Should I send my child back to school? A letter to parents.


This is the million-dollar question that I’ve been asked over and over again by distraught parents wanting to do right by their children.

Parents want to have their children stay home so they can keep them healthy and safe. At the same time, they are worried about the far-reaching consequences of them not being in school. School is not just about academics but also about social and emotional wellbeing. For some children, school may be the only place where they get a nutritious meal, a safe area to play, or a kind word from an adult. But even if the home is ideal, most parents have to put in a lot of time and effort to make sure that their child gets the most out of online school. In spite of all the evidence supporting in-person classes, parents are terrified that they will compromise the safety of their children by sending them to school.

I want to reassure all parents that, according to the data, children are about as safe as anyone can be in this pandemic. Does this mean they will be 100 percent safe? No. But when is your child truly 100 percent safe? Not when they walk on the road, get into the car, go to the pool, or do any number of daily activities that you don’t think twice about.

The American Academy of Pediatrics is encouraging children to get back to physical classrooms. Many doctors I know say they would send their children of any age back to school.

What is the COVID-19 data on children so far

As of now, there have been no deaths in children in California, Texas, and New York despite tens of thousands of cases. Florida has had four deaths, with over 23,000 pediatric cases. The total number of U.S. deaths is 31 for children under 15 (the CDC groups older children with adults up to age 24). In comparison, the CDC reports 101 flu deaths for the same age group and time.

But that’s deaths! I don’t want my child to get seriously sick.

Of course, that is totally understandable. Fortunately, most children are asymptomatic, and the ones who do get sick, mainly end up with mild symptoms similar to that of a cold.

A rare syndrome called multisystem inflammatory syndrome in children (MIS-C), which causes inflammation of multiple parts of the body, has been observed. Researchers are still studying this, and hopefully, we’ll have more information soon. The good news is that only about 200 possible cases have been reported.

To put it all in perspective, there have been a little over 30 deaths and about 200 cases of MIS-C out of about 74 million children in the United States.

Of course, when it is your child who is one of those numbers, it’s a wholly different issue. It’s devastating when it’s your child who gets killed in a car wreck or in a pool accident, but you still looked at the odds and made the decision that the risk was acceptable. Hopefully, you will feel the same way about COVID-19 as well.

How can I make sure they don’t get COVID-19?

You cannot be sure that they will never get COVID-19, just like you cannot be sure that they won’t get in a car wreck. But you put them in a car seat or have them wear a seat-belt. The same principle applies to COVID-19. You know what to do and what works – ask them to wash their hands, wear masks, and spread out whenever possible. Despite all these precautions, it’s still possible that your child might get COVID-19, but you likely won’t know that they had it, or they may just come down with the sniffles. And yes, your child might be the one that gets MIS-C or dies, just like your child might die in a car or pool accident. But you know now that the chances of those happening are minuscule.

It’s terrifying to read reports of surges in cases among kids in daycare and schools.

You can get over that terror by understanding the difference between testing an individual who is sick so you can treat them, and testing people in large groups for public health purposes to see how the virus is spreading in that community. Most of these recent surges in childhood cases are from states’ public health efforts to understand the load of the virus in communities and reduce its spread. Not because all of these kids were seriously sick and needed to be hospitalized. So be more analytical when you read about cases. Dig a little deeper into hospitalization and mortality numbers.

So if children are at such low risk, then why all this controversy over school openings?

The controversy exists because of adults. Adults in the school and at home. Unfortunately, COVID-19 is way, way worse for them than for children. We don’t want the kids to infect high-risk teachers and family members. Therein lies the problem.

Since we can’t leave the kids by themselves at school with no adults to teach or supervise them, nor leave them home alone taking care of themselves, we need to figure out how to protect adults who care for children.

Most teachers and parents of young children will be 65 years or younger, which means that the highest risk category, those over age 65, don’t enter the equation. The high-risk teacher or parent with medical problems will need to be addressed separately. But the majority of adults caring for these children on a daily basis will be in the lower risk group of generally healthy and under 65 years old.

It is clear that the issue is not really over the safety of children, but over the safety of adults. We adults must figure out ways to reasonably protect ourselves while giving children the opportunity to safely flourish in school again.

Sue Royappa is an internal medicine physician.

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