Health article

School Decision-Making Tool for Parents, Caregivers, and Guardians


Introduction

Schools play an important role in students’ educational achievement, health, and wellbeing. Working with local health officials and with parents and caregivers, schools also have an important role in slowing the spread of SARS-CoV-2 (the virus that causes COVID-19) while protecting students, teachers, and staff and helping ensure students have safe and healthy learning environments.

As schools begin to reopen across the nation, parents, guardians, and caregivers will be making decisions based on numerous factors, such as individual preferences, health concerns, work situations, and school considerations. When making decisions about school for your family, there are many things to think about beyond academics, such as access to school meal programs, social services, extended day childcare, extra-curricular activities, social-emotional support from peers and educators, and transportation. Parents, guardians, and caregivers will be thinking about numerous factors, such as individual preferences, health concerns, work situations, and school considerations.

Many schools are offering parents and guardians a choice between in-person and virtual modes of instruction. CDC’s Decision-Making Tool for Parents and Guardians is designed to help you think through school re-entry and the choices that your child’s school is offering. ​

Consider the risks and benefits

Because of the COVID-19 public health emergency (PHE), instructional formats such as class size, setting, and daily schedules will likely look different than in past years. Consider the risks and benefits of these different instructional formats. For example, in-person instruction may offer easier access to school services, improved educational efficacy, more opportunities for social interaction and return to work for some parents and caregivers, but it also has a higher risk of COVID-19 exposure for your child than virtual instruction. Families will differ in their choice of instructional formats based on whether  the student or members of the household are at increased risk of severe illness, the student’s academic needs, the level of COVID-19 spread in the community, available school transportation options, school ability to execute recommended guidelines, the student’s social-emotional wellbeing, comfort and familiarity with the school’s reopening plans, and the family’s situation and needs.

As you are making decisions about your child(ren) returning to school, it is important to consider the full spectrum of risks involved in both in-person and virtual learning options. Parents, guardians, and caregivers should weigh the relative health risks of COVID-19 transmission from in-personal instruction against the educational, social-behavioral, and emotional risks of providing no in-person instruction when deciding between these two options. Aside from a child’s home, no other setting has more influence on a child’s health and well-being than the school. The in-person school environment not only provides educational instruction, but supports a child’s social and emotional skills, safety, speech, mental health, reliable nutrition, and opportunities for physical activity. This tool is designed to help weigh the risks and benefits of available educational options to help you make decisions about sending your child back to school.

COVID-19 and children: what we know

COVID-19 is a newly identified disease caused by the virus SARS-CoV-2. Scientists are still learning about how it spreads, how it affects children, and what role children may play in its spread. Limited data about COVID-19 in children suggest that children are less likely to get COVID-19 than adults, and when they do get COVID-19, they generally have less serious illness than adults [1]. Common symptoms of COVID-19 among children include fever, cough, runny nose, sore throat, headache, body ache, and diarrhea; many children may have mild or no symptoms [1]. As of July 21, 2020, 6.6% of reported COVID-19 cases and <0.1% of COVID-19-related deaths are among children and adolescents less than 18 years of age in the United States [2]. While uncommon, deaths and rare illness such as multisystem inflammatory syndrome in children (MIS-C) may occur [3].

Evidence and information about transmission (the way germs move from person to person) of COVID-19 to children is relatively limited. Evidence from other countries suggest that most pediatric cases resulted from children becoming infected by a family member [4]. The more individuals a person interacts with, and the longer the interaction, the higher the risk of COVID-19 spread. The risk of getting COVID-19 is also influenced by the intensity of transmission in your community. Your State, local, Tribal, or territorial health department website should provide information about the spread of COVID-19 in your area.

Children at increased risk of severe illness from COVID-19

Some children may be at increased risk of getting COVID-19 or may be at increased risk for severe illness from COVID-19.  For these children, parents and caregivers may need to take additional precautions with regard to school re-entry. There are more COVID-19 cases reported among children with intellectual and developmental disabilities than those without [5]. People of any age, including children, with certain underlying medical conditions are at increased risk for severe illness from COVID-19. Additionally, children who are medically complex, who have neurologic, genetic, metabolic conditions, or who have congenital heart disease might be at increased risk for severe illness from COVID-19, compared to other children. Severe illness means that they may require hospitalization, intensive care, or a ventilator to help them breathe, or may even die.

Household members and caregivers at increased risk for severe illness from COVID-19

While there is no way to ensure zero risk of infection, it is important to understand potential risks and how to adopt different types of prevention measures when resuming activities, including returning to school. Parents and guardians should consider whether other household members are at increased risk of severe illness from COVID-19 when making decisions about which activities to resume.

In addition, long-standing systemic health and social inequities have put some groups at higher risk of contracting COVID-19 or experiencing severe illness, including some members of racial and ethnic minority groups, and individuals experiencing homelessness.

If you, your child, or a household member are at increased risk for severe illness from COVID-19, you will need to weigh the benefits, risks, and feasibility of the educational options available. The table below will help you to assess your risk for COVID-19.

Household and community risks for COVID-19

In this section, a “True” response indicates higher risk for COVID-19.

 

Critical role of schools

COVID-19 transmission and illness are not the only risks to consider when making decisions about sending children back to school. Schools provide important services and supports for children’s academic, social-emotional and physical health. For instance, social interaction among children in grades K-12 is important not only for emotional wellbeing, but also for children’s language, communication, social, and interpersonal skills [6]. Some students may have experienced social isolation and increased anxiety while not physically being in school due to COVID-19.

Schools also provide critical services, such as school meal programs and behavioral and mental health services. Continuity of other special services is important for student success and lack of access to these services and supports have the potential to widen existing disparities and cause long-term effects on children’s educational outcomes, health, and the economic wellbeing of families and communities.

Review your school’s plans to reduce risk

Review local school or school district reopening plans to understand the steps they are taking to reduce the spread of COVID-19 and support educational goals.

Schools can implement strategies across 4 key areas to reduce the spread of COVID-19:

  1. Promoting behaviors that reduce spread (e.g., social distancing, washing hands and wearing cloth face coverings)
  2. Maintaining healthy environments (e.g., ensuring proper ventilation, cleaning and disinfecting frequently touched surfaces)
  3. Maintaining healthy operations (e.g., staggering schedules, keeping students in small groups)
  4. Preparing for when someone gets sick

Schools in communities with higher levels of SARS-CoV-2 will likely take more steps to prevent the spread of disease. See CDC’s Considerations for Schools for examples of some steps schools may take as part of their reopening strategy. Parents and caregivers might also be interested in learning how the school plans to support the emotional wellbeing of students—both in person and virtually.

Schools can work with state, local, territorial, and tribal health officials to determine whether and how to implement these considerations to meet the unique needs and circumstances of the local community. Implementation should be guided by what is feasible, practical, acceptable, and tailored to the needs of each community.



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