Thread by @RheaBoydMD

Schools are critical sites for children's learning, development, social and emotional well-being.

@AmerAcadPeds wants to ensure our kids have access to the vital resources schools provide.

This administration does not.

As a pediatrician, I want to talk about schools opening.

Decades of work has placed critical supports inside of schools.

Let's review some examples.

1. Food - Schools feed 35 million kids a day. These meals make up more than 2/3rds of their nutritional needs. School closures threaten that vital food source.
nejm.org/doi/full/10.10…

2. Special Education - Schools are mandated to meet the educational needs of all learners and must evaluate and provide (for free!) any therapy or accommodations learners need to thrive.
www2.ed.gov/parents/needs/…

2. Special Education continued - This includes services as varied as speech, occupational, or physical therapy, counseling, audiology, and transportation.

School closures unevenly burden kids with special needs by limiting their access to these critical supports and services.

3. Healthcare - Schools are the site of nearly 2000 school-based clinics that operate daily. These clinics increase access to primary care and mental health supports for kids and teens.

School closures threaten children's health care access.
hrsa.gov/our-stories/sc…

4. Internet - At baseline, online courses have lower retention rates than in-class learning. During COVID-19, virtual drop out rates have soared across the country, particularly for families that lack reliable internet access or have limited data plans. bostonglobe.com/2020/05/23/met…

4. Internet continued - As a result, some students have to sit on sidewalks or in cars, just outside their school, to have equal access to their education. This is unjust.

Re-opening schools is one solution. Universal free broadband internet is another.
nytimes.com/2020/05/05/tec…

5. Safety - Teachers, like pediatricians, are mandated reporters. They are required to report any concerns for child abuse. Schools are also sanctuaries for students from the violence in their homes.

School closures mean some students lack sanctuary.

nytimes.com/2020/06/09/nyr…

6. Community - Schools are also gathering places for community. Some serve as polling places. Many have programs for elderly adults in the evenings.

Schools are vital pillars for child AND community health.

And the impact of school closures ripples across neighborhoods.

These are just some of the reasons why careful and thoughtful guidelines to re-open schools prioritizes those made most vulnerable.

Without school, kids are struggling.

So schools need support, to ensure they are safe for students and teachers, not threats of funding cuts.

This does not mean every school will be able to re-open.

It means we must have an honest conversation about the roles schools play in our children's lives and in our communities to ensure that come fall, every child receives the support they need.

I reiterate, this does not mean every school can (or should) re-open. It means we have to provide additional funding for schools to safely provide their services to kids. It means we have to find new ways to provide resources to kids (universal internet! home-based services! etc)

I am detailing the WHY, which is critical to acknowledge because school closures impact students in different ways.

But the HOW is also critical and requires preparation (and funding!) with teachers, staff, families, clinicians and local public health systems to best serve kids

To be clear, the United States’ failed response to the pandemic is also an outlier. There are clear measures that can and have been taken across the world to limit the spread of COVID19, including for K-12 students. Those measures rely on enormous governmental supports.

This includes income and housing supports that enable adequate quarantine and distancing. Universal PPE, for everyone, not just healthcare workers (which we also haven’t, as a nation, reliably provided). Capacity to regularly test, trace, and treat everyone. Home-based services.

These measures, at least, and more would be needed to offer children a range of safe learning environments. But they all require incredible government investments in social safety nets that we as a nation have have not historically. But there is time to change that. And we must.

Also, I am reading all the comments by stressed and frustrated parents and caregivers responding to this thread and asking for the HOW.

I hear you.

Give me a little time to gather references and provide a more complete answer that honors these important concerns.

More soon!!