When Illinois Governor J.B. Pritzker closed all public schools in the State due to the COVID-19 pandemic in March 2020, administrators and teachers in School District 65 quickly implemented remote learning. A spring of remote learning and the following summer gave teams of administrators, teachers, parents and community members time to understand that reopening school buildings necessitated balancing physical safety, academic progress and social/emotional wellbeing.

Plans to reopen school buildings changed with the waves of COVID-19. In the meantime, isolation from extended family and friends; restricted activities; economic hardship from the lockdown; concerns about health, safety and at times the loss of loved ones; and the remote learning took a toll on everyone.

This was not just a local problem. Studies show that children across the globe were affected by the isolation and the stress of the pandemic.

With no vaccine on the horizon in the fall, District 65 implemented programs to address students’ academic and social/emotional needs until the buildings could be safely reopened.

As the pandemic continued, administrators modified the metrics they were using to reopen the school buildings, saying they were protecting students and staff from COVID-19 and doing their best to meet students’ academic and social/emotional needs.

After a number of delays, District 65 decided to reopen the schools for in-person learning on Feb. 16. This article takes a look at the process leading up to that decision, the hybrid model used in the reopening, and whether the hybrid model was successful in providing for student safety, reaching students most in need and helping to address students’ mental health and social/emotional needs.

The Changing Metrics and Deferred Reopenings

More than 6,000 students attend District 65 schools. Its 18 separate buildings house kindergarten through fifth and sixth through eighth grade students in neighborhood or assigned schools; K-8 students in magnet schools; and students from 3 to 23 in a school for students whose needs cannot be met in any of those buildings.

During the summer of 2020, District 65 developed a return-to-school plan under which parents could choose whether to keep their children in a remote learning setting or have them attend school for in-person learning. The school year was to begin with all-remote learning on Aug. 27, with in-person learning scheduled to start on Sept. 29.

District 65 Superintendent Devon Horton (RoundTable photo)

The date to reopen for in-person learning was delayed twice before Thanksgiving due to the pandemic. Superintendent Devon Horton kept the community apprised of each of the changes, and he made public the metrics considered in making his decisions.

  • On Sept. 11, Dr. Horton advised that in-person learning would be delayed from Sept. 29 until Nov. 16, assuming it would be safe to do so.  
  • On Oct. 30, Dr. Horton changed the re-opening date from Nov. 16 to Jan. 19, 2021, again assuming it would be safe to do so.

On Oct. 30, there was a second surge of COVID-19 cases taking place in Illinois. The weekly number of new cases per 100,000 was 146 in Evanston and 267 in suburban Cook County. The target set by the Illinois Department of Public Health was 50. The test positivity rate was 2.8% in Evanston and 8.3% in suburban Cook County. The target set by IDPH was 5%.

During this period, many health professionals and educators throughout the nation raised concerns that the isolation of students in remote learning settings was taking a toll on students’ mental and emotional well-being.

District 65 administrators focused on students’ mental health and emotional needs throughout the pandemic. They trained teachers and social workers to intervene with students who needed emotional support. They opened several spaces where about 75 students could engage in remote learning with supports (these were shut down at the start of the second surge of the pandemic). They established a program to identify and then develop individualized support plans for students who were disengaged in remote learning.  

These efforts, though, could not eliminate the isolation and the effects felt by many students.  

The Survey of Students and Requests to Open the Schools

In the first two weeks of November 2020, District 65 administered a survey to students in sixth, seventh and eighth grades to gather input about their experience with remote learning. One question asked them to comment on this statement: “I am concerned with my mental health and well-being (ex. Stress).” Overall, 49.2% expressed various levels of agreement with that statement, indicating that a high percentage of students were concerned about their mental health and well-being: 12.5% strongly agreed, 16% agreed; 20.7% somewhat agreed; 14.2% somewhat disagreed; 21% disagreed; and 15.7% strongly disagreed.

… a high percentage of students were concerned about their mental health and wellbeing.

In early December, many parents began to publicly urge the School Board to open the schools for in-person learning, saying that students were suffering from emotional and mental health issues and falling behind academically. They argued that other schools had opened successfully and that recent studies showed it could be done safely.

Pediatricians Note the Stress on Children

Five parents’ statements were read at a District 65 School Board meeting held remotely on Dec. 7.

Dr. Bridget Wild said she was speaking as a pediatrician and as a District 65 parent. “My voice is solitary in this letter, but I am not alone in my perspective, and I am coming from a place of grave concern for every child in our District,” she said.

Bridget M. Wild, M.D. (Submitted photo)

“Editorial after editorial and academic paper after academic paper is highlighting the growing pediatric mental health emergency and widening educational outcome disparities for Black and Brown students.

 “A large group of local pediatric providers are coming together with objective data to show Evanston is not exempt from this [mental health crisis]. There is a steep rise and severe mental health crisis among children. Families are withdrawing their kindergarteners completely.”  

“Some parents spend all day trying to encourage their child to just log on to the iPad, something I never thought I’d say as a parent of three who have at times an unhealthy love affair with screens. Developmentally, their relationship to learning has been irreversibly damaged.”

Dr. Deepa Nair, mother of a second grader, said she was writing her letter as a concerned District 65 parent and as “a pediatrician who works in the pediatric emergency department caring for the many children throughout the Chicagoland area who have been presenting with their physical illnesses and injuries, but also at alarming rates for mental health crisis.

“I … have spent many hours over the past nine months caring for families and children who have had COVID-19, are concerned about COVID-19, or have come seeking psychiatric care for their children who are struggling in isolation, and with virtual school for our ongoing pandemic.

“Among the factors that need to be weighed, I believe that the impact on the mental health of our children has not been given fair consideration. We are seeing a greater than 70% increase in visits for mental health crisis at our institution. And I can tell you from personal experience on the front lines, the most common thread amongst these kids has been stress, depression, and anxiety exacerbated by social isolation.

“School is more than a place our children receive an education. As parents and educators, we all know the importance of socialization with their peers for all ages of children.

“As physicians, we see the effects of socialized isolation that seem to impact those who have been historically marginalized, even more so, as many of their parents struggle to work while having their children navigate virtual schooling independently.”

Both Dr. Wild and Dr. Nair pointed to research that showed that many schools had opened safely for in-person learning. They urged the District to consult with many experts in the medical field who lived in Evanston, who had children in District 65 schools and who were eager to assist.

The other parents said in their letters that current research showed that schools could reopen safely during the pandemic and they pointed out that private and parochial schools in Evanston and public schools in other suburbs had been able to reopen safely.

Cascading Delayed Openings

On Dec. 11, Dr. Horton posted a letter to the community that provided some information on the District’s tentative reopening plan for Jan. 19. But he made clear that no decision had yet been reached, and that any opening would need to meet the metrics.

He said the District was using both regional metrics applicable to suburban Cook County, adopted by IDPH, and local metrics adopted by the District.

Two of the key metrics that the District was using at the time were a test positivity rate of less than 8% (using a 3-day average) in suburban Cook County and a test positivity rate of less than 3% in the zip codes in District 65’s attendance area.

In his Dec. 11 letter, Dr. Horton said, “Based on what we are seeing currently, this will require lower positivity rates and less strain on our healthcare system.”

As of Dec. 14, the seven-day test positivity rate for suburban Cook County was 12.2%. The test positivity rate in Evanston was 5.3%.    

On Jan. 5, Dr. Horton announced that re-opening the schools for in-person learning would be delayed beyond Jan. 19.  

Many parents objected to the delay and urged that the schools reopen because their children were being adversely impacted by remote learning, and they argued that many other school districts had safely reopened their schools. The debate between parents advocating to open the schools and people who wanted to stick with remote learning as the only option became heated and vituperative on social media.

On Jan. 20, Dr. Horton announced that the District would bring many students back for in-person learning starting on Feb. 16, using a hybrid learning model. Parents had the option to stay with a remote-learning path.

On that date, Evanston’s test positivity rate was 1.2% and suburban Cook County’s and Chicago’s were each 8.0%. The cases per 100,000 were 135 in Evanston, 260 in suburban Cook County and 254 in Chicago. New cases, though, were showing a decline. There was a cumulative total of 537,748 vaccinations in Illinois.

The Change in Metrics and Reliance on a Medical Advisory Team

At some point before Jan. 20, Dr. Horton convened a Medical Advisory Team to provide advice. Seven doctors were on the team, including a specialist in pediatric infectious diseases, the chief medical officers at two hospitals, the physician director of another hospital, and a pediatric specialist.

In his Jan. 20 letter to the District 65 Community, Dr. Horton said the District, in consultation with its Medical Advisory Team, revised the metrics it was using to determine whether to transition to in-person learning.

The change in metrics was significant:

  • On Jan. 5, the metrics were that the test positivity rate for suburban Cook County be less than 8%, and that the test positivity rate for Evanston be less than 3%. 
  • On Jan. 20, the metrics were that the test positivity rate for both suburban Cook County and Evanston be less than 12%.

The letter also acknowledged, “We know mitigation measures like mask- wearing and social distancing are highly effective in preventing the spread of COVID-19. We know that we can operate safely when these measures are in place and everyone is committed to following them – both during and after the school day ends.”

At a presentation to the community on Jan. 28, Dr. Horton said, “I want to reiterate the science of this pandemic, as it shifts, we make better decisions and stronger decisions in our work to reopen our schools safely. There are a lot of questions regarding, ‘Why didn’t we do this back in the fall?’ There was not a lot of science available that we were comfortable with.”

“I want to make sure that that is clear as we move forward. [The Medical Advisory Group] were our partners, and they gave us the research and the knowledge that we need in order to open our doors, ongoing collaboration to monitor local and regional health conditions, mitigation plans, vaccine awareness, which is huge, and more than anything, just additional support.”

Dr. David Soglin, Chief Medical Officer at La Rabida Children’s Hospital and a member of the District’s Medical Advisory Team, discussed at a Jan. 28 community forum, held via Zoom, two recent studies. “I think at the beginning of the pandemic, we were very worried that just getting people together in schools would add to community spread,” he said. “We’ve learned quite a bit over the last year, both in the United States as well as internationally.”

David F. Soglin, M.D. (Submitted photo)

He summarized the results of two studies that showed a low infection rate in schools that had reopened with strong mitigation measures.

One study, he said, showed that even in communities that have very high test positivity rates (reaching a high of about 40%), and a very high number of new cases per 100,000 population (reaching as high as 1,200 per 100,000 population), the number of COVID-19 cases spread in the schools “is very small, … almost none.” He said there was “almost none despite huge community spread.”

The staff and students in these schools wore masks and socially distanced, he said.

Dr. Sharon M. Robinson, Physician Director, Primary Care NorthShore University HealthSystem and a District 65 parent, said, “What we know is that schools can successfully conduct in-person learning, regardless of the community metrics, as long as the mitigation strategies are in place and are layered.”

Sharon M. Robinson, M.D. (Submitted photo)

She described three levels of mitigation. Level one entailed wearing face masks, using hand hygiene and maintaining social distance. Level two included screening for COVID symptoms and keeping students in cohorts. Level three included enhanced cleaning of facilities, ventilation systems and contact tracing.

In its reopening plan, District 65 implemented the three layers of mitigation strategies, a move it was prepared to do in September. The Medical Advisory Team, though, gave District 65 confidence that it would be safe to open the schools if those mitigation strategies were followed.

In his Jan. 20 letter to the community, Dr. Horton acknowledged, “We know mitigation measures like mask- wearing and social distancing are highly effective in preventing the spread of COVID-19. We know that we can operate safely when these measures are in place and everyone is committed to following them – both during and after the school day ends.”

The Hybrid Model and the Learning Pathways

Dr. Horton acknowledged there were limitations on the number of students who could be brought back to school for in-person learning due to school-building capacities and the need to adhere to social distancing. In addition, many teachers were not willing to return and provide in-person learning. 

The District thus provided different pathways that were “intended to maximize the number of persons who can be accommodated for in-person learning while providing increased support for students who need it most,” he said.

The District prioritized the return of students in accordance with the guidelines of the Illinois State Board of Education. The guidelines prioritized students

  • who qualified for free- and reduced-fee lunch,
  • who were emergent bilingual students,
  • who were regarded as homeless under the McKinney Vento Act, and
  • who had an Individual Education Program (IEP) or a Section 504 plan (the “priority flags”).

While opening the schools for in-person learning was intended to limit learning loss due to remote learning, part of the rationale was to better address students’ mental health issues and wellbeing. “We will actively work to build community, prioritize mental health and wellbeing, and give space so that we can collectively and individually navigate this huge change in our lives,” said Dr. Horton.  

Under the hybrid model, all students in the District engaged in remote learning for the entire school day on Mondays, and all students had the option of continuing to engage only in remote learning. But if parents elected the in-person pathway, then on Tuesdays through Fridays, the model provided:

  • K-5 students with three priority flags had a full day of in-person learning with an in-person session in the morning and supervision for asynchronous learning in the afternoon.
  • K-5 students who did not have three priority flags would have a half day of in-person learning in either the morning or afternoon, and they would have remote learning the remainder of the day.
  • Students in grades 6-8 with one or more priority flags had a full-day of in-person learning. Students who did not have at least one priority flag would have remote learning all day. 

There were some variations for the magnet schools.

The hybrid model for in-person learning went into effect on Feb. 16. One goal was to address students’ mental health and social emotional issues, prioritizing those with a priority flag.

The Impact

There are at least three ways to measure the impact of opening up the schools for in-person learning on Feb. 16.

First, how many students were brought back, and did the reopening reach students most in need?  Second, how safe was the reopening? Third, how did the reopening benefit students’ mental health and social/emotional wellbeing?

How Many Students Were Brought Back for a Full Day of In-Person Learning?

In April 2021, the District issued updated figures that showed that 3,954 students, or 57%, returned for in-person learning and 2,958 students, or 43%, remained in remote learning.

At the K-5 grade levels, it appears that most students who opted for in-person learning were able to return for in-person learning, at least for a half-day. Students with three priority flags were able to return for a full day. The data shows:

  • At the K-5 grade levels, a total of 517 students with three priority flags attended in-person learning for the full school day. Of these, 265 were Black, 152 were Hispanic, 50 were white, 30 were multi-racial and 20 were Asian. These were the students most in need.
  • An additional 2,181 K-5 students who elected in-person learning attended a half-day of in-person learning. Early on the District viewed students in the younger grade levels as having a higher need for in-person learning, so it was able to address the needs of these students by bringing them back for a half-day.
  • At grades 6-8, 1,173 students with one priority flag attended in-person learning for the full school day. Of these, 578 were white, 304 were Black, 224 were Hispanic, 100 were multi-racial and 36 were Asian. Due to both a lack of space and staffing issues, the District was not able to bring back many other middle school students (i.e., those without a priority flag) for in-person learning. Students with higher needs, though, were able to receive a full day of in-person learning.

Dr. Horton also said, “We also know that COVID-19 has had an undeniable and disproportionate impact on people of color.”

At the K-5 grade levels, higher percentages of Black and Hispanic students were in the full-day program at District 65 than other subgroups. The chart below shows the percentages of each subgroup who returned for in-person learning in the K-5 grade levels who were in the full-day program. For example, 46% of all Black students who returned for in-person learning in grades K-5 were in the full-day program.

The data for grades 6-8 provides a different picture. The chart below shows the percentage of students in each subgroup who returned for a full day of in-person learning at Chute, Haven and Nichols middle schools.

It is unclear how much of the variance at grades 6-8 is due to parental choice.

Did the District Succeed in Keeping Students Safe?

One important goal was to keep students safe. District 65 maintained a dashboard that reported on a weekly basis: a) how many students tested positive for COVID-19; b) how many students were quarantined; c) how many staff tested positive for COVID-19; and d) how many staff were quarantined.

All positive COVID-19 cases that were reported were included in the District’s dashboard. The inclusion of a case on the dashboard, however, did not indicate that COVID-19 was contracted within a District 65 facility, said the District.  

Students and staff could be quarantined if they tested positive for COVID-19, exhibited symptoms of COVID-19, were in close contact with someone who tested positive for COVID-19 or exhibited symptoms of COVID-19.

The chart and table below show the number of positive COVID-19 cases and quarantines for the weeks ending on the dates indicated.

The data show that during the 15-week period, a total of 58 students tested and 13 staff members tested positive for COVID-19. This includes all cases, though, without regard to whether the students or staff contracted COVID-19 in the schools or outside the schools.

Superintendent Horton said in June that no student contracted Covid-19 within one of the District’s school buildings. District officials said that one staff member contracted COVID within a school building.

Did Opening the Schools for In-Person Learning Help?

District 65 took steps to address students’ mental health and social/emotional well-being throughout the pandemic when remote learning was the only pathway.

Despite these efforts, “The social emotional needs of some of our students persisted and were still not fully being met,” said Andalib Khelghati, Assistant Superintendent of Schools, Terrance Little, Assistant Superintendent of Secondary Schools, Stacy Beardsley, Assistant Superintendent of Curriculum and Instruction, and Romy DeCristofaro, Assistant Superintendent of Student Services, in a joint written response to the RoundTable’s questions.

“We believe that shifting to in-person learning was a critical step in terms of supporting the well-being of students who have the greatest risk factors (remote learning and managing the various challenges caused by the pandemic),” said the team of top administrators.

It should be kept in mind that the return to in-person learning was not a return to “normal.” Some K-5 students returned for only half a day. And, among other things, all students were required to wear masks and maintain social distancing, and joint activities were still limited. In addition, many households were facing food and housing insecurity and stresses resulting from a parent working on the front line or other factors that could not be relieved by a return to in-person learning.

Administrators, though, cited some of the steps the District took which they think had a positive impact on students’ mental health and social/emotional well-being.

“As we shifted to an in-person learning model and physical return of students and staff in February, schools were ready through the preparation and support of site-based ‘Let’s Get It Right’ teams. These teams represented various employee groups tasked with building preparation and enacting mitigation plans focused on health and safety (as directed by IDPH and CDC). We felt it was important for both adults and children to feel confident and safe so that they could fully engage with learning every day.

“School Climate Teams supported efforts by taking it a step further and created multiple plans that focused on students’ emotional well-being. …  SEL and mental health was a priority, and opportunities for this learning and engagement was built into the instructional day – something that will remain in place when we return in-person in August and long after the pandemic ends. The intentionality and creativity certainly had a positive impact on many students during some really challenging times.”

The team of administrators and social workers also listed some of the benefits of returning to in-person learning on Feb. 16 which they think led to this positive impact, including the following:

  • Greater and more consistent access to food and childcare for families in need;
  • Increased social interaction among students and semblance of social normalcy reported as having a positive impact in students mental health, even just returning in a half-day morning or afternoon program;
  • The ability to provide direct social/emotional support with students who had inconsistent attendance and engagement during remote learning;
  • General feelings that in-person contact is more fulfilling with a reported impact on student learning, self-esteem, and confidence
  • More opportunity for educators to collaborate with one another to handle immediate student needs;
  • More regular opportunities for feedback and encouragement which led to some students becoming increasingly more confident about their abilities and learning;
  • The ability to streamline crisis support when the student is present (direct access to mental health support, in-person assessments, and continued monitoring of mental health);
  • A daily routine and structure, which are more difficult to replicate in a virtual setting;
  • Stronger educator/student connections;
  • Safe reconnections of students with peers;
  • Academic and SEL benefits of full-day programming and support for students identified as having priority flags.

District 65 administrators, however, continue to recognize that the pandemic has taken a toll. They have developed programs to address students’ social/emotional needs during an expanded summer program and in the coming school year. 

In separate interviews, Dr. Soglin and Dr. Wild each told the RoundTable that they think the return to in-person learning had an overall positive impact on the mental health and social emotional well-being of District 65 students.

Both pediatricians noted that the mental health effects of school lockdowns may vary, depending on vulnerability factors including developmental age and pre-existing mental health conditions.

However, they said that the re-opening of schools, even for part of the day, was helpful to the social and emotional wellbeing of children who had experienced prolonged disruption of the face-to-face contact with teachers and friends that is fundamental to their development.

Chronic Stress and Social Isolation: Dr. Soglin focused on psychosocial factors relevant to health, including chronic stress and social isolation. In his current administrative role as chief medical officer on the far south side of Chicago, Dr. Soglin said he cannot speak to what Evanston area pediatricians see in their clinical practices, as Drs. Wild and Robinson can.

“I can make good theoretical arguments of why re-opening [the schools] should be helping, and how damaging the isolation was for kids, but I can’t give example of things that have been helpful,” said Dr. Soglin.

“They all missed their peers. But that sense of isolation is especially damaging for kids who are developing their identity – young adolescents…,” said Dr. Soglin. “We’ve seen a dramatic increase in anxiety and depression among children and adolescents. How that impacts patients medically in addition to psychologically, varies.

“There are a lot of anecdotal stories about kids who were previously ‘A’ students, who say they ‘just can’t do it’ and are failing classes… I think that kind of de-motivation was from isolation. And of course, de-motivation and the inability to perform come with anxiety and depression,” said Dr. Soglin.

He pointed out that anxiety at certain levels can stimulate people in positive ways. But when anxiety becomes excessive, it can have negative outcomes.

“Toxic stress has a huge impact on behavior, and mental and physical health,” said Dr. Soglin. He added that there is evidence that children who experience high levels of stress during childhood are at increased risk for high blood pressure and strokes, anxiety, depression and alcoholism years later.

COVID-Adjacent Outcomes: As a pediatric hospitalist, Dr. Wild sees Evanston patients and families daily. She is a mother of children who attend Evanston District 65 schools.

Dr. Wild expressed a mixture of optimism and concern when asked how, if at all, the return to in-person learning helped children with mental health or social emotional well-being.

“I fell in love with pediatrics because, in every way, children are resilient,” said Dr. Wild.

Yet despite her confidence in the ability of children to adapt and thrive as life gets closer to normal, Dr. Wild laid out many reasons why the pandemic could have a lasting negative impact on children.

“I can speak to what I’m seeing.  I’ve been using the term ‘COVID- adjacent outcomes,’” said Dr. Wild.

In terms of young children’s social and emotional development during the pandemic, Dr. Wild focused on the effects of social deprivation, both in and out of school.

“Beyond school interruption, kids’ lives came to a halt. Adults had other ways of going on with their lives. We ask a lot of children…

“Parents shared that some problems literally melted away within a week of their return to in-person learning.

“One child hid the iPad when it was time to start school during remote learning… By starting even hybrid learning, she was already on Zoom before school started, because she felt more connected to her teacher. With the chance to return to in-person learning, she did not even mind ‘Remote Monday,’” said Dr. Wild.

“As a pediatrician, children’s work is play. Their ability to imagine, solve problems with peers, and learn how to be human can’t happen without being together. Schools are a place where that happens – and a safe haven for kids.

“Teachers provide a safe haven for all children. We’ve all got stressors in our lives. Schools are a place where children can focus on themselves and their peers, and not have to bring worries from home. My own children needed that safe haven – as children of two health care providers,” said Dr. Wild.

Like Dr. Soglin, she said data reveals the harmful effects of stress on behavior and mental and physical health.

“Even before the pandemic, the American Academy of Pediatrics was trying to get the word out about the impact of adverse childhood experiences on health, even cardiovascular health and the risk for inflammation,” said Dr. Wild.

Despite ongoing challenges and uncertain outcomes related to the COVID-19 pandemic, Dr. Wild kept positivity at the forefront.

“We can anticipate challenges, but I have full confidence that our kids will rise to the occasion, and I hope next year will be better. There will be really hard outcomes that we’ll have to navigate, but kids are always worth it,” said Dr. Wild.

Continuing Efforts

District 65 administrators recognize that more needs to be done to address students’ mental health and social emotional wellness.

The District’s 2021 summer learning program is designed for 1,500 students compared to 500 in pre-pandemic years. Generally, the program serves students who are not reaching grade-level expectations or students who fall into one of the priority groups. Many of the programs being offered during the summer focus on social and emotional learning.

The District’s Return to School Plan for the 2021-22 school year contains one section that focuses on a comprehensive approach to mental health. One initiative is to use an SEL screener (Devereux Strength Assessment) to identify students who may need additional support with social-emotional skills and competencies, and then to design interventions tailored to assist the student. The plan would also add guidance counselors at the middle school level.

 

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