As school resumes, UF Health pediatrics expert gives advice on COVID-19 safety

By Doug Bennett

As students prepare to return to school, the coronavirus delta variant of the SARS-CoV-2 virus continues to surge. Meanwhile, an internal report by the Centers for Disease Control and Prevention concluded the delta variant is as contagious as chickenpox and more transmissible than the viruses that cause seasonal flu, the common cold and Ebola. Sonja A. Rasmussen, M.D., a professor in the departments of pediatrics and epidemiology at the UF College of Medicine and the UF College of Public Health and Health Professions, discusses what parents should know and do to help their children stay well.

Question: The American Academy of Pediatrics recommends face masks at school for children over age 2. Should unvaccinated students wear a mask this school year even if it’s not required?

Answer: The American Academy of Pediatrics and the Centers for Disease Control and Prevention both recommend that all students, whether vaccinated or not, wear masks. Scientific evidence shows that by wearing a mask and physical distancing, kids are protected from getting infected with the virus that causes COVID-19.

Q: Aren’t kids more mildly affected by COVID-19 than people of other ages?

A: It is true that children in general are more mildly affected by COVID-19. However, we know that they can get infected and get sick from the virus. Some kids have needed to be hospitalized and over 300 children in the United States have died from COVID-19. Until the pandemic is under control, we need to protect our children. We can do this by making sure they get vaccinated when they are eligible, and ensure that they wear masks and physically distance themselves from others in schools.

Q: Why do vaccinated kids need to wear masks?

A: While the COVID-19 vaccine does a great job at preventing illness, hospitalization and death from COVID-19, it may not prevent children from getting infected with the virus. If kids get infected, they can spread the virus to others. Children can spread the virus to their classmates or to their younger brothers or sisters, who might not be able to get the vaccine yet.

Q: Is the delta variant leading to more (or more serious) illness for children than the original strain?

A: The delta variant is much more infectious than the original virus. People infected with the delta variant have higher levels of virus and are much more likely to spread it to someone else. Whether the delta variant of the coronavirus causes more serious illness is not clear right now. Some studies have suggested that it causes more severe illness, but more work is needed to be sure.

Q: Should extra precautions be taken when unvaccinated kids are engaging in extracurricular activities including sports?

A: Outdoor activities are safer than indoor ones, so masks are generally not needed for outdoor activities unless you are in a crowded setting. At the current level of the pandemic, with lots of cases of COVID-19 related to the delta variant, masks are essential for indoor activities, including sports.

Q: What about playdates for younger children in the age of the delta variant?

A: Parents should consider having their child wear a mask while at an indoor playdate in light of medical evidence that shows doing so helps protect them from becoming ill with COVID-19. The decision on whether a mask is needed for a playdate depends on whether the other parents are fully vaccinated and whether they are ensuring that their child wears a mask in public, especially when indoors. Any time children are around people outside their family in an indoor setting, everyone should be wearing a mask.

Q: What is your best advice for students who will be interacting with vaccinated adults — especially higher-risk adults such as grandparents?

A: COVID-19 vaccines have been proved to be highly effective, even against the delta variant. However, no vaccine is perfect. Some vaccinated people are getting sick from COVID-19, although at a much lower rate and typically with milder illness than those who are not vaccinated. Older people and those whose immune systems might not be working well are at higher risk of becoming sick after vaccination. At this time, when transmission of the virus causing COVID-19 is high, students should wear masks when visiting higher-risk adults to protect the adults and themselves.

Q: Among school-age children, how much more transmissible is the delta variant than other strains of COVID-19? Are there additional precautions parents and students can take or do precautions and hygiene best practices remain the same?

A: It appears the delta variant is more than twice as infectious as the original virus. Some studies have shown that persons infected with the delta variant have much higher levels of virus, making it easier for them to spread the virus to others when they cough, sneeze, talk or even breathe.

For adults and children 12 and older, the most important action they can take to protect themselves and younger students is to get vaccinated. The more people that get vaccinated, the less spread of the virus there is in our communities, which means a lower risk for all.

We are hopeful that later this fall or early winter, a safe and effective vaccine will be available for kids under the age of 12. Until then, we need to find other ways to keep kids safe.

Q: What do we know about long-term effects of COVID in kids generally?

A: We know that, as with adults, some kids get “long COVID.” These effects occur after a child gets COVID-19. These problems, including fatigue, brain fog, difficulty sleeping, problems with breathing and heart palpitations, can last for months after the initial infection with COVID-19.

For additional information, visit these sites supported by the American Academy of Pediatrics:

This story originally appeared on UF Health.

Check out stories about UF research on COVID-19.