Back to school during COVID-19: Safety advice from 3 doctors

If you live in an area with a large number of daily new cases and hospitalizations, bringing students back to school in person could increase the level of community spread. Ideally, the World Health Organization recommends a community be below the 5% test-positive level for at least 14 days before reopening. Texas is at about 13%. View updated state-level Texas COVID-19 data.

In North Texas, the positivity rate of all people tested has been about 15% in Tarrant County and 22% in Dallas County.

In July, more than 1,800 Dallas County children were diagnosed with COVID-19, with 38 requiring hospitalization. While children tend not to get as sick as adults with COVID-19, a study published recently in JAMA Pediatrics suggests children can harbor high amounts of the virus in their noses and throats as compared to adults and may be a significant source of spread of the virus, even if they experience mild symptoms.

In addition, a recent study from the University of Texas in Austin estimated the potential risk in each county in the U.S. if school started in person now. In Tarrant County, schools with 500 people could expect four infected students to arrive in the first week, the study said. In Dallas County, it would be five. Search by county.

Takeaway for parents

It’s inevitable that an infected individual will enter your child’s school, likely without knowing they have the virus. That’s why you should review your school’s safety and isolation protocols to understand how it will handle the situation and minimize the risk of spread.

Children with certain medical conditions such as asthma, cystic fibrosis, immunodeficiencies, or cancer face increased risk for complications from COVID-19. Certain medications affect the body's immunity and can also increase their risk. If your child struggles with depression or anxiety, their symptoms may increase due to pandemic-related stress at school or at home.

Pediatric specialists at UT Southwestern and Children’s Health Dallas have created a guide that categorizes medical conditions by lower, moderate, and high risk for in-person learning. The information is based on a consensus of expert opinions. The guide will be updated regularly based on new data.

Takeaway for parents

Talk with your child's pediatrician and specialist about their physical and mental health. The doctor can help you compare the risks and benefits of virtual learning and in-person school for your family.

"Household" means anywhere your children regularly spend time – their grandparents' homes, another parent's house, or with a sitter. Assess your household risk by determining who at your home faces the most serious complications from COVID-19 infection.

Elderly family members are at increased risk, as are siblings, parents, or grandparents with chronic conditions or who take immune-compromising medications. Chronic conditions of note for adults include diabetes, high blood pressure, asthma, COPD, HIV/AIDS, hepatitis C, obesity, and cancer.

Takeaway for parents

Talk with loved ones who may come in contact with your child about their risks. Your strategy might involve more aggressive physical distancing measures, strict masking rules, or additional hygiene protocols if your child goes to school in person.

Grouping students together by classroom so they’ll have limited interaction with other children is one key strategy to reduce spread of the virus. If one child gets sick, the school can isolate their cohort and switch to online learning without closing the entire school.

Your child's school will have a daily COVID-19 screening plan, which may include checking temperatures at home or before entering campus. (Sending a child to school who is feeling a bit under the weather, which we’ve all done, won’t be possible this year.) Schools may also require testing if a child in their cohort gets sick. And there should be a strategy to reintroduce children and staff who either 1) test positive or 2) are exposed to someone who tests positive.

Instead of self-serve from the cafeteria, schools may offer a pre-packaged box meal like you'd get on an airplane. During meals, children will likely have to space out or stick with their cohort. On nice days, eating outdoors might be an option.

In Texas, schools could potentially move some classes to outdoor spaces that are covered from the sun. This is recommended for classes that require a lot of interaction (and exhalation), such as choir, speech, or gym.

Expect new strategies and safety protocols for sports, musical and stage performances, and other extracurricular activities. Some schools may decide to delay team sports or shorten practice and game schedules. Others might cancel entirely – it will largely depend on how the school year goes and whether local infection rates decline.

One-way halls or staggered schedules for excusing students will help avoid large groups in the hallways. Schools may also try rotating teachers among classrooms rather than students. If your child takes a bus to school or is part of a carpool, make sure that face coverings are required.

Each school district is approaching virtual learning differently. Some are using video services to connect students with teachers, while others are implementing educational platforms so students can track their assignments and conduct all their work in one place.

While the course material should be similar to the in-person experience, be mindful that your child will need extra support for socializing and peer interaction. Ask your school about virtual opportunities to stay involved with clubs and class activities. Also ask if there will be designated times for online tutoring or one-on-one interaction with your child’s teacher(s).

Your child may get frustrated or have trouble concentrating until the new routine sets in. Remain open-minded and reach out to the school if you need support. Expect some delays and technical difficulties on the school’s part, too. You probably experienced this in the spring when most schools shut down and went to remote learning. School administrators, staff, and teachers are adjusting to this new normal as well. Try to keep that in mind, be patient, and embrace the spirit of cooperation we all need now.