By  Dr Megan Neudecker, a general practitioner working in Wierda Park. She is a member of GGPC (Gauteng General Practitioners Collaboration) which has created a platform for doctors to share resources during Covid-19. Look for #VoicesThatCare on the GGPC Facebook page.
As GPs, we commonly get asked by parents and caregivers whether it is safe to send children to school, and more specifically younger children to creche or play school, during the second wave.

Attending play school, creche or school during the 2nd wave

Factors that must be considered :

  • The child’s health condition
  • The current transmission of COVID-19 within the community
  • Protective measures the childcare facility has in place.
  • The unique family situation

Risks of Covid during the 2nd wave :

When deciding what is best for  their family, parents would be wise to weigh up the following risks and benefits of sending their kids to school:-

  • The risk to each family member in the household
  • The risk to family members that they may interact with for example grandparents, domestic workers etc
  • The effect that staying home will have on the social, emotional and mental well being of the child
  • The effect that staying home will have on the social, emotional and mental well being of the parent(s)
  • The effect that staying at home will have on the financial stability of the family.
  • The age of the child. Children under the age of 3 do not need the social interaction of school and can often be adequately cared for by a nanny at home, if possible.

Consider your own and your child’s individual needs 

  • Some children thrive in the home environment and do not seem stressed by missing school but many children become very stressed and withdrawn due to lack of physical interaction with teachers and peers.
  • Some parents manage to juggle home schooling and their work situation with ease while most find this a strain. Each family is unique and there is not a one-size-fits-all answer.

How serious is Covid in children during the 2nd wave?

  • As per the CDC (Centre for Disease control in USA), the true incidence of COVID-19 in children is not known due to lack of testing.
  • Evidence suggests that, compared to adults, children have similar viral loads in their noses and throats and can spread the virus to others.
  • Current evidence also suggests that the risk of severe disease in children is lower overall than in adults.
  • Children with underlying medical conditions may be at increased risk of a more severe illness, however evidence on which underlying conditions are associated with increased risk is limited.
back to school in 2nd wave

Special precautions can be taken to minimize the risk of infection in children.

Research suggests that schools and childcare centers do not fuel the spread of COVID-19  during the 2nd wave if proper safety protocols are in place such as:
1. Cleaning and disinfecting procedures:
This includes cleaning and disinfecting surfaces and toys before toddlers play with them. Commonly touched surfaces should be wiped frequently during the day.
2. Daily health checks and screening:
Does the child have any symptoms of illness or was a fever noted on the temperature checks? A common complaint of mothers is that they have to bring their child to the doctor because the daycare noted a fever or worrying symptom. However, this indicates that the daycare or creche is doing a good job of screening and prevention of spread of disease.
3. Testing and Isolation:
If anyone in the household tests positive for the virus, the child should stay home from childcare for 10 days, as per Department of Health Guidelines.
If the child starts feeling ill during the day, there should be an isolation room set aside with supervision until they can be collected.
4. Visitors:
Visitors such as Occupational or Speech therapists should be limited during the second wave and virtual options should be used where possible. If face to face therapy is crucial, it should preferably be scheduled with the relevant therapist at their practice.
5. Personal and Group contact:
Who will have contact with your child? Are the numbers in the class reduced? Is there sufficient outdoor and indoor area space for children to practice social distancing?
6. Protective Gear:
Are the staff required to wear masks and do they encourage children from age 5 to wear masks? Younger children could also be encouraged to wear masks according to their tolerance but according to government guidelines, mask wearing is only mandatory from 6 years of age. Are the staff sanitizing themselves and the children adequately throughout the day?
7. Play time:
Do the children regularly spend time outside to help reduce the spread of the virus?
Is the outdoor equipment cleaned regularly between use?
Is hand washing practised before and after outdoor activities?
8. Meals and Naps:
Will the daycare keep children physically distanced during mealtimes and naps?
9. Drop-off and pick-up:
Are arrival and drop off times staggered to help avoid creating groups of people?
Are the drop off and pick-ups done outside?

** NB Sick children and staff should be required to stay at home.

Things to consider:
If your child or anyone in the immediate family has any condition that makes them susceptible to complications of COVID-19, it may be best to keep the child at home. These conditions include
cancer,
chronic kidney disease,
COPD (Chronic Obstructive Pulmonary Disease),
Down syndrome,
Heart conditions,
organ transplant recipients,
obesity,
pregnancy,
sickle cell disease,
diabetes,
moderate to severe asthma,
cystic fibrosis,
HIV,
use of corticosteroids or other immune weakening medicines,
liver disease,
pulmonary fibrosis and thalassemia.
It is best to discuss your individual situation with your GP.
Click here to find  link/checklist developed by the CDC that can be used by parents/caregivers/guardians to assess and decide whether they should send their child to school.
Conclusion:
There is no clear cut answer as to whether to send your child back to school or creche during Covid’s 2nd wave. No decision is a wrong decision. This topic is complex as some parents have to go to work or cannot adequately care for their child when they are working from home.
If at any time you are unsure about your decision to send your child to school, do not hesitate to contact your general practitioner.
 
 
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