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Healthy Students: Back to School During the Coronavirus Pandemic

By Dr. Jen Volland, VP Program Development, NRC Health

The fourth quarter of the last academic year brought many changes for students. The coronavirus (COVID-19) was a new pandemic, already starting to heavily impact the United States. Many teachers quickly adapted their classes to fit a remote learning format, and distance learning soon became not only the preferred but the only way of providing instruction to students in many districts—a significant change from how they’d learned in a classroom setting.

Information on COVID-19, and how best to protect ourselves and others from it, was at that time, as it still is, changing daily. The virus does not behave the same way as previously encountered coronaviruses; it also displays crucial differences from influenza viruses, with longer times of incubation and between cases and higher secondary-infection rates within individuals. As a result of these complications there are, as yet, no licensed vaccines or therapeutics to fight the disease.1

COVID-19 transmission

COVID-19 is spread person-to-person via the respiratory droplets produced when an infected person coughs, sneezes, or talks. These droplets land on the mouth, nose, or are inhaled into the lungs. The likelihood of spread increases as individuals come into close contact with each other. The virus can also live in the air and on surfaces, so infection can occur when someone touches a contaminated surface and then touches their mouth, nose, or eyes. Disinfecting counters, doorknobs, and other surfaces therefore reduces the potential for infection. COVID-19 can spread asymptomatically (infecting people without producing any symptoms in them) and presymptomatically (infecting people prior to their noticing any symptoms).

Many of the precautionary recommendations to date have focused on wearing facial masks, practicing social distancing (keeping six feet apart from others), washing hands with soap for at least 20 seconds or cleaning hands and surfaces with an alcohol-based hand sanitizer, avoiding crowded places, staying home to self-isolate if COVID-19 symptoms present, covering the mouth and nose while coughing or sneezing, and conducting state-run testing programs to achieve contact tracing (identifying those who are COVID-19 positive and others whom these persons may have exposed to the illness, and interrupting further transmission via home quarantine).

Methods and precautions schools are following to curb COVID-19

COVID-19 infection rates vary across states and counties. The precautions recommended or mandated can differ across states and counties as well, depending on the level of prevalence (number of cases that are present at a given time) in each community. As a result, back-to-school approaches also vary widely. Some states have initiated a late start to the next academic year, in hopes of reducing COVID-19 levels before allowing students to congregate in school buildings; alternating days of attendance and staggered start and end times are other ways schools are hoping to reduce in-building traffic. Some states have embraced moving toward either a synchronous remote-learning approach, in which all students attend class via computer at the same time, or a blended-model approach, in which parents can opt for synchronous remote or in-class learning. In a recent poll, 40.8% of registered voters said they were more likely to enroll their child in a home school, neighborhood home co-op, or virtual school once the lockdown ends. The leveraging of computer technology, already an increasing national trend for physician office visits, is now similarly being reported as a preferred method of educating children, both in and out of the home setting.2

Beyond academics: Community disparities and childcare

Different student segments can have different educational needs, and different capacities for meeting them. Low-income students who are assigned a Chromebook for home use, for example, may be less likely to have a reliable internet connection, which can impact their ability to engage successfully in remote learning; for these students, a return to school might allow for better support and wellness benefits (including nutrition/meal programs). Students with disabilities can find remote learning difficult, and often gain better access to educational specialists through an in-person education. Schools also provide valuable social supports and enhanced peer interactions for many students, especially those in vulnerable situations: for example, 18% of reported child abuse and neglect cases are identified by school personnel. School closures due to COVID-19 have placed some children at higher risk for domestic violence.3

In addition, many parents are dependent on childcare for their own employment. Providing after-school coverage for children under the age of 15 can be a serious financial concern for some families. In the United States, 26.8 million workers—a full 16% of the nation’s workforce—are dependent on childcare.3 Returning to work reopens the economy—and having children in school helps parents return to work.

What can you do to help monitor your child at school during the COVID-19 pandemic?

Some practical advice for the weeks ahead, for parents planning to send their children back to school:

  • Have your child practice wearing a face mask. Many educational facilities will be requiring students to wear masks with more than one layer of fabric instead of allowing face shields, for extended periods of time. Helping children become accustomed to this early will make for an easier transition when school starts.
  • Consider following this seven-step process for helping your child adjust.
  1. Control your own anxiety.
  2. Approach your kids and ask what they know.
  3. Validate their feelings and concerns.
  4. Be available for questions and provide new information.
  5. Empower kids by modeling behavior.
  6. Provide them with reassurance.
  7. Don’t blame others.

Additional information on each of these seven steps, and helpful guidance for children of different ages and developmental stages, can be found here.4

  • Keep your child home and notify your physician if they are showing symptoms of COVID-19.

Similarly, if a child has been in close contact with someone known to be COVID-19 positive, keep them home and monitor their health. Follow quarantine restrictions established by state and local health departments.

The amount of time to be spent in quarantine differs according to exposure. The Centers for Disease Control and Prevention (CDC) outlines who needs to quarantine and the appropriate steps to take to monitor their health. Information on four different scenarios, and the amount of time recommended for quarantine in each, can be found here. The scenarios include being in contact with someone who is COVID-19 positive, without further close contact; living with someone who is COVID-19 positive, but being able to avoid further contact; having COVID-19 oneself, when someone else within the household also becomes sick; and living with someone who is COVID-19 positive, when close contact cannot be avoided via separate living areas and/or maintaining six feet of physical distance.5

  • Ensure a solid understanding of any changes to student absenteeism or truancy policies.

Even prior to COVID-19, schools were a major site for the spread of infections—so when students return to the classroom, some of them will get sick. Given the amount of time to enact a quarantine, should one be required, you should research any recent changes that have been made to school-district policy and understand the necessary steps to take if your child becomes ill. Some school districts do not consider medical absences with a clinician note to be the same as out-of-school absences, for example; clearance documentation may also be required for a child to return to school after a COVID-19 infection.

  • Monitor your child for signs of chronic stress.

Children will have different reactions in a crisis, and one of those reactions is chronic stress. Signs of chronic stress in a child can include:

  1. Physical symptoms: chronic fatigue or exhaustion, difficulty paying attention, confusion, hypervigilance, headaches, stomach aches, muscle tension, changes in sleep/appetite patterns
  2. Emotional symptoms: excessive worry, anxiety, disconnection/numbness, anger, compassion fatigue, demoralization, resignation, distressing dreams, confusion, difficulty with decision making, sadness, depression, hopelessness, suicidal thoughts
  3. Social or interpersonal symptoms: difficulties in relationships (at home or in school), irritability, angry outbursts, social withdrawal, isolation, alcohol or substance use

Should these signs become evident, act quickly. Ways to guide a child toward resiliency include creating a daily structure and routine for greater stability and sense of control; reducing/limiting exposure to COVID-19-related media; ensuring the child is getting adequate sleep, taking breaks during homework, and getting adequate and healthy nutrition; engaging in exercise with the child; watching a funny show or focusing on something that allows for creativity; and ensuring that social connections are maintained.6 Most importantly, if you believe your child’s well-being may be at risk, seek the help of a school counselor or outside resources to help them cope.

  • Take your child’s temperature at home daily before sending them out to school.

Not all school districts are planning to provide entry-door surveillance to identify children who may be arriving with an elevated temperature (100.4 degrees or higher). Many schools are depending on families to do this at home, with educational staff spot-checking throughout the day if it appears a child may be becoming ill. Schools are advised to balance safety with the practicality of student volume and the loss of school time that could occur by screening of everyone upon entry. As a result, they are relying in many cases on home monitoring to be conducted. For families with multiple children, consider having a thermometer for each person in the household to reduce the potential for cross-exposure. Should one child become infected with COVID-19—even if they do not show symptoms—a shared oral thermometer can easily become a site of transmission.

COVID-19 is necessitating many difficult decisions for families, regarding their children’s schooling. While we now know more about the virus than we did in early summer, changes in our knowledge and precautionary measures are still happening rapidly, and parents and school officials will all have to make their decisions carefully and with consideration for the unique challenges the pandemic poses for children.

While there are benefits and drawbacks to both remote and in-person learning, it should be remembered that children are experiencing a set of circumstances unlike any other—a situation of ongoing ambiguity, in which their developing coping skills can easily become compromised. Parents have a vital role to play in monitoring their children for any personal changes that may occur, providing age-specific information to maintain their children’s awareness of the disease without arousing unnecessary fears around it, and understanding the actions that may be required should their children become infected. By championing the recommendations which children will need to follow in the classroom setting, and providing unwavering support for their individual needs, we can help our children thrive without panic in an uncertain time.

  1. World Health Organization. Q&A: Influenza and COVID-19 Similarities and Differences.
  2. com. COVID-19’s Surprise Effect: More Parents Are Interested in Home Schooling.
  3. McKinsey & Company. https://www.mckinsey.com/industries/social-sector/our-insights/safely-back-to-school-after-coronavirus-closures#
  4. The Clay Center for Young Healthy Minds. https://www.mghclaycenter.org/hot-topics/7-ways-to-support-kids-and-teens-through-the-coronavirus-pandemic/
  5. Centers of Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html
  6. National Association of School Psychologists. https://www.nasponline.org/resources-and-publications/resources-and-podcasts/COVID-19-resource-center/crisis-and-mental-health-resources/coping-with-the-COVID-19-crisis-the-importance-of-care-for-caregivers%E2%80%94tips-for-parents-and-teachers