Will the start of school bring the next COVID wave?

It’s a decision fraught with second-guessing, frustration, and fear as the delta variant of the COVID-19 virus continues to surge in the U.S. and her daughter, like every other child under the age of 12, remains unvaccinated. 

“The delta variant is truly the thing that’s keeping me up at night, because there is just so much unknown about it,” Gard said.

While Gard plans to have her daughter wear a mask while in school when classes start back Aug. 4, her school district in Atlanta has yet to announce whether it will require students and teachers to wear a mask, let alone if they’re planning to implement any social distancing protocols. 

If the school reaches out to parents and says it’s not going to require masks, Gard says she’s unsure what she’s going to be able to do since homeschooling isn’t an option unless she or her husband leave their jobs. “She’ll wear her mask, but if nobody else is wearing theirs, she’s no safer,” Gard says. “I don’t have an answer and that’s the worst feeling as a parent. Instead, we’re all just doing the best we can.”

About 70% of K-12 students in the U.S. attended school in-person at the end of last year, according to the latest data from Burbio, which aggregates school calendars. About 28% of students will be attending a hybrid mix of in-person and remote learning while only about 2% of students plan to attend fully remote.  

Yet the vaccinations levels among children and teens remains low. Only about 26% of 12 to 15-year-olds are fully vaccinated and only about 38% of those in the 16-17 age range have received both doses, according to the Centers for Disease Control and Prevention. President Joe Biden said Tuesday night that he expects vaccines for children under the age of 12 to be available “soon,” potentially even in the next few months. But an FDA official told NBC News last week vaccines are not expected to be ready until midwinter, a timeline that Dr. Anthony Fauci echoed in comments this week.

With so many unvaccinated children heading back to school over the next six weeks, there is going to be a rise in the numbers of COVID-19 cases, says Dr. Frank Esper, a pediatric infectious disease specialist at the Cleveland Clinic.

“Children are more resilient, but they’re not immune. They can still be infected and they have been infected throughout the pandemic, just not nearly to the rate of adults,” Esper says. And infected children can also transmit the virus to adults. A new study from China finds children are 60% more likely than adults over age 60 to pass on Covid to other family members.

Why returning to school will likely increase COVID cases

With so many older Americans vaccinated, the U.S. will start to see cases rise among children simply because this group remains vulnerable, Esper says.  

“The only way out right now for this virus is to become more infectious to younger age groups because the older age groups have done their part and gotten immunized,” Esper says.

Beyond the lack of vaccines, the physical school structures themselves have an impact. COVID-19 virus spreads a lot better indoors. So as children head back to school, that means they’ll be in close contact with others and usually enclosed in a room for a good portion of the day. 

Making matters worse, Esper anticipates a lot of the successful protections and strategies that Americans have employed over the last year, such as masking and social distancing protocols, are going to be implemented in a much more “piecemeal” fashion among schools and communities. 

In fact, Burbio estimates that only about 28% of students are heading back to schools that have announced some type of mask mandate. Most students are in states that are leaving it up to local schools to make the call or live in areas that aren’t requiring masks. Just this week, for example, governors in Alabama and New Jersey said they will not require masks in schools this fall.

That said, Esper says that while the reopening of schools will contribute to the next wave of COVID-19 cases, it won’t be the only reason. “Remember, the cases spiked last year without children in school,” he says. 

Factors such as the weather turning colder also have a big impact, Esper says. “The climate is going to start turning more towards the favor of a virus as things become a little more colder,” he says, adding that fall and early winter are time periods when the U.S. generally sees a rise in all respiratory viruses, including COVID-19.

It’s also worth noting that there’s no good evidence that the delta variant is more severe than previous strains of the virus. It’s definitely much more contagious, but it’s still pretty rare for children to develop serious symptoms. 

Additionally, many experts believe that children are better served being in school. In fact, the American Federation of Teachers, one of the largest teacher’s union, is supportive of in-person learning this fall.

“We share the growing concern over the delta variant, as well as the evolving science around COVID transmission in young people, all of which make it incumbent upon school districts to remain committed both to vaccinations, and to these safety protocols. But our ultimate goal is to get students, teachers and staff back in school buildings full time, and to make sure they’re safe while doing it,” says Randi Weingarten, president of AFT.

So what can parents do to protect their kids?

Although the CDC hasn’t yet recommended that all students wear masks in the classroom this fall, President Biden said Tuesday night that it’s “probably what’s going to happen.”

It’s a move that Esper, along with leading medical experts such as Dr. Fauci and the American Academy of Pediatrics support. The organization issued new guidance on Monday in support of returning to in-person school this fall, but recommended schools adopt universal masks policies.

“Wearing a mask is a fairly easy thing to do. I know that that’s certainly not in vogue right now, but it certainly does work,” Esper says. 

Social distancing also works but that’s not something parents typically can control and may be constrained by the amount of space available in a school building. But frequent hand washing and disinfecting is another easy step parents can encourage their kids to take throughout the school day. 

Requiring that everyone, including those who are already vaccinated, wear a mask is “the most effective strategy to create consistent messages and expectations among students without the added burden of needing to monitor everyone’s vaccination status,” said Sara Bode, a doctor and chairperson-elect of the AAP Council on School Health executive committee. 

Perhaps the biggest step is keeping everyone home when they’re sick, even adults. Prior to this pandemic, Esper says there was a bit of “medical machismo” in the U.S. where people would show up to work sick to show how dedicated they were to their job. But that’s a terrible idea these days. 

“You can’t tell the difference between a minor cold and the coronavirus — there’s no way based on symptoms,” Esper says. So to help stop the spread of COVID-19, it’s worth keeping the kids at home whenever possible, even if it’s just a minor sniffle.