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Schools need to come up with flexible plans for welcoming students back to the classroom in order to keep everyone safe.

The 2020-21 school year is not going to be easy. Qualities such as flexibility, courage and pure grit are suddenly paramount to providing an education to our children.

Many people are questioning whether it is worth it, and if we should just do online school until the pandemic is over. The American Academy of Pediatrics recently issued a firm statement regarding this quandary:

“The AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.”

Most pediatric health care providers, despite being acutely aware of risks, support in-person learning this fall. The reason for this is that there is already evidence to suggest that the effects of the isolation of spring 2020 on children are severe.

Despite extreme efforts by their parents and teachers, online educational advances were minimal for children in the spring. Add to that the “summer slide” and our children are behind where they should be.

More important are the social and emotional ramifications of closed schools, including increased depression, anxiety, physical and sexual abuse, food insecurity, physical deconditioning and loss of social touchpoints for children at risk.

I think it is important to say that this, like most tough decisions, is not without risk. However, based on recent studies children are less likely to get severe disease, and smaller children are less likely to transmit disease, which is reassuring.

A recent study out of South Korea indicates that older children and teens are as likely to transmit disease as adults; however, they are also more developmentally equipped for reducing risk with prevention tactics.

Each week will bring new information, which will require new direction and strong but compassionate leadership.

Guidelines for reopening

The AAP, Centers for Disease Control and Prevention and the state Department of Health have all laid out guidelines for schools as they make plans to reopen.

Health care providers, who have been working in the pandemic for months, feel compelled to emphasize a few things which should be priorities to schools.

— Reopening plans must be, more than anything else, flexible and practical so that they can respond to the changing pandemic landscape quickly and effectively.

• The plan must be inclusive. A society is only as good as the way it treats its most disadvantaged citizens. Special needs children, especially those with cognitive and social delays, must be a part of in-person learning in a safe, but inclusive way.

• All adults, middle school and high school students should wear a mask unless they are physically distanced more than 6 feet at all times. This is not and should not be a political statement: Masks help decrease the spread of disease.

Elementary students should wear masks if they can be encouraged to not touch their mouth or nose; however, it may make more sense to forgo this and concentrate on other infection-prevention strategies.

There are very few medical reasons to be mask exempt. Children may express discomfort, especially those with sensory issues, but efforts should be made on the part of parents, teachers and staff to provide comfort while enforcing mask rules.

If you can, consider purchasing masks made of different materials, colors and thickness and allow your child to choose their favorite. For more ideas about how to make children more comfortable and compliant with masks, see the resources below.

• Frequent hand-washing should be encouraged at all levels but especially the elementary students.

• All students and staff should check their temperature every morning before going to school and stay home if it is above 100.4.

• Incorporate outside time into the school day as much as possible, since outdoor spread of the virus is much less likely. Outdoor time can be used to give kids and adults a mask break and allow social distancing rules to ease up a bit.

All you need is a shade tree and some carpet squares to create an outdoor classroom. Schools should consider increasing recess time, doing phys ed classes outside and allowing older students to take breaks or eat lunch outside.

• Aim for students to be 3 to 6 feet apart while in the classroom. Adults should always maintain distance between each other, and, whenever possible, from students.

• Other adults, including parents and guardians, should not be allowed to enter the school unless it is an emergency. Dropoffs should be curbside.

• Flexible attendance policies should allow for parents to easily keep students home if they are concerned about their health. I have never been a fan of “perfect attendance awards,” as they encourage kids to go to school when they are sick.

Teachers are newest heroes

When you become a health care provider you understand that there are going to be infectious hazards along your career path. Having lived through many flu seasons, I can tell you that the courage it takes to work during this pandemic was already well developed in most of us. Which may be why the term “health care hero” is sometimes one that makes many of us uncomfortable because we truly are doing what we trained for.

However, there is a new set of heroes coming, who maybe did not count on this when they set their career goals: teachers.

It is stressful and downright scary for many, and I want educators to know that health care providers are here to provide support, inform and care.

School administrators should strongly consider doing the following things to make teachers’ lives just a tiny bit easier so that they can accomplish this critical work.

• Abolish dress codes to allow school staff to wear easy-to-wash and durable clothing such as scrubs.

• Provide multiple mask/face shield options, including clear panel ones for teachers who teach hearing impaired or language learner students.

• Empower teachers to choose outdoor time when feasible.

• Make any meetings, professional development, or other extraneous work requirements virtual.

• Cancel Pennsylvania System of School Assessments and other organized testing that interfere with teacher designed lesson plans that respond to individual students’ needs and goals.

• Have a well-rehearsed, well-staffed plan for responding to children who become sick at school that removes them from the classroom instantly but compassionately and provides an alternative safe location for teaching during cleaning.

• Outline very clearly what your school considers “exposed” to COVID-19. The CDC defines exposed as less than 3 to 6 feet away for more than 15 minutes with a person with the virus; not their sister, not walking in the same hallway, not using the same bathroom, etc. Once this definition is agreed upon, then require quarantine for these persons for 10 to 14 days.

Stubborn optimism

Returning to school during a pandemic requires stubborn optimism. We need to be determined to teach, support and move our children forward despite so many obstacles.

Collaboration, communication and flexibility are going to be critical. What we do now for our children will have ramifications forever. I have never known a group of professionals who I have more faith in than teachers — heroes for sure.

There is a great children’s book called “Lucy’s Mask,” by Lisa Thompson, which may be helpful to parents to get kids more comfortable with masks. Below are links to more resources, including advice on safely working during the pandemic, and talking to kids about returning to school.



Dr. Pia Fenimore, of Lancaster Pediatric Associates, answers questions about children's health. You can submit questions at

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