Rebecca Bell, MD, is a pediatric intensivist at UVM Children’s Hospital caring for critically ill infants, children and adolescents in Vermont’s only Pediatric Intensive Care Unit (PICU). She is also President of the Vermont Chapter of the American Academy of Pediatrics (AAP-VT) and the mother of two children.
It’s August, which means that a summer of uncertainty has given way to a school year full of new questions and concerns. There has been relief as more of our population has become vaccinated, but now news of the highly transmissible delta variant and rising case rates among children has brought more worry. On top of that, data now shows that although vaccinated people are very well-protected from severe disease, they can become infected and transmit the virus to others, albeit at a much lower rate than unvaccinated people
Parents are understandably frustrated. In the early days of the pandemic, there was a general feeling of shared sacrifice. There was a sentiment that we were all in this together. Now we see rising case rates in the U.S. in what has been dubbed by officials a “pandemic of the unvaccinated.” But the “unvaccinated” of course includes all children under 12 years of age. For families, this no longer feels like shared sacrifice. This feels extraordinarily unfair.
With news of the more transmissible delta variant, rising case rates and variable school guidance across the country, how should parents approach the upcoming school year?
Prioritization of in-person learning
Over the last year and a half pediatricians in Vermont and across the country have witnessed a significant decline in the health and well-being of some of our patients. Many became less physically active, more socially withdrawn and disengaged from academic learning. The pandemic exacerbated the existing mental health crisis among children and adolescents. The long-term effects of the pandemic on young people are unknown, and pediatricians are worried.
In-person learning provides a nurturing and stimulating academic and social environment for students. A full-time in-person schedule gives students consistency and support throughout the school year. For these reasons, AAP-VT agrees with the Centers for Disease Control and Prevention (CDC) that physical distancing should not preclude full return to in-person learning. We believe students can have a healthy and safe year even with strict social distancing guidelines relaxed as long as we rely on other mitigation measures: vaccination, staying home when sick, testing, contact tracing and masking. But keeping the school environment safe and limiting disruptions to the school year is not just the job of schools and families, it requires investment from the community as well.
Vaccination, vaccination, vaccination
Protection through vaccination is the only way out of this pandemic. The delta variant has shown us that we need as many people vaccinated as possible and New York and Vermont Departments of Health continue to offer walk-in and pop-up vaccination sites. You can find opportunities to be vaccinated everywhere you look: county fairs, farmers’ markets, state parks, school clinics, pharmacies and your medical home.
If you work at or attend school and are eligible for the vaccine, please get vaccinated as soon as you can. If you are the parent of an eligible adolescent, please have your child vaccinated as soon as possible. At this point, more than 11 million young people under the age of 18 in the U.S. have received the vaccine. Now is a great time to join this ever-growing group of young people who are protected from the serious effects of COVID-19.
For parents of children under 12 years of age who are waiting for their children to be eligible for vaccination — I feel you. The best way to protect your children is to ensure that those around them, especially adults, are vaccinated. I would avoid getting into arguments or exhausting yourself disputing misinformation with the unvaccinated adults in your child’s life. Instead, I would simply say, “Please let me know when you get vaccinated. Otherwise, until my child has had the opportunity to protect themselves with vaccination, we will need to limit contact with you”.
For those not connected to schools: Lowering rates of community viral transmission decreases the likelihood that COVID-19 enters the school and childcare settings in our communities. Our children and educators deserve a healthy school year with minimal disruptions. You can make a difference by getting vaccinated.
Stay home when sick
This part is going to be hard. Really hard. We will all probably get more colds this year compared to last year. We are currently seeing more cases of upper respiratory infections than we usually do in the summer season. All students and staff, vaccinated or not, should stay home when sick and get tested for COVID-19. The pandemic is not over. Employers should craft supportive sick and family leave policies. Employees should be encouraged to stay home if they are ill or need to care for sick family members. For families with children, this may mean lots of sick days this year.
Masking is a simple and effective tool that reduces the spread of COVID-19 as well as other respiratory viruses that can mimic the signs and symptoms of COVID-19. Students and staff wore masks throughout the school year last year. Continuing the practice makes good, common sense, and there is also broad consensus among medical and public health experts about the need for universal masking in schools.
How Should Parents Prepare for Back to School?
Stock up on masks. The best mask is the one your child will wear. Let your child help you pick out the patterns and colors they like best.
Have a backup plan for sick days. If your child wakes up with a cough and nasal congestion, they will have to be tested for COVID-19 and stay home until symptoms resolve. This will be challenging for most families, but we have to do this to keep our schools healthy.
Be prepared for changing guidance. Recommendations change because variables change during a pandemic. It can be frustrating but at the same time we should be reassured when public health guidance changes in response to updated information.
Look to your child’s medical provider for guidance. Despite our best efforts at prevention, some of our unvaccinated children will be infected with COVID-19. If it happens — take a deep breath. Most children get better on their own. Your child’s healthcare provider can guide you through the illness and help you through the back-to-school and return-to-play process. If your child gets really sick and needs more medical support, rest assured that you will be in good hands. Pediatric hospitalists and intensivists, along with our subspecialty colleagues, are very well trained to care for sick children. We work with teams of experts to care for children: nurses, respiratory therapists, pharmacists, nutritionists, social workers, child-life specialists and rehabilitation professionals. Taking care of sick children is what we do all day, everyday, and we’re very good at it. If you need us, we will be there.
We Can Do This
Despite all of the uncertainty, I am very much looking forward to the school year. I’m excited to see my children learn and grow in childcare and school. I know they will gain so much from being around their peers and educators. And please remember: teachers, school nurses, and administrators are already working hard to prepare for the school year. Early childhood educators have been caring for our children nonstop this entire pandemic. Patience and appreciation for the professionals who educate and care for our kids will go a long way. We are all in this together.