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Covid-19 Pandemic and Children going Back to School

Author:Dr.Irena Mehandjiska Shumanska

Children can get infected with Covid-19, and the infection is usually less severe. They typically experience an asymptomatic infection- don’t have any signs or symptoms of the disease, and if they have symptoms, the most common are cough and/or fever.
How can Covid-19 be transmitted among children, how long is the incubation period, the symptoms, how to prevent the transmission, and are children with underlying medical conditions safe to start school in person? With the beginning of the new school year and opening of the schools for in-person learning, while the Covid-19 pandemic is still present, it is important for every parent to be informed about every detail about Covid-19 infection and how to prepare their child for a safe beginning of the school year.

COVID-19 is mostly spread by respiratory droplets released when kids talk, cough, or sneeze. It may be possible that a child can get COVID-19 by touching a surface or object that has the virus on it and then touching their own nose, eyes, and mouth. The risk of transmission of Covid-19 among children can also be more significant while transporting the kids from and to school. The transmission also depends upon preventing the transmission in communities (the child gets infected in the community where it lives and brings the virus to the school).

What are the usual symptoms, and what is the incubation period? 

The incubation period of Covid-19 infection in children ranges from 1-14 days, with an average of 3-7 days.

The main symptoms of coronavirus infection are:

*fever

* a new, continuous cough (coughing a lot, for more than an hour, or 3 or more coughing episodes in 24 h)

*a loss or change to a sense of smell or taste meaning they cannot smell or taste anything, or things smell or taste different to normal

 Not specific symptoms:

*fatigue

*headache

*myalgia (pain in muscles)

*nasal congestion or rhinorrhea

*sore throat

*shortness of breath or difficulty breathing

*abdominal pain

*diarrhea, nausea, and vomiting 

Children infected with Covid-19 may have many non-specific symptoms, may only have a few, such as only upper respiratory symptoms or only gastrointestinal symptoms, or asymptomatic.  

Children with underlying medical conditions 

Children with underlying medical conditions such as children with obesity, diabetes, asthma and chronic lung disease, sickle cell disease, or immunosuppression might be at increased risk for severe illness from Covid-19. Children with neurologic, congenital heart disease or genetic disorders have a higher risk of severe infection with Covid-19. That’s why these kids have to be very well protected while attending school physically.

How to prevent the transmission of Covid-19 among children that started to go to school?

The most important principles that need to be followed by the children, teachers, caregivers, and all staff inside the schools are the personal prevention practices such as:

* hand washing 

* cleaning and disinfection with hand sanitizers 

* staying at home when sick

* social distancing during school sessions and activities

* wearing masks (considering adaptation and alternatives)

Masks are recommended as a barrier to prevent respiratory droplets from traveling into the air to other people when the person coughs, sneezes, and talks. There are cases when wearing a mask may not be possible or can be difficult and needs adaptations and changes. For example, pre-school children may be unable to wear a mask correctly and for a long period of time. Wearing masks in such cases should be prioritized when maintaining a distance is difficult. The education about the importance and proper wear of masks, from parents, teachers, and caregivers and ensuring wearing proper size of masks will help in accepting and proper use.

Tips on how to normalize mask-wearing among children 

*practice calming strategies like deep breathing, going outside for a walk;

*let your child choose a child-friendly design or help them to decorate a pre-made mask;

*try distraction methods like distracting with music, videos, video games while your child wears a mask (this will help them adapt to wearing a mask)

The beginning of this school year will be different than any other before. That’s why it is essential to explain to your child that all of the new steps are being taken to keep everyone safe and healthy. If you think your child needs help from a health provider, please contact your GP for further instructions on coping with stress during the Covid-19 outbreak.

References:
*Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 Case Surveillance — United States, January 22–May 30, 2020. MMWR
*Wu Z, Mc Googan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA
*CDC. Demographic Trends of COVID-19. https://www.cdc.gov/covid-data-tracker/index.html#demographics. Data retrieved July 27, 2020.