Interviewer: With many kids going back to in-person classes this fall, is there a danger that they can catch COVID-19 at school and then bring it home into a household that might have a vulnerable individual or give it to other family members.

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Dr. Adam Hersh is a pediatric infectious disease expert. What do we need to know about keeping other family members safe from COVID-19 if we have a child in the household that’s going back to in-person school?

Dr. Hersh: There is suggestion that children, especially younger children, may be less contagious when in fact it was SARS-CoV-2, certainly more likely to be asymptomatic so they could be silently contagious. But even if they’re less contagious than their adult housemates, caregivers, other family members, they’re still potentially contagious. So I think we just have to be a little cautious in saying that even though children may be less likely to transmit the infection, it doesn’t mean that they can’t transmit the infection.

And so one of the big concerns, that’s a legitimate concern, is not so much how children will fare by reentering school in person, but should they be exposing themselves to this virus by virtue of being in the school environment, acquire the infection and bring it home to the rest of their family, which could include adults or even other siblings, other household members who are at higher risk than the child is to experience a more complicated disease course? That’s absolutely a real risk.

Interviewer: How is a family’s at-home life going to change then if you have a student in school, could possibly come home with the virus? How do you protect the rest of your family?

Dr. Hersh: That is extremely difficult. First and foremost, I do want to emphasize though that it is my hope, I think it’s the hope of all school leaders that the physical environment of the school that the child would be attending is very safe. We are talking about opening schools, implementing really aggressive mitigation strategies. We’re not talking about a free for all in the school environment. But nonetheless, you can’t reduce the risk of transmission to zero in any congregate setting.

So there’s a number of things to think about. In some circumstances, people are in their own home are beginning to use face coverings in the home environment when people are going to be together, especially when one member of the household is at higher risk for more severe complications or for a more severe disease course. When say the child and, for instance, an elderly family member might be around one another for an extended period of time, there are some households that are using face coverings in their own home.

Other things that are really important are just thinking about your day-to-day routines. Just thinking about when am I close to someone even in my household, and do I really need to be this close, and can I change my routines a little bit to reduce the amount of time that say, again, I think what’s really important to think about are more vulnerable folks, older folks, those with underlying medical conditions that might predispose them to a more complicated disease course.

Just rethinking our daily routines, especially around how close do you physically sit with folks, you know, thinking about having meals outside instead of inside. Meals being a time when, you know, you might be spewing droplets as you’re chewing and sitting close to someone for an extended period of time.

And then lastly, what’s really, really important, although a large number of people do experience this infection completely without symptoms, I think we’re in a moment now when you do experience symptoms that could be associated with COVID-19, especially symptoms like fever, cough, shortness of breath, we need to double down and be really careful, not just about attending school, those are circumstances where a child will not attend school when they’re experiencing those symptoms, but even in our home environments. If a child is experiencing those symptoms and there’s an older caregiver or family member in the home, keeping those folks apart, in perhaps in a way that, you know, wasn’t typical before this pandemic.

Interviewer: So it sounds like a lot of the precautions that we already should be doing in our home, disinfecting high used areas, doorknobs, that sort of thing, perhaps thinking about washing your hands a lot in the house. And then some families, like you said, moving to wearing masks and also just rethinking, how can we maybe separate space out a little bit, which is hard for some families, but very, very effective.

Dr. Hersh: It’s not always possible. It’s really just a question of thinking about what you do and where can you make some modifications?

The Health Minute is produced by University of Utah Health.

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