(CNN) – Our children are getting coronavirus. Covid-19 infections in the United States have increased exponentially, with nearly 500,000 new cases in the past two weeks, according to the American Academy of Pediatrics. This represents an increase of 240% since early July.
Children now make up 29% of new cases nationwide. Many of the new infections are in children under 12, too young to be vaccinated at this time.
All of this is happening at a time when schools are returning to face-to-face teaching across the country. Many parents ask themselves: are schools safe? What if the public health precautions prescribed by the U.S. Centers for Disease Control and Prevention (CDC) are not taken? Do they have parents who can take their children out of school, or are there other methods to help reduce the risk?
To answer these questions, we spoke with Dra. Lean Wen, CNN medical analyst. Wen is an emergency physician and visiting professor of health policy and management at the School of Public Health at George Washington University’s Milken Institute. She is also the author of a new book, “Lifelines: A Doctor’s Path in the Struggle for Public Health,” and is the mother of two young children.
CNN: We’ve talked about this before, but here we are at the beginning of another school year during the pandemic. With the reopening of schools, do you think face-to-face classes are safe from the perspective of covid-19?
Dra. Lean Wen: Numerous studies have shown that schools may have a lower risk of coronavirus transmission than the surrounding community if they follow public health guidelines to use a “layered mitigation strategy.” Think of this method of layered protection as if you were wearing layers of clothing in the winter. When it’s cold, we need several layers to keep us warm. If we remove one layer, we have to add others. When it’s very cold, we need even more layers. They all work together, and the more layers, the more heat.
A group of children entering a school in Florida.
We consider the different layers that can help keep schools safe. One is that all people with the right to be vaccinated are vaccinated. That is, parents, teachers, staff, and all teens over the age of 12. Country regions with the highest vaccination rates also have the lowest infection rates among children.
Another layer is that of testing. The CDC recommends that unvaccinated children be tested at least once a week in areas with significant or elevated transmission. The tests themselves do not prevent an infection from occurring, but they do detect it and, if done often enough, prevent that infected person from going into public settings where it could infect others. The second largest school district in the country, the Los Angeles Unified School District, requires weekly testing for all students and teachers.
Improving ventilation also helps, as does the use of indoor masks, keeping children in cohorts, washing hands, making sure children with symptoms stay home, tracking contacts, and other key public health measures. The more widespread covid-19 is in your community, the more measures the school will need to prevent transmission within it.
CNN: What should parents do if their child’s school is in an area of high virus transmission, but where don’t many of these measures apply? Many school districts have banned even demanding masks.
Wen: This is difficult for parents, students and teachers in these circumstances. They know what needs to be done to make schools safer, and to take those tools away from them is, in my opinion, inconceivable.
That said, the parents are not helpless in this case. One of the things I urge you to do is talk to other parents at your child’s school. Union makes strength. Can they try to talk together with the administration to express their concerns? Remember the concept of layered protection. If the requirement to wear a mask is not possible for any reason, can other measures be taken? For example, can the school offer weekly or fortnightly tests to all students?
He would also suggest talking to other parents in their children’s class. If a sufficient number of parents think the same, they will be able to come together and insist that their children wear a mask when they are indoors. They can make the use of masks the norm in your child’s class.
You may want to consider talking to the teacher to see if all the children wearing masks can sit together. This also helps reduce the risk for your child.
Also remember that the quality of the mask your child wears is really important. A simple fabric mask may not be enough, especially with the more contagious delta variant, dominant at this time. A three-layer surgical mask will be more effective than a cloth mask. If your child is comfortable with an N95, KN95 or KF94 mask, these will provide you with even greater protection. However, the best mask is one that your child can tolerate consistently and comfortably.
CNN: At what point should parents be worried enough to get their kids out of school?
Wen: There is no single answer for all cases. I would encourage parents to think about the health of their child and their home, the alternatives available, the importance of face-to-face education for their child, and what other risks can be reduced. There may also be local, state, or national laws that require your child to go to school in person, and virtual or home instruction is not possible. Be sure to check the laws or regulations in your areas.
First, consider the health of your children and that of other family members. If your children are in good general health and everyone living with you is fully vaccinated, it could be considered differently than if your children are immunocompromised or if they have a particularly vulnerable family member. Of course, if your children are 12 years old or older, vaccinating them will be crucial to protecting them and also the rest of the family.
Second, what are the alternatives? For many parents, face-to-face schooling is essential because they have to work. There may also be no other options. Virtual learning is not offered in all schools, and many parents may not have the option of moving their child to a school that offers more safety precautions.
Third, many children have really suffered without face-to-face teaching. Face-to-face school may be necessary for a child’s emotional health as well as for their continued development.
If it is really crucial that your children are in school, they should see what other risks can be reduced. Yes, it is true that taking the child out of school can reduce the risk, but that should be the last resort. Especially because school is essential for many parents and children, they should see what other risks they can try to reduce instead.
Remember that the risk is cumulative. If your unvaccinated child needs to go to school, work to reduce the risk in other ways. That they do not participate in indoor games; instead, do them all outdoors. Do not lower your guard with extracurricular activities: they must take the same precautions that would be taken during school. Don’t do pajama parties or door-to-door pizza parties – it would be a shame to be so careful during class hours for your children to become infected during extracurricular social activities. And parents can reduce their risk and, for example, always wear indoor masks when they are close to people of unknown vaccination status.
CNN: Is there any other measure that would encourage parents to take to reduce risk in schools?
Wen: One of the most risky scenarios during school hours is mealtime, when children don’t wear masks and may be crowded. Ask what arrangements your school can offer during lunch and snack. Could kids eat outdoors? Could it be an option for some children?
I would also ask about quarantine protocols. How will you know if another child is positive? Do all children in the class need to be quarantined, or is the test an option that can reduce the need for extended quarantine and therefore extended time out of school? This is another case in which quick and frequent tests are useful: What types of testing options are made available to students and their families?
CNN: What about 10- and 11-year-olds who aren’t old enough to get vaccinated? Do parents try to sneak them in line to get the vaccine or do they have to wait?
Wen: The CDC and the Food and Drug Administration have advised parents not to vaccinate children who are too young to receive the covid-19 vaccine. Studies are still being conducted for young children. Former FDA Commissioner Dr. Scott Gottlieb, estimates that, at best, vaccines for children ages 5 to 11 could be licensed in time for Halloween. This is not so far into the future.
It is best to wait until we have the data confirming that the vaccine is safe and effective in this younger age group. It should be noted that the dose being tested in this group is lower than that given to children 12 years of age or older, so this is another reason to wait.
Meanwhile, parents and children need to take extra precautions, knowing that this is a particularly dangerous time for children during the pandemic, but that there are steps we can all take to reduce children’s risk while keeping them inside the pandemic. school in person.