STUDENTS ARE CONTRACTING COVID-19, occasionally in school – but medical experts say school is the safest place for kids. Parents are urged to vaccinate their children against COVID, though children are unlikely to get seriously ill. State policymakers are encouraging schools to increase one form of COVID testing, while ramping down another.

Education policy during COVID is complex, with no easy answers.

“As an education system, we need to be able to explain to parents what is being done, why it’s being done, and convince them, frankly, that what’s being done is still going to keep their kids safe,” said Natasha Ushomirsky, state director for Massachusetts at the Education Trust, a policy organization that advocates for low-income students.

Ushomirsky and Dr. Richard Malley, a senior pediatrician in the Division of Infectious Diseases at Boston Children’s Hospital, spoke to The Codcast about changing COVID policy in schools.

Since schools returned from the holiday break, administrators have struggled to staff classrooms with dozens or hundreds of teachers out sick or quarantined, and many absent students.

Medical experts say it is vital for children to learn in person, both for their educational and social-emotional development. Malley said keeping schools open is one way to moderate the virus’s psychological impact on kids. While children have not generally gotten as severely ill with COVID as adults, they have suffered “collateral damage,” including serious mental health issues, he said. “The biggest impact of COVID in children is actually on their parents, on their social networks, on their psychological well-being, on their physical well-being, beyond what the virus can do to them,” Malley said.

But given current staffing realities, Ushomirsky suggested some state flexibility in allowing remote learning might be warranted. “Ideally, all kids should be in school at all times,” Ushomirsky said. “That said, I do worry that the rigidity of the current policy might be preventing some districts and some schools from providing better learning experiences for students.” For example, students who are feeling fine but kept home due to a positive COVID test would benefit from being able to learn remotely.

One part of the changing landscape is testing. Massachusetts was one of the first states to implement test-and-stay, where a child exposed to COVID in school could take daily rapid tests and avoid quarantining. Last week, Gov. Charlie Baker offered schools the option of eliminating test-and-stay and instead having weekly rapid tests sent to staff and families.

Malley said testing close contacts for several days makes sense, since a person can test negative one day but become infectious the next day. But Malley acknowledged that contact tracing, which is required for test-and-stay, is more useful when there are fewer cases and becomes impractical when there are too many cases.

If schools rely on surveillance testing like the weekly pooled testing already used by many schools – or the use of newly available rapid tests, the question becomes how often to do it.

Many of us in the medical field are a little bit worried that once weekly antigen testing is potentially too little, too infrequent to really give us some sense of what is actually happening in the school,” Malley said. Malley suggested there may be a compromise where students who are exposed to COVID test at home, but more than once a week – though that poses logistical and cost issues.

At some point, Massachusetts will have to ramp down precautions as the virus becomes endemic – an illness like the flu that people simply live with. Malley said the Omicron surge, though it appears to be declining, makes clear that “we’re not there yet.” He said the way to get to that point will likely be through increased vaccination, combined with the availability of pills or other therapies and testing, so someone who tests positive can take medicine and avoid the worst outcomes. “Ultimately, I hope this virus will become one of these things that we live with, rather than a virus that dictates how we live,” Malley said.

Looking ahead, Ushomirsky said, stronger guidelines and more resources available in schools for dealing with future surges will be vital. She hopes lessons learned about the use of technology, the ability to be flexible, and the need for communication between schools and families will continue.

“The question is, can we capitalize on that learning?” Ushomirsky said. “Can we really try to do things differently moving forward for students in order to mitigate the impacts of the past couple of years and then in the process, learn how to serve students better from that experience moving forward?”