Hand hygiene and staying home when sick help
Your child’s back-to-school checklist likely includes a lot of things — buying school supplies, signing permission forms, packing lunch bags. Getting sick probably isn’t on this to-do list; although, it’s often inevitable that heading back into the classroom leads to germs being passed around.
In addition to catching the usual mix of cold and flu bugs, kids are at risk of catching COVID-19. With the rapidly evolving guidance around when kids should stay home from school when they’re feeling sick — and when they should return — parents might be wondering what’s best.
When to keep your child home from school during COVID-19
Before the COVID-19 pandemic, a kid who woke up feeling less than 100% may not have decided to stay home. Today, that’s not necessarily the case.
“The acceptableness of going out into public while you’re ill has just changed over the last several years,” says pediatrician Adam Keating, MD. “It probably wasn’t a great idea before to send kids to school who potentially have influenza or even significant respiratory symptoms, like coughing. But now, COVID is among those other respiratory viruses in which we’d ask people to stay home if they’re sick.”
Luckily, unlike earlier in the pandemic, you can access a wide variety of home tests that can help determine if your child is positive for COVID-19. This testing is especially effective if they’re exhibiting COVID-19 symptoms.
“We generally believe those home tests best when it matches the symptoms that the child or adult has,” says Dr. Keating. “So, if you’re sick and coughing and you test positive, we believe it. If you are not sick and not coughing and test negative, we tend to believe it.”
Of course, if a child tests negative while exhibiting COVID-19 symptoms, that doesn’t necessarily mean they’re in the clear. In a case like that, it’s best to err on the side of caution. “If you’re feeling symptomatic, the best thing to do is to stay home and perhaps test two days later,” says Dr. Keating.
When can you go back to school after COVID-19?
Guidelines for COVID-19 isolation after a diagnosis have changed over time, as doctors and scientists have learned more about the virus. For the most up-to-date information, Dr. Keating suggests looking at the websites of your local health department or the Centers for Disease Control and Prevention (CDC).
However, don’t count on students returning to school right away after a COVID-19 diagnosis. “Right now, the recommendation is that you can return to school five days after you’ve developed symptoms for COVID, as long as you’re fever-free and getting better,” notes Dr. Keating. “And the recommendation is to wear a mask for an additional five days after that, to help decrease the spread of any virus that may be there.”
What happens if a family member gets COVID-19?
When parents get COVID-19, it’s not always easy to isolate them from the rest of the family because kids need care. “In an ideal world, we could see if another adult could help,” says Dr. Keating. “But in the event that they can’t, there are options so others in the house avoid getting sick.”
Frequent hand washing is a big one. So is ventilation — in other words, open up those windows. Masking indoors can also help decrease the spread of COVID-19 within a household. And above all, keep your distance.
“To decrease your chances of catching COVID, it really is about maintaining distance from the person who’s ill,” says Dr. Keating. “If the infected person can distance themselves, perhaps in a separate bedroom or in another area of the house, and avoid using a common space at the same time as other family members, that decreases COVID spread.”
The importance of the COVID-19 vaccine for kids
The COVID-19 vaccine is currently available for all kids ages 6 months and older. Dr. Keating stresses that kids who’ve not had a primary dose of their COVID-19 vaccine should get one.
For the mRNA vaccines produced by Pfizer and Moderna, a primary dose means two shots for most kids and teens. (For children between the ages of 6 months and 4 years old, Pfizer defines a primary dose as three shots.) However, kids and teens between the ages of 5 to 17 years who are moderately or severely immunocompromised will need three shots.
“In the general population, kids do tend to be at lower risk for complications of COVID compared to adults, particularly older adults,” says Dr. Keating. “But that doesn’t mean zero risk. And the vaccines really are safe and effective.”
Kids ages 5 and up are also eligible for a COVID-19 booster five months after finishing their primary vaccine dose. That timeline might be shifted a bit if it falls near a COVID-19 infection.
“Generally, if someone has an acute infection with COVID, it’s probably reasonable to have some time spaced between their booster and their acute infection,” says Dr. Keating. “And it’s worth talking with their doctor about what that optimal interval is.”
For anyone unvaccinated who’s diagnosed with COVID-19, they should get vaccinated a month after recovering. That’s a much shorter timeframe than was recommended earlier in the pandemic, for good reason.
“Earlier in the pandemic, being infected with COVID likely protected you for three months or so,” says Dr. Keating. “Unfortunately, with the new BA.5 omicron variant that’s circulating right now, it seems like that interval is significantly shorter. We’re seeing more reinfections in the general public, even up to a month or six weeks after their original infection.”
Other COVID-19 precautions for back-to-school
For kids heading back to school, there are a few simple steps they can follow to stay healthy. “We’ve all learned how important basic hand washing is, and how to prevent illness, as well as not touching your eyes, nose and mouth as much as you can,” says Dr. Keating. “These are great ways to transmit pretty much any respiratory virus. Keeping distance from those that are coughing and sneezing certainly decreases the risk as well.”
Mask requirements have tended to be directed by local school systems or local health departments, following CDC guidelines based upon the specific prevalence of COVID-19 in an area.
“That being said, kids should feel free to stay masked at school if it makes them feel more comfortable,” notes Dr. Keating. “If a child is needing to protect themselves further, or protect family members further, they should certainly be allowed to do so without bullying or stigma associated with it.”
Dr. Keating adds that there are also kids where masking is “almost always recommended” due to the fact they live with certain health conditions where COVID-19 would be a more dangerous disease.
“They either have primary problems with their immune system, are on medications that make their immune system less effective in fighting disease, or are at higher risk of having complications of COVID if they have some inflammatory conditions, or chronic respiratory disease.”
Taking these precautions can help keep kids in the classroom. “None of us want to go back to fully remote learning for everybody in school,” he continues. “For the vast majority of kids, it wasn’t the ideal education environment. Particularly, as we’re likely to see an increase in COVID cases this fall, the best way to protect yourself is to get vaccinated, and continue things like washing your hands well and staying home if you’re sick.”
It’s never too late to make a pediatrician appointment
Dr. Keating says people are behind on their preventative care in general right now due to the pandemic. For kids, missing appointments and care appointments could be particularly dangerous. Not only could they be behind on the schedule of childhood vaccinations, but regular pediatrician checkups are vital to good health as well.
Luckily, it’s never too late to get caught up. “If you’ve gotten behind on their well-child preventative care, make an appointment with their child’s medical provider,” says Dr. Keating. “There are more reasons than just immunizations to visit your pediatrician every year. We want to look at a child’s growth and development. We want to do our screenings, to look at mental health and social situations and be able to help out with a complete set of advice.”
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