In Person or Online School?
With the number of Covid-19 cases increasing in Southwest Ohio and Northern Kentucky and school districts coming out with their proposals for the 2020/2021 school year, many parents are reaching out to us for recommendations.
This is definitely not a one size fits all situation. The American Academy of Pediatrics (AAP), the CDC, Washington, Columbus, local health departments, have all offered their recommendations/opinions. They are addressing what is best for the majority of children. We agree with the AAP 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.”
However, you the parents are not making decisions for the average child, you are making decisions for your child. Here are some things to consider, some questions you should ask yourself and your child, if she/he is old enough:
1) Clearly your first consideration is your child. Is your child healthy or does he/she suffer from a chronic medical condition that may be exacerbated by a serious respiratory infection? How did your child fare during in-home schooling this spring? Does your child need in person instruction in the classroom or does he/she do better learning at their own pace on their own time? Can your child navigate the virtual assignment board, find the necessary virtual materials, and submit them correctly? Is your child self-motivated to keep on track? It is very likely that in person instruction will be interrupted as the number of Covid cases increases. Can your student adapt to the possibility of going from in school to all virtual, to maybe a hybrid model? Or is consistency better for your student which could be achieved by an all online year. Does your child thrive in the social interactions with her or his peers or are those added stressors? Do you rely on nutritional support for your child in the school setting? Does your child have special needs, needs like OT/PT/speech/behavioral or mental health support? Are you concerned that your child has a learning disability that needs to be evaluated at school? Does your child have adequate opportunities at home for physical activity?
2) Then think of your own situation. Being a parent is a full-time job. Being a teacher is a full-time job. Are you equipped to support your child’s learning on a daily basis for multiple hours per day? Do you have a job outside the home? Are you a single parent? Are you healthy or do you have a chronic medical condition that requires you or those around you to quarantine? What about other members of your household? How would the possibly changing situation of in-school learning going to fully online to possibly a hybrid model affect your household? Do you need more consistency due to job or other constraints? School strategies may need to be revised and adapted depending on the level of viral transmission in the school and throughout the community. How will you be able to adapt to those changes?
3) What about extended family circumstances? Do you need to care for a sick grandparent or other individuals that are at higher risk from Covid-19? Do you have extended family available to you to help with your child’s learning? Are family members available to help when your child gets ill?
4) What is your school’s proposal? We know that social distancing decreases the risk of infection. The primary mode of transmission is through respiratory droplets by persons in close proximity to each other. Is your school able to socially distance children? How often will your child be in crowded hallways or are the students staying in the same classrooms and only teachers are moving between rooms? We also know that face masks mitigate the spread of the virus, when social distancing is not feasible. Is you school implementing a face mask requirement? Will your child be able to tolerate such a requirement? Where is your child eating lunch? What about physical education? Spread through respiratory droplets will be more of a concern at those times. What about busing or drop-off and pick-up procedures?
It is important to understand the mounting evidence regarding COVID-19 in children and adolescents, including the role they may play in transmission of the infection. SARS-CoV-2 appears to behave differently in children and adolescents than other common respiratory viruses. Although children and adolescents play a major role in worsening outbreaks due to influenza, information to date (and this may change) suggests that may not be the case with SARS-CoV-2. Although many questions remain, so far the evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from Covid-19 infection. In addition, children may be less likely to become infected and to spread the virus. There are multiple, granted small, studies that indicate that the primary spread is from adult to adult and adult to child rather than the other way around.
In summary, for most students and families, in school education will be best for academic learning, social emotional development, intervention services, and physical activity. With appropriate physical distancing when possible, face masks when distancing is not feasible, hand-washing, cleaning and disinfection of surfaces, and using outdoor spaces whenever possible, the threat of Covid-19 in our children can be mitigated. Most children will learn best when physically present in the classroom.
However, as a parent you know your child best. If you have specific questions about your child’s situation, please call us. As your child’s primary care provider we are happy to discuss your specific situation with you.
Petra Hackenberg-Bauer, MD, FAAP
