In March 2020, As the pandemic escalated, schools have closed across the United States. Students have switched to virtual learning and the medical community has started their crash course on a new virus. The following summer, Covid-19 rates stabilized or declined in parts of the country, and some people expected some form of in-person school to resume in the fall. But many school boards weren’t so sure, with some adamantly opposed to the idea.
As a pediatrician who had worked in a hospital since the start of the pandemic, I could see a path for children to return to school. During employee meetings, we were told that outbreaks in my hospital mostly occurred with prolonged unmasked contact, for example, when adults took off their masks to eat in break rooms. Evolving science suggested that if children remained masked and followed other mitigation measures, while also taking into account transmission rates in the community, the spread of Covid-19 in schools could be minimal.
But my local school district, Ann Arbor Public Schools (AAPS), with guidance from our school board, only offered a virtual option for fall 2020. Although the board consulted with the county health department, they have always defined rather impractical Covid-19 measures. for reopening the school in person – benchmarks as less than 9 new cases per 100,000 people over 14 days. In contrast, last summer, the Harvard Global Health Institute said elementary and middle schools could return to school in person if transmission rates in the community were below 25 new cases per 100,000 daily.
It was not clear why the board had not prioritized reopening elementary and middle schools earlier, and instead opted for HGHI’s more conservative steps to reopen secondary schools. We never encountered the metrics before they decided to partially reopen anyway. Instead, other factors influenced the subsequent decision to return, including significant pressure from the community and local government for the in-person school and, most notably, the availability of vaccines for teachers and staff. While preschools, kindergartens and small groups of students with special needs returned to school for blended learning at the end of March 2021, older children did not return until May 2021.
The reaction to Covid-19 in Ann Arbor is not the first time the school board has ignored science advice while making key policy decisions that affect the health and well-being of students. And other school boards across the country have had similar issues over the years. While school boards have to adapt to other issues, from logistics to finance to culture, their primary responsibility is to put the needs of children first. Accordingly, they should be required to seek and act on the basis of expert scientific advice in order to make informed decisions.
I began to wonder about the functioning of school boards during a meeting of the AAPS school board in the fall of 2018. On the program: lead contamination of drinking water. The Ann Arbor water supply system does not contain lead pipes, but until 1986 its copper pipes were joined with lead-based solder, and there were still concerns that lead would leak out. seeps into school district water. I was not asked to speak at the meeting, but volunteered out of concern for the direction the board was taking in dealing with the issue; the remediation plan did not follow guidelines from the American Academy of Pediatrics or the Michigan Department of Environmental Quality, which advised interventions at lead levels lower than those requested by the AAPS. In addition, at the time, the AAPS was not testing all sources of water used for drinking and cooking, going against Environmental Protection Agency guidelines. It was four years after the start of the Flint water crisis, just 55 miles away.
As I read aloud the Tips on Preventing Lead Toxicity in Children from the American Academy of Pediatrics to the Board of Education and Superintendent, I wondered: why should I be here to read a statement by policy that was not new, was freely available to the public, and was it widely accepted by the scientific and medical community? Shouldn’t the board be looking for that kind of information itself?
The reaction to Covid-19 in Ann Arbor is not the first time the school board has ignored science advice while making key policy decisions that affect the health and well-being of students.
But instead of forming a committee with subject matter experts and stakeholders early on, the AAPS education council seemed to rely primarily on advice from the public. And the only way to get the council to pay attention to the scientific evidence on drinking water was to bring more scientists into the public conversation. A colleague and friend of mine – a medical anthropologist at the University of Michigan and another relative of the AAPS – contacted the board members and spoke at the board meetings. We also co-authored a petition urging AAPS to follow scientific recommendations on lead, which has garnered over 1,000 signatures. Ultimately, AAPS responded by working with community members and local experts to complete testing and install lead filters.
Comparable stories of lead exposure can be found across the country, but many districts do not fare as well. And Covid-19 and lead isn’t the only health issue all school boards have faced. For example, many tips attempt to address pediatric medical concerns such as healthy sleep practices and obesity. Both of these topics called on the experts to weigh in and make a strong case for change. The American Academy of Pediatrics recommends that middle and high schools start the day at 8:30 a.m. or later to give students the opportunity to get enough sleep, but for the majority of American teens, school always starts earlier. (Rather than relying on science, this gap is likely related to potential conflicts related to entering school late: transportation problems, less time after school for sports and work, and being late. parents to commute to work in the morning.) In terms of childhood obesity, school boards needed federal involvement in the form of programs, policies and laws to help them provide a healthier environment for children. children.
It should come as no surprise that not all school boards are equipped to handle, at least on their own, a crisis such as organizing a school in person during a pandemic or other medical issues. School boards are generally made up of publicly elected representatives with varying professional backgrounds. Most of the council members ‘campaigns focus on local school issues, with an emphasis on supporting the local teachers’ union. It is in fact the union that often decides on an election. While teachers should certainly have a say in school affairs, including those decided by the board, their influence in elections can influence board members to vote in favor of teacher preferences over student needs. And a board member’s background and union support from teachers doesn’t always translate into knowledge of how to do the job successfully. Given the varied number of critical matters and decisions a board member will be involved in, it is difficult to understand why there are no more widely accepted procedures for situations where subject matter experts are needed.
It doesn’t have to be that way. In North Carolina in the summer of 2020, as school districts tried to find a response to the ongoing pandemic, a member of the Education Council contacted a relative named Danny Benjamin. Benjamin is a pediatric infectious disease physician and epidemiologist at Duke University, but he was known to the school board through his community service as the head coach of the college baseball team. The conversation led to a scientific collaboration between the medical and public education systems: the ABC Science Collaborative.
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The goal of the ABC Science Collaborative is to match scientists and physicians with school and community leaders to help understand the most recent and relevant information on Covid-19. In particular, the collaboration aims to help school leaders make informed decisions about returning to school using data from their own communities. The ultimate goal is to keep teachers, children and their local communities healthy and safe. As part of this effort, scientists studied 11 North Carolina school districts, including 90,000 students and staff who had returned for school in person, for nine weeks in fall 2020. The collaborative did. found no evidence of child-to-adult transmission. Covid19. Now, scientists and communities from 12 other states have joined ABC Science Collaborative to help school boards make informed decisions about Covid-19.
While the ABC Science Collaborative is new, the idea of school boards working with experts is not. This is even true in Michigan, where the state’s Association of Public School Boards said, “When making decisions, school boards seek the advice and guidance of administrators, teachers and others. district employees, as well as the opinion of the community and specialists with knowledge on the subject under study.
But what is missing is guidance on when advice should be sought and a practical way to ensure school boards are doing it, putting children first and consulting with the appropriate experts – focusing on evidence rather than council votes and politics.
Kimberly K. Monroe, MD, MS is Clinical Assistant Professor of Pediatrics at CS Mott Children’s Hospital, University of Michigan Health, Michigan Medicine.