Best Practices for Going Back to School During COVID-19

Healthcare News

Best Practices for Going Back to School During COVID-19

David Hill, MD, FAAP
By David Hill, MD, FAAP
Aug 17, 2021
Patricia Pinto-Garcia, MD, MPH
Medically Reviewed ByPatricia Pinto-Garcia, MD, MPH
Best Practices for Going Back to School During COVID-19

Key takeaways:

  • For children and teens age 12 and up, COVID vaccines provide the best protection against COVID-19.
  • Universal masking is the best way to protect unvaccinated children from COVID-19 infections. Universal masking means everyone wears a mask in school — even vaccinated people.
  • While physical distancing, effective hand washing, and cleaning are helpful in preventing the spread of COVID, they do not replace the need for vaccines and masks.
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Parents, teachers, and students are looking forward to in-person learning this fall after a year of partial and complete school closures. But with more contagious variants, like the Delta variant, driving an increase in COVID infections and hospitalizations among children, many people are concerned about how a return to in-person learning will impact the spread of COVID.

The good news is that there’s plenty of data on how COVID spreads, and you can prepare right now to make the coming school year as safe as possible for your family.

What are the best practices for wearing masks at school?

Children 2 years and older can safely wear face masks. Since COVID-19 is primarily spread by breathing in droplets from nearby people, masks are the best way to protect children both from spreading and getting COVID.

For the majority of children, properly worn and fitted masks do not restrict air flow enough to cause health problems. This is true even for children with underlying conditions like asthma. Masks also do not lower oxygen levels or increase carbon dioxide levels in the blood.

Your child is more likely to wear a mask that reflects things they like. So consider picking masks in your child’s favorite color or masks that have their favorite characters on them. When possible, let your child pick out their own mask. Your child is more likely to wear a mask if you wear yours, too.

Keep in mind that masks vary in quality and fit. When choosing a cloth mask, look for one with a wire or metal bar at the top that can be molded over the bridge of the nose. Also find one with multiple layers, ideally with a layer of spun/non-woven polypropylene. Surgical masks include polypropylene, so you can also just place a surgical mask under a cloth mask.

But no mask is effective if air leaks in and out around it, so you need to check to make sure the mask fits properly. You can check the fit of a mask by cupping your hands around its edges while your child breathes in and out. If you feel air flow, adjust the fit by knotting or tightening the straps or by adding a mask fitter. Remind your child to make sure that their mask is covering their nose and mouth. A mask worn under the nose or on the chin won’t prevent COVID spread.

If your child has special needs that make wearing a mask challenging, talk to your school about safe alternatives that would not exclude them from attending class.

Does your child need to be fully vaccinated before returning to school?

Some states require certain vaccines in order for children to attend school. Although some colleges and universities are requiring students to be vaccinated for COVID before returning to school, there is currently no requirement for COVID vaccination for grades K-12. However, your state may have requirements for other routine vaccinations.

The American Academy of Pediatrics urges all parents to contact their pediatricians to ensure children are caught up on all childhood vaccines before going back to school. The COVID pandemic has left many children behind on routine childhood vaccinations. This decrease in herd immunity increases the risk of outbreaks of other vaccine-preventable diseases like measles and varicella (chicken pox) as children return to school.

One of the most effective ways to keep children from getting COVID is to vaccinate the older children and adults around them. Getting your own vaccine will not only protect you from COVID as your child returns to school, but it will also protect your child and their classmates.

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What hygiene practices should you emphasize with your kids before they resume classes?

Most COVID cases are transmitted by droplets in the air, but COVID can also enter the body when a child touches their eyes, nose, or mouth. For this reason, handshakes and holding hands are still a bad idea. Hand washing is critical, especially after touching a high-touch surface like a handrail or class pencil sharpener. Hand washing is also important after nose blowing and covering a cough.

Before school starts, review proper hand washing with your children. Remind them to wash their hands for 20 seconds (one complete alphabet song) and to lather between the fingers and the backs of the hands. When washing with soap and water isn’t possible, alcohol-based hand sanitizer will also work. Sanitizer should contain at least 60% alcohol, and kids should apply enough to wet all the hand surfaces. Children under age 6 should get an adult’s help using sanitizer.

Additionally, children should learn to cough or sneeze into their elbows and to always dispose of tissues after using them. If they sneeze into a mask, they should replace the mask with a clean one.

Finally, distancing is now a form of hygiene. Children should always have at least 3 feet between themselves and another child. If possible, this should be increased to 6 feet if there is available space. Sadly, this means no hugs, at least until they get home.

What extra school supplies should you send out with your kids this year?

Back-to-school shopping can be fun and exciting, but as you head to the store this year, you may want to add a few items to the cart along with the usual backpack, art supplies, and notebooks. Include the following items in your back to school shopping:

  • Masks, masks, and more masks — your child will need extras
  • Hand sanitizer with 60% or more alcohol
  • Personal tissue packets
  • Extra pencils, safety scissors, and anything else that might normally be shared or lead to touching a surface lots of other children also touch
    Your school may have additional requests, so check with your school’s staff and website.

Will schools follow a normal in-person schedule this year?

Many schools are gearing up for in-person learning. That said, new COVID variants are emerging. Until vaccine rates are higher and cases are lower, there will be periodic community outbreaks that may close schools until the outbreaks come under control.

Check with your local school district for any calendar updates. If you’re not sure what the risk level is in your community, the CDC COVID Data Tracker can help.

What do COVID-19 symptoms look like in children?

Perhaps the most confusing aspect of COVID-19 is that people often have COVID-19 and pass it to others with no symptoms at all. Children who have COVID symptoms should leave school immediately and only return once they’ve seen a healthcare provider. The most common symptoms of COVID in children include:

  • Headache
  • Fatigue (feeling overly tired)
  • Fever
  • Sore throat
  • Abdominal pain
  • Cough
  • Loss of smell or taste
  • Congestion or runny nose
  • Muscle or body aches
  • Nausea or vomiting
  • Diarrhea A lot of these symptoms seem common and minor, but ignoring them can put your child, their classmates, and your family at risk.

What are the most important practices kids should follow to lower the transmission rates?

Here are the most important things kids can do to keep themselves, their classmates, and their school’s staff safe:

  • Get vaccinated. Any child 12 years or older is eligible for a COVID vaccine. Vaccination is the best protection against serious illness from COVID-19. Remember that full protection from vaccination may take 2 to 3 weeks to develop after a child is fully immunized.

  • Wear a mask. Masks are critical, even for people who have been vaccinated against COVID-19. Evidence suggests that vaccinated people may still carry and spread COVID-19 to others. Maintaining at least 3 feet of distance between other children can reduce the viral load in the air and decrease the risk of infection.

  • Wash their hands. Hand washing or sanitizing is a simple, common-sense measure that reduces the spread of infection and that kids already practice regularly.

  • Tell their teacher if they are sick. If a child feels sick at all, they should inform a teacher immediately and report to the school nurse’s office. Mild symptoms are often the only sign that a child has COVID. It is important that symptoms are taken seriously so that the child can be removed from school if necessary.

What are the most important practices schools should follow to lower the transmission rates?

In addition to encouraging the practices described above, there are steps schools can take to decrease the risk to students, teachers, and staff from COVID.

  • Ventilation can help disperse viral particles before they reach levels that can cause infections. Schools should take measures to ensure the best possible ventilation, including opening windows, testing and upgrading HVAC systems, and allowing students to spread out as much as is practical.
  • Schools can help enforce universal mask wearing by students, teachers, staff, and visitors. This includes ensuring that masks are worn properly, over the nose and mouth.
  • Schools can help with testing and contact tracing to ensure that parents are aware when their children have been exposed to COVID and may need to quarantine and get [tested][9].
  • Schools can ensure that all high-touch surfaces are cleaned and disinfected according to CDC guidelines using approved safety protocols.

The bottom line

In-person education benefits children academically, socially, and emotionally, and everyone welcomes a safe return to school this year. COVID remains a real and growing threat in most communities, but a handful of simple, common sense preventive measures can help ensure a safe school year for everyone.

David Hill, MD, FAAP

David Hill, MD, FAAP

Dr. David Hill is adjunct assistant professor of pediatrics at the UNC School of Medicine and a pediatric hospitalist at Goldsboro Pediatrics in Wayne County, NC. He serves on the American Academy of Pediatrics (AAP) Council Management Committee. Dr. Hill is author of Dad to Dad: Parenting Like a Pro, co-author of Co-Parenting Through Separation and Divorce, and associate medical editor of Caring for Your Baby and Young Child: Birth to Age 5. He also serves as associate editor of parent education for AAP Pediatric Care Online and on the advisory board of Parents Magazine.

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor for GoodRx and is board-certified in general pediatrics and pediatric hospital medicine. Dr. Pinto-Garcia received her medical degree from Rutgers-New Jersey Medical School and completed her residency training at the University of Connecticut. Dr. Pinto-Garcia is passionate about ensuring access to accurate, accessible, and reliable healthcare information.

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