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Adults caring for grandchildren can face difficult choices amid the COVID-19 pandemic. Getty Images
  • Older adults caring for grandchildren may face high risks during the COVID-19 pandemic.
  • More than 2.7 million grandparents in the United States are raising their grandchildren.
  • These families may face difficult choices about whether or not it’s safe to send children to school or daycare.

As schools across the country prepare to reopen for the fall term, caregivers are getting ready to face the next set of challenges posed by COVID-19.

With kids back in school, the risk of spread is once again posed, potentially putting people within the schools and at home at risk once again. But for a certain set of caregivers, like grandparents, the risk may be higher than for others.

Prior data reports that 2.7 million grandparents in the United States are raising their grandchildren, according to the U.S. Census.

A new study from the division of developmental and behavioral pediatrics at Northwell Health’s Cohen Children’s Medical Center and the Feinstein Institute for Medical Research intended to look at the characteristics and challenges many of these households face, which applied to things like adverse childhood experiences and children living with ADHD.

But the research can be extrapolated to also examine how these older adults may be at greater risk for developing COVID-19 as their grandchildren return to school.

Families and policymakers are facing the decision about whether to let their children return to school.

There are benefits and risks to both in-person learning and distance learning, and things to consider on either side.

Paula Christodoulides is the primary caregiver of her two grandchildren, ages 10 and 8. They will be returning to New York City schools in the fall.

The 10-year-old will be attending junior high school, which will be held in the school auditorium one day a week. The other days will be distance learning from home.

“It’s a different structure than I had in mind when [I previously thought] the kids would be in the classroom,” said Christodoulides. “I really don’t have any concerns, as this is the best [the school system] could do. My concern is when they are home, how much are they going to be learning?”

The Centers for Disease Control and Prevention (CDC) suggests that children under 10 with COVID-19 are far less likely to suffer severe symptoms, although research is still limited. Some young children have had severe symptoms or have died after developing COVID-19.

But children who are kept out of a school setting are more likely to suffer socially, emotionally, and behaviorally, as schools can often provide support, attention, and even things like proper nutrition that certain home environments cannot.

The issue with older people caring for kids is that children can become potential carriers of COVID-19, bringing it home to a group that’s far more susceptible.

And in these cases, grandparents can’t physically distance from their grandchildren.

A U.K. study published in The Lancet in early August looked to determine the optimal strategy for reopening schools.

The research found that reopening schools either full-time or in a part-time rota system, starting September 1, 2020, in conjunction with relaxed social distancing measures, will induce a second wave of COVID-19, which would likely peak in December or February depending on the intensity of reopening.

According to the CDC, the older a person is, the more at risk they are for developing a more severe form of COVID-19.

“For example, people in their 50s are at higher risk for severe illness than people in their 40s. Similarly, people in their 60s or 70s are, in general, at higher risk for severe illness than people in their 50s,” the CDC says.

The greatest risk is among those 85 and older.

Research has shown that adults 60 and older, especially those with preexisting medical conditions like heart disease, lung disease, diabetes, or cancer, are more likely to have a more severe infection from the coronavirus.

“If children are being expected to attend classes in the fall, they can bring home COVID-19 and pass it onto their caregivers,” said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center. He was the lead researcher for the new study.

There is no “right” decision when it comes to choosing whether children raised in a household led by grandparents should return to school. The decision is based on more than risk level.

It’s also based on whether or not caregivers have to return to the workforce, can afford part-time childcare, and many other factors.

When it comes to deciding the “right” move for each family, medical professionals agree that it should be determined case by case.

“In general, when we’re considering grandparents as primary caregivers, it’s no different than having parents as primary caregivers,” said Dr. Nicole Lauren Gerber, pediatric emergency physician at New York-Presbyterian/Weill Cornell Medical Center.

“Grandparents can be higher risk or lower risk,” Gerber said. “In general, everything has to be taken into consideration on a case-by-case basis.”

She added that if the grandparents are at a higher risk, they need to make a decision based on what’s best for the family, whether that’s learning in person or via a virtual platform.

The CDC has a tool on its site to help weigh the risks for each individual family.

“I wish I had the magic answer,” said Dr. Nina Blachman, assistant professor of geriatric medicine at NYU Langone Health. “We’re still learning about this disease all the time. We don’t know how risky it is for kids to transmit it to adults.”

“[The decision to return to school] is going to be dependent on what other options people have for that child to be cared for by other people if the older [primary caregiver] does not feel comfortable,” Blachman said.

“The two things to consider when we send children back to school is the role every single one of us has in this decision,” added Gerber. “The American Academy of Pediatrics says it is our goal [to send kids back to school] as long as it is safe.”

To keep it safe, all three doctors agree that wearing masks and physically distancing are ways to keep the levels of spread low, whether it’s in a school or in a community.

“People need to stay vigilant about social distancing, hand hygiene, and wearing the mask because we’re not out of the woods with this illness by any stretch, and we know that the older people in our community will be impacted far worse than the younger people,” said Blachman.

“I think [going back to school] is totally dependent on the individual scenario,” she added. “For so many, homeschooling was not a great option. It is going to depend on the best situation for the child and for the older person.”