Back to School During Delta: A Pediatrician With Young Children Offers a Road Map — and Survival Strategies | Kids VT | Seven Days | Vermont's Independent Voice

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Back to School During Delta: A Pediatrician With Young Children Offers a Road Map — and Survival Strategies 

click to enlarge ROSS SHEEHAN
  • Ross Sheehan

From the editor

How should parents approach this school year? In the early days of August, as the Delta variant started driving up COVID-19 case counts in Vermont, our Kids VT team came across this essay on Medium.

The author, Rebecca Bell, is a pediatric intensivist at the University of Vermont Children's Hospital, taking care of critically ill infants, children and adolescents in the state's only pediatric intensive care unit. She's also the president of the Vermont Chapter of the American Academy of Pediatrics, so she has a good sense of what her pediatric colleagues all over the state and country are seeing.

And she's a local parent; she and her family live in Burlington. Both of her young children have been attending an early childhood education center full time throughout the pandemic. Her oldest is about to start kindergarten.

We thought Kids VT readers would appreciate Bell's thoughtful guidance and pandemic-weary yet encouraging tone. We're grateful to her for helping us adapt her piece for our Back to School issue.

Cathy Resmer, Executive Editor/Copublisher


click to enlarge Rebecca Bell and family - COURTESY OF KRISTY DOOLEY
  • Courtesy of Kristy Dooley
  • Rebecca Bell and family

A summer of uncertainty has given way to a school year full of new questions and concerns. For parents of unvaccinated children, like myself, it has been an especially confusing time.

While older children and adults got vaccinated, shed their masks and made travel plans for the "Hot Vax Summer," families with unvaccinated children moved about hesitantly and experienced a "Not Vax Summer." We wore masks in solidarity with our kids, checked the vaccination status of everyone we socialized with and reassured our nervous children that there would be a vaccine for them soon, too.

Then news of the highly transmissible Delta variant brought more worry.

On top of that, data now show that although vaccinated people are very well protected from severe disease, they can become infected and transmit the virus to others, albeit at a much lower rate than unvaccinated people. Many vaccinated parents are putting masks back on in indoor public places and wondering and worrying what the school year will look like for their children.

Parents are understandably frustrated. In the early days of the pandemic, there was a general feeling of shared sacrifice. Children's lives were disrupted, and families really struggled. But it felt like we were all in this together. Now we see rising case rates in the U.S. in what officials have dubbed a "pandemic of the unvaccinated." But the "unvaccinated" includes all children under 12. For families, this no longer feels like shared sacrifice. This feels extraordinarily unfair.

So here we are. "Not Vax Kids' Summer" is coming to an end, and we're heading into "Not Vax Kids' Back-to-School" season. With rising case rates and variable school guidance across the country and the state, how should parents approach the upcoming school year?

The bottom line is that pediatricians believe this year can be safe and productive as long as we recognize that schools are a place where more unvaccinated people will gather, and that we'll need to take extra steps to make sure schools are accessible to all.

Here are the key principles we should be focused on.

1. Prioritization of in-person learning

You may wonder why, as a pediatric intensivist, I'm listing in-person school as a top priority. Over the last year and a half, pediatricians in Vermont and across the country have witnessed a significant decline in the health and well-being of some of our patients. Many became less physically active, more socially withdrawn and disengaged from academic learning. The pandemic exacerbated the existing mental health crisis among children and adolescents. The long-term effects of the pandemic on young people are unknown, and pediatricians are worried. This is why we are advocating for students to be physically present in school full time.

In-person learning provides a nurturing and stimulating academic and social environment for students. A full-time, in-person schedule gives students consistency and support throughout the school year. For these reasons, the Vermont Chapter of the American Academy of Pediatrics agrees with the Centers for Disease Control and Prevention that physical distancing should not preclude full return to in-person learning. We believe students can have a healthy and safe year even with strict social-distancing guidelines relaxed as long as we rely on other mitigation measures.

2. Vaccination, vaccination, vaccination

Protection through vaccination is the only way out of this pandemic. I've been grateful that Vermont has not lost sight of this despite being the most vaccinated state in the country. The Delta variant has shown us that we need as many people vaccinated as possible, and the Vermont Department of Health continues to offer walk-in and pop-up vaccination sites. You can find opportunities to be vaccinated everywhere you look: county fairs, farmers markets, state parks, school clinics, pharmacies and your doctor's office. Want to make an appointment? Visit the Vermont Department of Health website for walk-in clinic locations and hours, or call 855-722-7878 to schedule a time to receive your free vaccine.

If you work at or attend school and are eligible for the vaccine, please get vaccinated as soon as you can. If you are the parent of an eligible adolescent, please have your child vaccinated as soon as possible.

Many parents expressed a desire to "wait and see" when the Pfizer vaccine emergency use authorization was extended to include those ages 12 and older in the spring. But there is more urgency now to protect children before the school year starts, and there is even more compelling evidence that the vaccine is safe and effective in young people. At this point, more than 11 million young people under the age of 18 in the U.S. have received the vaccine. That's a lot of reassuring data points. More than two-thirds of Vermonters ages 12 to 17 — more than 28,000 Vermont youth — have been vaccinated. Now is a great time to join this ever-growing group of young people who are protected from the serious effects of COVID-19.

In Vermont, minors need parental permission to be vaccinated. Pediatricians are happy to talk to parents about why we think it's important. Helpful tips for young people on how to talk to parents about getting vaccinated can be found at teensforvaccines.org.

For parents of children under 12 who are waiting for them to be eligible for vaccination — I feel you. The best way to protect your children from the virus is to ensure that those around them, especially adults, are vaccinated.

If you feel comfortable having a conversation with the unvaccinated adults in your child's life, you may be able to motivate them to get vaccinated. I would avoid getting into arguments or exhausting yourself disputing misinformation. I would simply say, "Please let me know when you get vaccinated. Otherwise, until my child has had the opportunity to protect themselves with vaccination, we will need to limit contact with you."

For those not connected to schools: If you're eligible to be vaccinated and have not yet gotten a shot, please know that getting vaccinated now will have a positive impact on the ability of schools to run smoothly this year. Lowering rates of community viral transmission decreases the likelihood that COVID-19 enters the school and childcare settings in our communities. Our children and educators deserve a healthy school year with minimal disruptions.

3. Staying home when sick

This part is going to be hard. Really hard. We will all probably get more colds this year compared to last year. We are currently seeing more cases of upper respiratory infections than we usually do in the summer season. All students and staff, vaccinated or not, should stay home when sick and get tested for COVID-19. Your child's medical provider and school nurse can help you navigate this process. It's helpful to note that the health department's COVID-19 testing sites are open for those who are symptomatic, as well as those without symptoms. This should allow easier access to testing.

Workplaces will have to remember that the pandemic is not over. Employers should craft supportive sick and family leave policies. Employees should be encouraged to stay home if they are ill or need to care for sick family members. For families with children, this may mean lots of sick days this year. This is going to be challenging for families, but it's really important.

4. Masking

We are more than a year and a half into this pandemic, and we've learned a lot about effective mitigation strategies. Masking is a simple and effective tool that reduces the spread of COVID-19, as well as other respiratory viruses that can mimic its signs and symptoms. Students and staff wore masks throughout the school year last year. Continuing the practice makes good, common sense as we start school again in the fall.

There is broad consensus among medical and public health experts about the need for universal masking in schools. The Vermont Agency of Education, along with the health department, has recommended that school districts require masking of all students and staff regardless of vaccination status at the beginning of the school year. This recommendation is in line with national recommendations by the CDC and the American Academy of Pediatrics, as well as the AAP's Vermont chapter. Keeping students in school with minimal disruption is our shared goal, and masking can help us do that.

Vermont pediatricians recommend continued universal indoor masking in the school setting, regardless of vaccination rates, while we wait for younger children to have the opportunity to be vaccinated sometime this fall or winter.

We can do this!

I want to end on a hopeful note. Despite all of the uncertainty, I am very much looking forward to the school year. I'm excited to see my children learn and grow in childcare and school. I know they will gain so much from being around their peers and educators. I know school is the right place for Vermont students to be, and I believe that we can do this successfully.

And remember: Teachers, school nurses and administrators are already working hard to prepare for the school year. Early childhood educators have been caring for our children nonstop this entire pandemic. Patience and appreciation for the professionals who educate and care for our kids will go a long way.

How to Survive Yet Another Pandemic School Year

More advice from Dr. Bell:
  • Stock up on masks. The best mask is the one your child will wear. Let your child help you pick out the patterns and colors they like best.
  • Have a backup plan for sick days. If your child wakes up with a cough and nasal congestion, they will have to be tested for COVID-19 and stay home until symptoms resolve. This will be challenging for most families. I know how hard this is from personal experience, but we have to do this to keep our schools healthy.
  • Be prepared for changing guidance. Recommendations change because variables change during a pandemic. It can be frustrating, but at the same time we should be reassured when it happens, because it means public health professionals are responding to what's going on around us.
  • Look to your child's medical provider for help. Despite our best efforts at prevention, some of our unvaccinated children will be infected with COVID-19. If it happens — take a deep breath. We are here for you and your family. Most children get better on their own. Your child's health care provider can guide you through the illness and help you through the back-to-school and return-to-play process. If your child gets really sick and needs more medical support, rest assured that pediatric hospitalists and intensivists, along with our subspecialty colleagues, are very well trained to care for sick children. In the hospital, we work with teams of experts: nurses, respiratory therapists, pharmacists, nutritionists, social workers, child life specialists and rehabilitation professionals. Taking care of sick children is what we do all day, every day, and we're very good at it. If you need us, we'll be there to help you and your family.
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About The Author

Dr. Rebecca Bell

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