Health experts are urging parents to keep their children home when they’re sick, no matter what their illness may be.
With students returning to in-person learning this month along with COVID-19 and respiratory syncytial virus (RSV) circulating in many communities, experts say it’s more important than ever for parents to keep their children home if they are unwell.
In other words, just because your child tests negative for COVID-19, it doesn’t necessarily mean they should be in a classroom with other children.
“It’s never been OK to send your child to school sick. There have always been rules for returning to school after illness or certain symptoms, such as fever,” said Dr. Dana Hawkinson, an infectious disease specialist and medical director of infection prevention and control at the University of Kansas Health System.
“This continues to be an issue now, especially with COVID-19 and RSV circulating at high levels. Even with a negative COVID-19 test (if it was an antigen test, it needs a follow-up confirmatory PCR test), being ill you still have the potential to spread disease to others,” Hawkinson told ishonest.
COVID-19 isn’t the only illness that’s easily transmitted in communal environments. Schools can also be a prime spot for other infectious diseases.
“RSV, streptococcus pneumoniae (strep throat), gastrointestinal (GI) infections, [and] other typical cough and cold viruses are things that may transmit easily to others in school settings. Some of the infections can definitely cause serious problems for those infected,” Hawkinson said.
“Strep throat can cause significant problems leading to severe illness, and any of the respiratory pathogens have the potential to cause pneumonia and severe breathing issues, while the GI pathogens can cause significant dehydration leading to hospitalization,” he noted.
Influenza is also easily spread in schools, as children are more likely to contract the flu and transmit it to others.
The best course of action
Dr. Anne Liu, an infectious disease expert at Stanford University in California, said differentiating respiratory illnesses from COVID-19 can be difficult since symptoms are often similar.
“You can’t really distinguish the symptoms of these from COVID-19 symptoms, and sometimes they’re not easily distinguishable from allergies either,” she told ishonest. “Readily available, inexpensive, quickly-turned-around testing is going to be very important.”
The Centers for Disease Control and Prevention (CDC) advises that if a child has any COVID-19-related symptoms, they should stay home and get tested.
They should only return to school if it’s been at least 10 days since onset of symptoms, their symptoms have improved, and they’ve had no fever for 24 hours without use of fever-reducing medications.
“If testing is negative, fever has gone away, there’s no breathing issues, wheezing, shortness of breath that would warrant a trip to the doctor or emergency room, then I think following the school’s guidelines at that point is what I would recommend,” Liu said.
Even with a negative COVID-19 test, the CDC recommends that children with flu- like symptoms who don’t have a fever should still be kept home to minimize the risk of transmitting an infection.
If a child has a fever, they should stay home for at least 24 hours after the fever has lifted without the use of fever-reducing medications. Children who have a weakened immune system may need to stay at home for longer.
Children with symptoms of norovirus, a highly contagious GI virus, should stay home while ill and for 2 days after symptoms have stopped.
Symptoms include diarrhea, vomiting, nausea, and stomach pain.
Once norovirus is in a communal environment, it can spread quickly.
“(Norovirus) is extremely contagious and is responsible for most communal setting-related transmissions of an infectious diarrhea,” Liu said.
“Norovirus is pretty awful. It can present with or without fever, but vomiting and diarrhea that accompanies it can be pretty bad, and it can spread quite quickly in schools, day cares, nursing homes, and hospitals,” she said.
Illnesses spread quickly
Hawkinson said infectious respiratory illnesses and GI infections can spread easily in schools for a variety of reasons.
“First, many people, especially children, may not practice optimal hand hygiene and cleanliness practices, and children are in the same proximity for much of the school day.
“In addition, it may be harder, especially for younger children, to maintain distance from one another and continue to have physical contact. Respiratory or GI disease can be spread from person to person, or through touching surfaces, fairly easily in those environments,” Hawkinson said.
But there are steps parents and caregivers can take to help prevent their children from getting sick at school.
“Please, everyone 12 years of age and older, get vaccinated against COVID-19, and when flu vaccine is available this year, get that as well,” Hawkinson said.
“For now, mask use should continue to be encouraged. Continuing to talk to your children and encourag[ing] frequent hand hygiene with soap and water or alcohol hand sanitizer will help avoid contracting illness,” he said.
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