The recent COVID-19 pandemic unexpectedly halted in-person learning and school attendance globally. As schools reopen in the Fall, the issue of safety among students is an ongoing discussion. The Centers for Disease Control and Prevention (CDC) now recommends that all children from kindergarten through grade 12 should wear masks as they return to school, regardless of their vaccination status, and the American Academy of Pediatrics (AAP) recommends universal masking in school for all persons older than 2 years.

“As the next school year begins, there needs to be a continued focus on keeping students safe, since not all students will have the opportunity or be eligible to be vaccinated before the start of the next school year,” the AAP stated in the COVID-19 Guidance for Safe Schools. Though there is always a chance of transmission, the reopening of school does not necessarily mean that the risk of infection will escalate, especially if schools adhere to the COVID safety protocols outlined by the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), and CDC, the AAP noted.

To maximize protection from the Delta variant and prevent possibly spreading it to others, the CDC now recommends wearing a mask indoors in public in areas of substantial or high transmission. Substantial transmission is defined as 50 to 100 cases per 100,000 over a 7-day period and high transmission is defined as 100 or more cases per 100,000 over a 7-day period. The revised recommendation includes universal indoor masking for all teachers, staff, students, and visitors to K-12 schools. 


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In-Person Learning Is Essential to Child Development

Disparities worsened during the pandemic when in-person learning was unavailable, especially for children with English as a second language, children with learning disabilities, children living in poverty, and children who are minorities, according to the AAP.

The school environment and school-supported programs are essential for a child’s development, including “social and emotional skills, safety, reliable nutrition, physical/occupational/speech therapy, mental health services, health services, and opportunities for physical activity, among other benefits,” the AAP noted.

The guidance states that schools may lack the necessary resources to track the vaccination status of each student or enforce a mask mandate based on vaccination status. Also, the wearing of masks in school may protect against other respiratory illnesses that may impact students’ and faculty attendance.

AAP believes that it is fundamental for all in-person school activities to resume, but with protocols in place to reduce the risk of disease spreading. These interventions may include the following:

  • All eligible children and staff in schools should be vaccinated against COVID-19
    • Schools may require proof of vaccination from students and faculty as in-person learning resumes
    • Timely and adequate COVID-19 testing resources for both schools and communities must be available and accessible
  • All students 2 years and older and staff members should wear face masks at school
    • Since a large portion of the student population is unable to receive the vaccine, face masks will act as protection for students younger than 12 years of age
    • Mask wearing is important as there are concerns about more variants being easily spread among young children, adolescents, and adults
  • School policies should be adjusted to align with new findings about the pandemic
  • Schools should monitor the daily attendance of students, whether for in-person or virtual learning

The AAP outlined several ways in which students and faculty can maintain optimum health during in-person learning, including:

  • On-site, school-based health care services such as health centers should be supported if they are readily available
    • “Collaboration with school nurses is essential, and school districts should involve school health services staff and consider collaborative strategies that address and prioritize immunizations and other needed health services for students, including behavioral health, vision screening, hearing, dental and reproductive health services,” according to the AAP 
  • All children should receive recommended vaccinations on time and receive catch-up vaccines if they are behind as a result of the pandemic
  • For children with chronic illnesses, the risk of hospitalization and complications from COVID-19 is possible; therefore, these students and their family members should work closely with their pediatrician and school staff to determine the best decision regarding returning to school

With new variants of the COVID-19 virus emerging, students and faculty need to be vaccinated and adhere to the face mask protocols as in-person learning resumes. “At this point in the pandemic, given what we know about low rates of in-school transmission when proper prevention measures are used, together with the availability of effective vaccines for those age 12 years and up, that the benefits of in-person school outweigh the risks in almost all circumstances,” the AAP noted.

References

1. American Academy of Pediatrics. COVID-19 guidance for safe schools. Accessed July 21, 2021. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/

2. American Academy of Pediatrics. American Academy of Pediatrics updates recommendations for opening schools in fall 2021. Accessed July 26, 2021. https://services.aap.org/en/news-room/news-releases/aap/2021/american-academy-of-pediatrics-updates-recommendations-for-opening-schools-in-fall-2021/