Should my children go to school in the fall?
This is probably the question of the hour! For the vast majority of children, the answer is 100% yes! The American Academy of Pediatrics (AAP) recently released its recommendations for return to in-person, in-classroom learning for the fall. There are many considerations that must be taken into account with this question, but we must look at the importance of school not only from the educational standpoint, but also the emotional, social, and nutritional standpoint as well. Part of childhood development hinges on learning through social interactions and studies have shown that isolation of children can have such detrimental effects on their long term psychological well-being. Also, many children receive services through the school district including various therapies and specialized learning curriculum that cannot be given through online learning. Finally, thousands of children in the Baton Rouge area receive one, if not two, meals per day through their school attendance. These are just a few reasons outside of the education each child desperately needs as to why in-person school is so important.
Groups such as the AAP have released guidelines to help schools implement a school policy that will be as safe as possible for not only the students but also the teachers and staff. This includes wearing face masks, social distancing, grab and go lunches, and frequent hand washing.
Should my child wear a face mask in public/school?
It is recommended that all children 2 years of age and older wear a face mask when in public, particularly when in an indoor facility, less than 6 feet from other people. Face masks are certainly a hot topic that has polarized our country, but studies show that face masks along with social distancing measures, can be the most effective things to slow the spread of this virus. A face mask is important to ensure that an asymptomatic person (meaning a person who has COVID, but does not show any symptoms, and therefore does not think they are sick) is not spreading the virus to others. We have had parents tell us, “There is no way my child will wear a mask.” Well, is that because you THINK they cannot/would not do it or because they really will not? We must remember that children surprise us daily! Children rise to the occasion when they are presented with a challenge all the time. Think of a child wearing a helmet to ride a bike. When the parent sets the expectation, models the behavior, and does not allow bike riding to happen without the helmet, kids will wear the helmet. The same thing when it comes to children wearing a mask; set the expectation, model the behavior, and tell them why it is important. Let children know that they are “superheroes” for wearing their masks to protect other people. Allow them to pick out a mask in their favorite color or print. Give them the opportunity to practice their mask-wearing at home and have special rewards for when they do a good job practicing this skill.
From a school standpoint, each school will set the parameters as far as to mask-wearing, and there may be some age groups or particular groups of students that masking all day may not be required (think preschool age, those with certain disabilities or medical conditions). However, especially in middle school and older, we would expect that masking 100% of the school day is going to be a vital part of keeping our children and teachers healthy while at school.
Is COVID making children sick?
We have seen an increase in the number of cases of COVID in children in the past 2 weeks. We can tell you that in almost all of the positive COVID cases amongst children that we have seen in the office, each one of them had been exposed to an adult who was positive for COVID. Reports from around the country as well as data from around the world indicate that COVID remains a mild illness for MOST children. Symptoms such as fever and headaches for a few days have been the most common symptoms that we have seen in kids. That is not to say that there are not children who have become seriously ill with COVID. However, the rate of children requiring hospitalization because of COVID illness is a small fraction of what we have seen in the adult population. According to the Center for Disease Control and Prevention(CDC), as of June 27, 2020, there have been 28 deaths from COVID in children 14 years of age and under (data collection began on February 1, 2020). The death of any child is absolutely tragic, but we must remember that the flu killed 185 children last season alone. This year we are recommending that children get their flu vaccines as soon as they become available. Click here for more information about flu vaccines.
What do I do if my child has been exposed to someone with COVID?
First, we need to discuss what defines a “high-risk exposure” as we all have likely been around someone, probably unknowingly, that has COVID. The CDC defines a “high-risk exposure” as being within 6 feet for longer than 15 minutes of a person diagnosed with COVID. Now, since people are probably contagious 2 days prior to the onset of symptoms, this would extend to the “high-risk exposure” definition as well. If your child does have a “high-risk exposure” and they are having any symptoms of COVID, you should call your child’s physician to discuss if testing is necessary. If your child tests positive for COVID, then they must remain in strict quarantine for 10 days AND until fever-free for 24 hours without the use of fever-reducing medications (whichever of these is longer). If your child has had a “high-risk exposure” and is not showing any symptoms, then testing is not indicated as it will not change the plan of care. For asymptomatic children, they should quarantine for 14 days from the last known exposure. If the child develops symptoms at any time during the quarantine period, then call your child’s doctor to discuss further.
Tell me about the different testing options for COVID.
COVID testing is another topic of great debate right now. The debate is not if widespread testing is needed, but rather what type of testing will be the most helpful. There are two main types of testing for COVID, diagnostic, and antibody. The diagnostic tests are the ones that will help us understand how much COVID is circulating in our community at any given time. Diagnostic tests can be either molecular or antigen-based. The molecular tests are going to be a far more reliable test (meaning that a negative test really means the person does not have COVID), but these tests can take anywhere from 1-10 days to come back depending on the lab. Antigen based tests are often much more rapid with results commonly in less than 1 hour. However, a negative result might not be reliable, especially if someone does not have any symptoms of COVID. At this point, a repeated antigen or even molecular test might be needed if a person is still ill a few days later.
The antibody test tells us if a person has had a COVID infection in the past. When you have a viral illness, our immune system makes proteins called antibodies, which serve as “memory” of the infection. Antibodies help to protect the body when it comes into contact with the same viral invader again. The question when it comes to COVID is, how long do these antibodies last? There are some illnesses that we will have life-long antibodies against, and therefore life-long protection, like chickenpox. If you have ever had chickenpox or have received the chickenpox vaccine, you now have antibodies against chickenpox, and you are very unlikely ever to get the illness. However, given that COVID-19 is a new virus, only time will tell how long these antibodies might last. Right now, we can test for these COVID antibodies, but we are not sure what to make of a positive antibody test. Does it mean that a person is protected for life from COVID? Will these antibodies fade over time? At the moment, we are just not sure yet.