Should Cancer Patients/Survivors Return to School during COVID-19 Pandemic?

Parents of childhood cancer patients and survivors have been faced with many challenges and questions during the COVID-19 pandemic. One of the biggest questions on everyone’s mind is …

There is not a blanket answer for all childhood cancer patients and survivors. Each child’s situation is different.

For the most part, school systems around the country have presented their plans for the return to school. In general, families may have the following options for their children:

• Returning to the classroom for in-person learning
• Online instruction from home
• Mix of both in-person and online

Each option has risks and benefits.

What factors should I consider?

You are encouraged to talk to your child’s care team to understand possible risks. Your care team may not be able to draw conclusions about the risk of infection in your home community. Community risk varies almost from week to week and certainly from state to state or even county to county.

In making the decision about whether your child should return to school, there are several factors to consider.

Is my child healthy enough to attend school when it reopens?

It depends on what medications your child is taking and your child’s current medical status. It’s important that your child feel well enough to go to school and that his or her immune system is strong enough.

The immune system protects the body from infection. A weakened immune system cannot defend the body against viruses such as the coronavirus as effectively as a healthy immune system. It is possible that children with weakened immune systems may develop more severe illness and could be infected with the virus for a longer period.

Is it true that children with coronavirus don’t get sick or, if they do, the symptoms are mild?

In general, most children either have a mild form of disease or they don’t develop any symptoms (known as being asymptomatic). But they could spread the disease to adults in the school, their family, and in the community. When schools reopen, it is believed the number of COVID-19 cases and COVID-19 related hospitalizations will increase.

This is particularly a problem if someone in your home has risk factors for serious complications such as heart disease, diabetes, obesity, or being an older adult.

For the most part, pediatric cancer patients who have had COVID-19 have fared well overall.

What are benefits of attending school in person?

There is little doubt that attending school in person is generally the preferred mode of learning. School attendance is fundamental to a child’s overall development, influencing not only academic learning but social and emotional skills.

Often schools provide mental health treatment, speech and physical therapy, and necessary nutrition. Parents must weigh the risks versus the benefits of school attendance.

The emotional, psychological, and developmental toll that this pandemic has put on children should not be underestimated. It is a hard decision that should consider the risks versus benefits of whether to send kids to school or not.

What precautions should be taken while at school?

The CDC recommends:

• Physical distancing of 6 feet or more
• Wearing face masks most of the time, and certainly when physical distancing isn’t possible
• Practicing hand hygiene – frequent handwashing for 20 seconds or more or alcohol-based hand sanitizer
• Regularly assessing your child for symptoms and do not send to school sick
• Notification of positive cases in school, particularly of a classmate or teacher

Talk with your school to understand what precautions it is taking such as frequent cleaning of high-use areas and regular temperature checks of students and employees.

Can remote learning work for our family?

A parent or other responsible adult must be with your child at home if they are 12 years old or younger, and this is recommended for young teens as well. That may not be possible in all families because parents may need to work outside the home. You must have a reliable internet connection and device for learning. This is challenging in many parts of the country.

Are childhood cancer survivors at risk of developing COVID-19 complications? Should they be concerned about returning to school?

While cancer survivors have not been placed in a higher risk group, the late effects of treatment on multiple body systems can place the survivor at risk. High-risk conditions could include, according to the CDC:

• Chronic lung disease or moderate to severe asthma
• Serious heart conditions
• Compromised immune systems
• Obesity (body mass index (BMI) of 30 or more)
• Other underlying medical conditions such as diabetes, kidney failure, or liver disease

How are IEPs and 504 Plans affected during COVID-19?

Federal law provides for Individualized Education Programs and 504 plans, which allow for classroom accommodations and extra support for public school students with learning challenges and disabilities. Many childhood cancer patients and survivors qualify for these services because of their disease and the side effects of treatment.

However, the laws do not specifically address what happens if schools close due to a pandemic. Parents are encouraged to work collaboratively with the school team to meet your child’s educational needs during this time.

Some important information to know about public schools:

• If the school provides educational opportunities to the general student population, it must make sure students with disabilities have equal access. If the school closes and does NOT provide any educational opportunities to the general student population, the school is not be required to provide services to students with disabilities during that time.
• The school should make sure each student with a disability is provided with special education and related services, such as speech therapy, to the greatest extent possible without endangering the health of the student or school staff.
• Special education and related services may be provided online or over the phone. Many of the accommodations that students need can be provided online such as extended time on tests, modified assignments, and having materials read aloud.

If you have questions or concerns regarding your child’s academic supports or progress, please contact an academic coordinator or school liaison at your treatment center.