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.

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. If you aren’t sure which options are available in your area, talk with your child’s school.

What factors should I consider?

You are encouraged to talk to your child’s care team to understand possible risks. Safe and effective vaccines are now available for everyone over 5 years of age.

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?

It depends on what medications your child is taking and your child’s current medical and vaccination 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, like the virus that causes COVID-19.

Is it true that children with COVID-19 don’t get sick or only have mild symptoms?

In general, most children either have a mild form of disease or they don’t develop any symptoms (known as being asymptomatic). But children with cancer and other serious illnesses are at a higher risk for developing severe illness.

Children can also spread the disease to adults:

• At school
• In the family
• In the community

That’s why it is important for children who are eligible to be vaccinated. Every child in the United States over age 5 is now eligible for a COVID-19 vaccine.

What are benefits of attending school in person?

Attending school in person is generally the preferred way to learn.

School attendance is fundamental to a child’s overall development. It helps children develop academic and emotional skills.

Often schools provide:

• Mental health treatment
• Speech and physical therapy
• Necessary nutrition

Parents must weigh the risks versus the benefits of school attendance.

What precautions should be taken while at school?

The CDC recommends:

• Getting vaccinated if you’re eligible is the best way to prevent the spread of COVID-19
  
• Physical distancing of 3 feet or more is suggested
  
• Wearing face masks indoors and 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 not sending to school if sick
  
• Notification of positive cases in school, particularly of a classmate or teacher
  

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

Can remote learning work for our family?

The short answer is: It depends on your situation.

Many school systems have removed the virtual option for students and are requiring in person attendance. Parents can choose to homeschool as an option if they are still uncomfortable sending their child to school.

A parent or other responsible adult must be with your child at home if they are 12 years old or younger. 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?

Cancer survivors have not been placed in a higher risk group. But 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?

The law does not specifically address what happens if schools close or change schedules due to a pandemic. Talk with your child’s school and work together.

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.

If you have questions or concerns regarding your child’s academic supports or progress, your child’s care team can help. Talk with the academic coordinator or school liaison at your treatment center.