Updated AAP school reopening guidance calls for layers of protection, flexibility

Editor's note:AAP interim guidance is based on current evidence and best data at the time of publication. Updates are provided to reflect changes in knowledge about the impact of the disease on children and adolescents. For the latest news on COVID-19, visithttps://www.aappublications.org/news/2020/01/28/coronavirus.

Schools that conduct classes in-person should have multiple layers of protection in place for students and staff and be ready to adapt based on local SARS-CoV-2 rates, according to updated interim AAP guidance.

While the AAP continues to advocate for in-person education, it acknowledges many schools where the virus is widespread will need to adopt virtual lessons and is calling for more federal funding to support both models.

“This is on us – the adults – to be doing all the things public health experts are recommending to reduce the spread of the virus,” said AAP President Sara “Sally” H. Goza, M.D., FAAP. “If we can reduce the amount of COVID-19 in more communities, it will be possible for more schools to open, and this will be best for all of our children.”

“COVID-19 Planning Considerations: Guidance for School Re-entry,” has been updated based on the latest evidence including that children under 10 years may be less likely to become infected and spread infection, while those 10 years and older may spread it as efficiently as adults.

Educators will have to consider the degree to which SARS-CoV-2 is circulating in their community, as well as guidance from local public health officials. The benefits of in-person education for fostering instruction and social and emotional skills, and providing safety, healthy meals and support services also must be considered.

To mitigate the risks, the AAP recommends children over age 2 years and adult staff wear cloth face coverings. Other recommended layers of protection include keeping desks at least 3 feet apart, and ideally 6 feet apart, cohorting students, using outdoor spaces when possible, promoting hand and cough hygiene and increasing cleaning and disinfection of facilities.

The guidance notes the Centers for Disease Control and Prevention (CDC) does not recommend universal testing, which is not feasible in many areas and only shows whether someone has the virus at that moment. The AAP said temperature checks at school may not be practical and suggested parents perform symptom and temperature checks at home. Students and staff should stay home if they are ill.

The updated guidance places additional emphasis on the need to address racial and social inequities in education. Schools holding classes virtually should ensure all children continue to have access to nutritious meals and the technology they need to participate in lessons.

“The persistent racial and social inequities in our educational system, including disparities in funding, quality of school buildings, and resources for curriculum and teachers have only been exacerbated by the pandemic,” Dr. Goza said. “Without more resources, these disparities will worsen. Whatever school looks like this fall, we must be innovative and promote the well-being of all children, particularly children living in marginalized communities.”