Back to school means back to viruses. A doctor explains how families should prepare

By Katia Hetter, CNN

(CNN) — It’s back-to-school time — or nearly — for kids across the United States. While some schools have already started, other families are busy preparing for school starting in the weeks ahead.

That includes thinking about the sniffles. Every parent knows that returning to the classroom is accompanied by kids picking up germs and bringing home illnesses.

As families shop for school supplies, how should they prepare for the spread of viruses and other diseases? Is there anything parents and caregivers should take to be ready for the start of school? And what other preventive measures — such as sleeping and nutrition — can help keep the immune system strong and reduce the chance of getting sick and missing school?

To guide us through these questions, I spoke with CNN wellness expert Dr. Leana Wen. Wen is an emergency physician and clinical associate professor at the George Washington University. She previously served as Baltimore’s health commissioner and is the mother of two school-aged children.

CNN: I want to first ask you about timing. Does back-to-school season kick off cold and flu season, or is that something that happens closer to Halloween?

Dr. Leana Wen: Historically, respiratory illnesses peak later in the year when the weather gets cooler. Covid-19 has upended this trend. Since the start of the pandemic, we have seen summer waves of the coronavirus; indeed, there is one ongoing now. Emergency department visits due to Covid-19 are trending up, according to the US Centers for Disease Control and Prevention. The CDC data also show that wastewater levels are high, indicating that the coronavirus is in high circulation in most parts of the US.

Fortunately, the CDC is reporting that levels of other respiratory pathogens, such as the seasonal flu and the respiratory syncytial virus (RSV), are low. These levels are expected to increase in the coming months.

CNN: As families shop for school supplies, should they also pick up Covid tests or medications to treat respiratory illnesses? 

Wen: I think this is sensible. My kids are headed back to school in a few weeks, and I know that they will come home with a variety of respiratory illnesses. It happens every year. No doubt it will happen again this year.

People who should make sure to have Covid tests on hand are those who are eligible to take antiviral treatment should they contract the coronavirus and people who expect to be in close contact with vulnerable individuals. Those in the first group should take the test if they develop symptoms so that they could start antiviral treatment promptly. The second group should have the test available so that they could take it before visiting vulnerable people.

It’s also sensible to have remedies to treat respiratory illnesses. When kids get a cold, the treatment is symptomatic. That means that there is no cure, but there are things that can make the patient feel better. Someone who has a fever could take over-the-counter fever-reducers like acetaminophen or ibuprofen, for example. A kid who has gastroenteritis and is throwing up could benefit from Pedialyte and other rehydration solutions. It’s a good idea to stock up on these over-the-counter treatments.

In addition, kids who have asthma may have asthma exacerbations triggered by respiratory illnesses. If your child falls into this category, make sure you have an asthma plan. Talk to your pediatrician about whether your child needs to take extra doses of their inhaler if they start having symptoms of a respiratory illness. Depending on the age of the child, a nebulizer machine could also help to deliver certain medications.

CNN: Are there other steps that parents and caregivers should take to get ready for the start of school? 

Wen: Make sure to visit your child’s pediatrician for an annual checkup. Many schools require that there is up-to-date medical information from the clinician before the start of school. Certain sports activities might require additional forms.

Even if your school does not mandate a checkup, an annual visit is a good idea to make sure that your child is developing and growing well and to address any new or existing physical or emotional health concerns. It’s also a good opportunity to ensure that all vaccinations are up to date.

Finally, if the pediatric practice does not address vision and dental health, you may need to make separate appointments with an ophthalmologist or optometrist and dentist. Things get busy when school starts. It’s always a good idea to get screenings and preventive care visits taken care of before school if possible.

CNN: Speaking of preventive measures, can we talk about handwashing and masking? Are these still effective at preventing virus spread?

Wen: These measures are effective. Kids should certainly be encouraged to regularly wash their hands with soap and water and, if these are not available, to use hand sanitizer.

Masking with a well-fitting high-quality mask is highly effective at preventing someone from contracting respiratory illnesses. While most kids have stopped masking at school, families with children who are immunocompromised may decide  to continue masking.

Ventilation is another strategy to reduce virus spread. Many schools have implemented measures to improve ventilation, including opening more doors and windows and investing in high-quality air filters.

CNN: Are there other preventive measures, such as sleeping and nutrition, that can help keep the immune system strong to reduce the chance of getting sick and missing school? 

Wen: I’m glad you mentioned sleep and nutrition. A number of studies have shown a connection between sleep and the immune system. Getting adequate sleep is important for kids of all ages — and, indeed, for adults too. Not getting enough sleep can lead to a whole host of problems, including more frequent illness, lower overall well-being, and less ability to cope with stress.

Similarly, nutritious food is also linked to improved immunity. It’s best to have a diet rich in whole foods, such as vegetables, fruits, grains and nuts. And keeping physically active is another method that can strengthen immunity, in both children and adults.

Despite using these and other preventive measures, it’s likely that kids will contract respiratory viruses many times during the school year. I am anticipating that will happen with my family this year, just like years past. And, of course, what happens when kids bring back viruses is that adults get them, too. Which means adults would also do well to prepare for what happens if we get sick — and take preventive measures accordingly, too.

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