Back to school and the delta variant : 7 questions, answered

As many children prepare to return to school in person, the highly contagious delta variant continues to spur a rapid increase in COVID-19 infections.

So, what can parents do to protect themselves and their children, and curb their anxiety as students head back to class? We asked infectious diseases specialist and head of Internal Medicine David Tweardy, M.D.

What’s the best thing parents can do right now to prepare for in-person school?

Get the COVID-19 vaccine. There’s not much you can do about the Delta variant. But there’s a heck of a lot you can do about getting vaccinated. And anything you can do to move yourself and your loved ones from the unvaccinated column to the vaccinated column will help everyone.

So, get vaccinated, if you haven’t been already, and encourage your friends and family to do so, too. The vaccines are safe and recommended for people with cancer as well; just make sure you talk to your doctor about how to time the vaccination with your treatment.

And get your children vaccinated, if they’re between the ages of 12 and 18. The COVID-19 vaccines available in the U.S. have all been proven safe and effective in reducing the risk of severe illness for all age groups in which they’ve been granted emergency use authorization by the Food and Drug Administration (FDA).

Be sure to get both shots, too, if you get the Pfizer or Moderna vaccine. You’re not fully protected until two weeks after you’ve had the second one, so I’d suggest getting vaccinated as soon as possible.

When the vaccines become available for children ages 5-11, hopefully later this year, it will be important to get younger children vaccinated as well. This will be very important for protecting our families and getting us out of this pandemic.

What else can I do to protect my child from COVID-19 at school?

The Centers for Disease Control (CDC) is now recommending that students and teachers wear masks indoors again, even if they’re fully vaccinated. That’s because individuals who have been fully vaccinated can still be re-infected, or act as silent carriers who pass the virus along to others.

And while it’s true that the biggest benefit of wearing a mask is preventing droplet particles from escaping you, they can also protect you from the droplets generated by other people. So, if your child is within six feet of an infected classmate or a silent carrier teacher who is not wearing a mask, the mask on your child’s face will still reduce their chances of being exposed or infected.

Do cloth masks offer sufficient protection?

The best mask for any given child is the one they will actually wear. So, it’s all about finding what your child will tolerate. I’d like to think that most children are pretty used to wearing masks by now, so they’ll wear whatever you tell them to. But as parents know, when you’re dealing with children, you work within the realm of what’s possible.

That being said, I think almost any 2-ply cloth mask or medical-grade face mask for children would be satisfactory. But if your child is at a higher risk of infection or complications if they contract the virus, then talk to your pediatrician to see if a case can be made for only medical-grade masks or even an N-95.

What are some other ways to reduce my child’s risk of COVID-19?

The coronavirus is primarily spread by droplet transmission through the air. So, hand washing and hand sanitizer did not have as much of an impact on prevention as we initially thought they might — and certainly not as much as wearing masks and social distancing.

That being said, the delta variant is highly contagious; data suggests that one person can pass it on to as many as five people, or even more. So, I see no reason not to continue following the usual recommendations for good hand hygiene. Wash your hands frequently with soap and water. Use hand sanitizer if those are not available. And don’t touch your face with your hands.

With all of the other viruses still circulating out there, practicing good hand hygiene is always a good idea.

What should I do if my child is exposed to COVID-19?

First, don’t panic. COVID-19 cases have been mild so far in the vast majority of children who’ve developed it.

Fully vaccinated children do not need to quarantine unless they show symptoms. However, they should be tested within 3-5 days of the exposure and continue to wear a mask indoors for 14 days afterward until they receive a negative test result.

Unvaccinated children who have been in close contact with someone who has diagnosed or suspected COVID-19 should quarantine at home for 14 days since their last exposure, and watch for symptoms of infection like headache, fever and sore throat. If that child does develop COVID-19 symptoms, keep them at home and get them tested as soon as possible, then follow the CDC’s recommendations on what to do if they should test positive.

Should I use an at-home, rapid-result COVID-19 test to determine my child’s status?

I consulted my colleague, Micah Bhatti, M.D. Ph.D., to be sure on this. And he agreed that while some of these antigen tests can be really sensitive in people with symptoms, when they’re used in asymptomatic people, their accuracy drops significantly. Because you need a fair amount of virus in order for it to be detectable.

So, testing an asymptomatic child before they go to school every day, for instance, is not something that we’d recommend. But if your child has symptoms, go ahead. Follow up with their pediatrician for next steps, though, as even if a child’s rapid COVID-19 test is negative, their doctor may wish to confirm that with another test, or even test them for other circulating viruses.

Any other back-to-school advice for parents this year?

I can’t stress enough how important it is for everyone over the age of 12 to get the COVID-19 vaccine. But it’s also important to make sure your children are up-to-date on all of their other vaccines, as well, whether it’s flu, HPV, or routine things like DTaP (diphtheria, tetanus, and pertussis).

There’s always going to be some small risk of side effects with any vaccine, but those rarely approach the seriousness of the infections they’re designed to prevent. And vaccines not only protect you; they also protect your children, your family, your friends, your neighbors, your co-workers, and ultimately, your entire community.

Another thing to consider is that more and more doctor’s offices and children’s hospitals are overwhelmed with unvaccinated COVID-19 patients right now, as well as respiratory syncytial virus (RSV), which is also seeing a huge uptick in cases. That means their capacity to treat children with other illnesses and injuries right now is limited. So, anything you can do to reduce the chances that your children might need those services — whether due to complications such as pneumonia, RSV or other severe infections — is prudent.

Schedule a vaccine appointment at MD Anderson. Appointments are open to patients, caregivers and the community.