American Academy of Pediatrics Updates Guidance on School Safety Amid Pandemic

New information on transmission rates helps inform experts on best practices for in-person and virtual instruction.

As U.S. schools reach the mid-year of teaching classes during the COVID-19 pandemic, the American Academy of Pediatrics has updated its guidance for school safety based on the latest research.

In the updated document, the AAP outlines a series of safety protocols communities need to address to allow schools to be open for in-person learning. These measures include controlling the spread of COVID-19 in the community, implementing layers of protection for staff and students in schools, and coordinating closely with local and state health experts. With these measures in place, the AAP reaffirmed its recommendation that the goal should be to have students physically present in school.

“New information tells us that opening schools does not significantly increase community transmission of the virus, however it is critical for schools to closely follow guidance provided by public health officials,” said Lee Beers, MD, FAAP, president of the AAP.

“Children absolutely need to return to in-school learning for their healthy development and well-being, and so safety in schools and in the community must be a priority,” said Dr. Beers, whose term as AAP president began on Jan. 1, 2021. “We know that some children are really suffering without the support of in-person classroom experiences or adequate technology at home. We need governments at the state and federal levels to prioritize funding the needed safety accommodations, such as improving ventilation systems and providing personal protective equipment for teachers and staff.”

The “COVID-19: Guidance for Safe Schools” document is available here.

Younger children appear to be less likely to spread the virus in a class or child care setting, and they generally show milder or moderate illness. This suggests in-person instruction for primary and elementary grades is appropriate, with proper safety accommodations that are detailed in guidance provided by AAP and the Centers for Disease Control and Prevention (CDC).

“While the new vaccines offer hope for a return to a ‘new normal,’ schools must continue to take a multi-layered approach to protect students and staff,” Dr. Beers said. “Many are already taking precautions, and it is important to not let down our guard to protect ourselves and others.”

AAP also advises:

• It is critical to use science and data to guide decisions about the pandemic and school COVID-19 plans.
• Community-wide approaches to mitigation are needed for schools to open and remain open. Adequate and timely COVID-19 testing resources must be accessible.
• School transmission mirrors but does not drive community transmission
• Cloth face coverings in schools are strongly recommended for adults and all students over age 2.
• School COVID-19 policies should be practical, feasible, and appropriate for children’s and adolescents’ developmental stage and address teacher and staff safety.
• Special considerations and accommodations to account for the diversity of youth should be made, especially for those who are medically fragile or complex, have developmental challenges, or have disabilities.
• Schools should collaborate with state and local public health to assure that teachers and staff have access to the COVID-19 vaccine as recommended by the Advisory Committee on Immunization Practice (ACIP) and CDC. Pediatricians should work with families, schools, and public health to promote receipt of the COVID-19 vaccine as it becomes available to children and adolescents.
• School policies should also look to create safe working environments for educators and school staff. This focus on overall health and well-being includes addressing the behavioral/mental health needs of students and staff.

The AAP emphasizes that federal, state, and local funding should be provided for all schools so they can provide all the safety measures required for students and staff. The CDC estimates costs for safety strategies are between $55 to $442 per student, depending on type of strategy implemented. Funding to support virtual learning and resources must be available for communities and schools who have been under-resourced or in the event of school re-closure because of resurgence of SARS-CoV-2 in the community or a school outbreak.

“No single action or plan will eliminate the risk of virus spread at a school, but we have seen how face masks, physical distancing and other measures when combined can significantly lessen the risks,” Dr. Beers said. “By working together, we can get through this pandemic, as we must. Our kids are counting on us.”

For an interview, contact AAP Public Affairs.

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