A physician’s perspective
By: Dr. Chuck Williams
Do you wish you had a dollar for every time you’ve heard the phrase “uncharted territory” over the last two months? The COVID19 pandemic has affected much more than just our public health policy as businesses, churches, hospitals, and homes have been uprooted and profoundly changed. There is no playbook for emerging from a prolonged societal shutdown.
Education is no exception as school systems across the country have faced a rapid, monumental transition to online instruction. In many senses our schools are the linchpin of our sense of normalcy and the way we operate in the fall will have a significant cultural and economic impact.
Here are five points to consider as we think about what school may look like for students and staff.
- Who makes the decisions?
As in most things education this will ultimately be a local decision. The federal government and CDC will provide guidance but the states and local districts will make the final call.
In North Carolina, State Superintendent of Public Instruction Mark Johnson has assembled a bipartisan task force charged with developing a plan for our state’s school districts. The task force includes teachers, students, policy makers, and political leadership.
The task force will also consult with the Department of Health and Human Services (DHHS) and will likely include both general and specific recommendations – everything from keeping schools clean to suggestions on modifying day-to-day operations.
- How we will practice social distancing in school?
If there is any one thing that gives public health officials nightmares in the midst of a pandemic it’s crowded rooms with lots of children who haven’t yet learned the importance of personal hygiene. The physical spaces in which our schools operate – classrooms with twenty-five plus children, crowded cafeterias, and school buses – present unique challenges when trying to stop the spread of a highly communicable disease.
Fortunately the COVID19 illness thus far seems to rarely produce serious illness in children and adolescents. However they frequently serve as the vectors by which disease can quickly spread to our more vulnerable older adults and those with chronic health conditions. DHHS recently estimated that over half of the adult population in our state is at higher risk from severe illness from COVID19. We will need some creative thinking and consistent implementation of new policy to keep the schools as free of the disease as possible.
Multiple ideas have been floated about in the national dialogue over how schools might operate under these conditions. Frequent hand washing by everyone in the building throughout the day will be key. The utility of having masks worn at some points during the school day has been discussed. Classrooms may need to be reconfigured to maintain distance between student desks. There is discussion of a “partial week” solution where half the students attend school three days one week and two days the next week while participating in online instruction on their “off” days. Avoiding crowded cafeterias might be avoided by having lunch in the classroom. Keeping the same cohorts of children together when changing classes would minimize cross exposure throughout classrooms.
- What about sports, field trips and extra curricular activities?
At the middle and high school level in particular sports, music and theater are an integral part of the school community. Field trips are a time honored learning experience for elementary school students. School leaders recognize the importance of these programs but of course must weigh their re-implementation with the health of both the schools and the community at large in mind.
In our current environment it’s hard to imagine allowing large numbers of spectators crammed in a football stadium or gymnasium to take place. Having said that, the situation might look dramatically different when the school year starts again in three months. If the pandemic numbers trend the right direction and a more robust system of testing and tracing is developed one could envision a scenario where cautious re-introduction of some sports might take place.
The North Carolina Association of High School Athletics has been working on contingency plans for everything from a normal sports season to a truncated season with fewer games to moving some fall sports to the spring of 2021. High school athletic departments depend on revenue from high school football so the implementation of other sports may hinge on a decision about whether football can safely resume or not.
Last week North Carolina Sate Health Director Dr. Elizabeth Tilson said it’s simply too early to make a call one way or the other on fall sports seasons. Everyone will have to keep watching the metrics of the pandemic in the coming months before a final decision is made.
- How do we make up lost instructional time?
By the time school starts back in mid August – the NC General Assembly approved a start date of August 17 which is one week earlier than usual – some students will have not cracked a book or seen the inside of a classroom for almost five months. While some counties have previously faced prolonged closures due to hurricanes the state as a whole has never faced this type of prolonged closure before.
Our system’s teachers have valiantly tried to implement meaningful online instruction during the time away from the classroom but it is no surprise that the quality has varied significantly depending on technology access, student age and home support. Successes that had been achieved toward closing the equity gap will partially evaporate due to the pandemic.
Students who were already struggling academically will likely be much further behind that at the start of a typical school year. Teachers will likely perform more up front testing in various academic subjects to determine where students are in their learning curve prior to starting new material. Those in the critical fifth grade to middle school and eighth grade to high school transition years will need more attention.
- Are there any silver linings that emerge from this experience?
On a positive note the pandemic will give new opportunities to research blended models of online and live classroom learning which should help us better identify which strategies work best for which students.
We see an ongoing spirit of collegiality amongst educators as they share best practices in this new learning environment. What worked with online education and what didn’t? What subjects are most malleable to online learning? How were teachers successful doing online work with the younger elementary students?
The effort our system has made toward getting meals out to families during the pandemic has no doubt helped us further identify students with needs outside the classroom. Let’s gather that information as we craft new learning plans for students when they return.
When can we expect a “normal” school year again? Not likely until the 2021-22 academic year, assuming that a vaccine has been developed, tested and readied for general use by that time. Until then every system in the state and country will be adapting to the new world in which we find ourselves.
Chuck Williams, MD is a family physician with Horizon Family Medicine of Clayton and father of three high school students. Dr. Williams is the co-founder of Project Access, a medical non-profit dedicated to providing healthcare for the uninsured of Johnston County. He is a candidate for the Johnston County Board of Education this fall.
