FAAP, Riley Hospital for Children Pediatric Hospitalist/Founder of Ahimsa
Tony Giaquinta, MD FAAP, Pediatrician, Former Indiana AAP President
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