What School Might Look Like in the Fall, According to a Pediatrician

Hi, summer. You look different. Did you get a new haircut? You just don’t feel familiar this year. Maybe it’s that the cadence of your day is, basically, identical to the rhythm of a few weeks ago, when everyone was still in school. (Was it really only a few weeks ago?!) Maybe it’s the absence of all group socializing — no barbecues, no kids cannon-balling into a pool filled with slightly too many other kids. Maybe it’s the bizarreness of walking on a beach or through a park, masked, dodging people left and right, wondering if this is fun yet or if I should just leave already? This strange purgatory of summer 2020 has just begun, and many of us find ourselves fixated on the start of the school year when – hopefully – life will return to some form of normality.

Like most of my doctor friends, I am trying to help schools figure out what safe reopening will look like. Full disclosure: I’ve got a dog in this race (two, actually) who so desperately want to get back onto campus, words don’t suffice. By the way, that’s another unrecognizable feature of yours, summer: kids desperate to return to school. In the role of objective (as much I can be – I’m trying!) collector of data and integrator of all theories on how, when, and where kids will get back onto campus in the fall, I have learned quite a bit. And since this summer doesn’t feel like much of a summer at all, I thought I’d share a preview of what the upcoming return to school might look and feel like.

1. Your school is as eager to open as you are to get your kids there.
This is true across the board, from preschools to colleges. But opening a campus and opening classrooms are two completely different things.

2. Your kids, their teachers, and the staff and administrators who work at schools will all take safety precautions.
It’s just that the precautions will vary. A lot. My advice is to use the legs of a stool model: The more legs you have, the less likely the stool falls over. So, I am a fan of implementing all of the strategies we have learned in recent months – distancing, mask-wearing, hand-washing – on campus as well as off. The more of these we all engage in, the less the stool will wobble and the more we protect the higher-risk adults who educate our lower-risk children.

3. Your school may also do things like require that you take a daily survey documenting no coronavirus symptoms that day, check temperatures before walking in the front gate, or stagger the starting time so that fewer kids arrive at once.
Or your school may not. Each of these steps may be helpful, but no one of them is a silver bullet, especially when you consider that the vast majority of school-aged kids who are infected with coronavirus will show no symptoms at all, making screening for them a bit pointless. But some will have symptoms, especially the older ones and the folks working on campus, and so that’s the point.

4. Your school may require coronavirus testing — or may strongly encourage it — or may offer pooled testing, which is more of a screening approach, looking for one positive in a pool of people sharing a classroom space.
Or your school may not have access to testing, may not have funding to foot the bill, or may be worried that the still-high false-negative rates of testing will result in a false sense of security that outweighs the benefits of looking for disease at school. Testing is complicated, which is why the plans to invoke it are all over the map.

5. Your school may offer contact tracing – or even require it – which gets into murky privacy waters, but is also extremely effective in slowing the spread of coronavirus.

6. No one knows when the second wave will happen, which is why some schools are trying to start earlier than ever and take an extended break from Christmas through New Year’s.
They are betting on a late-fall coronavirus surge – while others are sticking with original plans and rolling the dice in that direction.
If you’re worried that your school has chosen the wrong path, don’t be. Seriously, no one knows when the second wave will hit.

7. Everyone knows that if we can avoid exclusively remote learning for the entire school year, that’s the win.

All of this means that there isn’t one right way to do things come fall, but also that everyone must do the right thing.

We could decide to put our collective heads in the sand this summer and pretend that the pandemic lockdown was a bad dream and we deserve to break free, socialize, and live! But if we do this, we will suffer one of two fates, maybe both: The first is poor training for what needs to happen in the fall if we want our kids to be back at school, because they need to be implementing good habits if for no other reason than to protect those around them who dedicate their lives to educating them and face risk of infection on account of age; and the second is a resurgence of COVID-19 now — yes, while the temperatures are warm and it’s not theoretically supposed to happen. A rise in coronavirus infections come summer, fall, or winter won’t achieve the goal of living.

Beyond my own musings about why schools will do things so differently, on to some articles that may shift these evolving plans.

There’s lots being written this week about the difference in coronavirus infection rates between kids and adults. It’s not just that kids are less likely to show signs of infection, but they seem to be half as likely to actually become infected with the virus in the first place. This, in turn, could make schools safer than previously thought. But, as this article explains, “What the study does not answer is the extent to which children, including ones with no symptoms, can transmit the virus,” meaning pass it along to teachers, staff, and family members back at home.

Meanwhile, major therapeutic news broke this week when a study showed that dexamethasone, an old standby inexpensive steroid, works to reduce death from COVID-19 in oxygen-dependent patients. But don’t run out and stockpile dexamethasone, please!

First of all, it’s unethical – let people who need it continue to have access to it. Second of all, it won’t help you to have the drug in your medicine cabinet. Yes, “Compared to those who received standard care, the drug reduced deaths by 35% in seriously ill COVID-19 patients on ventilators.” But most people who are on oxygen generally don’t have access to their home medicine cabinets because they tend to be hospitalized. And there’s no benefit for patients who aren’t receiving respiratory support. I repeat, no benefit.

I have said it before and I will say it again (and again and again):

As we grapple with issues like returning to school, work, and even in-restaurant dining, one thing seems to be very clear: masks work best. If you want more than a story covering this statement, here’s the actual study. And if you want a super comfortable, filtered mask so that you can play your part in reducing coronavirus spread, I happen to know a place everyone in your family can get some!

(This article first appeared on Dr. Cara Natterson’s website, Worry Proof MD.)

*Disclaimer: The advice on Mom.com is not a substitute for consultation with a medical professional or treatment for a specific condition. You should not use this information to diagnose or treat a health problem without consulting a qualified professional. Please contact your health-care provider with questions and concerns.