Should our children go back to school? Dr. Wen helps you decide

The US Centers for Disease Control and Prevention has just released a road map for bringing students back to in-person instruction. About 89% of children in the US, however, live in a county considered a “red” zone with high levels of Covid-19 transmission under that new guidance, according to a CNN analysis of federal data.

That’s more than 65.3 million children who live in “high-transmission” communities, defined by the CDC as a county where there were at least 100 new Covid-19 cases per 100,000 people or a test positivity rate of at least 10% during the past seven days.

The CDC guidance stresses five ways to mitigate risk: requiring masks, physical distancing, handwashing, maintaining clean facilities and contact tracing.

Many schools have already been teaching students in the classroom at least part time, if not full time, and more will likely resume a combination of in-person and online learning or full in-person learning.

How will you decide whether your child should attend in-person school? If you’re going back, what are some precautions your child should follow, and how can you help your child prepare?

We spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and visiting professor at George Washington University Milken Institute School of Public Health, to ask her advice.

CNN: First things first — do the CDC guidelines mean that all schools are going to reopen immediately for in-person instruction?

Dr. Leana Wen: No. The decision is ultimately not up to the CDC, but to each local school district. The CDC provided guidelines — not enforceable rules — based on four levels of community transmission and what kinds of mitigation measures need to be implemented at all four levels.

Many schools may be at too high of a level of Covid-19 infection to reopen fully at this time, according to the CDC guidelines, while others can reopen once they have mitigation measures in place.

Different schools have different combinations of instructional methods. Some are fully open for in-person instruction; some are virtual only; some have brought in only younger grades or children with special needs; some have hybrid instruction with some full and some virtual; and so forth. What each school is doing will probably evolve as community transmission levels change and as they put in additional mitigation measures.

CNN: Some parents have the option to bring their kids for in-person learning. What factors should they consider before deciding if it’s the right option?

Wen: There are three major considerations I’d take into account. The first is individual risk, which is the risk of your child and others in your household. Does your child or someone you live with have a chronic underlying condition? Is yours a multigenerational household with someone who is older and therefore more susceptible to severe illness from coronavirus? If that person is already fully vaccinated, they are probably protected enough themselves from severe illness. If they’re not — or the person who’s at risk is your child — that would weigh more in favor of staying virtual.

Second is the risk in the school environment. There are two determinants here. What’s the level of community transmission, and what mitigation measures are in place at your child’s school? If community transmission rates are low, and if there are good mitigation measures put into place — for example, mandatory mask wearing at all times and required 6-foot social distancing — this could substantially reduce risk. You’ll need to look at where your child’s school stacks up, according to the CDC criteria.

Third is how your child is doing with virtual learning and your own life circumstances. If your child is doing just fine at home, maybe this is not the time to make a big change. On the other hand, if your child has been miserable, and if you also need to get back to a more functional workday, that might tilt the balance more toward trying in-person schooling.

CNN: What about your children? Are you going to send them to school?

Wen: Not yet. We initially kept my 3-year-old son out of school because we had a newborn. (She is now 10 months old so I’m less worried about her than before.) We are also very fortunate to have another family that helps take care of our kids during the day, with whom we are in a pandemic pod together. This other family has also kept their schoolchildren in virtual school. This is constantly being reevaluated. At some point — certainly by the fall but perhaps sooner — they may go back to in-person school, which will mean that we have to reevaluate, too. I know that my son can’t wait to go back to preschool.

Note that this is a personal decision that our family has made. I can imagine many other circumstances where we would make a decision to send our children to in-person schooling. Every family should make the best decision for them.

CNN: Once you’ve decided to start your child at school, how would you prepare them?

Wen: I’d involve them in the decision from the start. Then I’d make sure I know the school’s rules, and we’d rehearse them at home.

For example, it helps to practice wearing a mask. It might take some time to get used to it. Start with shorter intervals and work your way up. It helps to wear a mask yourself, too, to show how it can be done. Make sure your child has a well-fitting mask that covers both the nose and the mouth. It took my 3-year-old a few weeks to get used to wearing the mask, but he now wears it without a problem whenever we are around others.

If 6-foot distance is required in hallways and classrooms, show your child what that distance looks like. You can use a 6-foot piece of string to demonstrate. If someone in your house is about 6 feet tall, you can ask that person (in our case, with my husband) to lie down and see what 6 feet looks like.

Talk to your child about not sharing drinks or picking up other kids’ pencils and books. If your child is going on a bus, discuss rules for distancing on the bus and make sure they know to wear a mask at all times.

CNN: Would you talk to the teacher and other parents?

Wen: Definitely. Especially if it’s a teacher you know and trust, I’d have a frank conversation about safety. Know the what-ifs. What if someone in the class has a positive test — how long will your child be quarantined and where will they be tested? Are they doing contact tracing and what does it mean to be a positive contact? What if the school needs to close or your child is sent home, do you have a backup child care plan?

If you know the other parents in your child’s class, it could help to reach out to them. This is particularly important if your school is separating children into cohorts. Some parents who are in cohorts together decide to share carpools and arrange after-school care. Try your best to limit after-school interactions to the same cohort to limit risk. And remember, if the kids have masks around one another at school, they need to keep masks on for social activities, too.

CNN: Now it’s the night before. How do you prepare?

Wen: Pack ahead. Bring at least one extra mask in case the first one gets damp or soiled. The school should have handwashing stations, but it never hurts to bring your own hand sanitizer. Fill your child’s own bottle of water and pack any snacks or lunch.

Go through a symptom checklist the night before and the morning of. This should be done every day. If your child has any symptoms of coronavirus or is sick for any other reason, please do not go to school.

If your child has been to that school before, prepare them that things will feel very different. It may take time to adjust, and a lot may still change. Keep tabs and check in to see how they’re doing.

I know this is such an uncertain time. We’ve all been through so much, including and especially our children. We can keep going and get through this pandemic together!