American Academy of Pediatrics on School

3,360 Views | 20 Replies | Last: 5 yr ago by culdeus
Keegan99
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AG
https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/

Quote:

With the above principles in mind, the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school. The importance of inperson learning is well-documented, and there is already evidence of the negative impacts on children because of school closures in the spring of 2020. Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality. Beyond the educational impact and social impact of school closures, there has been substantial impact on food security and physical activity for children and families.

Policy makers must also consider the mounting evidence regarding COVID-19 in children and adolescents, including the role they may play in transmission of the infection. SARS-CoV-2 appears to behave differently in children and adolescents than other common respiratory viruses, such as influenza, on which much of the current guidance regarding school closures is based. Although children and adolescents play a major role in amplifying influenza outbreaks, to date, this does not appear to be the case with SARS-CoV-2. Although many questions remain, the preponderance of evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from SARS-CoV-2 infection. In addition, children may be less likely to become infected and to spread infection. Policies to mitigate the spread of COVID-19 within schools must be balanced with the known harms to children, adolescents, families, and the community by keeping children at home.

Finally, policy makers should acknowledge that COVID-19 policies are intended to mitigate, not eliminate, risk. No single action or set of actions will completely eliminate the risk of SARS-CoV-2 transmission, but implementation of several coordinated interventions can greatly reduce that risk. For example, where physical distance cannot be maintained, students (over the age of 2 years) and staff can wear face coverings (when feasible). In the following sections, we review some general principles that policy makers should consider as they plan for the coming school year. For all of these, education for the entire school community regarding these measures should begin early, ideally at least several weeks before the start of the school year.

RandyAg98
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That is great news. We need some "experts" to advocate in-person school so that school districts have "guidance" so they can CYA.
cone
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you are greatly underestimating our society's tolerance for risk
AgLiving06
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And my kids summer camp just closed next week, not because of a positive test, but bc of Lena's scare message yesterday.
Barnyard96
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cone said:

you are greatly underestimating our society's tolerance for risk
I think OP is fully aware. He is trying to encourage society to be brave and move forward.
cone
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also you need to put your kid into a car seat until HS
culdeus
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AgLiving06 said:

And my kids summer camp just closed next week, not because of a positive test, but bc of Lena's scare message yesterday.


Lena?
Infection_Ag11
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cone said:

you are greatly underestimating our society's tolerance for risk


30-35 years ago millions were outraged by the audacity of the state to require their kids wear seatbelts in the back seat. Nearly half of all American adults opposed it. HALF. I'd rather we not return to that level of indifference to risk.

That being said, the work from home model for education failed miserably and needs to be tossed IMO.

No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
GAC06
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Anything other than kids physically in school five days a week is absolute nonsense
culdeus
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The focus needs to get off the kids and onto teachers. If we learned anything from pro sports it's the staff and administration that is the source of the outbreaks. Teachers/adults can spread this thing so fast between them. Kids is a different story.

Kids are so low risk that there should be virtually no restrictions on them whatsoever short of a known positive test or known positive exposure. All these stupid rules like don't use lockers are beyond dumb, and are just theater.
3rd Generation Ag
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This is the issue. Kids can't be at school alone and every teacher I know has some level of concern about anything being done to protect us. My daughter did hear from her school that they will provide two face masks and a shield to teachers if they want to wear them.

And unless there are massive changes in the evaluation system, teachers are marked down and in some cases put on growth plans for being behind a desk and not circulating from child to child or student to student as they work. Additionally the push is to have seating in groups and students always working in collabortion with others.

Picadillo
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Pleasant surprise. Acad of Pediatrics has been left leaning for a long time.
cone
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okay so the model failed but the virus still exists, deadly as ever. so what to do.
The_Fox
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cone said:

okay so the model failed but the virus still exists, deadly as ever. so what to do.
Same thing we do with other things where the minimal risk is outweighed by the benefit of the activity. Go about our lives knowing that there is a minimal acceptable risk. What else?
Pelayo
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AAP gets one right.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
TefIon Don
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Face shields for all teachers. Next?
HotardAg07
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This is such a breathe of fresh air. A science-informed policy guideline that balances the science-grounded concerns with the virus, the uncertainty with what we know and don't know, and the broader ramifications for potential policies that could be utilized to combat the virus. This is exactly the model for what I wish all of our leaders could do.
deadbq03
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Teflon Don. said:

Face shields for all teachers. Next?
This comment tells me you didn't read.

They recommend "face coverings" for all students at secondary level, and say it's probably a good idea at the elementary level too. They don't recommend it for Pre-K due to inability of kids to wear them correctly.

I think face shields for everyone would be the right approach and the wording of "face covering" in their document allows for this as an option I would think. Helps prevent transmission from kids to teacher due to sending droplets straight down rather than out, but allows kids and teachers to been seen and heard better. I really hope someone makes this call soon otherwise it won't be an option (need to get shields manufactured asap) and schools are gonna have to choose between masks (safer but inhibit learning/experience) or nothing.
culdeus
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I dunno if face shields will cut it. They are mainly used so people don't need to wear goggles to keep it out of your eyes where you can't socially distance. They are not a mask substitute.
HotardAg07
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Actually, I believe Ranger222 posted a study here that showed that face shields could be even more effective than home made cloth face masks. Here's one article I found that discusses the same conclusions:

https://www.aarp.org/health/healthy-living/info-2020/shields-compared-to-masks.html
deadbq03
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culdeus said:

I dunno if face shields will cut it. They are mainly used so people don't need to wear goggles to keep it out of your eyes where you can't socially distance. They are not a mask substitute.
This study from the Journal of the American Medical Association. They argue it may be more effective than "homemade" masks, and may be more economically and socially viable than regular masks.

Quote:

... Cloth masks have been shown to be less effective than medical masks for prevention of communicable respiratory illnesses,8 although in vitro testing suggests that cloth masks provide some filtration of virus-sized aerosol particles.9 Face shields may provide a better option.

...

Face shields offer a number of advantages. While medical masks have limited durability and little potential for reprocessing, face shields can be reused indefinitely and are easily cleaned with soap and water, or common household disinfectants. They are comfortable to wear, protect the portals of viral entry, and reduce the potential for autoinoculation by preventing the wearer from touching their face. People wearing medical masks often have to remove them to communicate with others around them; this is not necessary with face shields. The use of a face shield is also a reminder to maintain social distancing, but allows visibility of facial expressions and lip movements for speech perception.

Most important, face shields appear to significantly reduce the amount of inhalation exposure to influenza virus, another droplet-spread respiratory virus. In a simulation study, face shields were shown to reduce immediate viral exposure by 96% when worn by a simulated health care worker within 18 inches of a cough.10 Even after 30 minutes, the protective effect exceeded 80% and face shields blocked 68% of small particle aerosols,10 which are not thought to be a dominant mode of transmission of SARS-CoV-2. When the study was repeated at the currently recommended physical distancing distance of 6 feet, face shields reduced inhaled virus by 92%,10 similar to distancing alone, which reinforces the importance of physical distancing in preventing viral respiratory infections. Of note, no studies have evaluated the effects or potential benefits of face shields on source control, ie, containing a sneeze or cough, when worn by asymptomatic or symptomatic infected persons. However, with efficacy ranges of 68% to 96% for a single face shield, it is likely that adding source control would only improve efficacy, and studies should be completed quickly to evaluate this.


Here's good discussion on the topic that's more readable than a medical journal article:
https://www.contagionlive.com/news/universal-face-shields-a-better-option-for-covid19-containment
culdeus
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HotardAg07 said:

Actually, I believe Ranger222 posted a study here that showed that face shields could be even more effective than home made cloth face masks. Here's one article I found that discusses the same conclusions:

https://www.aarp.org/health/healthy-living/info-2020/shields-compared-to-masks.html
Interesting.
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