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School or No School

School or no school, fall 2020

One question that my partners and I are hearing on a daily basis is “should my child be going back to school in the fall?” I wish I could tell you that there is a one-size-fits-all answer, but there just is not. However, at The Pediatric Group, we do feel like the decision of local schools to start the school year in person is a good one for the majority of students. We have based this on recommendations from numerous resources, along with some good common sense, and an abiding commitment to hold facts over fear.

Let’s be honest, there is so much we do not know about SARS-CoV-2, aka novel Coronavirus, aka Covid-19. SO MUCH!!! But there are many things that we have been able to surmise from other countries’ experience.

In studies done in China and Switzerland, it is surprising and encouraging to see that young children do not seem to transmit the virus to their contacts at the same rate as older people. In countries where schools were not closed during the early stages of the pandemic, schools were not shown to be the sources of outbreaks, and were successfully able to remain open, despite the illness raging in the communities around them.

Studies from around the globe report that in a vast majority of cases of COVID-19 in children, the index case in the family was actually an adult family member, who had documented illness before the child became symptomatic. In other words, it was the adult who got the child sick, not the child who got the adult sick.

Although evidence is still being gathered to give us scientific answers as to why children do not seem to get COVID-19 at the same rates as adults do, why they do not seem to get as ill as adults do, and why they don’t seem to transmit it to others like adults do, we are without a doubt seeing these phenomenon play out in our communities. Much research is underway regarding numerous possible explanations, including that there are fewer receptors for this virus in the respiratory tract of young children, therefore a reduced infection rate; that there is better protection from COVID-19 in children due to immunities to other non-COVID-19 Coronaviruses (aka, the common cold) being higher in young children. Other research points to the physics of the difference in how much velocity a child’s cough generates compared to that of an adult’s, and how far those coughs spew viruses. These theories and many more are in the process of being studied by hundreds of researchers all over the world right now. The specifics of why children do not seem to be significant sources of community outbreaks will one day come to light. But it seems clear in the studies that have been published so far that young children just don’t seem to be the petri dishes of infection that we all assume them to be. At least when it comes to COVID-19.

Teens may be a different group entirely. A recent study from South Korea seems to suggest that teens are spreading the virus at higher rates than younger children, but was not able to address the question of whether the index case in the family was actually an adult.

I find this statement from a recent article in one of the most highly regarded pediatric medical journals quite helpful. “Almost 6 months into the pandemic, accumulating evidence and collective experience argue that children, particularly school-aged children, are far less important drivers of SARS-CoV-2 transmission than adults. Therefore, serious consideration should be paid toward strategies that allow schools to remain open, even during periods of COVID-19 spread.” – Pediatrics, 004879

The American Academy of Pediatrics (AAP) strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.

Clearly no one is saying that keeping the schools open is without risk. But I think those who advocate for this approach are saying that the benefits of having children in schools outweigh the potential risks. This is not to say that there aren’t students who have a very successful home school or online learning situation. There are many who do. Wonderful! Stick with that! (All you home schooling families, please don’t email me – I know you’re doing a great job and I respect you for it!) But that is not the case for many families. Trying to achieve successful distance learning in many homes was a disaster! Unmotivated teenagers having to be dynamited out of bed to show up in front of their screens, working parents trying to work remotely while supervising their children’s schooling, households where parents actually did continue to go to work and had no one to be at home with kids needing supervision and help with school work – these were disasters! Not to mention the children who were not safe in their home environments, who missed meals because they didn’t get to go to school, who didn’t have access to internet in order to attempt distance learning. What we learned from spring break to the end of the “school year” was that distance learning was far less than optimal for many families.

However, there are some of our patients who should think long and hard about whether going back to school is the right decision for your family. We have patients with chronic health conditions, patients with elderly or high risk family members in the home, and those with family members who are immunocompromised. Maybe you have all teenagers, and evidence seems to suggest they spread the virus more like adults do. Being in school may not be best for some children this school year. I hope you’ll have that discussion with your pediatrician. In the Oklahoma City and surrounding area the majority of schools are offering parents the ability to make the choice. I hope you are able to make your decision based on the best information available at this time. Whatever your decision will be, I encourage you to be kind to others. Be kind to those who choose differently than you do. You have no idea what may have gone into this decision for an individual family. There is no reason to make this a political issue, or to make your decision a political statement. My decision to make this recommendation comes from a place of loving and caring for children for more than three decades. When we are seeking the best for those we love, we are unlikely to err.

Stay tuned….you know things will change!


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