Reopening Schools -- Now, So Much Depends Upon ...

"School is important for student's academic growth, but it is also important to their social and mental health. Each family must make decisions on how to take part in school this fall based on their specific circumstances, such as spread of COVID-19 in your community, your work demands, your child's health and academic needs, and health risk."

– Jeremy Forster, M.D., a pediatrician at Mayo Clinic Health System

Schools are reopening amid fears of the spread of COVID-19. Parents are the front line for protection. And, of course, schools are taking extra precautions to stop the virus. What is painfully clear is that a united effort will be the only successful strategy to keep schools open and coronavirus infection down. Now is the time to guard educational operations.

Parents, guardians, and caregivers need to check local transmission rates, be sure rapid access to tests and results are available, and employ means for “track and trace” for contacts of testing and quarantine.

The website covidactnow.org monitors community transmission using five indicators or numbers: new cases, infection rate, degree of testing, hospital capacity and contacts traced. The website also created a warning system building on an early monitoring system developed by the White House coronavirus task force. 

At home, there are crucial actions to take and points to consider:

Check in with your child each morning for signs of illness. If your child has a temperature of 100.4 degrees or higher, they should not go to school. Make sure your child does not have a sore throat or other signs of illness, like a cough, diarrhea, severe headache, vomiting, or body aches. If your child has had close contact to a COVID-19 case, they should not go to school. Follow guidance on what to do when someone has known exposure Identify your school point person(s) to contact if your child gets sick. (“Back to School Planning: Checklists to Guide Parents, Guardians, and Caregivers.” Centers for Disease Control and Prevention. July 23, 2020.)

"Even though it may seem like just a minor runny nose or cough, staying home from school or work is the right thing to do to reduce the risk of exposing others to not only COVID-19, but other respiratory viruses like influenza, as well.”

– Nipunie Rajapakse, M.D., pediatric infectious disease specialist at Mayo Clinic

The checklist below is meant as an additional – although not comprehensive – guide for teachers, parents and administrators.

Masks. Teachers, staff and school employees should be fitted for KN95 or N95 masks. These masks block 95 percent of particulate matter when properly fitted. Students must always wear masks, except when they are eating or drinking. But teachers and parents need to emphasize the importance of keeping the mask on and not fidgeting with it. Taking off and putting on a mask throughout the school day may contaminate the mask and child.

Air flow. Like in hospitals, schools should install and use HEPA filters. Ideally, schools should keep windows and door open, letting fresh air reduce the concentration of indoor contaminants, such as virus particles. High-efficiency particulate air (HEPA) filters work in a similar way, but won’t create problems for children with allergies or asthma. Removing viruses from the air reduces the potential for exposure.

Pods. Students should be divided into groups or pods of 10 to 15 students. The pod learns, eats and exercises together the entire school day. This way each student can stay 6 feet from their peers while seated at their desk. A pod also helps identify and contain a potential outbreak.

Drinking fountains. Schools must replace water fountains with bottled water. Using a water fountain brings hands, mouths and noses close to a high traffic surface. A student infected with COVID-19 may shed the virus on the on/off knob, water source and other parts of the fountain. Closing a fountain eliminates a potential source of contamination.

Hand Washing. Schools should promote and demonstrate regular hand washing and positive hygiene behaviors and monitor their uptake. Ensure adequate, clean and separate toilets for girls and boys. (Post signs encouraging good hand and respiratory hygiene practices.)

Outdoor education. Students should eat and exercise outdoors as much as possible. Intense activities require more inhales and exhales. This can increase the number of virus droplets in the air, leading to greater exposure to COVID-19. Conducting both activities outside allows fresh air to reduce the concentration of viruses.

Movement. Hallways are one-way corridors, moving students in one direction. One-way hallways reduce the chances of face-to-face contact, which increases the likelihood of transmission.

Cleaning. Classrooms and buses are cleaned twice a day. Depending upon the surface, COVID-19 can live on surfaces for hours to days. Cleaning is necessary to destroy the virus in common space surfaces, such as bathrooms, lockers and buses.

Testing. Schools must be vigilant. Surveillance systems should be set up to periodically test sewage, heating air conditioning and ventilation systems and compressors to help in the early detection of an outbreak.

Extracurriculars. School should stop chorus, band, wrestling, football and other contact sports. Social distancing is impossible with these group activities. Singing and playing wind instruments aerosolize the virus. A two-hour choir practice with one symptomatic singer in Washington state resulted in 87 percent of the group becoming infected.

Students at higher risk. While COVID-19 school policies can reduce risk, they will not prevent it. Some students with high-risk medical conditions may need other accommodations. Talk with your pediatrician and school staff (including school nurses) to see if your child needs additional solutions to help ensure safety at school.

(Dr. Valda Crowder. “Back to school? COVID-19 advice for American parents and teachers amid a pandemic.” NBC Think. August 24, 2020.)

So much needs to happen so that students can learn and thrive without raising the risk of spreading COVID. The goal of having children attend school in person will only be safe when a community has the spread of the virus under control. And then, a layered approach is needed to keep students, teachers and staff safe. But this will only be possible if intense cleaning, social distancing and testing protocols are carried out. And if an outbreak does occur or rates begin to rise again, schools may have to close again