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AAP continues to advocate measures to allow students to return safely to school

January 5, 2021

Editor’s note:  AAP interim guidance is based on current evidence and best data at the time of publication. Updates are provided to reflect changes in knowledge about the impact of the disease on children and adolescents. For the latest news on COVID-19, visit

The AAP has updated its interim guidance on measures schools can take during the COVID-19 pandemic to conduct classes safely in person, which is critical to students’ well-being.

“Children absolutely need to return to in-school learning for their healthy development and well-being, and so safety in schools and in the community must be a priority,” AAP President Lee Savio Beers, M.D., FAAP, said in a news release. “We know that some children are really suffering without the support of in-person classroom experiences or adequate technology at home. We need governments at the state and federal levels to prioritize funding the needed safety accommodations, such as improving ventilation systems and providing personal protective equipment for teachers and staff.”

The school guidance, which is available at, is one of two guidance documents that were updated today. The other addresses emotional and behavioral health during the pandemic.

The school guidance details the important role schools play in children’s educational, social, physical and emotional development as well as being a source of special services and nutrition. Without access to the support systems schools provide, disparities among students who are Black, Hispanic, American Indian/Alaska Native and living in poverty will continue to widen, according to the AAP.

The guidance presents new research findings that schools have not been a significant driver of SARS-CoV-2 transmission in their communities when they take safety precautions. Transmission has been especially low among younger children.

Schools should use science and data to make decisions about conducting classes in person and provide layers of protection for students, teachers and staff. Those include requiring everyone 2 years and older (with limited medical exceptions) to wear cloth face coverings, enforcing physical distancing and improving air circulation.

“No single action or plan will eliminate the risk of virus spread at a school, but we have seen how face masks, physical distancing and other measures when combined can significantly lessen the risks,” Dr. Beers said.

The AAP is advocating for federal, state and local funding to implement these measures as well as to support schools conducting classes virtually.

It also recommends students and staff continue to take precautions when they are outside the school. Communities also must do their part to limit the spread of the virus and ensure access to testing, both of which will help make it safer to re-enter schools.

As vaccines become available, the AAP recommends schools collaborate with state and local public health officials to ensure teachers and staff have access to them.

The school guidance also places additional emphasis on supporting students’ emotional and behavioral health, which have been impacted by the uncertainty, fear and separation from friends and family brought on by the pandemic.

Updated AAP interim guidance on emotional and behavioral health released today at expands on the stress of remote learning, especially for children with attention-deficit/hyperactivity disorder and autism spectrum disorder.

In addition, it says students with significant anxiety and fear may be among those who need a referral for additional support. It also includes new research finding increased racism and xenophobia against Chinese Americans. Pediatricians should be aware of the added stress racism is causing to these children as well as to students who are Black and Hispanic.

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