Battle against RSV in schools recalls COVID-19 fight

Schools are preparing for another winter marked by mass sickness, as the respiratory syncytial virus (RSV) continues to spike among children, prompting precautions that mirror those seen during COVID-19. 

Facilities with younger children such as day cares and pre-K programs face a potential “tripledemic” of RSV, COVID-19 and the flu this season.

For the majority of adults and older children, RSV causes cold and flu-like symptoms that resolve themselves in about a week. However, younger children, particularly infants and toddlers who have not been exposed to the virus, are at a high risk of developing severe illness.

Day cares and classrooms are known to be vectors of transmission for pathogens like RSV, a virus for which there is currently no vaccine.

However, educators are well practiced in the necessary precautions for combating RSV, which are similar to those taken during the height of the pandemic.

A big part of keeping children safe is clear communication between the educators and parents, said Shannon Robinson, health and nutrition manager at the child care non-profit Bright Beginnings in Washington, D.C.

“It’s just a matter of continuing to educate our parents and allow them to ask questions that they may have, because a lot of the information is new to parents where they don’t quite understand what exactly is happening,” Robinson said. 

Bright Beginnings runs a weekly flier in their newsletter to parents about COVID-19 and RSV precautions, providing information on what symptoms to look out for, what precautions are advisable and when to take their children to the doctor. 

“The constant communication with early prevention is key to combat where we are right now trying to get the cases down with RSV,” Robinson said, noting they have had five to six confirmed cases this year compared to 20 to 30 cases last year. 

It is possible the children’s immune systems are better this year since “last year there were also a lot of children’s first time in a school setting,” she added. 

Along with communicating symptoms, child care facilities also need to have strict standards about when children should stay home. 

“I do know that most child care providers are really reinforcing to the parents that they are not going to accept a child that has any symptoms into their program, which is hard to do. Parents need to go to work, but that’s the number one line of defense,” Cindy Lehnhoff, director of the National Child Care Association, told The Hill. 

Along with boundaries for the child care providers, Lehnhoff emphasized that parents should be “very, very mindful” of the facility where they take their children, asking the providers questions about hand washing policies, sanitizing regimens and what the eating setup is like. 

Major U.S. school districts told The Hill that while they are not mandating mitigation methods, they are encouraging parents, teachers and students to return to the practices that became commonplace during the worst parts of the COVID-19 pandemic.

Hand washing, sanitizing toys, keeping children home when they are sick — and clear communication between parents and educators — are all seen as crucial to keep children safe this winter. 

The Los Angeles Unified School District (LAUSD) acknowledged in a November news release it was experiencing “extremely high respiratory infections among children.”

“Unfortunately, there has been a tremendous impact on our hospital emergency rooms,” the district, one of the largest in the country, said in a statement.

Children’s hospitals across the country are facing shortages in both beds and staffing amidst this current respiratory viral season. Many have resorted to using emergency room beds as their departments fill up.

Taking a cue from the Los Angeles County Department of Public Health, the school district encouraged parents to remind their children of proper hygiene etiquette, to consider masking while indoors and to get vaccinated against both the flu and COVID-19.

The only treatment available for RSV is monoclonal antibodies, which is typically reserved for extremely high-risk cases as a proactive measure.

Both Miami-Dade County Public Schools and Chicago Public Schools have made similar recommendations this season while stopping short of issuing outright mandates.

Even in non-traditional educational settings for students, precautions are being taken against RSV.

Erica Phillips is the executive director for the National Association for Family Child Care, an organization focused on family child care programs that encompass small groups of children in a home-based setting. 

She said family child care educators are taking the same steps traditional schools and day cares take. And despite the anxiety and concern surrounding the circulating viruses, Phillips expressed confidence child care providers are up to the challenge. 

“Family child care educators have become masters of this over the last almost three years after the onset of the COVID-19 pandemic,” she said.