Back-to-school stress? UCSD experts unmask strategies for keeping children healthy as they head to campuses

A student at San Diego French American School in La Jolla undergoes a temperature screening in August 2020.

As La Jolla schools welcome students back to campus for a new academic year amid the continuing COVID-19 pandemic, local experts are passing along lessons for keeping children safer in both their physical and mental health.

With coronavirus cases surging from the highly contagious Delta variant, “one of the most important things that parents can do is make sure that their kids are comfortable wearing masks all day,” said Rebecca Fielding-Miller, an epidemiologist and assistant professor at the Herbert Wertheim School of Public Health and Human Longevity Science at UC San Diego.

All schools are mandated by the state to require staff and students to wear masks indoors, regardless of COVID-19 vaccination status. Fielding-Miller said it’s important to ensure that children “have a mask that fits them well that they like, because the best mask is one that stays on your face.”

Rebecca Fielding-Miller
Rebecca Fielding-Miller, an epidemiologist and assistant professor at UC San Diego, says students and parents should “be kind” as the school year opens. “It’s kind to wear a mask, it’s kind to get vaccinated,” she says.
(Courtesy of Rebecca Fielding-Miller)

She advised parents to stock kids’ backpacks with “an extra one or two” in case the first becomes damp or soiled.

“We know that masks are pretty effective, especially if everybody is wearing one,” she said.

As to whether children should be asked to wear masks outdoors (currently, most La Jolla schools are not requiring that), Fielding-Miller said: “Personally, I would prefer that my kid keep her mask on, especially if she’s in like a larger setting with a lot of kids.

“We know that outside is much safer than inside because it’s the open air. It is less dangerous. But why take a chance?”

For the second year, local schools are welcoming students with protocols in place to minimize the spread of COVID-19 and promote excitement for a new academic year.

“It’s really scary that kids [younger than 12] can’t get vaccinated,” Fielding-Miller said. “A lot of data is coming out that when kids, especially smaller kids, get sick, they’re actually very likely to pass it on to somebody in their household.

“One of the best things we can do to protect our kids is make sure that we’re vaccinated. The more [vaccinated] people who surround somebody who can’t get vaccinated, the safer that person is.”

Since schools have done away with temperature and other health screenings implemented last academic year, Fielding-Miller said it’s important to keep children with symptoms such as a fever, cough, stomach trouble or headache home from school.

“It’s a bummer for everybody, but I think it is good to be sort of extra cautious with Delta going around,” she said.

As the San Diego Unified School District prepares for a new school year to begin Monday, Aug. 30 — the first in which campuses will be open to students full time since the COVID-19 pandemic began — a group of parents and scientists is asking for more measures to help prevent the disease’s spread.

Fielding-Miller, who also runs an environmental COVID-19 monitoring project at schools in high-risk communities, said her most important advice is to “be kind. It’s kind to wear a mask, it’s kind to get vaccinated.”

Still, there continues to be pushback against mask and vaccine requirements at schools and elsewhere. An Aug. 21 rally at San Diego’s Waterfront Park drew about 150 people who urged the recall of Gov. Gavin Newsom, largely because of his COVID-19 mandates.

That followed a protest at the San Diego County Board of Supervisors meeting Aug. 17 that drew about 300 demonstrators and more than 100 speakers, most of whom assailed state and local restrictions initiated in response to the pandemic.

And last month, area parents group Let Them Breathe filed a lawsuit against the state seeking to end the mask mandate for schools. The group argues that masks can harm children’s social, mental and physical health and should be a choice for families, not a requirement.

Katherine Nguyen Williams, a UC San Diego psychiatry professor, says putting feelings into words can help reduce anxiety.
(Courtesy of Katherine Nguyen Williams)

Katherine Nguyen Williams, a professor of psychiatry in the UCSD School of Medicine, said that in preparing to send their children back to school, parents should familiarize themselves with the latest school guidelines on masks and physical distancing and communicate those expectations to their kids.

“When kids are prepared and they know what they’re walking into, they’re less anxious when things happen,” Nguyen Williams said. “Things are more predictable for them.”

She encourages parents to have their children get used to wearing masks for many hours a day, since many will not have done so over the summer or at all if they opted for online-only instruction last school year.

Nguyen Williams said parents should watch for “the red flags of anxiety” in children — “avoiding what ... they’re fearful of.”

She said students may “have a challenging time putting their feelings into language,” so they may instead avoid school or anxiety-inducing situations such as lunchtime or a specific class. The anxiety may be exhibited in “somatic sensations” such as a headache or stomachache, she said.

“If you give in to that,” Nguyen Williams said, “it actually increases anxiety.” She said parents need to talk to their children about “what’s happening during that time period that [they’re] avoiding so that we can address what it is that’s anxiety-provoking ... to help [them] feel better.”

Nguyen Williams, a mother of four children at public schools in La Jolla, suggests regular conversations with kids to help them “put their feelings into words,” which will decrease anxiety.

“You can model that for them,” she said. “You can say as a parent, ‘I know I’m feeling a little bit nervous about school opening back up and you’re going to be gone all day at school and one of the things that I can do to help myself feel better is take some deep breaths. ... I talked to your teacher and she’s really excited to see you.’

“You’re modeling, ‘Yes, I get anxious, too, and this is what I do to help manage my anxiety.’”

“One of the challenging aspects of this pandemic is that some parents have responded differently to mandated mitigation measures,” Nguyen Williams said. “For example, while most are following [Centers for Disease Control and Prevention] guidelines regarding masking, some parents have disagreed and are pushing to keep their children unmasked at schools. This can become a source of distress and anxiety for children on either side when they attend school together.

“The best way to prevent this added stress in the school environment is to let your children know that regardless of their personal values at home, when they attend school, they need to follow the school community’s rules.”

Nguyen Williams also encourages parents to reach out to others in the same school community “to empathize and get answers together.”

“Humans are social creatures,” she said. “So having somebody else to reflect back your own thoughts and your own feelings and having that shared experience can help you manage your own anxiety.”

— San Diego Union-Tribune staff writer Deborah Sullivan Brennan contributed to this report.