Doctor advice for kids as California schools open: Masks or face shields? Soap or sanitizer?

Thousands of California parents are preparing to send their children back to school campuses in the weeks ahead.

New studies, like one from Brown University, suggest that schools are not super-spreaders of the coronavirus. But children are not immune, and can be transmitters of the virus.

So what can parents and children do to increase their protection from COVID-19?

We asked Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital, and Sacramento County Public Health Officer Dr. Olivia Kasirye some pressing questions parents may have as campuses reopen.

How often should kids disinfect their hands? Is hand washing better?

Both Blumberg and Kasirye said soap and water work better than hand sanitizer, but recognize that hand sanitizer is much more convenient and is more likely to be used.

Blumberg recommends hand sanitizer after using the restroom, before eating or preparing food. Students should use it after touching frequently common surfaces such as door knobs and light switches, or when someone sneezes.

Kasirye recommended that, while hand sanitizer should be readily available to use in classrooms, adults should never give younger students unsupervised access to hand sanitizer.

Masks or face shields? And how often should I wash my child’s mask?

While face shields provide additional protection to a person, Blumberg said they do not provide the same protection as a face mask.

Kasirye agrees, adding that if there are no drapes around the sides of a face shield, particles will get into the air, under the shield and up to the wearer’s mouth and nostrils.

“If your child doesn’t like to wear a mask, maybe it’s too tight or too uncomfortable,” Blumberg said.

He recommends searching for a different design or material. Some students might have sensory issues with wearing mask, so some may require a referral to a therapist.

“This is our new normal for the foreseeable future,” Blumberg said.

Everyone should wash reusable masks everyday. Masks can be washed with the rest of the laundry, according to medical experts.

Should I worry about shared materials at school like books and pens?

“The primary route is through the respiratory route and that’s why social distancing and masks prevent transmission. They work,” Blumberg said. “There is a theoretical risk of acquiring COVID-19 from touching surfaces, but it hasn’t been shown that outbreaks from surfaces are frequent.”

Blumberg recognizes that there are a lot of concerns about how long the virus can survive, but stresses they are all theoretical.

In general, if students are maintaining six feet of separation, there should not be touching of other people’s property, Kasirye said.

Should students shower and change clothes when they get home? What if my child wears a uniform?

Blumberg said this strategy doesn’t make a lot of sense.

“We know the primary route of transmission is respiratory route,” he said. “If it does contaminate clothes, it has to be a high concentration and remain viable. Then you have to touch that area, then touch your eyes, nose or mouth.”

Blumberg said he is not aware of any outbreaks from mail, groceries or clothes, and he himself does not immediately change his clothes when he returns from the hospital.

Once we return back to campus, should we still isolate ourselves from others? Should I keep my children away from their grandparents?

With students returning to campus in pods, there still is a significant level of isolation happening on campus. Classes are not mingling or meeting in common areas like gymnasiums or cafeterias. And schools are conducting testing and contract tracing when needed.

“Your child should continue to socially distance within their household, their school and classroom,” Blumberg said. “They should not be doing extracurricular activities and should maintain social distance from people outside of their homes.”

Should we expect weekly COVID testing at schools?

The Sacramento County Public Health Department received an antigen test from the state called BinaxNOW. The county plans to distribute it to jails, schools, urgent care and other places. The county’s guidance is these tests should be used mainly for situations where someone is exhibiting symptoms.

Antigen tests give you results in about 15 to 30 minutes. Kasirye called it an incremental step forward. With antigen tests, Kasirye said the concern is there could be false positives, especially when testing is being done in groups where the likelihood of COVID-19 is not very high, such as in student groups.

Jesuit High School is running a pilot program and testing all students and anyone that comes to campus weekly. The test is a nasal swab and results come back in about 20 minutes. They are not using the BinaxNOW test, Kasirye said.

She said she plans to check in with Jesuit High and their program, but added that at this point she would not recommend schools test non-symptomatic students.

Besides testing, are there early indications that an illness is COVID-19 and not seasonal flu?

It will be very difficult to tell, Blumberg said, adding that anyone that has a fever and respiratory issues will need a test. And any child that displays illness should not be going to school.

Kasirye advocated for testing students if they have symptoms. Sacramento County is providing “surveillance testing” at mobile sites for adults who work at schools, and Kasirye suggested those school workers get tested every two months if they are not symptomatic.

This story was originally published October 30, 2020 at 9:55 AM with the headline "Doctor advice for kids as California schools open: Masks or face shields? Soap or sanitizer?."