Keeping kids in school, safely

As Montana families are preparing to send children back to school, we are confronting the uncomfortable fact that the COVID-19 pandemic is not over, much as all of us dearly wish it were.

Late spring brought big reductions in COVID-19 case rates from the circulating alpha variant. But what we’re dealing with now, the delta variant, behaves differently. It is two to three times as contagious and may also cause more severe illness in young people. In states with low immunization rates, we are once again seeing overflowing hospitals. This means no one gets good medical care, whether it be for car accidents, cancer, or heart attacks. We are also seeing more children hospitalized daily than at any prior point the pandemic.

The Montana Chapter of the American Academy of Pediatrics, representing 146 pediatric providers in our state, prioritizes children’s health. We know that attending school with peers is important to children’s well-being. We know that can be done safely. We urge schools to make that in-person school experience possible: to take part in tried and tested measures to reduce the spread of COVID-19, to reduce the need for repeated quarantines and illness that result from uncontrolled spread. 

The world has made tremendous progress over the last 18 months in what we have learned about COVID-19 viral transmission. We know now that using layered mitigation approaches — a combination of vaccination when eligible, hand-washing, staying home when sick, contact tracing, distancing, cohorting, and masking — prevent in-school spread, even for schools in areas hard-hit by COVID. The evidence is now overwhelming masks work. They work because they protect the wearer, and worn universally, they protect others, including those who have not been vaccinated, cannot yet be vaccinated (children under 12), those who are immune compromised and cannot mount protective immunity even with a vaccine (through cancer, transplantation and more), and those with serious medical problems. Luckily, children are resilient and adaptable and have adjusted to masking throughout the pandemic. Not being able to see friends, to attend school, family members falling ill: that has caused far more distress in the children we see in our offices.

Montana has seen the unfortunate preview of what happens when you ignore the reality of viral transmission. Many schools in the South have now opened only to immediately close again, with hundreds of children quarantined due to contacts. Many Alabama schools have reinstated mask requirements, the governor of Arkansas has attempted to undo the law he previously supported banning mask mandates and schools in Florida and Texas are increasingly defying state bans to open with universal masking.

As kids go back to school, the light at the end of the tunnel is this: we have vaccines that are better than we had dared hope. They are safe and effective, have been extensively monitored, and have been given to millions of people.  We hope in the fall vaccines will receive authorization for use in the 5-11 year old age group.

However, the challenge is this: To date, only 49% of eligible Montanans are fully vaccinated. Of the 12-17 year old age group eligible for the vaccine since the spring, only 30% are fully vaccinated. We need to do better in order to end the disruption that COVID-19 has caused all of our lives.

Our message is twofold: Get vaccinated. Get your family vaccinated. And ask that your school board use the tools that we know work to prevent SARS-CoV-2 spread, including universal indoor masking. Ask your elected officials to keep Montana kids in school and allow Montanans to live their lives without disruption and without fear of a new surge.

Children have already sacrificed so much throughout this pandemic.  Keeping them in school, safely, is the very least we can do for them.  

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John Cole, MD, MTAAP President (Kalispell)

Erin Green, DO, FAAP (Helena)

Emily Hall, MD, FAAP (Polson)

Kathryn Lysinger, MD, MTAAP Child Health and COVID-19 Committee Member (Billings)

Cathy White, MD, MTAAP Immediate Past President (Butte)

Lauren Wilson, MD, MTAAP Vice President (Missoula)