Know the Signs, Fight for Victory

Schools play a critical role in supporting our children’s educational and social development, overall health, and well-being. While educators and healthcare providers share the goal of having children return to school safely in the fall, it is important that schools reopen in a way that is safe for students, teachers, and staff.

Decision-making should be guided by science and data, taking into account the spread of COVID-19 (coronavirus) in the local community. Reopening policies should be flexible and adjustable according to the local level of transmission.  

Although policies for reopening schools should be flexible, they should all include the following safety measures:

  • Parents should check their children each morning for signs of illness. If your child has a temperature of 100.4oF or higher, sore throat, cough diarrhea, severe headache, vomiting, or body aches, they should not go to school and should see their pediatrician.
  • Make sure that your child is up-to-date with all recommended vaccines, including for flu. This is especially important because it is not known whether being sick with COVID-19 at the same time as the flu will result in more severe illness.
  • Children should wear face masks, which cover their nose and mouth. They should wash or sanitize their hands frequently and maintain physical distancing (at least 6 feet apart when feasible) from other children. They should avoid sharing objects with other students, including water bottles, devices, writing instruments, and books. Schools should communicate how they plan to ensure that these safety measures are followed.
  • Avoid close physical proximity in situations of increased exhalation (i.e., singing, exercise). These activities may be safer if performed outdoors.
  • Schools should clean, disinfect and sanitize surfaces on a regular basis.
  • Make sure your information is current at school, including emergency contact and authorized individuals to pick up your child in the event of illness or emergency.
  • Transportation
    • If your child rides a bus, plan for them to wear a mask and adhere to spaced seating.
    • If carpooling, every child and driver should plan to wear a mask for the entire trip.
  •  Develop a plan as a family to protect household members who may be at increased risk for severe illness.

The CDC website has a comprehensive back to school planning checklist for parents as well as other resources that may be helpful.

There is still much to learn regarding the effects of COVID-19 on children and what role they have in its transmission. To date, limited data suggest that children may be less likely to get COVID-19 than adults, and that, when infected, they tend to have less serious illness than adults. Although rare, death and complications related to COVID-19 and associated multisystem inflammatory syndrome in children (MIS-C) have occurred.  

Children with Marfan and Related Conditions

For children with uncomplicated Marfan syndrome or related connective tissue conditions (that is, they do not have significant lung involvement, valve regurgitation, or ventricular dysfunction), the risk for returning to school is likely no different than that of the general population.

On the other hand, children with more significant systemic and cardiac involvement (i.e., infantile or neonatal Marfan syndrome, lung involvement, cardiac dysfunction, chronic malnutrition, or conditions requiring chronic steroids or other immunosuppressive agents) are at a higher risk for hospitalization, intensive care, need for a ventilator to help them breathe, and even death if they become infected with COVID-19. For this reason, it may be necessary to take additional precautions with regard to school re-entry and the feasibility of alternate educational options should be considered.

While there is no way to ensure zero chance of infection, it is important to understand potential risks and how to implement preventive measures to lower transmission. Decisions regarding return to school need to be made on an individual basis, taking into account risk of infection to the individual, as well as potential transmission to family members who may be at increased risk for severe illness from COVID-19.