As students return to school, here’s what parents need to know about COVID, the flu and RSV

School is starting back up again, meaning likely cases of flu, colds, and COVID-19 are, too. At least this time around, health officials are working with three years of experience in mitigating COVID, while researchers have continued to develop vaccines to protect students against most viruses.

On Monday, the Philadelphia School District released its health and safety protocols for the 2023-24 school year, and while COVID-19 is still a concern, so is the common cold, flu, and respiratory syncytial virus (RSV).

For many Philadelphians, it may feel like the pandemic is over, but vulnerable populations like the immunocompromised and older adults are still at risk and need protection. RSV is a cold-like virus that can be dangerous for infants and young children with health complications. The CDC says almost all children are infected with it by 2 years old, and last year there was a huge surge which left the Children’s Hospital of Philadelphia “at or near capacity” for weeks last fall.

Even though COVID-19 is no longer considered a national or global public health emergency, that doesn’t mean the pandemic is over, said Landrus Burress, the city’s director of disease control. According to the Centers for Disease Control and Prevention, there has been an uptick in COVID cases and hospitalizations this summer, a trend for the last four summers.

“It’s really hard to predict what to expect in the forthcoming months with COVID-19,” said Burress. “We expect a slight increase in cases during the school year because there are higher chances of students being close together. We’re mostly just recommending that individuals take the same precautions that you would see in previous years.”

Philadelphia health officials recently reported a slight increase in cases, but the risk of catching COVID-19 is still low in the city — nothing like in previous years with thousands of cases per day. For children heading back to school, Burress and the school district’s medical officer, Kendra McDow, want parents to know that they should expect COVID infections to rise, especially during the winter months.

The most important step for protecting children heading back to school is making sure they’re up-to-date on all immunizations, including booster shots, said Burress. What might be new for some parents is that the CDC and FDA have approved COVID-19 vaccines for children 6 months or older, expanding eligibility to 20 million additional children.

All children 6 months or older should have their first dose of a COVID-19 vaccine. Everyone who is 6 years or older and has had their first dose is eligible for one updated Pfizer-BioNTech or Moderna COVID-19 vaccine, according to the CDC. People 65 and older can get a second booster shot, and folks who are immunocompromised can receive additional doses depending on their doctor’s orders.

At this stage, the majority of school-aged children should have had their first dose and one booster shot to be up to date on COVID-19 immunization, according to the CDC. Currently, there is a new booster shot expected to be released in mid-September that will target newer variants of COVID-19; however, it is unclear if the FDA and CDC will recommend that booster for healthy, younger people who have already received a booster.

Apart from COVID-19, people should still be getting their flu booster shot each fall in preparation for the winter sickness season.

“This winter season there’s concern for respiratory illnesses such as COVID, flu, and RSV similar to what we saw last year. The good thing is that now we have vaccinations for all three,” said McDow, the school district’s medical officer.

Vaccines against COVID-19 and the flu are available for all school-age children, however, the district doesn’t require students to get them.

RSV vaccines and treatments are not available for school-age children, but all infants younger than 8 months who are born during or entering their first RSV season should receive one dose of the monoclonal antibody product, nirsevimab (sold under the brand name Beyfortus), according to the CDC.

You can get all of these vaccines at any of the city’s health centers, in many cases for free. Find a city health center at phila.gov/services/mental-physical-health/get-vaccinated or call 215-685-2933. Looking for more options? Search for vaccine providers at vaccines.gov.

If you need a free COVID-19 test, find a testing site near you at phila.gov/covid-testing-sites.

Just like Americans have been doing for three years, if someone tests positive for COVID-19, isolate the person in the household, according to the CDC. The Philly school district is modeling its protocols off that guidance.

Students who test positive for COVID-19 will need to stay at home and be isolated from the rest of their household for five days. This is when a person is likely to be the most infectious. Additionally, if possible, the household should have separate bathrooms, not share items, and take steps to improve ventilation in the home.

If a student shows symptoms of COVID-19 while at school, they will be directed to the nurse’s office where they will be given a COVID-19 test and assessment. If the student tests positive for COVID-19, a parent or guardian will need to pick up the student immediately. OTC tests will be provided for testing to be done at home, and they should begin isolation.

After that five-day isolation period at home, if the person has shown no symptoms for 24 hours without the use of fever-reducing medicine like Tylenol or Motrin, they’re free to stop isolating and go back to school. However, they must wear a high-quality face mask (N95 or KN95 recommended) at all times for an additional five days after isolation.

In this post-pandemic era, health officials urge parents to be even more proactive when symptoms arise.

“We highly recommend that parents, if possible, keep their kids at home if they are presenting any type of symptoms such as a cough or fever, or any type of cold symptom at this time,” said Burress.

Besides getting vaccinated, the next best preventative measures are the use of face masks and effective hand washing. Burress suggests parents get a multipack of face masks to place in their child’s book bag, on top of the face mask they’re already wearing to school. While masking may not be mandatory, if COVID-19 is a family concern, it’s a good idea to wear them.

Pro handwashing tip: Germs spread when touching the face, mouth, and eyes, and when preparing or eating foods at school. After wetting the hands with cold or hot water, lather the backs of your hands, palms, and between your fingers and under your nails for at least 20 seconds (Hum or sing the “Happy Birthday” song twice). Teach your child to wash their hands or use sanitizer before and after lunch, recess, or when interacting with someone who might be sick. Of course, also after using the toilet, blowing your nose, and throwing out garbage.

Additionally, if a student is exposed to someone who is positive for COVID-19, the school district heavily encourages that student to wear a mask for 10 days after the last date of exposure to COVID-19, and ideally get tested within 48 hours. After five days of not experiencing symptoms, they should get tested again to be safe. Students who were exposed to someone with COVID-19 will be notified.

At the start of the school year, masking is not required, but in the case of a classroom, schoolwide, office-wide, or department-wide outbreak of COVID-19, the Philadelphia Department of Public Health may issue a masking requirement until the outbreak subsides.