Turn on the tap! School drinking water access in COVID and beyond

By Wasan Kumar, Anisha Patel, and Christina Hecht

Should drinking fountains be turned off because of the COVID-19 pandemic? Public health experts say, “no.”

Despite perceived concerns by some, the virus causing COVID-19 has not been found to transmit through drinking water. Moreover, the risk of acquiring the COVID-19 virus through surfaces including water fountains is low and can be eliminated by proper disinfection practices. That’s why public health experts, medical professionals, parents, students and school officials all have concerns about water fountains being off at schools.

“When we returned to school, students were on campus for two hours only. Every single water fountain was closed,” said one teacher. Another educator observed, “If a student didn’t bring their own water bottle, they were not allowed to use any water fountains both inside the class or even outside.” One parent explained how their child spilled their water bottle early in the day and “had no access to drinking water for the whole day — note temperatures were in the mid-80s! He said it would have been great if the school cafeteria had bottled water instead of the sugary drinks they provide.” Stories like these illustrate the difficulties facing students and parents due to closed water fountains in schools.

Lack of drinking water access can lead to negative health outcomes including impaired learning, increased obesity and poor dental health. With water fountains shut off, students may be more likely to consume sugar-sweetened beverages  they bring from home or sweet milks and juices offered with school meals. A new study of 430,000 children ages 2–19 found that the rate of increase in Body Mass Index doubled during COVID-19 as compared to pre-pandemic years. Pandemic-related weight gain has intensified the need to introduce nutritious diet options for children and adolescents. Substituting plain water for sugary drinks is a simple but effective change that can promote better health. Children who consume sugary beverages also have an increased chance of developing cavities.as fewer have people sought out routine dental care during the pandemic, leading to worse oral health. Fluoridated water plays a role in protecting teeth and preventing cavities; hence tap water consumption should be promoted as a public health measure to improve dental hygiene. Several studies have shown improved retention and academic performance with increased water drinking.

There is also an important equity component to consider in moving to reopen water fountains. Issues of who does or does not have access to clean drinking water as well as the disproportionate marketing of sugary beverages in communities of color exacerbate a widening gap in health that is only furthered by water fountain shutdowns at schools. Several intersecting factors lead to increased obesity and pandemic-related weight gain in communities of color. It is well known weight gain typically accelerates during out of school periods, particularly for low-income children and those of color.

Steps to safely reopen water fountains

Consider taking the following steps illustrated in a new guide for safely reopening water fountains from the Centers for Disease Control and Prevention Nutrition and Obesity Policy Research and Evaluation Network:

  1. If your drinking water fountains or other outlets have been out of use, follow guidance for reopening building plumbing
  2. Ensure water sources are available during mealtimes and throughout the day, and promoted with signage
  3. Make sure all drinking water sources are regularly cleaned
  4. Ensure students stand spaced apart when using the water fountain
  5. Encourage use of reusable, recyclable or compostable cups and refillable water bottles to get more than a sip of water and reduce spread of germs
  6. Touchless water bottle filling stations can help minimize touching surfaces

Schools should take steps to ensure water fountains do not contain unsafe levels of lead or contamination with legionella. Water systems that have been left unused for several months contain stagnant water that can be harmful. Flushing (as described in guidance above) is an effective, cost-efficient technique to address these water safety hazards.

A combination of public health measures such as masks, ventilation, spacing and frequent surface disinfection, known as the ”Swiss Cheese Model of Pandemic Defense,” will reduce COVID spread. Reopening water fountains, with adequate precautions, is a low-risk and high-reward policy decision for school administrators to take. All we need to do now is turn on the tap.


Access the new infographic, Turn On the Tap!

Wasan Kumar, BS, is a first-year medical student at Stanford University. Anisha Patel, MD, MSPH, MSHS, is an associate professor of pediatrics at Stanford University. Christina Hecht, PhD, is senior policy advisor for the Nutrition Policy Institute, University of California, Division of Agriculture and Natural Resources.