Back-to-school guide designed to help parents

by Nebraska Medicine | August 10, 2020

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We're probably all in agreement that this school year will be different from any we've ever experienced, as students, parents and grandparents. In the news, we see contrasting opinions about what's best for the students in our community -- in-person vs. remote learning.

School districts are getting creative with how to reopen safely: smaller or spaced out classes, more hand washing and minimizing larger groups in cafeterias or hallways. So far, pediatric cases of COVID-19 seem to be less severe than cases in adults.

We've created this safety guide designed to help parents with the following items:

  • What to add to your shopping list
  • How to schedule school physicals
  • Is it safe for kids to wear masks?
  • Reducing risk in sports and other activities
  • How to talk to worried kids about school

Back to school shopping

Along with traditional notebooks and pencils, add some new supplies to your list:

  • Kid-friendly masks (bonus points for fun designs)
  • Hand sanitizer (contains at least 70% alcohol)
  • Disinfecting wipes/sprays for your teacher's classroom

When buying masks for kids, multiple layers of fabric is good. Ideally, the fabric is breathable and resists water. The more snug it fits around your child's face, the more effective it will capture anything they're exhaling or that they might be exposed to.

If you can't find sanitizer in stores, you can make your own hand sanitizer at home. Family physician Amber Brown Keebler, MD, also recommends backpacks and lunch boxes that are easy to clean and sanitize.

Keep kids' health on track

Immunizations and school physicals are perhaps more important now than ever.

"Pediatricians use school physicals as a comprehensive overview of your child's health," Dr. Brown Keebler said. "We measure blood pressure, height and weight. We also administer important vaccines." Back-to-school appointments are best done in person, if possible. Your local doctor's office continues to be one of the safest places to go.

Is it safe for kids to wear masks?

"The wearing of masks is not harmful," said Mark Rupp, MD, chief of the UNMC Division of Infectious Diseases and medical director of infection control and epidemiology at Nebraska Medicine. That goes for schoolchildren too. Dr. Rupp said that wearing a mask may even help people with asthma.

Dr. Rupp sees masks as a matter of safety. "Kids resist sitting in a car seat at first, and then it becomes part of the natural process of riding in a car," he said. "Masks work the same way. If you teach kids that masks are good for the safety of their classmates, they'll be more willing to listen."

For younger children, a reward chart is a fantastic way to encourage mask wearing, said Howard Liu, MD, chair of the UNMC Department of Psychiatry. "When trying to shape behavior, positive reinforcement works better than punishment."

As parents know all too well, children notice hypocrisy and mimic behaviors that aren't ideal. Help your kids learn how to wear a mask by wearing one yourself in public. "Parents and older siblings are the best models for wearing masks," Dr. Liu said. "If you wear a mask without complaint, your children will too."

A quick recap:

  • Wash your hands before putting on the mask and after taking it off
  • Cover your nose and mouth with the mask
  • Don't wear a mask around your chin

There are two groups that masks aren't ideal for: some children with special needs and children ages 2 and under.

"Some kids -- especially kids with sensory or behavioral conditions -- may have problems wearing a mask," said John Lowe, PhD, UNMC assistant vice chancellor for interprofessional health security training and education, while answering questions from the public. "Clear face shields can help these kids communicate while protecting others. Face shields aren't as effective as masks, but they will block some droplets."

What about younger children? Kids over the age of 3 can wear masks without worry. Two-year-olds and below tend to play with them or take them off. A COVID-19 researcher, Dr. Lowe said, "I was a mask skeptic for children, but my 4-year-old proved me wrong. With very little coaching, she wears a mask in public very well."

Critical care physician Kelly Cawcutt, MD, debunks three common mask myths here.

Reducing risk in sports and other activities

"Participating in extracurricular activities is a personal choice for families," Dr. Brown Keebler said. "Assessing your family's health and those you see regularly can affect how much risk you and your family are willing to take on." For example, if grandma helps with childcare (and she has diabetes or high blood pressure), you may want to protect her and limit how many and with which families your child closely interacts.

For sports and clubs, here are some general guidelines:

  • Outdoors is better than indoors
  • Distance (six feet apart or more) is better than close contact
  • Smaller numbers are better than large groups
  • Masks are better than no masks
  • Avoid sharing equipment or water bottles
  • Wash hands before and after kids interact with others

How school affects mental health

The American Academy of Pediatrics supports in-person learning, because remote learning may mean social isolation and food insecurity. Even so, some kids may worry about returning to school.

Child psychiatrist Katrina Cordts, PhD, recommends setting a positive tone for younger children. "As a parent, you often set the tone for your child's experience. By modeling excitement and confidence for your child, it sends a message to your child that things will be okay."

Child psychiatrist Ryan T. Edwards, MD, shared some tips for talking to kids about coronavirus.

"Talk about what measures are being put in place at school," Dr. Brown Keebler said. "Often having something kids can actively do helps ease anxiety -- like eat healthy foods, washing hands regularly and exercise." You also can remind them that children -- especially elementary students -- have been mostly unaffected by the coronavirus.

Dr. Liu said, "If your kids have persistent anxiety, consider having them meet with a therapist skilled in cognitive behavioral therapy (CBT)." You can schedule an appointment with any of these experienced therapists who specialize in child and adolescent psychiatry.

Have more questions?

If you have any other back-to-school questions, a school counselor or principal can ease your concerns. As the situation changes locally, schools may change in response. At some point in the school year, there may be a shift back to virtual learning. You might come up with a family plan now for what you'll do if that happens.

We learn more about coronavirus every day. Get the latest guidance - with your unique health condition in mind -- by scheduling an appointment with your family doctor.

This school year will look different, but we're all in this together.

As the director of research for the Nebraska Biocontainment Unit and National Quarantine Unit, Dr. Lowe is hopeful. "There's a great deal of uncertainty. We're learning more every day about how the virus works and how to effectively manage it. I want to applaud all the school administrators and school staff across Nebraska that are working really hard to figure out what's best for our kids," Dr. Lowe said.

The Global Center for Health Security recently released its playbook to help schools protect its students from infectious diseases, like COVID-19.


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