MONDAY, May 11, 2020 (HealthDay News) -- As parts of the United States begin to reopen, two big questions loom for parents -- how quickly can kids get back to school and can it be done safely?
Many factors need to be considered and worked out in partnership with local health departments before individual school districts can open again, according to the American Academy of Pediatrics (AAP).
In newly released guidance, the AAP highlighted some of those factors, such as how do you keep kids at a safe distance from each other when in the classroom or on a playground, and when schools will need to shut down again if infection rates rise.
"From a health perspective, the health of kids and the health of staff has to be thought through before schools reopen," explained pediatrician Dr. Nathaniel Beers. He's a member of the American Academy of Pediatrics' Council of School Health, and a pediatrician at Children's National Hospital in Washington, D.C.
"But the reality is that not having schools open decreases the ability of parents to return to work. Kids are missing out on education, but schools also provide much more than just education," Beers said. "School is important for a child's development. Many children are reliant on school for free lunch and other meals. Other kids get special education services like speech therapy and occupational therapy. Schools are a real, clear piece of kids' behavioral health support and community support."
Lily Eskelsen Garcia, president of the National Education Association (NEA), the teachers' labor union, also pointed out that while there are problems with reopening, a closed school causes its own problems.
"Teachers may live in areas without good Wi-Fi. A lot of kids don't have access to the technology they need. There have been a lot of problems with consistency and equity, and with who can get a meaningful learning experience. Schools have been creative -- bus drivers might drive their routes to deliver meals to kids, or to provide a Wi-Fi hot spot from a router in the bus," she said.
Despite these and other challenges, Eskelsen Garcia said, "Teachers aren't going to open these schools unless it is safe for children and every living thing."
Serious inflammatory condition showing up in some kids with COVID-19
But it may be difficult to say whether children will be safe. There are still huge knowledge gaps when it comes to children and COVID-19 infections, and their role in transmitting the virus. Recent studies have found that children are less likely to become infected, and when they are infected, young people tend to have milder symptoms, according to a New York Times report.
But that's not always the case. Doctors have recently reported that 38 children in New York have a serious inflammatory condition that's linked to the virus, with another 85 cases under investigation. This reaction resembles the childhood infection called Kawasaki disease and toxic shock syndrome. So far, three children have died from this condition, the New York Times reported.
There's also concern that even when children have mild infections, they may be spreading the disease to parents, teachers and other caregivers.
Before reopening, the AAP said some of the issues that must be addressed include:
- The availability of testing and contact tracing.
- Implementing infection control measures, such as disinfecting classrooms and surfaces, screening children and staff, use of masks, appropriate social distancing, limiting interactions between children and staff, and testing for infection when appropriate.
- The availability of supplies for disinfecting and testing.
- How will plans for opening differ by grade level?
- A plan for possible intermittent school closings.
- Creating options for a phased reopening, perhaps with reduced school hours, to allow local health officials to monitor community infection rates.
- Making plans for children with high-risk medical conditions who might not be able to return to school safely.
- Consider plans for sports teams and events, as well as other extracurricular activities.
Other countries can show what works
In addition to paying heed to the AAP's guidelines, U.S. officials can also look to other nations that are further along in their reopening process.
Asian countries are trying a variety of approaches as schools there reopen. In China, students get temperature checks before they can enter school buildings, and cafeteria tables are outfitted with plastic dividers, the New York Times reported.
In Sydney, Australia, schools are opening in staggered stages, holding classes one day a week for a quarter of the students from each grade. Hong Kong and Japan are trying similar phased reopenings, the Times reported. In Taiwan, classes have met since late February, but no assemblies are being held and students are ordered to wear masks.
In Germany, which will allow all students back in coming weeks, class sizes have been cut in half. Hallways have become one-way routes. Breaks are staggered. Teachers wear masks and students are told to dress warmly because windows and doors are kept open for air circulation, the Times reported.
"It's really critical that [American] schools have a strong plan, not just for reopening now, but for what future school closures would look like," Beers said.
Eskelsen Garcia said that teachers need to be part of the planning and, so far, she hasn't seen teachers included on reopening committees that have politicians and business leaders. "Let us be part of the design for a healthy school opening. There is no one-size-fits-all solution," she said.
One enormous concern when it comes to schools reopening is cost, Eskelsen Garcia pointed out.
She said school budgets are typically very tight. Ideally, schools would be able to hire extra cleaning staff, teachers and teachers' assistants to ensure safe reopening. But state and local budgets have already been decimated by the pandemic.
"Tax revenue is going to decrease dramatically. Not only will we not have money to reduce class sizes, we may have huge layoffs," Eskelsen Garcia said.
The NEA just asked Congress for $175 billion for America's schools, she added.
"Kids will have faced months of fear and uncertainty and lived through trauma, but school nurses and school psychologists will likely be laid off," Eskelsen Garcia said. "And we need more custodians to disinfect schools and they need training on disinfecting for coronavirus. If we don't have what we need this time, someone could actually die," she said.
Read more guidance on reopening schools from the American Academy of Pediatrics.