Public school districts across the U.S. are gearing up to start a new school year, tasked with protecting students and staff from further COVID-19 spread.

Dr. Anu Seshadri, an internal medicine and pediatric physician at the University of California in Los Angeles, said she refers parents to guidelines laid out by the Centers for Disease Control and Prevention in addition to the American Academy of Pediatrics when deciding whether to keep their children home for remote learning or to send them back to campuses for a more traditional in-person learning experience.

Seshadri, who also serves as a medical correspondent for +Life, said in a July 24 interview that planning and communication is key for school districts looking to reopen this fall.

“It’s like starting a new project or launching a new app—there are going to be glitches, and changes have to be carried out quickly to adapt to the needs,” she said.

This interview has been edited for length and clarity.

Is it safe for school districts to reopen this fall?

The CDC as well as the AAP strongly recommend that children go back to school. They are actually discouraging against the closing of schools and complete online learning for the most part. They think it’s more detrimental to keep kids home because of a lack in proper education.

There might be further educational gaps, and then there’s the emotional and social impact it has on kids. In the spring when schools were shut down, there was an increasing number of mental health issues associated with kids being at home. Schools are providing a lot of their coping mechanisms and supportive measures.

What should parents be considering when deciding between virtual learning and on-campus instruction for their children?

Parents should consider if the school is actually implementing the recommended guidelines from the CDC and AAP—things like effective communication measures, face mask policies, hygienic precautions, disinfecting measures, screening measures, social distancing policies, protocols when a child gets sick, reporting measures and quarantining measures.

If a child is exposed and one of their family members is sick, then technically that child shouldn’t be going to school; they should be quarantining. So then how do you continue to educate that child even though they’re at home? That’s why it’s not just in-person versus distance learning—I think some of this has to be somewhat hybrid.

One of the groups that we’re really concerned about is children that have learning or mental disabilities. They really thrive in a one-to-one setting, but with distance learning that can really be compromised.

Once schools open, they should see what policies work and what doesn’t work and then change it as quickly as possible. Parents need to ascertain if schools are being open with them and sharing exactly what their plans are and how they’re going to communicate that.

What are some health risks associated with students returning to campuses?

This is where it needs to be very personalized from family to family and child to child. When it comes to transmission or the risk of the impact COVID has on a child, children are the largest group of asymptomatic carriers. When they do get infected with COVID-19, most of them don’t even show any symptoms—at least for now.

When it comes to the child being affected by COVID-19, it’s not as much as a 65-year-old or a high-risk patient. Of course, that will vary if the child is considered high-risk, but the personal fear that I have is what they take home and who is at home.

This is why policies need to be fluid when reopening schools. Yes, we can plan and prepare, but they also need to be fluid enough to make the adjustments that are needed depending on what difficulties they face and make those adjustments quickly, efficiently and communicate that very well.

Both the CDC and AAP are really reinforcing health screenings. But then how impactful is screening the children if they’re not having any symptoms such as fever? You don’t want to implement screening measures that are going to take away from educational time, so that falls on the parents to report any sort of symptoms. There’s a lot of trust that’s involved in the process, too.

What advice do you have for teachers as they return to work?

It’s important for them to talk to their school officials to learn about policies being implemented to protect them, too. The criteria that’s given for adult staff includes social distancing among themselves.

Personally, I think a teacher that is going to teach kindergartners or first graders are put in a little bit more of a difficult situation compared to one that teaches 11th graders who understand social distancing and face mask policies.

It’s a tricky situation, and they have to look at their own health status. If you’re a kindergarten teacher and you’re considered high-risk, you might consider not returning to school. Unfortunately, I have to say that because it’s going to be more difficult to practice social distancing with kids that could potentially be infectious and not exhibit any symptoms.

For teachers, I can definitely understand why they might be worried. I also think it’s tough because you have the added responsibility of enforcing these policies in addition to teaching. It’s stressful, so schools need to make sure teachers also have the mental health help they need to combat the stress and fears they have.

How quickly can the virus spread if a teacher or student contracts it?

We know that for every one person that’s impacted, it can be spread to at least three people. These organizations are recommending we socially distance as much as possible.

The infectivity rate is really going to depend on how they’re practicing face mask donning and personal hygienic measures, disinfecting shared surfaces frequently, ventilating the areas, making hallways one-way traffic.

It can vary according to the age group. As you get older, you’re more mature, and you can socially distance a little bit better. You can’t really expect 5-year-olds to wear a face mask all the time and understand social distancing. But what you can do to combat those effects is take them outside a little bit more. Classes or physical activities like singing in choirs can be done in well-ventilated spaces or outdoors.

What should a school’s policy be if a teacher or student contracts the virus?

It really depends on your exposure level. If one person contracts the virus, you don’t know if they contracted that at school or outside of school. If everybody was practicing social distancing and wearing face masks, technically you could say they were protected to a certain degree.

If the kid showed symptoms and other kids are showing symptoms, you would definitely advise the kid to follow the CDC criteria of quarantining. If family members are positive, the kid also needs to stay in quarantine for 14 days.

Let’s say there’s more than three people impacted in a class—they may decide children should be quarantined for two weeks and then resume classes. It really depends on the number of kids infected in the class.

If it’s kindergartners and they’re in close contact for over 15 minutes without wearing protective equipment, then you might consider quarantining for two weeks.