What a COVID expert advising schools wants families to know

July 27, 2021
Folder, notebook, scissors, hand sanitizer and a child size mask.
Back-to-school supplies will include masks for some kids. Photo by Sarah Pack

Each COVID case in a school could affect many more children and teachers this fall than last year, thanks to the highly transmissible delta variant and opposition to mask wearing. That’s according to a pediatric infectious disease expert at MUSC Children’s Health who’s working with schools to help them reopen as safely as possible amid a surge in COVID cases.

“As we near a new school year, COVID cases appear to be trending higher again due to the impact of new variants, and there is uncertainty as to whether schools will be able to deal with COVID cases as effectively as last year. I am concerned about what will happen this year, because we’ll have more kids in each classroom combined with fewer effective ways to minimize close contact exposure and decrease transmission,” said Allison Eckard, M.D.

“Severe illness from COVID-19 is rare in healthy children, but the virus is highly infectious. More children will be sent home to quarantine. And if schools follow the same guidance they used last year — which was if there were three kids with COVID-19 in a classroom, they shut down the classroom — that's going to be happening a lot more this year. The less that people do to protect themselves and others, the more likely we're going to have classroom and school closures.”

What can families and schools do to protect kids and the people around them as we face the prospect of a third school year affected by COVID-19? Plenty, Eckard said.

First, consider following the American Academy of Pediatrics’ recommendation of universal masking in schools.

While public schools cannot require masks in South Carolina, parents can choose for their children to wear one. 

“There is an abundance of evidence that masks are safe in children and highly effective in containing large respiratory droplets, the primary way that COVID-19 is spread. They’re really your No. 1 strategy for preventing transmission. And frankly, my advice is to encourage your child to wear one at school,” Eckard said.

“There are a couple of reasons. One, a lot of school-age students in South Carolina are unvaccinated, which increases a person’s chance of being exposed to the virus. With some of the new variants of the virus, we are also starting to see breakthrough cases in people who are vaccinated as COVID-19 cases in the community increase. That may be particularly relevant to the schools, where the risk of coming into contact with someone who is infectious is high and yet some of the primary mitigation tools, such as wearing masks and other classroom precautions, are restricted.”

Two, wearing a mask keeps other people from feeling uncomfortable about wearing one. “We don’t want to shame people for wearing masks, regardless of their reasons for wearing one.” Eckard said. “The more people that you have wearing a mask during the pandemic, the safer the school is going to be.”

Second, double down on cohorting, also known as podding.

That means keeping kids together in groups, limiting their contact with students and staff outside their group. 

“Cohorting becomes incredibly important, because that way, if there’s a positive case in a pod or cohort, they can isolate and quarantine those individuals versus having to shut down a whole grade or a whole school,” Eckard said.

But cohorting may become a little tricker this year. Some of the sheets of plexiglass used last year to separate kids have already been removed because they were in such bad shape. 

“Before the state government banned mask requirements in schools, we suggested Charleston County schools take down the plexiglass if they could not be replaced periodically with new panels. The chemicals that were needed to clean the plastic were causing the plexiglass to become cloudy,” Eckard said.

“They started with some of the high schools where vaccination rates were a little bit higher and they had a little more space to separate people, and they were working their way down in grades. But one often overlooked consequence of eliminating a mask requirement and removing the plexiglass is that now, everyone within six feet of a person who tests positive for COVID-19 will automatically be sent home to quarantine for at least 10 days.”

Another challenge with cohorting: Most kids will be back in school in person, not learning virtually. That’s a good thing, Eckard said – kids need to be in school. But it may make ensuring there’s plenty of space between them to try to prevent COVID transmission more difficult.

Third, when younger kids are eligible to get vaccinated, Eckard recommends that families consider doing so.

Parents should talk to their pediatricians regarding the benefits and risks of getting a COVID-19 vaccine,” she said. 

But kids under 12 may not get access to the vaccine until early-to-midwinter, a Food and Drug Administration official recently said. Clinical trials are underway, including at MUSC Children’s Health, that will help determine the shots’ safety in kids under 12.

MUSC Children’s Health worked with Charleston County schools last year to offer vaccines to students 12 and up. Eckard said they plan to do the same thing when younger kids are eligible. They’ll have to get their parents’ permission to get a shot. It’s all part of MUSC Health’s Back2Business partnership with the school district.

Fourth, take symptoms of respiratory infections seriously.

“Testing and staying out of schools with even simple cold symptoms is going to be important,” Eckard said. 

The Centers for Disease Control and Prevention notes that the cold, along with other illnesses such as strep throat and the flu, have some of the same symptoms as COVID. The agency has an online coronavirus self-checker and recommends that anyone with COVID symptoms get tested.

But some parents have asked Eckard why we need to take any precautions to protect kids at this point. Most of us don’t wear masks during flu season, so why now?

“One big difference between influenza and COVID is that families don’t have a vaccine option for their younger children, at least right now. Some children are hospitalized and can develop severe disease, so it makes sense that we should do what we can to limit COVID transmission in the schools. I think we may have a different discussion when the vaccine is available for the younger kids,” Eckard said.

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