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AAP Expands School Re-Opening Guidance to Reduce Community Spread of COVID-19


As leaders in education and public health continue to discuss how to begin the next school year, the American Academy of Pediatrics offers updated guidance to support healthy and safe development for all children and adolescents, whatever form school takes.  

In its guidance released Wednesday, the AAP emphasizes the need for federal assistance to support schools throughout the U.S. This includes schools where high levels of COVID-19 in the community make it unsafe to open for in-person learning right now.  

The AAP routinely re-examines its clinical guidance during the pandemic to make sure the recommendations reflect the latest evidence. This update includes additional guidance on cloth face coverings to align with AAP recommendations; additional discussion about the decision to open schools based on community spread of COVID-19; and an expanded discussion regarding equity in education.  

“The persistent racial and social inequities in our educational system, including disparities in funding, quality of school buildings, and resources for curriculum and teachers have only been exacerbated by the pandemic,” said AAP President Sally Goza, MD, FAAP. “Without more resources, these disparities will worsen. Whatever school looks like this fall, we must be innovative and promote the well-being of all children, particularly children living in marginalized communities.”  

A recent Pew Research Center study found 1 in 5 teens are not able to complete schoolwork at home due to a lack of a computer or internet connection. This technological ‘homework gap’ disproportionately affects Black, Hispanic, and low-income families.  

In places in the U.S. with high levels of COVID-19, schools will need more assistance to support remote learning for all students, according to the AAP. Schools should also consider ways to deliver meals to families who were unable to access nutrition programs in the spring despite attempts to make meals available for pick-up. 

The ultimate goal should be having students physically present in school, according to the AAP, but unfortunately, in many parts of the U.S., the uncontrolled spread of the virus means that cannot be safely accomplished now.  

“This is on us – the adults – to be doing all the things public health experts are recommending to reduce the spread of the virus,” Dr. Goza said. “If we can reduce the amount of COVID-19 in more communities, it will be possible for more schools to open, and this will be best for all of our children.” 

Where it is possible to re-open for in-person learning, the AAP recommends schools implement a layered approach to protect students, teachers and staff. That includes:  

  • Requiring cloth face coverings for all children over the age of 2 years, and all adult staff 
  • Implementing physical distancing with desks placed 3-6 feet apart  
  • Cohorting students to minimize crossover among students and adults  
  • Using outdoor space when possible 
  • Promoting hand and cough hygiene and increasing cleaning and disinfection 
  • Implementing protocols to ensure students and staff do not come to school when they are ill.  

The AAP believes that school is important for students’ academic instruction as well as their social and emotional development. The benefits of in-person learning are well-documented, and there is evidence that lengthy time away from school can result in social isolation, learning deficits, and mental health problems.  

Since AAP first issued its school re-entry guidance in June, several other organizations including the Centers for Disease Control and Prevention, National Association of School Nurses, and the National Academy of Sciences Engineering Medicine have also released documents. 

All these documents, as well as the AAP’s guidance, are consistent regarding the importance of considering the level of COVID-19 in a community in making school re-opening policies. Ultimately, the decision to re-open schools to in-person learning should be based on the guidance of local and state public health authorities and school administrators.  

For more information for parents, go the AAP HealthyChildren.org article, and Return to School During COVID-19, here.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow them on Twitter @AmerAcadPeds

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