The COVID-19 pandemic rages on and casualties pile up. But they are not limited to respiratory or cardiac failure. Coronavirus has crept into the mind and spirit of every American. Each segment of society is plagued by unique concerns and the field of education is no exception. With return-to-school dates looming on the horizon, public health experts and educators must work together for the first time. As parents, educators and physicians ourselves, we have the dubious privilege of front row seats for this horrifying pandemic. We have tried to honestly evaluate this complex phenomena from multiple angles. We have no heartwarming solutions but hope to provide something beyond frenzied tweets and posts that serve little beyond sowing discord in an already ravaged society.

How and when do we safely re-open schools? Typically guided by educational principles, how to educate our children has become first and foremost a question of how can we keep our school communities safe and healthy. The answer is not obvious and must be derived with rapidly evolving science. It is never as simple as the teacher’s health versus a student’s education. Such narratives will only divide us at a time when it is most critical to come together

Educators and health professionals both seek to nurture the minds and bodies of our children. Yet their premises differ. Teachers want the best for every student and they spend a lifetime trying to achieve this. Whether it is a general curriculum or an Individualized Educational Plan, their goal is to touch every life in a positive way. In medicine we start with the same intent — to keep everyone healthy — but the science of providing health care is much more complicated. We are in the business of balancing risks. We never have the luxury of a 100% feel-good option. For example, side effects of an antibiotic must be weighed against the risk of infection and balanced with the possibility of creating antibiotic resistance. Toxic chemotherapy is essential when the risk of disseminated cancer is worse. We always settle on an option that minimizes risk, but we never eliminate it.

In the pandemic’s early stages, the risk of infection and death far outweighed all other risks because we were so ill-prepared, unprotected and also due to the abject lack of national leadership. Hence a shut-down made painful sense. However, we are now at a juncture, at least in some states, where we have reduced our risk of getting COVID to the point where the risks of other morbidity and mortality become relevant and hard to ignore. The risks of not re-opening include a silently unfolding mental health epidemic. Is mental health not a measure of how “safe” we are too? Or is that only relevant after a mass shooting? Besides the loss in learning, which is not equal across society, we must also ignore reports of child abuse, food insecurity and emotionally disturbed teens. They will not come into any School Board meeting, nor will they post or tweet their grievances. Yet these silent victims of the pandemic will haunt us in the years to come.

Worldwide public health data indicates that children are at extremely low risk of contracting the virus or dying from it. Is it zero? No. But nothing, including childhood vaccinations, is without risk. Our public health officials are guided by this science and speak from our regional health departments, National Institutes of Health, Centers for Disease Control and the World Health Organization. Just as we heeded their words of caution to shut down, we must consider their qualified guidance on when to re-open. Coronavirus cannot be eradicated in the foreseeable future; its effects can only be mitigated. Even if the much awaited vaccine is developed there will be risks to using it and despite using it. It is not a panacea.

As proud Virginians, we appreciate Governor Northam‘s thoughtful and measured approach. We were the first state to close schools and halt our economy. Thus, we have much lower COVID morbidity and mortality compared to other states. We applied the CDC gating criteria and moved from one phase of re-opening to the next. Now public health experts urge consideration to open schools and to do so safely. Is the risk zero? No. In the near conceivable future it never will be. But the risk of remaining closed is not zero either.

To safely mitigate the risk our school division has asked the Board of County Supervisors (BOCS) for increased funding. We have asked for funds to support building out the technology needed for virtual schooling, acquiring PPE, professional development and other high priority projects necessary to reopen schools safely. The Prince William BOCS has received $41 million through the federal CARES Act. Congress intended localities to support schools and other county pandemic needs with these monies.

As of today, the BOCS has not shared a single penny of that $41 million with the schools. Schools are being asked to essentially reinvent themselves in the pandemic. The Prince William County School Board has unanimously passed a resolution asking the BOCS to share the CARES Act monies according to our longstanding revenue sharing agreement. At the beginning of the pandemic we asked for support to buy laptops for our high school students. As of today, the county executive, Chris Martino, and the county administration has refused to share any of the federal stimulus dollars or any other supplemental monies with the school division. As the pandemic proceeds, public outrage over the county government’s failure to support will grow. Officials elected on pro education platforms must decide if they are willing to support schools now. If they don’t support schools in a pandemic, when…will they ever support schools?

We must unite as educators, parents, health professionals, local governments and move forward informed by public health experts, using data relevant to our region, and with resources to do so. No plan will please everyone and there is no “perfect” during a pandemic. It will involve the same kind of sacrifice that frontline healthcare providers, grocery store employees and all other essential workers make. No one will get a perfect score but, as a society, we must pass this test together.

This piece represents our personal views and not those of the organizations we work for or the public boards we serve.

Babur Lateef, MD

Chairman At Large Prince William County School Board

(Babur Lateef is an ophthalmologist in private practice in Prince William County and also serves as a member of the Board of Visitors of the University of Virginia.)

Tarannum Lateef, MD, MPH Pediatric Neurologist

Pediatric Specialists of VA

Associate Professor, George Washington University School of Medicine Departments of Pediatrics and Neurology Washington DC

Staff Researcher, Branch of Genetic Epidemiology National Institutes of Mental Health National Institute of Health Bethesda, MD

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