As schools reopen across the United States and children attending school test positive for the coronavirus, getting students back to school safely continues to be at the forefront of many people's minds.

While there are options when it comes to reopening schools, including guidance from the American Academy of Pediatrics, it's not feasible for every school district.

"However, as many school districts face budgetary constraints, schools must evaluate their options and identify measures that are particularly important and feasible for their communities," said authors from the Division of General Pediatrics at Stanford University School of Medicine in a commentary published Tuesday in JAMA Pediatrics.

Their guidance comes as the number of children getting Covid-19 has increased sharply. There has been a 90% increase in the number of Covid-19 cases among children in the United States over the last four weeks, according to a new analysis by the American Academy of Pediatrics and the Children's Hospital Association that will be updated weekly.

The authors offered a number of suggestions on how the AAP guidelines can be used in schools to make reopening as safe as possible.

School districts, the experts suggested, should create Covid-19 task forces that are made up of key stakeholders, including superintendents and parents, to develop procedures and policies for safety.

The authors addressed physical distancing, personal protective equipment and fixed cohorts of students and teachers -- all things that are covered in the AAP guidelines.

"The AAP guidance states the importance of identifying symptoms and signs concerning for Covid-19 but does not discuss operational approaches in depth," the authors said. The AAP guidelines also don't include an approach for testing, they said.

The authors recommended a three-pronged testing approach, carried out in collaboration with local hospitals.

Firstly, all students with symptoms should be tested. Secondly, schools should conduct random staff and student testing to identify asymptomatic patients. Thirdly, students from high-risk households should be offered testing more frequently.

The authors also discussed the need for schools to continually be flexible, with plans in place for virtual learning and the potential need for extra nurses, psychologists and social workers in schools.

"In summary, to maximize health and educational outcomes, school districts should adopt some or all of the measures on the AAP guidance and prioritize them after considering local Covid-19 incidence, key stakeholder input, and budgetary constraints," the authors said.

Another option for reopening schools is virtual learning -- something that comes with its own considerations, according to authors from the University of Florida College of Medicine's department of pediatrics and the Research Center for Educational Technology at Kent State University, who published a separate commentary in JAMA Pediatrics on Tuesday.

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