Question:  Why are you the best candidate for the job?

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I received this question the day after I found out that my friend's daughter tried to commit suicide, so my answer will be influenced by this news. While I won't provide too much detail to preserve the family's privacy, she is one of our community members; a rising district 128 student. She is not the only one I personally know in our community who tried to take her own life this past year. I do not have that large of a local friend/family circle; to be personally connected to two students who have struggled so much this past year, is heartbreaking and gut wrenching. I am sure there are many more I am not aware of whom are going through the same.

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The students district 128 plans on welcoming back to their buildings, full-time in the fall, will be students who have lost a lot-- perhaps a loved one to COVID; perhaps friends that they fell out of touch with; perhaps the love and passion for a sport or other extracurricular activity that they weren't able to participate in it like they normally do. Maybe their grades have plummeted, as they've lost their desire or drive to study. Many won't want to come to school at all, and going back will create debilitating fear and anxiety.

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Why am I the best candidate for the job? Because I have experienced these losses with children who are my patients, and now children whom I know personally--whom I have seen growing up alongside my own kids. And I will advocate for them like no one else can. In the words of Deanna Behrens, MD, a pediatric critical care physician at Advocate Lutheran General Hospital:

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"We are natural advocates because we are the experts in child health. The stories we tell can help create or strengthen policies that can affect the well-being of all children."

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She, like me, and many other physicians, are being called to bring our passion, knowledge, and sincere care for others, to partner with school districts, to make a difference in the lives of others. Are we experts in finance? No. Are we experts in curriculum planning and delivery? No. Are we experts in building maintenance and upkeep? No. Are we experts in running a school district? No. But fortunately, we don't have to be--there are others who are. Are we one of the hardest group of workers that exists? Yes. Are we intelligent and quick learners? Yes. Are we intense overachievers? Yes. Are we willing and able to learn all those things which we don't know? Yes. Will we listen to and take into account experts' and others' input to help bring about solutions to problems) Yes. Will we fight for what we believe in and not back down when we know we shouldn't? Yes.

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Who do you want fighting for your kids, and your community?

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District 128 has done so much in the past to achieve its stellar, well-deserved, top-notch rankings. But they, like all other schools, have never experienced a pandemic. The strain on schools this past year has been tremendous. It will not abate soon. How have COVID costs affected the budget? What new COVID strains will surface that the current vaccines won't be effective against? What will happen then, will there be a demand to pivot to remote learning? Should there be? I heard at a recent board meeting, that remote learning is here to stay (or something to that effect). What exactly does that mean?

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Sadly, while I toggle between D128 and D70 board meetings that occur on the same day so could have missed this, I don't believe I've heard any discussion about how D128 is planning to make up for the academic losses that occurred this past year (more students than ever are getting D's and F's, WAS something I clearly heard at a recent meeting). I also haven't heard discussions regarding recruiting/hiring more social workers/psychologists to help with the mental health pandemic COVID has created. Again, I could have missed it. But if these discussions haven't been happening, they should be. Because while COVID's physical effects on children are for the most part minimal, the mental health and academic effects are alarming, and need to be addressed.

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Myself, just like many other physicians seeking office, don't have a lot of experience in politics or with school boards, but perhaps that's a good thing. Maybe a fresh perspective is beneficial. All can be lulled into a sort of complacency, especially when everything is going so well. But a true testament to anyone or anything, is how they handle crisis. Our school district has been dealing with a crisis. Since this crisis is a pandemic, I think having a medical professional involved in making decisions that affect schools will be incredibly beneficial. Experience should be valued on a school board (it's necessary, in my opinion), but so should a new, different way of approaching problems. The way I will approach problems as a school board member, is the way I approach problems I encounter at work and in my life: I look to evidence/factual data; seek input from others/experts; very carefully weigh pros and cons and analyze risks and benefits, eventually choosing that which has the least amount of risk, and the most and greatest benefits, for the most. But always when making decisions, the health and well-being of children--their needs, will come first.

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Who do you want fighting for your kids and your community? Me.

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Question:  When addressing an issue or problem, how do you work with people who have differing views to get to a solution? Please give examples.

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This actually comes up quite a bit in my line of work. As a pediatrician, I often make recommendations to parents of patients, or to patients themselves when they are old enough, that are not well received. The most important part of coming to a solution together, I feel, is asking questions to try to understand their perspective, and then listening without judgement to their reply. From there, good communication is essential, in response to what they've said, asking myself: Is there a different way I can explain why I think what I think, considering what they've told me? It's important to look for alternate solutions, and present those. Compromise is important at times, as is being patient. Sometimes multiple encounters are needed to reach a solution. It's important to read a situation and know when to explore further, and when to back down. There's nothing wrong with taking a break to ponder (usually....some decisions need to be immediate), and return to the discussion at a future time. Since many recommendations in medicine are evidence-based, I at times pull articles to give to parents/patients, to help them understand why I make a recommendation, or consult another physician to give their thoughts.

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If elected to the school board, I expect there to be disagreement. I don't see this as a negative, in fact, I see it as just the opposite. How can there be positive change, growth, and improvement, if things aren't looked at in a different way? If other sides/ideas are presented and considered by others, creativity flourishes and positive outcomes result. But, there must be respect from all, for all: whatever one's thoughts and opinions are, he/she should not be shamed/attacked for those: that will certainly breakdown any sort of productive conversation. There's always a reason for someone's beliefs, no matter how different they are from our own. Listening to others' perspectives, and putting ourselves in their shoes, is essential to reaching an agreement.

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Question:  As a prospective board member, can you commit to adhering to the standing board policy below or do you plan to take action to change the language? "Equal educational and extracurricular opportunities shall be available for all students without regard to race, color, national origin, ancestry, sex, sexual orientation, age, ethnicity, language barrier, religious beliefs, physical or mental disability, economic and social conditions, gender identity, status as a homeless youth, order of protection status, or actual or potential marital or parental status including pregnancy. . .. No student shall, on the basis of sex, or sexual orientation, or gender identity be denied equal access to programs, activities, services, or benefits or be limited in the exercise of any right, privilege, advantage, or denied equal access to educational and extracurricular programs and activities.”

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Without a doubt, yes. I am sure, since I am a pediatrician, this does not come as a surprise. Pediatricians are notoriously strong advocates for ALL children. Our professional organization, the American Academy of Pediatrics, has its own equity policy which can be seen here https://services.aap.org/en/about-the-aap/aap-equity-agenda/ As it is tailored to physicians, it differs from the school board's policy a bit, but should exemplify that in my field of work, just as in schools, the creating of and need for such policy is imperative.

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Of course, it's easy to say such policy should exist and one should adhere to it; I think most of us know it's "right" to say this, and will follow the law that we are obligated to follow. But I feel I put my money where my mouth is so to speak, as I can say I not only agree with it, but take steps to put it into action. I work at a federally funded health clinic in Waukegan. Here, my patients are roughly 80 % Hispanic, 10 % African American and 10% Other. I serve patients from all of the groups mentioned in the posted question. It is incredibly fulfilling. Due to financial and other struggles the families I take care of often face, I alone cannot always help my patients as much as I'd like. I often look to others, such as social workers, psychologists, and school staff, for assistance.

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As children tend to spend such a significant portion of time at school, it is a huge relief for me to know that schools' policies line up with pediatricians' views. There's only so much of a difference I can make in a 10 minute visit with a patient; thankfully, teachers and other school staff can help. Taking care of children is a privilege that I share with our schools, and which I hope I can further a partnership with, by being elected to the school board. I know that what I provide as a physician, are not the "educational and extracurricular programs and activities" mentioned in the District 128 policy. But in providing health care to all of those mentioned, I think the parallels are obvious. If elected to the school board, just as I practice what I preach through my work, likewise I will practice what I preach at District 128.

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Question:  The district is currently planning to reopen with normal in-person learning in the fall, but if Covid-19 is still an issue at the start of the 2021-22 school year, how do you think schools should reopen? What are the advantages and disadvantages of this type of schooling? What data or criteria would you use to inform your decision? Finally, what mitigation strategies do you think should be employed?

 

It is hard to answer this question, in a way, for the fall, when one is looking at the situation currently, since so much can change between now and then. However, If COVID were still an issue in the fall, I feel full-time in-person learning still must be an option. Besides the academic benefits of in-person education, the interactions in - person school provides are necessary for our children's social-emotional as well as physical health.The school routine (wake up, get dressed, eat breakfast, get to school) in itself provides structure and comfort; it provides movement and exercise. Without this alone,many kids have fallen into a cycle of apathy and disinterest that has led to much worse.I could provide data from numerous reputable scientific journals attesting to this (please PM me if you'd like those), however, in the past many months that I have been working with school districts regarding reopening, I have found that anecdotal stories seem to have more of an impact. Prior to COVID, the patients I saw in my office for mental health or issues involving school struggles (ie: depression, anxiety, ADHD, behavioral issues) were roughly 4-6 a month. Now, this number averages to 4-6 a DAY. Visits to the ER for mental health emergencies have skyrocketed; in-patient psych units are full; outpatient behavioral health support is at capacity. I often feel helpless, not knowing what else to do/where else to get help for kids who desperately need it. I will call schools and speak with social workers and psychologists there, who are quick to offer help in the form of outreach to students and families. But how many kids are affected that myself or my colleagues don't know about, whom the schools don't know about because no one alerts them, and whom they aren't aware of because remote learning makes it difficult to identify those who are struggling?

 

Of course, if full-time school reopening put others at risk for acquiring COVID (ie staff and community members), one could argue that solutions to the above problems would need to be found that did NOT involve school reopening. But, it doesn't. This data has been available since June/July 2020, published in reputable, well-researched and well-critiqued scientific literature, as many schools across the world had reopened even as COVID cases still surged. The data was clear that certain mitigations prevented the spread of COVID in schools, and in fact, schools at times were one of the safest places anyone could be (their transmission rates were lower than those in the surrounding communities). It also showed what DIDN'T work, as some schools that reopened without mitigations in place saw transmission of COVID (for example, the infamous study out of Israel where COVID spread DID happen in schools, happened only when mask restrictions were lifted due to a heat wave). Sadly, however, this data didn't necessarily make it to the mainstream media (or at least the important details of it didn't). And while many of us in the medical and scientific communities saw it, others did not.

 

I do believe misinformation/misunderstanding (many scientific articles published this past summer, in even well-respected journals like JAMA, unfortunately had bias present which could only be discerned by those with training and experience in evaluating and critiquing scientific literature) led many to choose remote learning over in-person learning in the fall of 2020; but, I can't say that for sure, and the fact remains that many in the community DID choose remote learning back then. So, for a fall plan if COVID were still an issue, resurveying would be essential. The survey should not only have the choice presented for in-person vs remote learning, but it should also provide space for writing WHY that choice is being made. Hearing the reasons for the choices, will help the district figure out solutions to meet everyone's needs. And of course, if remote learning is still necessary to meet everyone's needs, that still needs to be an option.

 

However, I feel that remote education is subpar compared to in-person learning, and places those kids who have to engage in it at a huge disadvantage. Maybe in the future, if remote learning has to resurface, the district could look into outsourcing it to a 3rd party as Lake Forest High School did. In this way, the burden of creating both in-person and remote learning plans, and simultaneously delivering those, wouldn't fall on our teachers--teachers whom at the start of this pandemic (I believe) had little or no training or experience in remote education. Perhaps there are specialists out there who already mastered this feat, and enjoy it, and could give remote learners the best experience? I don't know, this is just food for thought.

 

For data to guide my decision, I am fortunate in that I have access to and read on a daily basis those journals which notoriously provide unbiased, unpoliticized information (Pediatrics, JAMA, JAMA Pediatrics, NEJM, The Lancet, etc), and when they rarely let bias affect their presentation/interpretation of the data, I can discern that. Also, we physicians often participate in journal clubs and other discussions, to critique articles and share ideas. I am lucky to have access to world renowned specialists to address questions to and bounce ideas off of (for example, I was fortunate to be part of a discussion with Anthony Fauci last month). I also have the experience of working during the pandemic, knowing where numbers of local hospital COVID inpatients lie (Condell had about 22 on average last week, down from the 110 or so it had at its peak), and knowing now that opening schools doesn't affect numbers of COVID inpatients at all. I've seen first-hand the huge volume of people I work with in my clinic (pediatricians, family practice doctors, OB/gyne's, resident physicians who are still in training--all seeing roughly a patient every 10 - 15 minutes, along with all the staff required to make this happen), whom have all been inches away from the faces of COVID positive patients, who haven't acquired COVID from these patients; it's quite reassuring that our masks work. So for mitigation strategies, I am a believer that masks help prevent the spread of COVID. As for other mitigation strategies, I agree with The American Academy of Pediatrics, who provides guidance for school reopening based on data that has been well-researched, discussed, and agreed upon; while a long read it is worth it: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/

 

Doctors, including myself, are incredibly cautious individuals. "First, do no harm" is part of an oath we take when becoming physicians, and is a motto most of us live by. As such, the CDC and AAP have in place MANY layers of mitigation for school reopening. While their intentions are to provide more reassurance, I worry that in some ways they are creating more angst (ie: schools can't open safely unless they have each and every one in place). I hope that is not the case: meeting all of them is not necessary for a safe reopening of schools. But, our district is fortunate in that we do have the ability to implement just about all of them. A recent D128 board meeting gave me the impression that D128 teachers and staff were having a hard time getting the COVID vaccine. After discussions, I now think that's not the case. But, if any teacher/school staff member would like the Moderna vaccine, please let me know...the clinic where I work can provide it for about 100 individuals, NOW. While not necessary for a safe, full in-person reopening, I do understand that many would like the vaccine; and while as a board member, if elected, perhaps what I say might not be liked by all, and while I cannot change facts/lie about what I know, I can do everything in my power to make everyone feel heard, respected, and satisfied.

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Follow-Up Question:  Hi Katy! A comment you made on the D128 Forum group caught my eye. You said that there are flaws in the JAMA research. I look to journals such as JAMA as reputable sources so that concerns me. Which research article(s) were you referencing and can you please elaborate regarding the flawed data? Thanks!

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Hi! Glad to see you're a fellow fan of scientific literature!!! I agree, I see JAMA as a reputable source; and I still do. They only published one article over the summer that concerned me--they published many more that were top notch. The one that was odd (to me and others) was an article that came out at the end of July. It is titled Association Between Statewide School Closure and COVID-19 Incidence and Mortality in the US, and is written by Auger, Shah, and Richardson (and others). It was touted by some as the reason schools should stay closed-- headlines last summer by some media outlets (nonmedical) even specifically said that. However, the problem with the article, very simply stated, is that it claims that school closures saved lives/decreased COVID incidence, when in fact spring school closures were done at the same time as many other things (masking, distancing EVERYWHERE as stay at home orders were taking place, restaurants/bars/gym closures, etc). So, one can't attribute decreased COVID incidence/deaths to school closures, when it could have been due to these many other things. Correlation doesn't prove causation.

 

A more detailed description of its problems is said much better than I could ever say by Courtemanche, Yelowitz (PhDs of out Univ of Kentucky) and Benjamin Sommers (MD/PhD out of Harvard):

 

"Auger and colleagues’ study used interrupted time-series analysis of state-level data and found that school closures in March 2020 were associated with lower COVID-19 incidence and mortality [1]. However, multiple other peer-reviewed studies found no significant association. An analysis of four social distancing restrictions – school closures, large gathering bans, restaurant and entertainment closures, and shelter-in-place orders – found that only the latter two were associated with significant reductions in COVID-19 cases across U.S. counties [2]. Using similar methods, an analysis of Italy, France, and the U.S. found that social distancing restrictions as a package were effective, but school closures alone were not [3]. Another study used an epidemiological model and data from 11 European nations, reaching similar conclusions [4]. Auger and colleagues did not cite two of these papers, and only briefly mentioned the third. Readers and policymakers should be aware of these studies with opposite conclusions. Why the differing results? One possibility is the handling of other restrictions implemented at similar times as school closures. The three studies that did not find that closing schools influenced COVID-19 spread all used methods that put these policies on a “level playing field,” allowing the data to determine which interventions were most important. In contrast, interrupted time-series methods focus on a single intervention. While Auger and colleagues aimed to control for other restrictions, they did so using a step-wise procedure that selected covariates for the final model out of a list of candidates. This led to several distancing policies being excluded from the model during the post-school closure period. In effect, these other policies were omitted confounders. This approach gave school closures an advantage in emerging as the intervention with the greatest estimated impact, and this potential bias raises doubt as to whether school closures were responsible for the results. The interrupted time-series approach also forces a linear underlying trend in the pre- and post-school-closure periods, which is more restrictive than other methods.[2]"

 

In JAMA's defense, they did come out later with a sort of rebuttal in another one of their publications. But, the timing of the publication of the Auger, et al article (at the end of July when many school districts were making important decisions regarding fall school reopening) was really unfortunate. It's been a tough year, for science, for school districts, for politics....let's hope the worst is behind us!!!!