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American Academy of Pediatrics: 'Children may be less likely to become infected and to spread infection'

Guidelines for return to school encourage in-person learning

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As school districts across the country work out plans to safely reopen schools, the American Academy of Pediatrics last week released guidelines recommending in-person instruction. Local school districts are developing plans that could include fully in-person classes, fully remote learning or a blend of both.

The guidelines state that:

"Schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits. The importance of in-person learning is well-documented, and there is already evidence of the negative impacts on children because of school closures in the spring of 2020. Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality."

As many districts are expected to require students to wear masks, Dr. Diane Nielsen, pediatrician at Northwestern Medicine Delnor Hospital, said that masks do work to reduce the spread of virus, yet there will be challenges in a school setting.

"For the children and teens who can wear them, they are very effective," she said in an email. "Physical distancing of 6 feet is important when face coverings are not being warn. Desks need to be further apart than usual. Outdoor learning should be used as much as possible with 6 feet distancing."

AAP guidelines also state that spacing as close as 3 feet can be as effective as 6 feet, especially is students are asymptomatic and masked.

Nielsen said that teachers and school staff members should also wear masks when they can't be 6 feet away from others, especially in gym, band or choir classes. Staff members should also stay 6 feet away from other adults, and staff meetings should take place virtually.

"Particular avoidance of close physical proximity in cases of increased exhalation (singing, exercise); these activities are likely safest outdoors and spread out," AAP guidelines state.

Nielsen cited studies that show that children may be less likely to become infected and to spread infection. Evidence also indicates that children and teens are less likely to be symptomatic and have severe complications from COVID-19.

"So far, researchers agree that children are not contracting the new coronavirus at the same rate as adults. According to CDC, children under the age of 18 account for under 2% of reported cases of COVID-19 in China, Italy, and the United States," she said in an email. "It must be stated that we do not have enough information yet to be sure."

And while districts may begin the year with in-person schooling, there is still the possibility that schools will have to close once again.

"If the percentage of positive COVID-19 cases in a particular area increases to a level of great risk for the whole population in that area, consideration will need to be made to close schools," Nielsen said. "We have more information available now than we did in March and April of 2020 in order to make this decision. This should be a last resort."

One important thing to remember is parents should keep their children home when they're sick, which means a fever of 100.4 degrees, or any symptoms of COVID-19.

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