Evanston Township High School continues to teach classes exclusively remotely. In their E-Town Live address Feb. 19, Superintendent Eric Witherspoon and Assistant Superintendent/Principal Marcus Campbell noted that COVID positivity rates for Black and Brown individuals are 1.4 to 1.7 times higher than those for white individuals, and the death rate for non-whites is 2.8 times higher. These statistics are sobering and tragic. But they are also the wrong justification for keeping ETHS closed.
Schools can reopen because mitigation strategies work equally well no matter one’s background or the color of one’s skin. According to CDC guidance, being in school with proper masking, physical distancing, cleaning, hand-washing, and contract tracing does not contribute to community spread – not in any of our communities. This cannot be emphasized enough.
Instead of keeping schools closed, the higher positivity and death rates in communities of color should be a call to action to address health disparities that have simmered for decades and have now boiled over. Most health experts agree that keeping children out of school will likely exacerbate health disparities, not improve them.
We also have to come to grips with one unfortunate fact: This virus is never going away.
Therefore, coexistence is the goal. Coexistence occurs through mitigation and immunologic training. As the CDC reports, “layered mitigation” strategies – including masking, distancing, hand-washing, cleaning and tracing – can successfully limit transmission in schools. Mitigation is difficult – we miss congregating, hugging, and sharing – but it is possible, even in a high school.
Immunologic training occurs over the long haul through antibody development in people’s bodies, either through exposure to the virus or through exposure to the vaccines. The healthier we are, the better we respond immunologically. The vaccine trains our immune system with significantly less risk than the virus. The more immunologic training we have, the less mitigation we will need.
The challenge is that it will likely take many months before our community has enough vaccine for everyone. If we wait for this, we will continue to pay the very real costs of remote learning: less instruction and more mental health illnesses. Vaccination is obviously helpful, but is not a prerequisite for return to in-person learning because layered mitigation strategies work.
Consider vaccines another layer.
Meanwhile, rather than keeping schools closed, the ETHS School Board and administration can accomplish much more by addressing the social determinants of health. The school curriculum and schedule can emphasize healthy habits around sleep, stress management, nutrition, and movement. Reducing rates of obesity, heart disease, COPD, and diabetes would help all of us in our collective coexistence with the virus, but particularly Brown and Black communities where rates of these diseases are far higher. Even simple measures such as ridding the school of vending machines help impact health disparities. The earlier children are provided such guidance, the greater the effect.
Colonel Edwin J. Atwood, M.D., a cardiology professor at Stanford University, challenged his medical students with the following questions: “When treating patients, always ask yourself: 1) Is there a problem; 2) Is there a solution to the problem; 3) Is the solution to the problem worse than the original problem?” Applying these principles to the ETHS’s yearlong commitment to remote learning, the answer is clear. The original solution has now become a problem. It’s time to begin returning to in-person learning.
Eric Chehab, M.D.
Shana Christian, M.D.
Virginia Depaul, M.D.
Cathy DiVincenzo, M.D.
Mary Hall, M.D.
Val Kimball, M.D.
Teri Merens, M.D.
James Olson, M.D.
Matthew Pellerite, M.D.
Melanie Thomas, M.D.