Proper Pandemic Play: From Pods to Preschools and More

The COVID-19 pandemic has affected many families’ usual activities, and as states continue to adjust to safety measures, families will need to adjust, too. Schools, parents, and pediatricians will need more resources and support than ever to support kids’ physical safety and mental health as children return to indoor sports and families begin exploring what it means to safely play together again.

Safety in Schools

Safety for kids in school, if they attend in person, will depend on clear and supportive relationships between schools, parents, and pediatricians to reduce the spread of COVID-19. The AAP’s position is that schools should begin with the goal of in-person learning in schools. As such, flexibility and consistency are key in sanitization, safety, and learning measures at your community’s schools.

Your pediatric practice will have an important role, both as part of the team contributing to safe plans for individual children with complex medical needs, and as mentors for the health and safety of all children. Your goals as a practice should be:

• To collaborate with school nurse staff to: support patients with complex medical needs; isolate and treat students with COVID-19 symptoms; respond to possible outbreaks at the school.
• To encourage equal access to in-person and remote resources for all children, taking educational and technological access into consideration
• To encourage and support access to nutritious meals for families via a school program or federal programs such as SNAP and WIC
• To assist in developing safety measures appropriate to children’s developmental stages (e.g., cohort groups for kindergarten, masks and desk distancing for high school students)
• To emphasize that safety measures for adult staff and teachers, such as masks and distancing, are as important as measures for kids, as there is increasing evidence that adults transmit COVID-19 more easily between one another than children do to adults
• To assist in developing care plans for sick children that allow them access to learning without undue risk of transmission to others
• To support children’s mental health needs as they adjust to shifts in learning at school

It is normal that some kids will struggle with school this year, especially if they have had mostly remote learning this year. By working with schools to ensure physical, emotional, and mental health needs are accounted for at school, your practice can help coordinate care that ensures resources are available as soon as a child needs them.

Safe Play: Indoors and Out

As families tire of pandemic restrictions, pediatricians are noting that more families are gathering together for play dates. While this is great for pressured parents and energized kids, it’s still  important to encourage vigilance to keep everyone safe, especially indoors.

If you or a parent is concerned about the spread of COVID-19 in your community, you can cover the basics in almost any visit type. Are kids over 2 wearing masks? How often does the family wash their hands? Do they have access to masks and hand sanitizer? Beyond these concerns, you might discuss the “pod” system:

• Pods are groups of families who limit non-distanced interactions to only one another
• Some experts recommend no more than 12 people across 3 individual households
• Appropriate pod partners will have similar standards and values around wearing masks, washing hands, vaccination, and other safety measures
• Pods may be helpful for balancing social needs and parenting demands between families, especially those working or learning remotely

Indoors or out, families should be sure to sanitize any public playgrounds, toys, or play areas that may have been touched by other people. Older kids who want to visit friends should understand both households’ rules around safety. The key factor in successful pods or social gatherings is trust, safety, and communication.

Finally, if parents have concerns about their child’s play, whether it’s a case of too much Roblox or refusal to wear a mask, success in returning to safe play centers around open communication between families and with your practice to ensure safe habits for everyone.

Safe Holidays and Gatherings

Families will naturally want to gather together around holidays and celebrations, yet as the public health circumstances continue to shift, many gatherings may look different this year. Your practice can help parents by offering guidance on safety, as well as support in the face of disappointments.

Help families organize safe holiday celebrations by recommending virtual events and parties organized by local businesses or between friends and families. Outdoor public gatherings are safe when everyone wears a mask and practices social distancing. Food is also an important part of any celebration, but families should take care around shared dishes or treats (such as Halloween candy) in favor of individual servings.

The AAP’s healthychildren.org has great resources for families looking to celebrate Halloween safely together. As more winter celebrations approach, similar measures for virtual fun may be in order if families can’t gather outside. It’s natural for kids to feel disappointed if their favorite activity or celebration is changed or cancelled. Parents and pediatricians can give them a sense of control by letting them choose safe in-person or virtual activities for their families to enjoy.

Sports, Teams, Clubs, and Activities

The decision to return to sports, teams, clubs, and other supplemental activities, if they are offered, is ultimately up to parents. However, your practice can help families weigh risks and take a measured approach to returning their child to their favorite activity.

As in any other gathering, in deciding to allow a child back to their preferred activity, families should weigh local COVID-19 activity rates, their child’s individual needs, the presence of a person with high risk in the household, and the activity’s relative safety (indoor or outdoor location, shared equipment, sanitization measures).

Reducing the risk for clubs and teams will require commitment by members and athletes as well as coaches and families. The CDC’s public health safety guidelines for masks and social distancing apply, and the AAP also has more insights on safety when returning to sports.

Commonly Asked Questions

Pediatricians are facing a lot of common questions from parents and schools regarding how to best keep kids safe while learning and playing. Here are some of the more common questions and answers from AAP guidelines. Please note that every state’s and school system’s regulations will be different, so you should become equally familiar with your local requirements.

• When should a child be removed from an activity or school?
• When they are symptomatic or have been in contact with someone who has tested positive for COVID-19. Return to school and play can be initiated after the appropriate quarantine measures are completed.
• What are the quarantine guidelines if a child is tested for COVID-19?
• If they have tested positive, a child should quarantine with their household for 14 days after the remission of symptoms and remain in contact with your practice to determine the best care plan.
• What are the guidelines for returning to play if a parent cannot or does not want their child to be tested for COVID-19?
• A child may return to school and activities safely 14 days after their last symptoms. If suspected of COVID-19, families may be counseled to notify their schools and discuss any restrictions upon returning to school/play.
• What should schools be doing to encourage safety? What should they be asking of pediatricians?
• Universal testing for COVID-19 is not recommended by the AAP at this time for schools or activities.
• Safety in schools should focus on developmentally appropriate measures, such as teachers moving between classrooms instead of students, and sanitization.
• Schools should encourage parent-reported symptoms for students and self-reporting by staff. Children with symptoms should be kept from attending school, especially with a fever of 100.4 degrees Fahrenheit or above.
• What should be done in the event of an outbreak at school, an activity, or gathering?
• Children presenting symptoms at school or during a gathering should be isolated immediately from others while their guardians are contacted, to reduce the spread of illness. The CDC has more information on safely responding to a child presenting with symptoms at school.
• COVID-19 presentations in children may appear like many other childhood diseases. Communication between parents and pediatricians is important to determine testing measures.
• In the absence of testing, students and families should follow local health department guidelines.

While every adult in their lives considers ways to keep children safe as the pandemic progresses, there is comfort to be had in that no matter the restrictions, kids at play nearly always manage to have a great time! By basing your conversations on practical guidelines and empathy for kids and their families, your practice can guide your community to the safe habits and practices that will keep kids safe as they play, gather, and celebrate together. 

For continued guidance on all things COVID-19, be sure to visit PCC’s COVID-19 Links and Resources page to get the latest information about safely caring for patients at your practice.