What parents need to know about returning children to school during Omicron

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(CNN) – Millions of American children will return to classrooms in the coming days – just as the Omicron variant fuels a new record number of Covid-19 cases.

And it has made many parents wonder what is safe as the most contagious variant is sweeping the country.

“We are concerned that it will get even worse between the holidays and back to school,” said Dr. Stanley Spinner, chief medical officer of Texas Children’s Pediatrics & Texas Children’s Urgent Care in Houston.

As Covid-19 pediatric hospitalizations approach record highs, some cities and school districts are taking aggressive new measures.

In Washington, DC, all students and staff in public schools must show proof of a negative Covid-19 test before returning from winter vacation.

In New York City, public school students who test positive will get a week of home testing so they can know when it’s safer to return to school.

But do vaccinated students still have to wear masks? What should families do if they cannot pass the Covid-19 tests? Should activities like choir dancing and playing basketball be put on hold until the Omicron wave passes?

Here’s how several pediatricians and health experts answered some of parents’ most critical questions:

Shouldn’t the children be going back to class right away?

Health experts are divided.

In areas of very high transmission, it might be too early to resume in-person learning, said pediatrician Dr Peter Hotez.

“I wouldn’t do it now,” said Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.

“You have a screaming level of transmission in the Northeast, New York and Washington, DC. Trying to open schools at this point, it’s hard to imagine how well things will go.”

But the US Department of Education is urging school districts to take security measures and ensure classrooms are open for in-person learning.

“It is extremely important that all schools strive to remain open to in-person learning five days a week, especially in light of the Omicron variant,” according to a new resource guide for principals and school leaders. obtained by CNN.

Pediatrician Dr Paul Offit said it was important for children to be able to stay in classrooms – and not just for their academic health.

“There are so many advantages to learning on the spot. Children need the socialization that comes with being in school, ”said Offit, director of the Vaccine Education Center at Children’s Hospital in Philadelphia.

He said many children also depend on school meals. And in some cases, signs of child abuse are only noticed in school.

But many students are returning to class on Monday – just two days after the New Year’s Eve celebrations, said Dr Lawrence Kleinman, vice chair of the pediatrics department at Rutgers University.

And because Covid-19 testing might not detect new cases until days after infection, some schools or parents might choose to delay return for a few days to allow more time for testing, Kleinman said.

Do children have to be tested before going back to school?

“Getting children back to school must be number 1 – but doing it safely must be essential,” said epidemiologist Dr Abdul El-Sayed.

“So I think requiring a negative test before going back to class is a prudent approach here.”

But many families cannot find rapid tests at home or cannot afford them. And a federal program to make millions of tests available for free doesn’t start until next month.

Offit said he does not think children necessarily need to be tested before returning to school, unless they have recently been in contact with someone with Covid-19 or have any symptoms. symptoms.

“If you’re otherwise healthy, you don’t really need to test,” he said.

But if a child has symptoms “and you can’t test for them, assume it’s Covid,” Offit said.

“And then follow all directions – ie quarantine until asymptomatic and mask for five days after that.”

Can parents feel more confident if their children are immunized?

“Definitely,” said pediatrician Dr. James Campbell. “Their sigh of relief should be knowing… that even if a child does get a breakthrough infection, they are likely to only experience cold symptoms. “

Although Omicron is more contagious than any previous variant, vaccinated children have a major advantage.

“In the past, if they didn’t have access to a vaccine or weren’t vaccinated, they would have had a higher risk of potentially being hospitalized,” said Campbell, professor of pediatrics and pediatric infectious disease specialist at the ‘University of Maryland. . “But now that risk is drastically reduced by having been vaccinated – even with this new variant.”

Early studies suggest that Omicron causes less severe disease than the Delta variant – which fueled a record number of hospitalizations for Covid-19 in children at the start of this school year, when vaccines were not yet available for children from 5 to 11 years old.

But because Omicron is much more contagious than Delta, doctors say the crude number of children hospitalized in the coming months could be higher.

And almost all children currently hospitalized with Covid-19 are unvaccinated, said the president of the American Academy of Pediatrics.

“What we’re hearing from hospitals, really across the country – and it’s very consistent – is that the vast majority of children who are admitted are not vaccinated,” Dr. Lee Savio Beers told CNN Thursday.

“Not being vaccinated dramatically increases the risk of hospitalization.”

For children who are not yet fully immunized, doctors say other safety measures become even more important.

In some cases, children who start with mild or no symptoms of Covid-19 find themselves hospitalized weeks or months later with a condition called MIS-C – multisystem inflammatory syndrome in children.

MIS-C is “a rare but serious disease associated with COVID-19 in which different parts of the body become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. US Centers for Disease Control and Prevention. noted.

And long-term complications from Covid-19 can be significant for children – even for some who initially had mild or no symptoms, the American Academy of Pediatrics has said.

Do fully immunized children still have to wear masks at school?

All of the pediatricians interviewed for this article said yes.

“We have layers of protection. And getting the vaccine is perhaps the most important of those layers,” Kleinman said.

“But it’s not quite enough because it’s imperfect. They’re all imperfect layers,” he said.

“It’s a pattern of Swiss cheese … each (layer) has holes, like Swiss cheese.”

So while the vaccination layer has the smallest holes, other layers – such as masking and distancing – are also important, Kleinman said.

Additionally, it is not yet clear how many vaccinated children could pass the Omicron variant on to others, such as younger siblings who are too young to be vaccinated, Kleinman said.

While some vaccinated children might be disappointed to learn that they should always wear a mask in school, “simple explanations work quite well with them,” Campbell said.

“And it is that the virus has become smarter. And it infects people better. Your vaccine will definitely protect,” he said.

“But you can still get infected, which means you can still catch a cold, you can still have a fever. You can still feel a little sick.”

There’s also a broader reason why students should avoid getting infected – even if they don’t get sick, Campbell said.

Reducing infections is key to helping prevent new variants that could prolong this pandemic even further.

“If the virus is kind of beaten to the point where there is very little circulation, the less circulation, the less replication,” Campbell said. “The less the virus replicates, the less likely it is to mutate. “

What Kinds of Masks Should Children Wear Now?

Much has changed since the last school year. The once dominant Alpha variant has been replaced by the more contagious Delta variant, which has been overtaken by the even more contagious Omicron variant.

This means that basic fabric masks with gaps around the edges will no longer cut it, said Mercedes Carnethon, vice president of preventive medicine at Northwestern University Feinberg School of Medicine.

“They are quite effective at spreading Covid,” she said.

Instead, three-layer surgical masks with an adjustable nasal thread and KN95 masks are much more useful, Carnethon said.

“This is really what you need to keep the air from escaping,” she said.

More than ever, a good fit is important, said Carnethon. One way to test the fit is to have a child put on a mask and then put on glasses or sunglasses. If they can feel the air escaping or misting up on the glasses, that is not a good fit.

Should activities such as choir and basketball be put aside for now?

“I think that’s a really tough question,” Kleinman said.

Ideally, students participating in activities involving heavy breathing will be vaccinated – as well as coaches, directors and any other adults nearby, he said.

“Testing is the other thing that is a friend of all of these activities,” Kleinman said.

The answer should also depend on how quickly Covid-19 is spreading in a community, Campbell said.

“They might just have to say, ‘Well, we’re going to have to put (some activities) on hold for a while,'” he said.

“But I think just stopping all extracurricular activities is probably wrong at this point.”

Children who are frustrated with ongoing Covid-19 safety precautions should take comfort in knowing they might not last too long, Offit said.

Like several other health experts, Offit said he expects the current increase in Covid-19 cases to begin to decline in the coming months.

“So hang in there for six weeks if you can,” he said. And by then, more children will likely be immunized as well.

This story first appeared on CNN.com “What parents need to know about returning children to school during Omicron“.


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