Return to school during the COVID pandemic: Information for families with children affected by stroke

By Adam Kirton.

As clinicians caring for children with stroke and cerebrovascular disease, most of us have been fielding questions from parents about whether they need to take special precautions to protect their children during the pandemic. There are no clear answers, and our understanding of the risks of COVID, and of basic activities like returning to school, seems to be changing on an almost daily basis. Answers also depend on the prevalence of COVID in a region. However, we thought it would be helpful to share different approaches. Here is the advice being provided at the Alberta Children’s Hospital in Calgary, Canada, where COVID infection rates are currently quite low. We welcome your input on how you are handling this at your institution.

Dear families,

The current pandemic has undoubtedly created many worries and challenges for children with neurological conditions or disabilities and their families.

Many families have had specific questions around the issue of returning to school.

With this in mind, we would like to offer a few basic facts based on current evidence to help your family decide about return to school and related issues during the ongoing pandemic.

• The exact risks of acquiring COVID in school versus other environments are not known.
• Children are relatively resistant to the serious complications of COVID; only a very small proportion ever become sick enough to require hospitalization.
• The risks of having a more severe illness from COVID-19 once acquired in children with severe neurological disabilities and some medical conditions may be increased.
• There is no evidence of increased risk of acquiring COVID-19 or having a more severe illness for children with stroke, neurological or developmental conditions that do not cause severe disability.
• There is no evidence that the risk of severe disease from COVID-19 for children with disabilities is higher than from common viruses children are exposed to in school such as influenza.
• Given the strict measures in place, the risks of acquiring influenza and other infectious illnesses appears to be lower than previous years. However, it is still important for children with disabilities to receive their annual influenza vaccination.
• These possible risks should be compared to what you and your family see as the potential benefits of school including educational, social, access to therapies and services, etc.

This information is provided on best available evidence and has been reviewed by multiple experts in child neurology, disability and infectious disease. Relative risks and public health policies are expected to vary by country.

Such information is subject to change and IPSO will endeavour to post significant changes as soon as possible.