Transcription:
Sending Kids Back-to-School During COVID-19

Melanie Cole (Host):  If you’re a parent like me, when you think of your child returning to school this fall; it can be scary. And if your children go out of state or will be far away; it can be even scarier. So, what’s a parent to do? Welcome to BayCare HealthChat. I’m Melanie Cole and today, we’re discussing preparing to send your kids back to school during the COVID-19 pandemic. Joining me is Dr. Marcy Baker. She’s the Medical Director of Pediatrics at BayCare Medical Group. Dr. Baker, thank you so much for joining us today. For children going back to in-person school, what do you want parents to know about helping lessen their child’s risk of COVID infection and what can we do as we start wondering what schools will do in the fall without any definitive answers?

Marcy Solomon Baker, MD (Guest):  It’s definitely a difficult time for parents and for children also in making these difficult decisions. I think as far as preparing them to go back to school; I think you need to just stress all the things that we’ve been talking about for months now. And that’s wearing face masks, social distancing, and hand washing. And hopefully, the schools will have some good strategies around that and also encourage the kids to be doing that. But I think you need to talk to your child about the fact that they need to wear their face mask in school at times that it’s required. And they shouldn’t be pulling it down below their face. They need to keep it above – over their nose and over their mouth. And so just talk to them about that. Talk to them about good hand hygiene and washing their hands, maybe send them with some hand sanitizer, not touching their face. Just all the good health habits that we’ve been talking about over these last few months.

And you can also encourage them not to be in close groups with their friends if at all possible. Again, when they are outside doing outdoor play, trying to keep their distance when they are walking in the halls going potentially to their lockers or not depending on what the school decides. Not congregating very close to their friends, trying to keep that at least three feet and maybe six feet distance when at all possible.

Host:  Thank you for that and Dr. Baker, as we talk about safety recommendations, are they different depending on the age of the child and what would you like parents to do to help the teachers at this time especially for our littler ones. Is there something that we can be doing to help the teachers help our children?

Dr. Baker:  Absolutely. So, again, it really does vary by age group. Smaller children are going to have a difficult – kids under two should not be wearing masks by the way. But smaller children, if we are talking about school age children, so pre-K and kindergarten children and maybe even some first graders are going to have difficulty potentially wearing their masks, but they can be worked with at home and within the classroom with their teacher on getting used to wearing these masks. And that’s something parents can do at home to help protect the teacher is reinforce that and also, I’ve been telling my patients to start practicing a little bit now, wearing some masks. Because some kids now are not out at all. So, they’re not wearing masks ever. So, it’s a good idea to start practicing a little bit at home, getting them used to that, trying to have them not touch their face very much and coaching them on that.

The other super important thing that parents need to do to help keep schools open is that if your child has a fever or is not feeling well; they need to stay home. And additionally, if they have had an exposure, they also need to stay home. So, it’s very important that as parents, we are being responsible for not sending kids to school sick and that will help protect our teachers and the other children in the classroom.

Host:  Well that’s great advice and certainly a good point and now as we’re also talking about anxiety. What can parents do if their child is fearful of returning to school in person? Maybe they’ve been listening to the news. Maybe they’ve been talking to their friends and along those same lines; what if the parent themself is nervous about sending their child back to school?

Dr. Baker:  Well I think everybody is nervous about sending their kids back to school to be honest. Many, many people are. And that’s a normal reaction. I have had some patients that have had true anxiety during this time that just developed during this time. A lot of times, when I talk to the parents, they have the 24 hours news on in the background all the time. I said well you’ve got to turn that off. So, we really need to limit – it’s not that kids shouldn’t know what’s going on, but they also don’t need to be watching 24 hour news. We need to have open and honest conversations that are age appropriate with our children. We need to say to them, I understand – ask them about their fears, acknowledge the fears they have. I understand this can be scary but at your age the risks are lower. How much do you miss being at school, which most kids at this point do and discuss – we always are talking about the risk, but I don’t feel like we spend enough time talking about the benefits of them going to school, which are many.

So, I think that’s something to focus on with the parents and the children. And then I think something super important for both parents and kids to realize is that kids do much better than adults with this disease. From the knowledge we have now, they do not become as sick and they are much, much, much less likely to be hospitalized or have an even worse outcome.

Host:  Well that’s very encouraging for parents to hear. Now with our littler ones, especially the ones in grammar school; what if they’re scared of people in masks or what if they tug on the mask and they don’t like the mask and they don’t want to wear the mask, or it makes them nervous? What about that, the whole mask thing?

Dr. Baker:  Yeah, that is part of the difficulty with all this and especially like you said, for the kids in elementary school. So, hopefully middle and high school kids can be pretty good about wearing their masks. They’ll get used to it over time. But for the little ones, there’s a number of things you can do. So, first of all, again, like I talked about before; you want to start practicing at home basically. You want to have times when they’re wearing their masks. You should wear your mask some at home with them. So, and again, I’m not saying you need masks in your own household, but it’s just good to get a little bit of practice in before they are going to school.

You can have them – for the little ones, you can have them put a mask on their stuffed animal. You guys can – you can have the parent and the child like both put on their masks, look in the mirror, discuss it. They can draw one on one of their characters from a favorite book of theirs. There’s a lot of things they can do that can kind of help with this. It is tough as far as getting them not to touch their face. You just have to be good about reminding on that.

Host:  Well that’s certainly true and especially with our littler ones, they are notorious nose wipers and they going to pull those masks down, they’re going to play with them. So, it’s really about communication, right and teaching our children and before we move on to what happens if somebody does get sick; is there anything else you’d like to share about keeping our children and families safe from the spread of COVID-19 as they head back to school?

Dr. Baker:  Yeah, I mean the one other thing I was going to say is just for your – so again, like I mentioned earlier, this disease is – I’m not saying children aren’t getting it but there are some studies that at least in kids under ten, that they don’t spread it as readily as older children and adults. So, that’s encouraging for our teachers and families. And again, like I said, kids don’t get as sick from it but that doesn’t mean they can’t bring something home to their parents especially the kids in middle and high school. So, I think a nice strategy maybe is to have them change their clothes when they get home and maybe shower at that time. I mean, I think that is at least a little bit of help for families. The other thing that we are talking about with the younger children, there’s going to be some important things because again, it is harder for them to wear masks. So, and it is harder for them to social distance. So, hopefully the schools are going to look at some strategies of keeping them in smaller groups so at least they have limited exposure and some things like that. And again, it is very age dependent on what the strategies for the school are going to be. And again, although we are going to try for mask on the little kids, it’s a more important strategy in the older kids.

Host:  Well thank you. So, Dr. Baker, in the event that a child does develop symptoms of COVID-19; what should a parent do, and I’d like to give you a situation. If the child becomes ill after being at school with a group of 20 students a day or so. The child is diagnosed positive. If the other children around that child wore masks, should they all be isolated and if not, what do you recommend for both the students and the staff? Tell us a little bit about the what ifs.

Dr. Baker:  Right. So, these are difficult questions and this is what the schools are dealing with. And it’s tough. So, if everybody was masked – well let me just say, so with this virus, you are typically contagious two days before you show symptoms. That’s the whole point of all the masking because if you just were contagious when you showed symptoms, then anybody who is sick could stay home and we wouldn’t have all the spread and problems that we have. So, again, it’s very important as I mentioned before, that if kids have symptoms, they should stay home. And actually, parents should be temp screening their children before they send them to school. So, they should be taking their temps before they send them to school and if they have a 100.4 or higher, they need to stay home.

Now as far as your scenario about the kids in the class, adult in the class, it’s going to be up to what the schools want to do as far as do they – how much exposure do they think these other students had. So, for example, was everybody wearing masks all the time? If they were, then those kids probably just need to – and their teacher probably just need to self-monitor themselves and take their temperature twice a day and be really aware if they have symptoms and they start to feel sick, they should stay home. Additionally, it’s extra important then that that group of children and teacher wear their masks very religiously all the time. Because they could end up being someone who is spreading it in those first 48 hours because they do have this kind of exposure.

Now, let’s say there is – what is defined as a real exposure is 15 minutes of time within six feet, so less than six feet, 15 minutes of time and unmasked. Okay. So, if they kind of analyze that classroom and they feel like those kids fall in that criteria; then they probably are going to have to stay home for two weeks. And the teacher also. So, it all depends about what’s going on in the classroom. And these really are going to be the difficult decisions that the school has to decide.

Host:  Wow, so much information packed into that answer. Dr. Baker if a parent becomes ill with COVID, do they keep their child home?

Dr. Baker:  Absolutely. So, that would be a real exposure. So, think about it. If you are living with a parent, right, you’re definitely with them more than 15 minutes – a lot more than 15 minutes, a lot less than six feet, right, and you’re not wearing a mask in your house all the time. So, yes, that child – that is a true real exposure and that child would need to stay home for two weeks. That’s why it’s going to be so important for schools to have some way to toggle back between real learning, real in life learning and maybe some e-learning because there are going to be situations where parents test positive and then the child’s going to have an exposure and have to stay home.

They need to stay home for 14 days from the time you had an exposure. So, not from the time that the test was positive, from the time that the adult first developed symptoms.

Host:  Okay, that’s really, really great information. Now if somebody does develop symptoms, Dr. Baker, what is treatment? What do you want parents to do if their kids are running this high fever or if they are feeling sick or if the parent is?

Dr. Baker:  So, the tricky part – so if the parent is feeling sick, they obviously need to reach out to their healthcare provider. If the child’s – and the problem is testing can be difficult, right. I mean in an ideal world, right, do we test everybody before they go to school. I mean, maybe. But we don’t have that. That’s not the reality of what we’re dealing with. So, it is difficult for people to get tested so, I think if a parent is feeling sick, they should reach out to their healthcare provider. If a child is sick, now you mentioned high fevers. See the interesting thing with COVID in kids, is that their symptoms can be all over the place. Their symptoms can be some diarrhea, their symptoms could be a little runny nose, a slight cough or it could be a fever. So, the symptoms are very wide ranging. For adults and kids but even more so for kids.

The nice thing again, like I said, is kids usually have mild symptoms. So, let’s say for example, a parent tests positive and then the kid starts to get a runny nose or a fever or something. Well then, the odds are the kid probably has it. They need to call their healthcare provider. They’ll probably set up a Telemedicine visit with them and see how they’re doing. They may or may not recommend some testing. Even if they don’t recommend testing; the assumption is going to be that they probably do have it and recommend they stay home for at least ten days from when their symptoms started.

So, treatments. So, yeah, I mean symptom management is just Tylenol or Motrin as needed. As far as – and actually there is – and we’re not sure if it’s true, there is a little lean more towards Tylenol which is acetaminophen versus ibuprofen. And there’s just not much treatment for kids. Luckily, they don’t usually need much treatment. If your physician thinks that you need to be seen in real life, they’ll bring you into an office where they are seeing some COVID patients or if needed, they’ll send you to the emergency room, the hospital as needed. But luckily that’s not been needed too much for children.

Host:  So, wrap it up for us then, Dr. Baker, because it’s been so much really important great information for parents to help reassure them about what they can do to help keep their children safe. So, give us your best advice as we’re sending our kids back to school whether it’s our little guys, or middle schoolers, high schoolers or our college aged students. Please give us your best advice.

Dr. Baker:  Well there’s no doubt that school itself is beneficial for children, in person real life school. So, I think the AAP has said this that’s American Academy of Pediatrics has said this already. That the goal should be to try to do in-person school if possible. So, for children, it is more beneficial. The risk versus the benefit for children is it is more beneficial for them to be in school and that’s pretty clear.

Now, when you talk about the risk for maybe their parents or their teachers, then that’s where it becomes a little murky. I think the kids when if at all possible, should be in school. And the things that parents can do to help their kids get in school is a lot of what we talked about. They need to keep kids home if they are sick or if they have a COVID exposure. They need to stay home. They can work with their kids in advance about being comfortable with face coverings and in older kids, really stress to them the importance of wearing their masks at all times. And the importance of social distancing. I guess when I say at all times, when they cannot social distance.

So, I think if parents can really work with their children, get them used to masks, stress hand washing, stress social distancing and then everyone be very responsible about not going to school if they are sick or if they have a definite COVID exposure. Hopefully, we will get kids back to school successfully.

Host:  Hopefully we will. And thank you so much for great information, Dr. Baker, and that concludes this episode of BayCare HealthChat. For more information and resources for sending your child back to school; please visit our website at www.baycarebacktoschool.org for more information. Please also remember to subscribe, rate and review this podcast and all the other BayCare podcasts. I’m Melanie Cole.