Back to School ’21 With COVID-19

Kids and parents alike are sure to have questions as they prepare for a new school year that figures to have the characteristics of pandemic learning at least to start. Dr. Erica Waddington at UConn Health’s family medicine practice in Canton offers her perspective on back-to-school time as a physician who sees both parents and kids — sometimes from the same family.

Transcript

Chris: What kind of a school year can we expect this year? Today on the Pulse, preparing parents and kids for back to school ’21 while we still deal with COVID-19.

This is the UConn Health Pulse, a podcast to help you get to know UConn Health and its people a little better, and hopefully leave you with some health information you’ll find useful.

I’m Chris DeFrancesco. The last time our kids had a normal school day, they were two grades behind the one they’re starting this fall. And it looks like things were getting better this summer, and widely available vaccines, looser restrictions, and lower hospitalization rates giving us reason to feel better about that. But with the variant factor and the fact that many, many students are going back to school without being vaccinated, what should parents and kids be ready for this school year? To help us with these questions. We have Dr. Erica Waddington from the UConn Health family medicine practice in Canton. Thank you for your time today.

Dr. Waddington: Yes, you’re welcome.

Chris: First, let’s talk a little bit about family medicine. You’re a general practitioner with overlap in internal medicine and primary care, but there are other aspects to family medicine.

Dr. Waddington: Correct. Family medicine is, how we like to term it as, “cradle to grave” medicine, which basically means we, as practitioners, we take care of babies, we take care of newborns, we take care of children, pregnant women, adults in their twenties, thirties, forties, all the way to the geriatric population.

Chris: So that means that when it comes time for a new school year to start, you might be the physician of both the child going into the school year and that child’s mom or dad.

Dr. Waddington: Right, exactly, which is kind of nice. I think all of us who do practice family medicine like that aspect of being able to get to know the whole family, the whole family’s history and it provides a nice backdrop when you’re taking care of one individual person in that community.

Chris: Going into a new school year, kids probably have questions, parents probably have questions, and if you’re the physician for both, how does that maybe help the dynamic of that whole relationship?

Dr. Waddington: I think it’s really nice to be able to be the health care provider for both the child and the adult, and probably the siblings, in that household, because it just gives us the opportunity to sort of know the whole system rather than just one piece of the system. It’s sort of like, I feel like I’m inside their house and sort of seeing them in their natural habitat.

Chris: Oh, I could see some benefits to that when you’re trying to deal with health care, especially preventive medicine. Now in a normal school year — and we’re talking with Dr. Erica Waddington who’s a family medicine practitioner at UConn Health in Canton — Dr. Waddington, in a normal school year, what kinds of conversations are you having this time?

Dr. Waddington: This time of year, I’m usually talking about getting ready to restart school, so starting those healthy habits that we might have gotten rid of over the summertime, going to bed at a decent hour, making sure that if a child needs to have an alarm in the morning, that’s established, that’s set. Some children will try to get a new phone or iPad out of it so that they can get their own alarm clock.

Pretty soon, it’s going to be time for fall sports. And if your children are like my children, they’ve tried to relax all summer and haven’t been really doing that much, so encouraging them to get out and exercise, right? Like start walking with them, you know, in the evenings and then maybe start running, buy them, some sort of device to track their steps. Can be very externally motivated by praise. So having a sticker chart, or give them a dollar if they’re going to run a mile, all these sorts of things will help get their bodies ready for the fall so that whatever sport they decide they want to play, then they’re not starting from ground zero.

Chris: And that’s good for people who aren’t even on organized sports teams, right, just to generally get some exercise and kind of get the blood flowing?

Dr. Waddington: Yes, without a doubt, children should have at least an hour of exercise every day, moving their bodies, going out and doing stuff. It’s good for their brain, it helps them sleep, it helps them maintain a healthy weight and a healthy appetite. So yeah, all of us, including children, should be active every day.

Chris: So regarding sleep. One of the reasons I wanted to have this conversation with you now, instead of like, as the school year was starting was, the idea that the wisdom that I understand is you want to try to kind of start tapering down that how late we’re staying up and not just say, OK, stay up till midnight all summer, and then go to bed at nine o’clock the night before the first day of school.

Dr. Waddington: Correct. Sleep habits for kids and for teens as well, they really do need between 10 and 12 hours of sleep a night, which seems like a lot compared to adults. We usually want to average seven to eight, but kids are still developing body and brain, so that sleep is really important. For their body and brain to stay healthy.

If you’re going to change the time that you’re going to initiate sleep, you can really only change it by about 30 minutes a night. So if you’ve got a teen who’s been going to bed at midnight, they really need to slowly start to wind back that clock to hopefully eight or nine o’clock at night for them to be able to go to sleep and then get up in the morning. Some children need to get up at somewhere around five o’clock, six, seven in order to get there, get on their bus or get to their transportation and get to school.

Chris: Do you find yourself in the middle of an argument with parent and child about whether or not they can use their phones after a certain hour in the evening, or whether they keep their phones in their room at night? That kind of a thing?

Dr. Waddington: Yes. With the advances in technology have brought new challenges for both the teens and the parents. Parents need to set a good example. They also need to not be on their phones before bed, because we know through research that the blue light waves that are stimulating our brain through our phones are going to make it harder for us to go to sleep. So parents also need to put their phones down. I tell my children and my adults, at least two hours before you’re going to initiate sleep, you’ve got to turn it off. I don’t advocate for phones in the bedroom. It’d be great if everybody’s phone just was in a basket downstairs and not accessible. There’s going to be caveats to that, of course, depending on what the parent’s profession is. And screen limit times also can be a source of argument between your teen or even your younger child. Really you want to try to limit your screen time to no more than two hours a day. That’s very hard. I know that’s challenging, but the more we put down our phones and engage with each other in a household, the better off we are.

Chris: Related to that, and obviously not all families can do this, but there are advantages to making like family dinner time a priority at the end of the day, right? Put your phone away. We’re all present for each other. Sit around the dinner table to the extent that families can make that work. There’s benefit to that, right?

Dr. Waddington: Yes, without a doubt. Our lives are so busy and they’ve become busier and busier as the years progress. And really what we’re finding is people will live in a household and become very disconnected, and that has mental health effects on each other, especially children. So if you, if it’s possible, maybe just start with one night a week where you’re going to all sit around the table, the dinner table, or the breakfast table, whatever, and interact with each other. And then really try to make it a goal of making that at least five nights a week. And that will help the children feel more connected with the adults and the their role models in the house.

Chris: We’re talking with Dr. Erica Waddington, who practices family medicine at UConn Health in Canton. We talked a little bit about the kinds of conversations you have with your patient families.

Going into a typical school year. This I would say is not a typical school year, so what are the kinds of things that you think should be, or are, on the minds of parents going through this school year?

Dr. Waddington: A lot of parents this school year in particular are asking me what I think about COVID, where it’s going in the state of Connecticut, and they’re asking me about if travel is safe and they’re asking me about masks in schools. And as we know the COVID vaccine has been widely successful, especially in the state of Connecticut. We’ve done an excellent job with vaccinating a large portion of our population, which is great because vaccination is what’s going to prevent the variants from evolving. Viruses always make variants. That’s very common. So this is not something unique to the coronavirus at all. And the more you’re vaccinated and less likely to become infected, the less likely you are to make more variants. What I’ve been telling my children and my parents is the best defense besides getting vaccinated is wearing a mask and washing your hands. That in my mind should not change. I really do think you’re going to see masks and hand-washing and social distancing again in schools. I think the kids and their parents both want the kids to be in school. Kids do better, they’re able to interact with their peers, they’re able to interact with their teachers in a supportive environment. So it’s really critical that we keep kids in schools this year, as much as we can, safely. And honestly, the best way to do that is for parents to get vaccinated, anybody who’s of vaccination age to get vaccinated and continue to wear a mask and wash your hands.

Chris: Now the reintegration into the school ecosystem, from a social standpoint, right, we’ve had for basically the last year and a half some combination of learning from home learning from home half the time. For the most part, there hasn’t been that regular, steady interaction with peers in the classroom, in the buildings, in the hallways, like we grew up with, that we took for granted. And probably it’ll be years before we really know what kind of impact that had on the development of these children and what age they were when they had to go through it. But what are some things that we should maybe expect to be challenges to our children and our teachers and our parents, as we try to get back into that “fully present” school ecosystem?

Dr. Waddington: I think for kids, most of the kids that I talked to are excited about going back to school. I think most of the parents are as well. The teachers want the kids back in school. I think part of the challenge comes with, if there’s a outbreak at a school, what’s going to happen. It was very stressful for everybody, kids, parents, and, and teachers too, with regard to making sure that everybody stays safe.

I think, if you’ve got questions about what’s happening in communities, then reach out to your health care providers. That’s why we’re here. I encourage all my patients to call and the parents to call and ask me questions and I have access, we all have access to numbers and transmission rates through every town. So we can sort of put our finger on the pulse and figure out maybe a couple of steps ahead what the possibility is of having another quarantine again. Nothing else is more constant in life than change. And if we’re able to be resilient, and be flexible with what we need to do as a community, then our kids are going to learn from that, and they’re going to model that behavior from their adult, you know, role models that are around them.

We’re all very on edge and nervous and want this to be over now. But all we have to do is turn on the news and realize it’s not over yet. And what we can do is to support each other, to support our kids and let them know it’s going to be OK, we’re going to get through this, and to get vaccinated.

Chris: Now we’re speaking at the very, very end of July. Information could change between now and when people hear this, but we don’t seem to have a consensus yet on whether we’ll need a booster on the vaccine, or additional vaccination or when, or whether kids under 12 should get vaccinated. And of course, there’s the ongoing variant situation. What kinds of things are you most concerned about or paying most attention to as someone in health care, practicing family medicine?

Dr. Waddington: Because I’m practicing family medicine, I ask all my patients if they’ve gotten their COVID vaccine if they’re vaccine eligible, and if not, then I say, please consider it. And if not, please wear a mask, wash your hands and try to avoid indoor crowded situations. Because as in any virus that’s a respiratory virus, the transmission is much easier when you’re indoors than when you’re outdoors. So if you have the opportunity to travel, then that’s great — planes are very safe because they’re use HEPA filters and recirculate the air. But when you’re in the airport, put your mask on, wash your hands. And if you’re going to a social event with a crowd, please wear a mask, wash your hands. That’s really, besides getting vaccinated, that’s the best defense that you have. And then you’ll lower the risk of acquiring the illness, and then lower the risk of bringing it home to your family.

Chris: And before we say goodbye, Dr. Erica Waddington, family medicine practitioner at UConn Health in Canton, what else should parents or kids know about getting ready for school in 2021?

Dr. Waddington: Well, with regard to mental health, we saw during COVID, when kids were home, there was a higher incidence of anxiety and depression. Probably because, we’re assuming it’s because they felt disconnected from their peers, which is their main support group. They’re disconnected from their teachers, who provide great support and care for them on top of being instructors of certain subjects. So sit down and talk with your child. If your younger child’s complaining of headaches or a belly ache, sit down and talk to them and see if there’s something else going on emotionally. Little kids have a hard time verbalizing their emotions. They don’t know the words to use. So usually they, what we call is somaticize. They complain of something in their body hurting. That’s a clue that there might be something going on in their brain that’s really bothering them. So seeking social support, seeking a behavioral therapist that does child psychology or even reaching out to your psychologist in your school — most schools have either a clinical social worker or a psychologist that can spend time with your child during the school day to sort of get a nice screen, to see if there’s anything going on with them that needs further assessment outside of school.

And with our teens as well, bullying happens at all levels. It’s never right. It’s never appropriate. And just having a nice open dialogue with your children in the house so that they know they can come to you, they can talk with you if something’s bothering them, it’s a huge resource for them to hopefully make them healthy adults in the future.

Chris: That’s Dr. Erica Waddington, family medicine practitioner at UConn Health in Canton. Thank you for all of the wonderful advice that you provided for us today. That is our time for today. And for Dr. Erica Waddington I’m Chris DeFrancesco. Thank you for listening to the UConn Health Pulse. Be sure to subscribe, so you can catch us next time, and please share with a friend.