Anxious parents preparing for the school year have questions—lots of them.
While many of them are being answered as the science concerning the coronavirus is shared, there’s also a laundry list of competing entities and authorities who don’t seem to agree with one another leaving parents confused when all they want is someone to shoot straight with them.
Children may simply want to hug their favorite teacher, but classroom interactions will look different in the COVID-19 world.
Dr. Victoria Regan, pediatrician and VP of Children’s and Women’s Service line at Memorial Hermann, provides answers to some of those questions and offers some of her own personal advice in hopes of allaying some of the fears and worry confronting parents, teachers, and kids.
Pediatricians have learned over the last few months that the coronavirus doesn’t act similar to a regular cough and cold virus. Was that a surprise to you?
Yes, as a pediatrician absolutely. COVID has definitely been unique in the pediatric world in that kids if they do get it are much more likely to be asymptomatic and with mild symptoms. Although some studies show that they may be spreading the disease, they spread it at a much slower rate than adults.
How likely is it that a teacher can have the virus transmitted to them in a school environment?
We still don’t know the exact answer, but in studies that have been done so far in small populations, the rate of transmission from children to adults is still very low and especially the younger the child the less likely they are to transmit the virus. The elementary school teachers are the ones most worried about the children transmitting to them and they really have the lowest risk of the child transmitting it to them. It’s possible, but it’s probably not that likely. As the kids get a little older, studies show it’s more likely for them to spread the virus, but older kids are also much better about hygienic practices than younger children.
Will the social distancing practices and masking work at school?
It will be lower in the schools with the safety measures we are trying to set up than if they’re walking into the grocery store or even a social event that your family is having.
Would you say then that the highest risk is between adults?
Exactly. The teacher to teacher contact will be most risky. Studies have already confirmed that in Europe and Australia with schools already open. They’re primarily seeing teacher to teacher transmission rather than child to teacher. Part of it is going to be if the kids are wearing their masks all day, good clean hand hygiene, and socially distancing, they’re going to be much safer in the classroom. When they get to the teacher’s lounge, they may relax and take off their mask and even though they are social distancing, that may be where it happens. We’ve seen more exposure to our own staff from outside the hospital or in the break room than they were from the patients they were taking care of.
Is there a suggestion on how to condition children and teens to do these things?
The problem with middle schoolers and teens is going to be that they want to always challenge rules. You should work to get their buy in and make it seem cool to do these things. I know in my own practice they are all talking about getting back to school and so I tell them to remind their friends to do these practices because we saw what happened in Georgia. When they don’t do what they’re supposed to, the school could get shut down and no one wants to be stuck at home again. That’s the carrot stick for them—do these things so that the school stays open and they can have a little bit of normalcy in their lives. The underage kids are a little more challenging. At their age they really want to please. They want to do what’s right, so parents can begin by educating them why they have to wear them and conditioning them to wear them now before they go to school. Remind them that it’s to protect themselves and those around them from the potential of getting sick. It has to be a joint effort between the parents and schools to accomplish this task.
Are there any studies that suggest the risk is greater for elementary, middle, or high school?
There’s really nothing out there of substance because the schools shut down during the pandemic. All we have are the schools that have opened overseas and there’s very little there. We do know that high school kids are a little more likely to test positive and wind up needing further care.
With the possible spread being aerosolized, is there a concern about the H-VAC system spreading it?
If you have stagnant air that lingers for a while with someone who is positive, yes, theoretically it could be spread. But, again, if you have your mask on, your hands washed, and practicing social distancing, that will reduce even the small chance of “contaminated air” around you. For the most part, I don’t consider that a big risk. Yes, outside would be better. I wouldn’t advise co-mingling. The studies from Europe and Australia show they stay with that one group of students for the whole day. In Denmark, they have one school where they don’t even wear the masks. They only cohort with the one group at school and of course, only the one at home with their family. I don’t expect that to happen here, but that takes a village to make that work.
Is the no co-mingling a mantra you would advise?
I think at this point that’s the best recommendation that we have. Stay in those cohorts—one teacher and one class all day. That also means staying in the classroom for lunch. It’s like extending your family a little bit and no more. I wouldn’t allow others inside that cohort—even parents or others because the more people you introduce into that cohort, the more likely the chance of spread.
What advice would you give parents to help their child be successful when they return?
This is going to be a family by family decision because there may be extenuating circumstances for each one. Someone at home may be taking chemotherapy. The risk may be too great for the child to have in-person education with the cohort. It should be based on the family dynamic. Prepare the kids for the process and the rules they will have to follow once they get to school. Teach them how to wash their hands using the Happy Birthday song. To teach them the concept of social distancing six-foot, use a pool noodle to help them understand the length. Remind them that there should be no hugging and no shaking hands and start practicing the six-foot social distancing at home.
Memorial Hermann recently went through a brand change with their pediatric facilities throughout the area. What’s the logic behind that?
We felt we really wanted to show the connection between these pediatric practices to show that we’re a real pediatric facility and have everything a child will need if the child gets really sick or to keep them healthy and well. We are a part of the Memorial Hermann Health System that also includes pediatric Emergency Centers, specialized emergency pediatric and neonatal transport services through the Children’s Transport Team, access to Memorial Hermann Life Flight, pediatric Urgent Care services, and renowned specialty programs in neurosciences, trauma, orthopedics and cardiac care. We are excited to bring Memorial Hermann Medical Group Pediatrics and Children’s Memorial Hermann together under one distinct brand for our community. The Children’s Memorial Hermann Pediatrics brand will be dedicated to pediatric clinics across the Greater Houston area including in Atascocita, Sugar Land, Katy and the Texas Medical Center. Although the names of these clinics have changed, their physicians, staff, addresses and phone numbers remain the same, as well as the level of high-quality care the community has come to expect from Memorial Hermann.