School districts around the country are returning to in-person learning, and many parents are anxious about sending their children back to class. "Children aren't immune to COVID-19 and there is reason for caution, but I'm confident that appropriate safety measures can keep children safe," says Melissa Stockwell, MD, MPH, chief of the Division of Child and Adolescent Health in the Department of Pediatrics at the Columbia University Vagelos College of Physicians and Surgeons.
Stockwell is associate professor of pediatrics at VP&S and of population and family health at the Mailman School of Public Health. She is co-chair of the CUIMC COVID-19 Vaccine Committee and a principal investigator of a study evaluating the safety of COVID-19 vaccination in children and adolescents. She joined us for a discussion on parents' most pressing concerns surrounding COVID-19 and the return to in-person learning.
Is school safe right now with the Delta variant spreading in the community?
"I do believe if we follow guidelines from the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC), we can have a safe return to school for kids," Stockwell says.
"We know how to do this and we need to go about it with care, because COVID is going to be with us for a while yet and in differing forms. But there are effective ways to establish a new normal that is safe," she adds.
"School is simply the best place for kids to be, not only educationally, but socially and emotionally."
And while it is important for parents to be aware of the risks of COVID-19, pediatricians are stressing the critical importance of getting children back to school.
"It made sense to have remote and hybrid learning last year when we didn't know enough about infection and transmission, but it was a really hard year for a lot of kids and parents," Stockwell says. "School is simply the best place for kids to be, not only educationally, but socially and emotionally.
"We do know that kids can get infected, and it's important to protect them. More severe COVID is thankfully less likely, but there are kids who end up in the hospital and there's growing evidence that kids can suffer from long haul COVID," she says.
"Knowing that, we do want to offer the best protection that we can for kids, and that starts with vaccinating everyone around them-especially if children are too young to get vaccinated themselves-and then wearing masks and taking other precautions."
What factors should I consider before making the decision to send my child back to school?
"I want to stress this above all else: Vaccination is our way through," Stockwell says. "For any person who is eligible, I am encouraging you to get vaccinated as strongly as I possibly can. It not only protects you as a parent, but also provides an added layer of protection for your family. The same goes for teachers and other staff in schools. The hope is that we will see vaccinations approved for children under 12 later in the fall, but in the meantime, it's a shared responsibility to do our part and get vaccinated if we are eligible. Kids who are 12 and older should get vaccinated too.
"I want to stress this above all else: Vaccination is our way through."
"The next most important question is 'What's the mask policy?' We know that masks are a very effective tool in our toolkit, and we need to be sure we're reinforcing that in schools."
Other considerations include the school's physical distancing measures and air filtration and circulation.
"Is there air filtration? Are windows open where possible? It's helpful to know what kind of air circulation is occurring," Stockwell says. "In some schools, three feet apart is no problem, but in others it may be hard to have that kind of space. In those cases, it's going to be really important to make sure that there is good air filtration, that masks are being worn, and that we're practicing good hand hygiene. All three are very important and those are things that I would look out for as a parent.
"My children's school is a high school that is mandating masks and vaccinations for teachers, staff, and students, which makes sense to me and makes it feel safer sending them back," she says. "Both of my kids are diligent mask wearers, so that also makes me feel better."
What if the school district isn't adhering to safety recommendations?
If recommended safety measures aren't being put in place, Stockwell advises caution.
"We are already seeing what happens if we don't follow those guidelines," she says. "We can turn on the news and see places where schools have reopened without masking, without mandating vaccinations, and without other precautions in place. Many of those schools are shutting down after a week or two of in-person learning.
"If you're in a community with high rates of transmission-which isn't uncommon thanks to the Delta variant-and you put children in school unmasked, it's not at all surprising to see infections," Stockwell says.
"If your child's school can't create a safe environment that offers appropriate protection and allows them to focus on learning-and there is a substantial or high level of transmission in the community-then families might need to consider remote learning."
What do we know about how lockdown has affected kids? Does the damage of isolation outweigh the risks of returning to school amidst a surge of COVID variants?
"There has been an uptick in depression and anxiety in kids and adolescents this year, particularly in teens, but also in younger kids," Stockwell says. "I think it's been very socially isolating for kids."
Children are at higher risk of mental health issues and developmental setbacks without in-school learning, according to the AAP's July recommendations for opening schools. AAP guidance also recommends that schools be prepared to adopt an all-encompassing approach for mental health support as children return to school after a long hiatus.
"For some kids, remote learning really worked, and they actually were able to focus much better," Stockwell says, "But many kids just couldn't. They really needed to be in that classroom for their social, emotional, and academic well-being. There's a lot of concern, particularly in communities of color, about being left behind with another year of remote learning.
"With that in mind, we do think getting kids back is going to be the best thing for them."
Closing thoughts?
"Get vaccinated," Stockwell says. "We all hear stories about people who get COVID, end up in the hospital, close to death, and they say they wish they had gotten vaccinated. That is heartbreaking, especially considering how easy it is to get vaccinated in this country.
"The single most important thing people can do as adults is get vaccinated and get your adolescents who are 12 or older vaccinated. Protect yourself and help protect your kids as well."
