by Stephanie Kuhlmann, DO, FAAP
To be or not to be (open)? That is the question that seems to be on the minds of many school administrators, board of education members, teachers, and families as the traditional start time of the academic year is upon us. School reopening during a pandemic has certainly captured the attention of our nation and continues to spark debate and controversy nationally and within our local communities. As schools seem to be in a “no win” situation no matter how they choose to reopen, we as pediatricians need to be prepared to offer support and guidance to our educational colleagues and to our patients and families. Until schools are able to be open full time, healthcare and the economy will be unable to return to full capacity due to parents’ responsibilities of providing childcare and education at home and the social disparities and inequities that exist in our nation will continue to widen.
As Pediatricians and experts in children’s health, we are certainly tuned in to the benefits that in person school provides. The benefits of our school systems extend beyond academic education and preparation for future success; schools also provide an important means for children to develop socially and emotionally. Schools offer an environment of structure and stability, facilitate peer relationships, provide adult mentorship, and offer experiences to promote activities that teach youth important life skills. Among others, skills such as teamwork, communication, goal setting, are necessary to help youth transition into adulthood. Schools also meet many physical needs for students such as overall safety, stable nutrition, access to medical and health related services, and mental health support. School is an important institution in the lives of our children and youth and reopening our schools in the safest manner possible should be a priority.
Safely opening schools requires engagement and commitment at all levels of the community to lower the rates of community transmission. Schools must be open in a manner that mitigates the risk of viral transmission and protects students and staff. Schools in other nations have opened successfully but those countries have prioritized school opening over nonessential services and have demonstrated the ability to adhere to risk mitigating procedures such as mask wearing and physical distancing; through these measures, countries have sustained low rates of community transmission. For our schools to open successfully and sustain, all members in the community must chose to accept responsibility for their actions and participate in risk mitigating procedures. It is estimated that death rates in the community can be lowered by 90% within two to three months of adhering to stringent control measures. This means that our community members need to limit nonessential activities. Our communities must accept that a pandemic is truly a non-political healthcare issue. Policy makers and legislators- must understand that schools are essential services for our communities; as such, schools must be supported financially to ensure they have needed resources.
As we advocate for the safe reopening of schools, we must also identify ways we can support and advocate for our educational colleagues. Teachers and school staff are facing the new label of being essential workers, creating fear and panic in a time of uncertainty. We as healthcare workers have a unique perspective to provide empathy and support. These are many of the same feelings and thoughts that we experienced in March when we were deemed essential frontline workers as everyone else remained under stay at home orders. These feelings are those that left many of us questioning our own mortality and finding ourselves making preparations to preserve our own households and protect our family members. We must acknowledge and validate those feelings in our educational colleagues and provide support and reassurance. In our work environments, we were called upon to innovate, adapt, and create new processes to protect our colleagues, staff, and patients. We must now encourage our educational colleagues to do the same. Now is the time to move away from the traditional school models as we know it and innovate, adapt, and create for our children. Our colleagues need to understand that with new processes and policies in place, they actually may find themselves in a safer and higher functioning environment.
Many families will seek the opinion of their pediatrician to determine the best mode of learning for their child. It is important that as pediatricians we welcome these discussions. It is also important that we remain politically neutral and share scientific evidence to assist families in making informed decisions for their families. Families need reassurance that there are no wrong choices; decisions should weigh benefits with perceived or real risks for their households. Schools should be supported to provide different learning models for families that meet their social needs. Despite these choices, families need to commit to the overall safety of others. As physicians we need to maintain a mindset that promotes safety for all students and staff by upholding mask requirements and promoting adherence to other risk mitigating behaviors.
As schools certainly have many challenges ahead of them, pediatricians must partner with our families and our educational colleagues to ensure success as best we can. We know and understand the benefits of school and to open and maintain schools, we need to do our part while encouraging others to do theirs. As stated best in a recent article published New England Journal of Medicine,” But the fundamental argument that children, families, educators, and society deserve to have safe and reliable primary schools should not be controversial. If we all agree on that principle, then it is inexcusable to open nonessential services for adults this summer if it forces students to remain at home even part-time this fall”.
