While we know much more now than we did back in March when COVID first started to impact our community, there still seem to be more questions than answers. One of the most pressing questions for our families is the question of what to do about the return to daycare or school. We all agree that daycare and school can be vital in terms of helping our children develop effective social skills, learn crucial academic skills, and in allowing parents to remain effective at work. For our most vulnerable, daycare and school provide a safety net, providing food and other social services that may not be available at home. But while we all agree we'd love for our children to get “back to normal” there are some legitimate safety concerns. Read on as we break it down.
Here's the good news:
· There is convincing data that children don't seem to catch COVID-19 as readily as adults do.
· There is convincing data that children (10 and under) don't seem to spread it as readily as adults.
· Children who get COVID-19 typically acquire it from a family member.
· Children rarely have severe symptoms or require hospitalization. Most children with COVID-19 have mild symptoms, such as a sore throat or cough. Less than 50% have a fever and many stay symptom-free despite testing positive for the virus.
· Simple measures such as wearing a mask when around others, practicing social distancing, and regular hand-washing can dramatically decrease the risk of catching and spreading COVID-19.
Here's what concerns us:
· This is still a very new virus, and we just don't know what we don't know.
· For instance, we don't know enough about the possible long-term effects of having the virus in childhood. Emerging data indicates that, in rare cases, children with a history of COVID can develop heart issues or a multi-system inflammatory disorder requiring hospitalization.
· All of the data on the risk of spread in daycares and schools was either gathered in the US during lock-down or was gathered from other countries without the ongoing wide spread of the virus that we are experiencing in the US.
· Teenagers do seem to be easily infected and effective spreaders of the virus, which means high school will need to be assessed and managed differently from elementary school. Middle schoolers fall somewhere in between (as always!).
Ultimately, each family will need to make the best decision for their own children. Families with high-risk members may need to opt for a more conservative approach. Children with underlying medical conditions such as severe asthma, diabetes, congenital heart disease, or a history of severe prematurity should check with their pediatrician or subspecialist individually to talk through the risks and benefits of resuming activities and how to stay safe. Call our office to schedule a video visit with your child's pediatrician if you would like this individualized guidance. While we certainly don't have all the answers, we are here to help guide you through this and help you make the best decision for your family. If you'd like to learn more, please see below for links to helpful resources.
Resources: (disclaimer, these are for informational and educational purposes only. Matthews Children's Clinic does not recommend using these resources as a substitute for individual care from your pediatrician.)
Helpful article from the parent educational website sponsored by the American Academy of Pediatrics
https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Return-to-School-During-COVID-19.aspx
This is a simple checklist from the CDC for parents of school-age children:
https://www.cdc.gov/coronavirus/2019-ncov/downloads/schools-checklist-parents.pdf
This is the North Carolina state COVID-19 site, full of helpful and up to date information:
https://www.nc.gov/covid19
This is the North Carolina school reopening tool-kit:
https://files.nc.gov/covid/documents/guidance/Strong-Schools-NC-Public-Health-Toolkit.pdf
Detailed and comprehensive guide to reopening from the CHOP Policy Lab.
https://policylab.chop.edu/sites/default/files/pdf/publications/Policy-Review-School-Reopenings-PolicyLab-2020.pdf
Detailed list of resources from MassGeneral – links to specific studies are included:
https://www.massgeneral.org/assets/MGH/pdf/medicine/infectious-diseases/COVID-19%20School%20and%20Community%20Resource%20Library_July%206%202020.pdf?fbclid=IwAR3QrMkFwdncOvaZZz_xJm9-DZHrIQYWpzgHn6glUpNWcaDbDO9o7naaC8M
This is a series of helpful graphics that show how quarantine/isolation timing can vary and how it is calculated.
https://www.kingcounty.gov/depts/health/covid-19/~/media/depts/health/communicable-diseases/documents/c19/how-long-to-stay-home-when-sick.ashx?fbclid=IwAR2hNktce4vD-re3tj4BxZf-h1qkn6B1syjOShBGspCpoJ-S5r-wBGBVcA4