Back to school advice for paediatric oncology patients

Childhood cancers

By Michael Woodhead

26 May 2020

As schools reopen it should be safe for most immunosuppressed paediatric oncology patients to return to the classroom, according to advice from the Australia and New Zealand Children’s Haematology/Oncology Group (ANZCHOG).

However the group acknowledges that return to school decisions in relation to COVID-19 risk are complex for families of children who are receiving or have just completed chemotherapy or who have recently undergone a bone marrow transplant.

In an updated advisory statement, ANZCHOG says children who were withdrawn from school on the advice of cancer centres when the pandemic risk was at its highest in March may now be able to return to school, but with decisions depending on their individual circumstances and the local pandemic situation.

Based on the low rates of COVID-19 community transmission in Australia and the low risk of infection in children, ANZCHOG states that “ our recommendation now is that it is safe for all siblings and the vast majority of paediatric oncology and BMT patients to return to school.”

“If your doctor had advised that it was safe for your child to attend school prior to the onset of the COVID-19 pandemic, we are advising that it is now safe for your child to attend school when they are re-opened.”

According to ANZCHOG, children are far less likely than adults to contract SARS-CoV-2 infection and the evidence suggests that most immunosuppressed children are not at a significantly higher risk of severe COVID-19 disease than their age matched peers.

They note that child to child transmission of SARS-CoV-2 is rare and it is not in children’s best interests to exclude them from school indefinitely when the evidence suggests that the risk of developing severe COVID-19 is very low.

However ANZCHOG also cautions that the evidence is still evolving and “we don’t have all the answers regarding this new virus and the risks that it presents.”

It notes that advice may differ depending upon individual children’s circumstances and location. BMT patients, for example, are often more immune suppressed and susceptible to viral infections.

But parents can be advised that being neutropaenic should not increase their child’s risk of contracting SARS-CoV-2 or other viral infections and should not influence whether you send them to school.

It recommends flu vaccine for vulnerable children and their families but not wearing of face masks at school, which is says mainly act to reduce the risk of asymptomatic or minimally symptomatic adults spreading the virus rather than protecting an individual from contracting the virus.

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