Parents and educators must prepare a hybrid of programs to resume some in-person instruction for students this summer and next fall amid the COVID-19 pandemic and reduce youth isolation, medical officials said.
Voices for Healthy Kids, an initiative of the American Heart Association and the Robert Wood Johnson Foundation, held a briefing Thursday afternoon with medical experts from across the nation about strategies to keep children resilient, learning and active this summer as they prepare to return to an unknown learning environment in the fall due to COVID-19.
Laurie Stradley, chief program officer of Alliance for a Healthier Generation, said risk reduction is the goal for children to return to summer programs and school next year. The Centers for Disease Control and Prevention and emergency child care centers have released guidance on how to safely reopen and limit the spread of the coronavirus.
“It will never truly be eliminated,” Stradley said. “My opinion is, if we follow the science and listen to the recommendations of the CDC, we can support children returning to some level of school and participation.
School officials and program leaders expect parents will be split across the country on feeling safe to send children to school.
“I’m optimistic — if you just look to those practices, I think we can have no guarantee, but a relatively safe environment for our kids,” Afterschool Alliance Executive Director Jodi Grant said. “I know we’re concerned about liability, but my two kids desperately need to be around other kids. The answer is, we’re going to have to rely on the best guidance out there.
“These kids are facing social isolation. We have kids where home is not a safe place. I think we’re going to have a hybrid of programs and they’re going to need to be open for kids. There’s a huge need to get kids back to a place where they can learn safely.”
Trauma-informed care and safe spaces are necessary for students as they return to school — especially for low-income or Black children who have witnessed weeks of stressful and trauma-inducing videos and news stories following the controversial deaths of unarmed Black men and women at the hands of police, and images of protests, rioting and racial unrest.
“Black students are much more likely to have lost a loved one or family member to COVID-19 than their white counterparts,” Stradley said of the virus’ disproportionate impact in communities of color.
She discussed nonprofit A Therapist Like Me, which helps minority families connect with other psychologists of color, who can support their unique mental health needs.
“The awareness raising that is critical in our educators and their ability to connect with the right mental health support at the right time so parents can navigate into this and feel safe doing so,” Stradley said.
On average, children and adolescents of all races and ethnicities in low-income areas are active for 14 minutes fewer each day during summer vacation than during the school year.
A recent study conducted at the University of California’s Physical Activity Research Center showed students use screentime of TV, computers and mobile devices, on average, often twice as much during summer as opposed to the academic year. Medical experts fear the usual problem will be compounded by stay-at-home orders this summer as COVID-19 spikes increase in 27 states and Puerto Rico.
“Kids could be a lot healthier in the summer,” said James Sallis, co-director of the university’s Physical Activity Research Center. “The closing of parks, trails and schools have created challenges in helping children remain active. We need to do more to help kids be active.”
The center studied a sample of 207 youth from low-income geographic areas. The majority of youth said they walk or run in their neighborhood or near their home as their preferred method of physical activity. The study showed girls favor playing in water. Other popular areas to exercise included parks and walking or biking trails, which may be closed or restricted depending on location.
Sallis suggested community organizations such as the YMCA or Boys and Girls Club organize group walks, hikes, park outings or other opportunities for local kids to get active this summer. The get-togethers are most needed in low-income communities of color.
“It’s more essential than ever for children and adolescents to meet physical activity guidelines during the pandemic,” Sallis said. “Everybody is under stress and physical activity is very helpful in managing stress at all ages and maintaining overall physical and mental health,” he said. “Physical activity improves both youth function and reduces inflammation, which comes into play especially if children become infected by the virus.”
Children in several states and in at least six European countries first reported COVID-19 complications in children and young adults up to age 21 that cause inflammation of tissues and extremities. The complications often mimic Kawasaki disease and toxic-shock-like syndrome, and have killed several New York children or teens.
Sallis said Thursday the complication is primarily seen in the European strain of COVID-19, which mainly infected east coast states.
“We don’t really understand it, Sallis said. “It is similar to Kawasaki disease, which is really well-recognized by pediatricians, but poorly understood by what causes it. I think the prevalence of the inflammatory disease has slowed down a little bit. The best way to avoid it is to avoid exposure to Covid. I feel really fortunate that we are where we are as terrible as the inflammatory symptom is.”
Summer programs are essential for youth and students of all ages — especially this year after most have spent months in isolation, Grant said.
Many schools, which are often the gathering place for several summer programs, are not allowing community organizations to use their facilities during the pandemic. Schools and group administrators need to think long-term and develop safe ways to resume programming.
Community- and faith-based organizations must be involved, and may benefit from offering split schedules.
“I think that’s going to be the future for after-school programs,” Grant said. “Time, space and staff are key issues. More and more kids are going to need these programs with access to virtual learning being a challenge. It’s not going to be easy, but if we start by leveraging each community’s unique resources, we can embrace all types of educators beyond the traditional school day.”
Dr. Ben Hoffman, chairman of American Academy of Pediatrics Council on Injury, Violence and Poison Prevention, said parents and caregivers must be diligent in providing adequate supervision to prevent tragedies because of common summertime hazards to children, such as water, heatstroke, dehydration and hot vehicles.
Reports of at-home children’s injuries and window falls have increased as families’ routines and work schedules have been disrupted by COVID-19. Parents have vaccinated their children at alarmingly low levels during the pandemic, Hoffman said, because of reduced pediatric care.
“It’s impossible to completely injury-proof a kid,” Hoffman said. “This means identifying risks, thinking about the people who might be at risk and taking measures to minimize them. ... Kids are stuck inside much more than before and parents and caregivers are often multi-tasking and not able to provide the supervision that’s necessary. Kids may have access to things they didn’t previously.”
Prescription drugs, medications, cleaning supplies and other household toxins must be locked away and out of sight. Heavy dressers and bookshelves should be anchored to a wall, he added.
Drowning is the leading cause of accidental death for children ages 1 to 4 years old. Hoffman urged families with swimming pools to enclose them with four-sided fences and locking gates or pool alarms, which decrease the risk of drowning by 50%. Bathtubs should be emptied as soon as they are not in use.
“Kids, toddlers are built to explore,” Hoffman said. “They’re impulsive, they’re not great at following rules — they’re fascinated by stuff. Make sure there’s an adult who is tasked with constant supervision for those kids within arm’s reach.”