As the coronavirus pandemic continues, many plans for the school year are being thrown into disarray — and some schools and parents are preparing to return to measures like mask-wearing and social distancing, so students can learn in person safely.
Dr. Andi Shane, chief of the division of pediatric infectious diseases at Emory University School of Medicine, said that the delta variant and the increase in coronavirus cases doesn't have to mean the school year is a bust.
"What we have shown consistently is that with appropriate mitigation efforts, like masking, hand hygiene, social distancing and not coming to school when one is ill, children can be in person learning very safely," Shane said.
Will kids need to wear masks in 2021?
Public health experts agree that most students will likely be wearing masks in indoor classrooms for at least the beginning of the school year, since many school-aged children are too young to be vaccinated and the coronavirus is surging again in much of the country.
"The need for for mask usage for kids under the age of 12 is still incredibly important," said Dr. Krystal Pollitt, an assistant professor of epidemiology at the Yale School of Public Health.
Their advice followed recent guidance from the Centers for Disease Control and Prevention, which said that all people regardless of vaccination status should wear masks indoors if they lived in an area with high cases of COVID-19 spread.
"Because schools have kids that cannot be vaccinated and high rates of kids that can't be vaccinated in the younger age groups, I think really adhering to the mask guidelines can help reduce the risk of spread of illness in the classroom," said Dr. Ashley Lipps, an infectious disease physician at the Ohio State University Wexner Medical Center in Columbus, Ohio.
When can we safely relax about masks? If a community has extremely low levels of coronavirus transmission, experts say it may be safe to unmask in schools — though doctors hesitated to give an exact number that they believed would be a green light for mask-free schools.
"One has to look at what's happening locally in one's community," Shane said. "But what we have also seen is that masking definitely does prevent the transmission of both SARS-COV-2 and also other respiratory viruses."
Dr. Jon Zelner, an epidemiologist at the School of Public Health at the University of Michigan, said that masking could be the key to a somewhat regular fall semester.
"In the fall, you would want schools to be employing masking and other measures, particularly for unvaccinated kids," said Zelner. "I think if people and schools can get on top of the mitigation efforts, then I think we might see a pretty calm fall."
How else can we make schools safe?
Experts said schools can also do things like increasing ventilation, having smaller class sizes, emphasizing hand-washing and maintaining social distancing to keep students and staff safe for in-person learning.
"We've learned so much over the past year and know more than we knew going into the fall 2020 school reopenings," said Pollitt. "The need for continued hand hygiene, we know is important. We also know that the use of physical distancing and lower class sizes with cohorts can also be effective for limiting contacts and potential transmission."
Pollitt also highlighted the importance of ventilation, suggesting low-cost measures like portable air cleaners and opened windows as a way to keep kids safe without straining a school district's budget. Lipps said that she would lean on social distancing, trying to maintain "at least three feet" of distance between children as much as possible.
Zelner said that one strategy he wouldn't focus on is testing; the level of testing necessary to stop outbreaks would be higher than most schools could manage.
"On its face it seems like testing people regularly should be a useful thing, and it doesn't hurt, but the density of testing that you need to do to get some bang for your buck is pretty high," Zelner explained. "You would need to be testing people multiple times a week ... looking for that period before people know they're ill. Testing is useful from a confirmatory perspective and for tracing contacts and so forth, but ultimately the horse is kind of out of the barn at that point."
NBC's senior medical correspondent Dr. John Torres said on Weekend TODAY that it's important to maintain the guidance many have already followed in the last year. "As far as before you send them off to school and keeping them safe, taking their temperature is extremely important. So that doesn't necessarily mean taking their temperature all the time with a thermometer, but just keeping an eye on them, making sure that you don't think they have a fever."
He added, "Pack them a lunch, so they're not getting food from a buffet. And then when they come home from school, if you work in school and you come home — and this is what we do in the emergency room since I've been in the emergency room — change your clothes, take a quick shower. That way you're keeping them safe and you're keeping the family safe as well."
What about extracurricular activities?
Experts said the same mitigation strategies used in schools could make sports, clubs and other activities safe even amid variants.
"Schools will have to think creatively: how to accommodate lunchtime, how to keep the day going," said Dr. Jennifer Lighter, a pediatric infectious disease specialist at NYU Langone Health.
Anthony Santella, a professor and coronavirus coordinator at the University of New Haven, noted that gym class and recess periods outside could pose a perfect opportunity for "mask breaks."
"We have to accept that there's some harm reduction in all of this, that things aren't going to be perfect, but that wearing a mask most of the day except for when kids are running outside is much better than not wearing the mask at all," he said.
The No. 1 way to protect unvaccinated kids
Get vaccinated if you can. Doctors agree that the best thing adults can do for kids right now is get themselves vaccinated against COVID-19.
"Every person who can be vaccinated decreases the opportunity for transmission," said Shane. "Vaccinating everybody around someone who cannot be vaccinated is one thing that adults and people who are eligible for the vaccine can do to protect those who can't be vaccinated."
Dr. Diego Hijano, an infectious disease doctor at St. Jude Children's Research Hospital in Memphis, Tennessee, said adults should also think ahead to winter and the accompanying cold and flu season.
"Everyone should get their flu shot on time when it becomes available before the winter," HIjano said.
Lipps said vaccination for coronavirus could be the key to keeping schools open and operating this year.
"Getting as many adults in the community who are eligible to be vaccinated vaccinated will certainly reduce the overall spread," she said.
When can kids get the vaccine?
The CDC has not yet approved COVId-19 vaccines for children under 12 years of age but does continue to recommend that unvaccinated children wear masks in public spaces and around people outside their households.
Torres said on Weekend TODAY that the timeline for approving vaccines for young children may come this fall. "For those kids under the age of 12, It's still going to take a little bit of time and right now, according to the timeline of when data is going to be submitted from the human trials, and the authorization might happen, it looks like for kids five to 12, sometime around Thanksgiving, probably before Thanksgiving, maybe even October, they can start getting shots.
"For kids under the age of 5, we're probably talking early next year," he continued. "And then for kids under the age of 3, we're probably talking even later in the winter of next year and so, it's happening. It's just not happening as fast as some would like but we want to make sure it's safe and effective for them."