With COVID-19 cases on the rise, should students take extra precautions?

By Katia Hetter, CNN

(CNN) — Summer has ended and kids are back in school. However, COVID-19 cases are on the rise, along with key metrics like hospital admissions. New variants are constantly appearing, and the arrival of fall could also bring increases in influenza, respiratory syncytial virus (RSV), and other respiratory diseases.

What steps are schools likely to take—will they reimplement masks or social distancing? Is it time for students and their families to take additional precautions themselves? When should parents and caregivers get their children the flu vaccine and the new COVID-19 vaccine? What about a vaccine against RSV? What else can parents do to reduce disease transmission?

To guide us through these questions, I spoke with the CNN Wellness medical expert, Dr. Leana Wen. Wen is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She previously served as Baltimore’s health commissioner. She is also the mother of two young children.

CNN: What steps are schools likely to take to deal with latest spread of COVID 19?

Dr. Leana Wen: I don’t think that most US schools will bring back early pandemic-era measures like requiring masks, “pods” and social distancing. The few schools that have brought back mask mandates are already experiencing substantial backlash.  It’s also not clear that mask requirements in a few limited settings will reduce community transmission rates if people aren’t following other precautions and are freely associating with one another in other settings.

It’s important to put the current surge into perspective. Though hospitalizations are up, they remain well less than where they were last year at this time. Also, compared to 2020 and 2021, we have far more tools to reduce the chance of severe illness from COVID-19. Precautions that were necessary then may not be now, and we can turn instead to these other tools—like effective vaccines and treatments.

CNN: Is it still a good idea for students to take additional precautions?

Wen: That depends on their family’s circumstances. People who are generally healthy with some immunity to COVID-19 through vaccination, prior infection, or both are unlikely to become severe ill from it. Many may decide that they do not wish to live their lives any differently than before the coronavirus. Pre-2020, there were plenty of other circulating respiratory viruses.

While no one wants to contract these viruses—there is always the chance of persistent symptoms, and being sick, even with a mild illness, can be uncomfortable and result in missed days of school and work. Still, most people were probably not changing major aspects of their daily lives to avoid them.

Some families will want to take additional precautions. Let’s say that there is someone in the household who is at high risk for severe illness. The members of the household can decide, together, that they will work to reduce infection risk. They can forgo going to indoor restaurants, avoid crowded indoor spaces like music concerts, and, if they must be around many other people, they can wear a well-fitting N95 or equivalent mask.

Children, too, can take on these precautions at school, though, depending on the situation, the costs versus the benefits will need to be weighed. In a situation where no other students are masking and everyone is eating together in the cafeteria, a child may feel left out if they masked or ate by themselves. If they are wearing a cloth mask, which offers little protection, I’d argue that the benefit is insignificant compared to the cost. On the other hand, if there is an outbreak in the classroom, and the child is wearing an N95 or equivalent mask, then the benefit versus cost increases.

CNN: Does it matter whether it’s the child or the family member who’s at higher risk?

Wen: It depends on whether the vulnerable family member is someone who lives in the same household as the child. If they don’t live together, there is always the option for the child to take additional precautions in the days leading up to seeing the vulnerable family member.

I highly recommend that you speak with a healthcare provider to understand the actual risk of COVID-19 to your vulnerable person. I’ve talked to parents who say they have high-risk children because they have asthma, for instance. While COVID-19, and any respiratory illness, can certainly worsen asthma, that condition itself is not on the same level of risk compared to, say, a child who is on chemotherapy for leukemia.

Along those lines, advanced age is a risk factor, but the advent of vaccines and antiviral treatment substantially reduces that risk. To weigh the cost and benefit of reconfiguring your lives to avoid COVID-19 requires an accurate assessment of risk, which is specific to your family.

CNN: Let’s talk about vaccines. Should parents get their children the flu vaccine and the new COVID-19 vaccine?

Wen: Parents should get their kids the flu vaccine. Everyone 6 months of age and older should get the flu vaccine every year, with very rare exceptions. The flu vaccine is available now. I’d recommend that students get it sometime in September to early October, before the arrival of peak flu season.

The new COVID-19 vaccine is important for people vulnerable to severe illness. People in this category should receive it when it becomes available. Those who are generally healthy should discuss the decision with their physician. Someone who recently had COVID-19, for example, may choose to wait, as they have good protection due to recent infection.

CNN: What about a vaccine against RSV? Should students receive that, too?

Wen: School-aged children are not eligible for the new RSV vaccines, which have been approved only for people 60 and older and for pregnant patients.

CNN: What else can families with school-aged kids do to reduce disease transmission?

Wen: Basic good hygiene goes a long way. A lot of viruses are transmitted through direct contact. A child sneezes, touches a book or toy, and then when another child touches that and then their nose or mouth, the pathogen gets transferred. Kids—and adults—should try to sneeze into their elbow and cover up their cough. They should wash their hands frequently, and use hand sanitizer in between washing with soap and water.

Parents should heed their child’s school’s policies about when to keep kids home. Many will require that the child stays home until they are fever free for at least 24 hours, for example, without the use of fever-reducing drugs. And parents and caregivers should make sure that their child is up-to-date with all their routine childhood immunizations.

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