Today's article is for parents and students with or without diabetes and their safe return to school.
This is not an easy time of the year for most children and parents. Children may be starting school or going to a new school and wondering what to expect and what changes they will have to make to their routines. Will they meet new friends, will they have good teachers are all thoughts of parents and students. This year the pandemic has increased our anxiety, our questions and makes decisions even more difficult. People living with Type 1 diabetes and their families have extra factors to juggle when making decisions and planning to return to school. My goal in today’s blog is to provide you with some resources that I hope will help you prepare for the school year ahead.
At the onset of COVID-19, there was much discussion about type 1 diabetes increasing the risk for hospitalization, but now we are told that there is no association between type 1 diabetes status and COVID-19 hospitalization risk, especially if the individual has no diabetes related complications. The Center for Disease Control (CDC) reports that people with type 1 may have an increased risk for more severe illness from COVID-19 but you are not necessarily at higher risk of developing serious complications from COVID-19 if the diabetes A1C values has been within normal range.
Factors that could mean a person with T1D is at an increased risk of the outcomes of COVID-19 include: age greater than 65 years; A1C greater than 10 mmol/L (180mg/dl);
a body mass index > 30; other chronic disease conditions or medications that weaken your body’s ability to fight infection.
It is important to understand that even though type 1 diabetes is an autoimmune disease (ie the body attacks itself) it does not mean a person is immunocompromised (their ability to fight infection is weakened). Any viral illness can increase blood glucose levels and put you at an increase risk of ketones and diabetic ketoacidosis (DKA) so maintaining blood glucose within an acceptable range is of great importance.
Whether it be virtual learning, in person learning, or home schooling each method has favorable and unfavorable characteristics. The in-person learning creates somewhat of a social environment. Even with physical distancing, there is still interaction between students, teachers and others. On the other hand, virtual learning allows you to go at your pace and you are at home in a comfortable and safe environment which can help lessen the stress of being exposed to the virus.
In Canada, each province is creating a plan for back to school. To check for your province just type “back to school and your province name” in a search engine and you should find what you need. Be careful and check the most recent article since things can change every day and you want the most up to date information. If you and your family are worried about going back to school, keep in mind that this stress can elevate blood sugar values. Be wise and understand the facts about the disease and its connection to children with diabetes. Keep reminding yourself that this pandemic is temporary and limit the exposure that the child has to the media on this topic. The American Diabetes Association has excellent resources that may help to answer some of your questions
The Canadian Pediatric Society website has published a good question and answer document that I encourage you to read. Because of copyright laws I can’t write the information here, but do take some time to check it out. Topics about what students and schools can do to reduce the risk of getting COVID-19, pointers on whether or not you should send your child back to school and what steps you should take if you (the child) got COVID-19 are included in the mentioned article.
The list below provides some thoughts to help you in decision making about going back to school.
· Are you comfortable with the school plans for reducing risk of spreading COVID-19?
· Do you believe the school has the resources (staffing, supplies, training) to implement the plan effectively?
· Have you been satisfied with the responses you received from the school when you asked questions?
· Do you and your child know how to wear a face mask and wash hands correctly?
· Do you have all the required set-up for the child to learn at home? Have you discussed this option with your child? Will he/she be able to keep up at home with virtual learning? Is there a space in the home that is free of interruptions during school hours?
· Are you satisfied with the method of transportation being used and its guidelines?
· If virtual learning is chosen, will the child still have access to other facilities offered by the school such as emotional or mental health services, access to a guidance counsellor if needed, tutoring or special needs help?
A few weeks ago CTV News published COVID-19 Risk level by School Activity which you may find useful.
By now I feel it is safe in saying that people with type 1 diabetes, providing the diabetes has been in good control, face no greater risk of getting COVID-19. If children with type 1 diabetes get the virus, they are not at a higher risk of complications. Any illness can raise blood glucose values so sick day management guidelines must be followed and staying in touch with your diabetes health care team.
Safe use of Hand Sanitizers:
Effective handwashing means scrubbing with soap and water for at least 20 seconds and then rinsing. When handwashing isn’t possible, hand sanitizers can be used. Alcohol-based hand sanitizers should contain at least 60% alcohol. People have easy access to these products at many stores. Even though no professional advice is required to buy these products there are some precautions to follow:
i. You only need a dime size amount and apply it to dry hands. Rubs your hands together until they are completely dry.
ii. Parents or the caregiver should be present when young children are using the hand sanitizer themselves.
iii. Be sure the child does not put any sanitizer in their mouth. Even a small amount of hand sanitizer can cause alcohol poisoning in children.
iv. As with other hazardous products in your house, keep them out of reach of children and pets. Some of these products have a nice smell and a brightly colored container which may attract the child’s attention.
v. Keep hands away from the eyes when they are wet with sanitizer.
vi. If you think your child has ingested any hand sanitizer, call the nearest poison control center immediately. Do not wait for symptoms (sleepiness, low blood sugar, seizures, coma) to develop. The word “denatured” on the product usually indicates that the product has a bitter taste so it may not be as appealing for ingestion.
Many hand sanitizers have been recalled by Health Canada since they don’t meet the required criteria and standards. Check the list to see if your product is listed.
Going back to school with comfort is still possible. Do your homework and talk to your children if they have any fears of returning. The knowledge and social aspect of school is important for both students and parents.
Continue to follow all all provincial and local guidelines to decrease your chance of being exposed or developing COVID-19 .
Wishing all students and parents a happy, safe and healthy year.
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Please be aware that this blog and the discussions do not replace advice from your health care providers.
Today's references are the websites provided in the discussion.
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