'It's not children who are really sick' — Experts advise on getting kids back to school

Dr. Kathy Georgiades, pediatric psychologist with the Offord Centre for Child Studies at McMaster University and Hamilton Health Sciences and Dr. Martha Fulford, infectious diseases specialist at McMaster Children’s Hospital and Hamilton Health Sciences offer advice on getting kids back to school.

Handwashing and mask-wearing will help fight the flu too, infectious disease specialist says

How might social distancing work when school starts? How will students be able to keep their masks on over an entire school day? How can parents support their child's mental health while they face anxiety over COVID19?

On Thursday at noon we asked these questions and more to Dr. Kathy Georgiades, a pediatric psychologist with the Offord Centre for Child Studies at McMaster University and Hamilton Health Sciences and Dr. Martha Fulford, an infectious diseases specialist at McMaster Children's Hospital and Hamilton Health Sciences. 

Read an edited and abridged transcript below or hit play above and watch the entire interview with the CBC's Conrad Collaco. Some of the questions we asked were suggested by CBC readers. There names are posted beside their question.

Dr. Kathy Georgiades and Dr. Martha Fulford 
Dr. Kathy Georgiades (left), a pediatric psychologist with the Offord Centre for Child Studies at McMaster University and Hamilton Health Sciences and Dr. Martha Fulford, an infectious diseases specialist at McMaster Children’s Hospital and Hamilton Health Sciences. (Hamilton Health Sciences)

How do I make a choice between my child's physical health by sending them to school versus their mental health and keeping them home away from friends? - B. Shenton

Dr. Fulford: If we look at the numbers in Canada and worldwide, children are spared, probably even less than influenza would affect a child. In all of Canada we've had only one hundred and forty-nine children hospitalized. We've only had twenty-nine in ICU. And no child has actually died from COVID in Canada, one child died with COVID and that's Canada, where we've had very good success with controlling the numbers. But this is true everywhere in the world. Even the United States, the group that has the least physical impact from this virus, our children, our young people, and that's young adults as well. 

I'm not worried about the physical health of children, from COVID. They're either asymptomatic and you'll never know they even had the virus or it's essentially a mild fever with maybe a bit of a cough and a runny nose. So, that's one of the reassuring things about COVID in young people. 

Dr. Georgiades: What we do know from the emerging evidence is that since the pandemic, particularly since school closures and our public health measures, research has definitely demonstrated increases in feelings of depression, feelings of anxiety, feelings of loneliness and children and young people. 

Mental health impacts have been great for many children and families and they've been even greater for populations that are at risk — children with pre-existing mental health conditions, children with special education needs — these closures have really impacted particular subgroups of our children. And schools are a setting that really help facilitate access to needed care. And so the mental health impacts have been great and we're continuously needing to monitor those impacts as we transition back to school to ensure that we have the effective supports in our schools, but also in our communities to support children as they transition back.

What about kids who physically can't wear a mask? Or have anxiety?

Dr. Georgiades: We need to acknowledge the challenges associated with wearing a mask all day. But some strategies that have been recommended are explaining to children why they're wearing the mask. It's to protect themselves and to protect others and to give them some ability to choose their mask and to practice wearing that mask at home and also to demonstrate mask wearing ourselves to help normalise the use of wearing a mask. And so, I think those are a few strategies that could be helpful to children.

Dr. Fulford: It is extremely challenging to wear a mask. One thing I know some schools are suggesting or considering are maybe having mask breaks where you can sit quietly somewhere without one, particularly for children who have difficulty. I know if you look at the recommendation to the ministry, which are very comprehensive, they have exemptions and things to consider that each school or school board could put in place. But masks are not all the same, and it's probably a good idea to practice finding one that's comfortable for the face.

Tips for teachers

What are some practical tips for educators to support the return to the classroom (mental health) for our younger learners, keeping in mind that we cannot be physically close not share physical materials (toys/sensory tools). -Erin Lynn on Facebook.

Dr. Georgiades: Allowing children to express their emotions, acknowledging their emotions, validating the feelings that they have, identifying supports within the classroom — that they can share what they're feeling within that classroom and some of that frustration that children or educators are feeling. But I think clear communication always around why we're doing this could really help children understand that these rules are in place to help protect myself and protect the people that I care about within my classroom and within my school.

Dr. Fulford: We know that schools are actually not where most of the outbreaks occur. It's from the community. So, if we have really good control in the community and really low numbers in the community like we do have right now, the risk of having any virus in the school is extremely low. I mean, if you look in Ontario, 29 out of 34 public health units have less than five, and 20 of them have no current cases. And so when the numbers are low, we have really good control in the community. The risk of having the virus in the schools very low.

'It's not children who are really sick'

Dr. Fulford: It's not children. It's not children who have been hospitalized. It's not children who are really sick. So, that is, in fact, an important message for parents. There are clearly households that might have a higher risk grandparent. I think there's lots of unique situations. But for children, their physical health is one that we should be comfortable is not going to be compromised. 

Will all this hand washing and mask wearing help keep us from getting colds and the flu?

Dr. Fulford: These interventions will work for any virus. It'll work for influenza. It'll work for any of the other respiratory viruses that we normally deal with during the winter months. And so the guideline that we put out that was spearheaded by my colleagues at Sick Kids is the whole package of everything together. And I think in a perfect world, we do absolutely everything we could. But I would stress that for me, I think we all want our children to have a childhood. We all want our children to be educated... And maybe we're not going to be able to have perfect class size. We probably won't have perfect physical distance. Not everybody is going to wear a mask perfectly. But if we do our best with all of them, that bundle of all of those things we're doing together is going to decrease the rate of transmission of the virus. There's early data to suggest that there's seeing very little influenza in the Southern Hemisphere in Australia and New Zealand. So it'll be very interesting if our numbers go down. 

I've always been a fan of handwashing and I've always been a fan of don't go to work and don't go to school if you're sick. 

Mental health tips for parents with kids staying home

Some kids are not returning to school because they live in households with adults who are at risk. Any tips for parents to support the mental health of their kids who will be staying home? - Louise Fueten Ciarniello

Dr. Georgiades: I think it's really important to try to facilitate opportunities for socialization, still, with peers, with family members, whether they be virtually or within their social bubbles. Really important to do that. Continue to engage in activities that help them feel a sense of belongingness and connectedness, physical activity. Sleep hygiene is really critical. It's easy when we are home and lack structure to be sleeping or being up all night... Sleep hygiene is critical. Physical activity. 

Engage with their educators and their virtual classrooms as much as possible if they have concerns that their child might be struggling with feelings of loneliness or anxiety they can reach out to an educator for support. Our schools and Mental Health Ontario, which is an organization that supports all 72 school boards in the province for the provision of mental health supports are there to help support children who might be struggling with mental health, whether it be in person or virtually. So, there are supports embedded within our schools currently that can help students that might be having a bit of a difficult time. 


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