Is it safe for kids to go back to school?

We think of children as germ spreaders. When a kid comes home with a runny nose and a cough, the rest of the family often follows.

Naomi Bardach, MDBut that’s not true with COVID-19. Naomi Bardach, MD (right), who is researching how to control the virus’s spread, shares why school reopening is safe for kids – and everyone else.
 

Why aren’t children as susceptible to COVID-19?

One reason is that COVID-19 enters into the body via something on the cell called the “ACE-2 receptor,” which children just don’t produce as much as adults. Elementary school kids produce less than middle-schoolers, and high-schoolers and older teens produce less than adults. If the virus has fewer doorways into your body, you don’t get COVID-19 as often. And when you do get the disease, it’s not as severe. 

We have less data about why children don’t transmit the virus as much, but there are a few likely reasons. First, children have smaller lungs, so they don’t pump out as much air, and therefore less virus, than adults. Then, because they don’t get as severe disease, they don’t cough as much, so, again, less virus comes out of their bodies. Also, simply because kids are shorter, they tend to not pass disease to adults because their droplets fall to the ground before reaching adults.

What would you say to parents who worry about sending their child to school?

The reality is that the risk to children who are otherwise healthy is very low. If you’re willing to drive a child to school, that’s probably about the same risk to their health.

As for kids bringing the virus home to other family members, it’s not impossible, but based on a number of scientific studies, we have learned that most of the time, even when schools are open, kids are getting the infection from an adult in the household who brought it home.

What research are you working on?

We know that the keys for safety at school are masking, physical distancing, stable cohorts, ventilation, hand hygiene, symptom screening, and testing. I’m leading research on how best to implement these tactics so that we can stop the virus’s spread and keep kids in the classroom uninterrupted. 

Unfortunately, COVID-19 looks like every other viral syndrome known to children, so having cold-like symptoms is going to keep kids out of school a lot. We’re trying to better understand and refine a list of the symptoms that increase the likelihood that a child might have COVID. We might learn, for example, that one day of a runny nose is so low-risk that it should not prevent kids from attending school.

So if your child has cold-like symptoms, what should you do?

Right now, in the absence of better data, the answer is that we need to keep such kids home. There are stories of kids with really mild symptoms having COVID.  Until we have a more robust, data-informed way to move forward, symptom screening is crucial. That being said, it’s important for kids who tend to have runny noses because of allergies, or little coughs because of their asthma, to not have to constantly stay out of school. 

What is the biggest key to safe school reopening?

Wear your mask, wear your mask, wear your mask – particularly adults. When school staff are eating lunch in the break room, for example, they might let their guard down, thinking that their colleagues would never get them sick on purpose. No, of course they wouldn’t. But someone may have asymptomatic disease.  So keep your mask on.

Visit give.ucsfbenioffchildrens.org/coronavirus to learn more about how our hospitals have responded to the pandemic and how you can help.