6/9/2020
The Pediatric Society - Palestine Statememt on:
Back to educational institutions (schools)
These days our children are returning back to school,, The return raises fears given the morbidity of the corona virus COVID-19 that still exists.
The children’s health is our top priority, the gradual and controlled return to learn is justified. The benefits of school re-opening outweigh the risks for children, provided, that we stick to rules, recommended by the MOH and WHO.
The vast majority of children in non “hot spot” areas can return to school without individual approval from a physician, and it is recommended that they do so, while adhering to the rules of physical distancing &personal hygiene and to wear masks.
For children with chronic illnesses, the Pediatric Society emphasizes, that the recommendations were written in accordance with the information available nowadays, and may change in the future.
These recommendations do not replace the Ministry of Health guidelines or individual discretion, which also takes into account parents' feelings, past experience and family unit needs.
Children with chronic illnesses:
In general, children with chronic illnesses are advised to continue with the necessary treatments, including immunosuppressive drugs, biological and radiation therapy, without dose reduction during the corona, unless there is a recommendation of the treating physician.
These children and their families need special attention to the rules of personal hygiene, social distancing and avoiding contact with patients with influenza-like respiratory illness or other febrile illnesses.
Respiratory diseases:
According to data available regarding children with COVID-19, chronic respiratory illness was not a significant risk of morbidity. Therefore, stable asthma, inhaled steroids, do not prevent children from going back to school.
For children with chronic respiratory illnesses (such as Cystic Fibrosis) accompanied with a marked decline in respiratory function tests, or severe asthma requiring systemic steroid or biological therapy.
The information currently available is insufficient to determine that they are not at risk and it is recommended to postpone their return at this time to school.
Neurological, neuro-muscular or muscular diseases:
In general, children with these illnesses can go back to school if their condition is stable, avoid school if they have impaired lung function, or heart function.
Oncological diseases:
Children receiving chemotherapy or immunosuppressive therapies, including children receiving radiation therapy to the chest are more likely to be at higher risk of serious illness and it is advisable at this point to avoid returning to school.
Children who have completed treatment a year or more ago are not defined as immunosuppressed and may return back.
Rheumatological diseases:
There is no evidence that children with rheumatic diseases, including those treated with biological drugs, are at increased risk of severe corona virus. The vast majority of children with these diseases can go back to school.
You may consider delaying the return of children if they are on high-dose steroids or receiving a combination of immunosuppressive drugs or those with active disease.
Immunedeficiencies:
There is no evidence that children with congenital immunodeficiency are at increased risk of severe morbidity in Corona. Some of these patients, especially those with chronic lung disease, are considered at risk.
Therefore, it is advisable to consult the treating physician, and discuss each case individually.
Solid organ transplant:
They can go to school, depending on the time after the transplant (usually one year after the transplant).
Bone marrow transplant:
It is recommended to postpone the return to school of bone marrow transplant children still undergoing immunosuppressive therapy, Or Graft versus host disease
Gastrointestinal inflammatory diseases:
Children with inflammatory bowel disease in remission, including those treated with biological preparations, can return back to school.
Diabetes, obesity and metabolic diseases:
There is no evidence that diabetes increases the risk of morbidity in Corona, so children with diabetes can return back to school. There are no data on corona morbidity in overweight or obese children.
It is recommended to delay at this step obese children with impaired lung function tests. Metabolic diseases are rare and different from each other, and it is advisable to consult the treating physician of the child.
Cardiovascular disease:
No specific information regarding children with cardiovascular disease. Most children with these illnesses can go back to school. There is a possibility. Avoid going back to school in the presence of significant heart failure.
Siblings and children of children with risk factors, including of children with oncological diseases:
There is no restriction for siblings and households of children with risk factors, of course while in personal hygiene, including washing hands with soap and changing clothes upon return from school.
There is no restriction for siblings and households of children with risk factors, of course while in personal hygiene, including washing hands with soap and changing clothes upon return from school.
Abdulsalam Abu-Libdeh
President of Pediatric Society - Palestine (PSP)
Secretary General of The Union of Arab Pediatric Societies (UAPS)