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As happens every year, the long summer that stretched out in front of us in June has already whizzed by. It’s hard to believe it’s time for children to return to school. This year, in addition to regular back-to-school activities, we must also think about how COVID-19 will affect schooling and what we can do to keep our children healthy. As humans, we tend to be creatures of habit. Children, in particular, often depend on routines to regulate their energy and emotions. So, although it is wonderful to relax and let things go during summer, getting back into familiar routines can feel comforting, especially when the transition does not have to occur overnight. Transitioning from summer to schooltime routines over the course of a week or two can make the first day of school far more pleasant for everyone. One of the biggest adjustments for children is the shift to earlier bedtimes and the morning activities required to prepare for school. Children need between nine and eleven hours of sleep each night. If children need to get up at 6:30 am for school, they have to get to bed by about 8:30 pm to get ten hours of sleep. Practicing getting dressed, eating breakfast, combing hair, and brushing teeth within an hour of waking can make the first day of school easier. Now more than ever, student immunization records are being checked prior to school entry. Vaccines required by California schools include MMR, Varicella, Hepatitis B, Polio and Dtap/Tdap vaccines. Families can talk with their local school and medical provider to determine whether their child needs catch-up vaccines and should arrange to get them done as soon as possible to avoid a delay in school entry. Children 12 years and older are also eligible for the Pfizer COVID vaccine. This vaccine will help protect children against infection and against spreading the virus to others, including immunosuppressed people and young children who are unable to get the vaccine. In addition to children’s physical health, we also need to consider their emotional health. Some children are hesitant to return to school, either because they fear COVID-19 or because they have been socially isolated and are uncomfortable with the idea of interacting with peers and teachers at school. Just like with implementing new routines, it can be helpful to begin socializing your child slowly. Start with a trip to the park or maybe invite a few friends over for an outdoor playdate. Ask your child to accompany you to the grocery store or on other errands while following safety protocols. It’s important to acknowledge your child’s concerns and offer to work together. I sometimes tell my young patients what I refer to as the “duck metaphor.” Above the water, other kids may appear calm and relaxed, but underneath, many of them are going as hard and fast as they can. Many kids are just as nervous as they are. Some anxiety is normal, especially under the current circumstances, but if your child seems overly worried, reach out to your child’s primary care provider or behavioral health provider. We are trained to provide support. It is also a good idea at the beginning of the academic year to reach out to your school if your child has special needs, whether they are medical, emotional, or academic. If your child requires an inhaler for asthma or an EpiPen for severe allergies, be sure the right person at school has up-to-date information and current medication. If your child is highly anxious about returning to school, check in with the school’s social-emotional counselor. And if your child has an individualized education program (IEP) or 504 plan, ask about how services will be provided this year. Going through hardship can help children build resilience. They learn they can overcome their fears and thrive. Let’s help them do so. Dr. Casey Johnston is a pediatrician at MCHC Health Centers—a community-based and patient-directed organization that serves Mendocino and Lake Counties, providing comprehensive primary healthcare services as well as supportive services such as education and translation that promote access to healthcare. Learn more at mchcinc.org.