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Coronavirus in the Classroom: Experts answer 27 questions about unvaccinated kids

Kids are returning to school this month, and children under the age of 12 still can't be vaccinated. An expert panel answered TODAY's biggest questions.
/ Source: TODAY

As millions of unvaccinated kids prepare to head back to school, TODAY is answering all of your questions with "Coronavirus in the Classroom."

A team of experts spoke with TODAY's Sheinelle Jones to answer questions about the current state of the pandemic and the delta variant.

1. How close are we to an approved vaccine for children?

Dr. John Torres, NBC News senior medical correspondent, said that this question is the biggest one he gets from parents.

"The answer is, yes, I think we're going to see this this school year," said Torres, noting that experts have broken down vaccination by different age groups. Right now, data about 5- to 11-year-olds is about to be submitted by Pfizer, and Torres said that he expects an emergency use authorization for that group "probably before Thanksgiving."

Younger groups, including kids aged 2 to 4 and kids between the ages of 6 months old and 2, will likely have to wait until at least 2022.

Torres said that studies included looking at things like what dosage children should get, and how frequently or in how many doses the vaccine should be given.

2. Why is it so important for kids to get back in the classroom?

The American Academy of Pediatrics is recommending that children be back in the classroom if at all possible, so long as it's safe for students to do so.

"Children have missed a lot by not being in school," said Dr. Sally Goza, former president of the AAP. "Some children have trouble having access to the internet. They can't focus looking at a computer screen. ... They've missed the social-emotional interactions. So it is really critical that we do everything in our power to make the school safe so our children can be back in school and parents can feel comfortable sending their children to school."

3. How at risk for COVID-19 are children? How does the delta variant change things?

Goza noted that "low risk is not no risk," and pointed out that more than 4 million children have been diagnosed with COVID, with 18,000 hospitalizations and around 400 deaths. The delta variant, she said, makes things more urgent.

"This delta variant is different. It's more contagious which means more children are getting the illness. ... We're seeing this now and it's spreading rapidly. It's very, very contagious," Goza said.

Relaxed school measures might lead to easier spread of the virus. Goza said that schools should continue to enforce masking, encourage hand washing and increase ventilation.

"We believe that schools should be doing the same things they did last year," Goza said. "All those layers of protection are what's so important. I like to call it the Swiss cheese. With every layer we put in there, we are decreasing the risk of our children getting COVID-19."

4. How does the delta variant present itself in children?

The delta variant, Goza said, can "look almost like anything," including symptoms like a cough, sore throat, runny nose or vomiting.

"If your child is sick, you need to keep them out of school and you need to contact your pediatrician or your doctor to have them evaluated to see what you need to do, especially if they've had a contact in school that you know of," Goza said.

5. How common is 'long COVID' in children?

Long COVID is the colloquial term for lasting coronavirus symptoms. Some have reported symptoms lasting months or longer. While it's "a concern," Goza said, it's hard to know how many children are actually dealing with the syndrome.

"We really don't know how many children are affected by this because we know a lot of children were asymptomatic with their COVID," Goza said.

Symptoms of long COVID include fatigue, brain fog, trouble breathing, a cough or chest pain, muscle and joint pain, headaches, depression and anxiety, heart palpitations, loss of smell and taste, and occasional dizziness. Goza said many of these symptoms are normal for older kids and teenagers, so it can be hard to diagnose long COVID.

6. Is there an end to the pandemic in sight?

Dr. Tina Carroll-Scott, a pediatrician and medical director at the South Miami Children's Clinic, said the pandemic will eventually end.

"There is an end in sight, because all pandemics eventually end, but I think we have to decide as a society how we want that ending to look and if we value not only our own lives but those of people that we may not even know," she said. "I think what's clear from everything that we've seen over the last few months is that the vaccines are a key component to ending this, and it can't be only certain individuals or groups getting vaccinated. It's going to take every eligible citizen doing the right thing."

7. Are kids that ride the bus to and from school at greater risk for contracting COVID?

Torres broke this down into two questions: Waiting for the bus and riding the bus. Torres said the risk is low when waiting for the bus, especially in an outdoor setting and at a non-crowded bus stop. Kids at crowded bus stops should wear masks and distance as much as possible.

"Once they get on the bus, think about any other type of transportation: A subway, an airplane, anything like that," Torres said. "All the children should be masked, and hopefully the children are in a cohort or a pod where they're on the same bus with students that they're in the same classroom with all day long. ... The risk does go up but it can be minimized."

Children should also be seated apart, and windows on the bus should be opened, Torres said, adding that he "can't overemphasize" the importance of wearing masks. If a person on the bus is showing symptoms, the kids on the bus should be isolated and contact traced to protect riders, other students and their families at home.

8. How do we get information about faculty vaccination statuses?

NBC News investigative and consumer correspondent Vicky Nguyen said that this can be a "sticky situation," but emphasized that "it's OK" to ask the question, especially as some school districts mandate teacher and staff vaccinations.

"We talked to legal experts, we talked to etiquette experts, they said it's not illegal or rude for you to just be direct and ask the question. ... They suggested one way of talking to your educators at school, saying, 'You know what, vaccinations are really important to us, we'd just like to know what the status is of our teachers or staff who are working with our students,'" Nguyen said. "People don't have to answer, but it's OK to ask."

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9. How will school systems handle teacher and bus driver shortages due to the pandemic?

Nguyen said that underfunding and understaffing exacerbated by the pandemic have snowballed into a "very real concern" for districts. Some schools are offering bonuses or other financial incentives for new employees, while others are relying on student teachers who are getting advanced degrees. Some are asking substitute teachers to spend extended period of times at work, or even giving money to parents directly so that they can transport children themselves instead of using buses.

10. What are the best masks for kids?

Nguyen had some mask recommendations for parents who want their children to be safe and comfortable while learning in school.

A child-size surgical mask works best when stretched from nose bridge to under the chin, which will keep the mask from slipping. Nguyen said that these are "perfectly fine and safe."

Cloth masks can also be "helpful and useful," Nguyen said, and recommended a mask from Tokki x Gravitas, which she said her own children wear. These masks tie around the back of the head, so it doesn't strain a wearer's ears and can be pulled down around the neck during mask breaks.

If you like masks with ear loops, look for adjustable options. Nguyen recommended a mask from BlueCut Aprons.

"The best mask for your child is the one that they're going to wear," Nguyen said. Search for masks that have at least two layers of fabric and use material like cotton.

11. Why can't kids wear a face shield?

Nguyen said the problem with face shields is that because the coronavirus is aerosolized, the shield doesn't cover enough of the face to be effective. As a result, they are not recommended as a substitute for face masks.

12. How often can kids take breaks from wearing their masks?

Torres said that children will likely need breaks, especially if they're younger. In hot, humid environments, it can be especially difficult to wear a mask. The best way to safely have breaks, he said, is to have them outdoors.

"If they're at recess and they're socially distanced, and there aren't that many children out there, then they don't necessarily need to have masks on," Torres said. "That's a good place to have a break."

Children with asthma or bronchitis or other respiratory conditions should wear a mask when not having symptoms, but if they are dealing with things like shortness of breath, they should tell a teacher or staff member so that accommodations can be made for the child to take their mask off in a safe environment.

13. How much are masks really protecting our kids, especially if they wear them incorrectly?

Carroll-Scott said that masks make a difference, but it's important to make sure that the mask fits correctly and comfortably and allows for easy breathing.

Try finding a mask specifically made for children, since those can be better fitted.

14. In addition to masks, how can I make sure my child is safe at school?

Carroll-Scott said that this is the question every parent is asking.

"The first thing I would say is give yourself grace," Carroll-Scott said. "There are things that we can control and other things that we can't, and we all have to do our best to advocate for the safest environment possible for our children."

Carroll-Scott said parents can encourage schools to make sure that eligible people within the school are vaccinated. The best way adults can protect children is to get vaccinated, experts say.

"Parents have to raise their voices now more than ever to make sure that the schools are setting children up for success and not failure," she said. "We do know that high vaccination rates in teachers, staff and students over the age of 12 will not only protect the vaccinated individuals but those who aren't eligible to be vaccinated yet."

In addition to making sure their children wear a comfortable, well-fitted mask, parents should make sure that their school has increased ventilation and is maintaining strategies like social distancing and hand washing.

15. Are kids at their breaking points after another year touched by COVID?

Dr. Sue Varma, a board-certified psychiatrist, said that she doesn't think most kids are at their breaking point, because they are "super resilient," but noted that emergency room visits for mental health concerns among children have increased.

"We do know the numbers are up," said Varma. "I think a lot of it has to do with what we can do in prevention and early detection and early treatment. I think that will make the biggest difference."

16. What questions should parents ask to understand how their child is feeling?

Varma notes that children may do better if they're asked indirect questions, and may bring up concerns at unexpected times.

"Things will come to them naturally and usually it takes time for them to warm up and to feel safe and to feel comfortable," said Varma. "Plan for those extended lengthy 'I'm sitting here, I'm waiting for you to talk.'"

However, if a child doesn't bring up their concerns organically, Varma said it can help to ask them open-ended, neutral questions, like "How is everything?" or "How are you feeling today?" Varma also recommends asking about a child's friends and their relationships with those peers, since kids may be more willing to respond when the focus isn't on them.

17. How can parents recognize mental health issues in kids?

Varma said that parents "have to recognize the warning signs" of issues and talk to a pediatrician or doctor immediately. If you see symptoms or signs of low mood, lack of interest in activity, changes in behavior, or difficulty sleeping, it can be helpful to book a mental health consultation.

18. How can parents guide their kids through this uncertain time?

If you are waiting on a therapy appointment or can't make an appointment with a mental health professional, try doing things at home that can help your child. For example, implement a morning routine that focuses on fun, and try deep breathing to help children who are feeling stressed.

Distractions like coloring can help, as can movement and exercise. Varma recommends the "Four Ms" of mental health: Movement, mindfulness, mastery, and meaningful engagement.

"Get your kid into a new hobby ... Get their hands dirty," Varma said. "Get them out of their head is my point."

19. What about older children?

Those techniques may not be helpful for kids who are older, so Varma recommends trying to "fall back a little" and see if those children might talk to an older cousin or other young adult closer in age. Varma also said that picking your battles and not fighting things like a messy room can reduce stress on a teen.

While a parent should know what their kid is watching and engaging with, and can use tools like parental locks or screen time limits, Varma said that parents should feel comfortable taking a step back and letting their older child engage with their peers as well. Try inviting the child into activities, which can lead to organic conversations between kids and parents.

Questions from parents

20. Is my 2-year-old with Down syndrome at greater risk for severe disease and death from COVID-19?

Carroll-Scott noted that there isn't much data about outcomes for very young children with Down syndrome.

"It is true, however, that many adult people with Down syndrome are at higher risk for serious illness due to the immune deficiency related to Down syndrome and higher frequency of other conditions such as heart disease, diabetes, obesity and other respiratory difficulties associated with a higher risk for serious illness," Carroll-Scott said.

Carroll-Scott noted that the delta variant could be "a game-changer," since it seems to affect children and is more contagious.

21. Should children who are physically small take a lower dosage of the vaccine?

Sheinelle said that she and some friends have worried about their children getting vaccinated because their 12-year-olds are physically small. She asked if her child should wait until the vaccine is approved for 11-year-olds and younger.

Carroll-Scott said that this isn't necessary, because the data for 12- to 15-year-olds did look at different weights and sizes of children.

22. I am vaccinated with an underlying condition and am worried my kids may bring COVID-19 home. What will the efficacy of my vaccine be in the fall if I had it in the spring?

Torres said that the efficacy of the vaccine will start to decrease due to time and the impact of the delta variant, but said that a third dose booster could strengthen the immune response again. At about eight months, he said, the efficacy of the vaccine does appear to begin to wane.

"We're still talking in the 70ish percent range," Torres said.

23. Are parents protecting their kids by getting vaccinated?

Torres said that parents are "absolutely" protecting their kids by getting vaccinated themselves, referencing the "Swiss cheese approach" of layered protection: each layer individually isn't totally perfect, but together they'll cover you.

"Everything going on here is like those holes you see in Swiss cheese," Torres said. "They're not necessarily lined up, so if you get layered protection, you can certainly help out."

Mitigation measures like hand washing and social distancing make a difference, but the "biggest thing by far," Torres said, is making sure that the adults around children under the age of 12 are fully vaccinated. This means that those adults are less likely to catch and transmit the virus.

24. How can working parents extend their work-from-home model to support kids at home?

Nguyen said in this situation, parents should remember that we're still in limbo and that "nothing is 100% back to normal." If working from home is something you'll need, bring it up with your boss sooner rather than later.

"Make sure you've done your homework. Look back at what have you accomplished over the past few months or this year. How productive have you been at work?" Nguyen said. "You are asking for flexibility — don't forget, this is a company. They want to know what's in it for them."

According to job sites and workplace surveys, flexibility is top of mind for employees, so managers and companies are more likely to allow hybrid schedules or other strategies than they have in the past.

"You've got to ask for what you need and make sure you tell them what you bring to the table too," Nguyen said.

25. How can I save money on school supplies?

Nguyen recommends first contacting your school district to see if you can get electronics or other necessary supplies. If that doesn't work, try shopping secondhand on sites like Swapa, TradeMore or Gazelle.

If you do need to buy things new and you see a great price online, bring it to a brick-and-mortar store to see if they'll beat it.

Questions from kids

26. Is it safe to eat lunch and snacks at school?

Carroll-Scott said that there are "safer" ways to eat at school. If students can be distanced at least 3 feet apart while eating, that's "helpful," she said, and increasing ventilation can help reduce transmission. Eating outside is best, if weather permits, and in some cases it can be helpful to have students eat at their desks at the classroom, so they're not exposed to new classmates.

"There is no 100% effective way to do that in a school setting, especially during lunch and eating snacks, but trying your best is all that we can ask," Carroll-Scott said.

27. Is using hand sanitizer the same as hand washing?

Carroll-Scott warned that hand sanitizer is not as good as washing your hands with soap and water for at least 20 seconds, but since soap and water isn't always available, hand sanitizer is a great backup. The sanitizers should be alcohol-based with at least 60% alcohol.