Why public schools need to open for the most vulnerable

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Pandemic. COVID-19. Quarantine.

The words will forever be etched in our memories.

While for all the pandemic has been a challenge, it has also meant more time with family, time to learn a new hobby, and the flexibility of working from home.  Its memory is one of loss of income, home, and loss of life for others. For me, the memory seared into my heart is that of me staring into a well, full of so many of my patients, trying to throw them a lifetime one by one, convince them that there is still daylight in front of them, that there is life beyond this pandemic, all while I myself am having a hard time seeing that light.

As a pediatrician working on the Southwest side of Chicago, I have seen child after child go from being full of life to bored and withdrawn as the weeks at home spanned into months and now almost a year. I wonder what advice I can give these kids that wouldn’t fall empty. Keep a routine? Exercise? Eat your veggies? Get outside? Even meditate?  While that may work for some, what about the kids whose parents are constantly fighting, whose dad drinks and gets violent, or the 11 year old whose uncle molested her those nights they had to stay over because they lost their home?  What about the fact that they have nowhere to go to get away from the facts of life, as they stand now, that their mom is so afraid of COVID-19 because they live with grandma that they can’t go outside even for a walk? What about school, usually an emotional buffer for kids?

This brings me to my point.  This week Chicago Public Schools was to finally open up for its students with special learning needs and in February for all K-8 wanting to attend in person.  But the opening is threatened by the Chicago Teachers Union’s concerns about safety, equity, and trust.  While these concerns are completely valid in theory, in the reality of my day to day work with children through this pandemic, I am sorely disappointed, especially for children with special needs. I understand CTU’s reasons for not accepting the plan are many. While I agree that staff whose role can be carried out remotely should be allowed to do so, and that there should be flexibility for staff with certain high-risk medical conditions, CTU’s request for a 3% or lower positivity rate to keep schools open is unrealistic and not supported by evidence. There is much nuance to a plan that encompasses such a large and varied district, nuance that it seems may need some clarification but needs to move forward.

They argue that few families have “bought into” the plan.  While only about a third of families are opting for in-person learning, these are likely those that need it the most- those needing to juggle jobs while supporting e-learning for their kids, those who, because of language barriers cannot support remote learning, and those whose children with disabilities or emotional disturbances make remote learning additionally challenging.  These are amongst the kids I see standing in the well with the worst possible outlooks. After 10+ months of negotiations, shame on the adults involved for making pawns of the most vulnerable kids. Shame on the adults because what are we saying to our kids?  That your education, your mental health, your life, in fact, doesn’t matter enough for us to figure this out?

It may sound like hyperbole to say that these kids’ lives are in our hands, but it is not.  Unfortunately, we rely on resiliency in kids, but what supports that resiliency is a mentor, somebody who supports them during their challenges. Many kids are going through right now is irreparable; children with special needs are especially at risk for abuse and neglect, a particularly damaging form of stress called toxic stress.  Young people who have experienced adverse childhood events such as these are at risk for chronic conditions, including obesity, diabetes, and heart disease. An emotional connection with a teacher (which is not easy to establish online) can buffer against this toxic stress.  What I am saying is that teachers are essential, even more so now than ever, and we need their help to get our patients whose parents are stressed and emotionally unavailable through these hard times.

We understand that masks and social distancing work for those of us who have been in contact with COVID-19 on a likely daily basis and not caught it.  I, for one, also understand the fear.  I never thought I’d be working in a zip code with the highest rates of COVID-19 in Chicago.  If somebody had told me some twenty years ago that I’d be practicing medicine during a pandemic and daily I would put myself and my family at risk, I probably would have turned around and left.  But here we are, our resolve being tested over and over again.  I’m privileged to serve and to be one of many holding the lifeline for so many.  It is time to let go of our fears and our political maneuvering for the sake of kids.  How much longer will we continue to refuse a decent education to those most in need of one?  There is no perfect school reopening plan in the middle of a pandemic, but many are reasonable.

What I do fear is I am writing this too late.  With the announcement of Britain closing schools this week, related to potentially more transmission in kids of the new strain, more folks will say this should occur here as well.  Currently premature, this call for closure may be imminent and necessary if this strain takes hold in the United States. But until and unless that happens, we must act in the best interest of our youngest, at least the most vulnerable amongst them.  Otherwise, we will be left with my pedantic advice without any framework with which to support it.

Nidhi Kukreja is a pediatrician.

Image credit: Shutterstock.com

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