An Open Letter to Ohio Governor Mike DeWine and Interim Director of Health Lance Himes:

Reopening urban public schools will cause disproportionate harm to the Black and Latinx communities.

July 20, 2020

Governor DeWine and Interim Director Himes,

Since the COVID-19 pandemic has become a partisan issue, I want to dispel any partisan motive by writing not just from the perspective of a concerned parent of a third grader in an urban public school, but also as an individual who has a doctorate in School District Leadership, as a former education professor and dean, a Distinguished Visiting professor at international pharmacy and medical colleges, and as a member of the American Academy of Pediatrics (AAP) Family Partnership Network. These experiences shape my perspective and are the foundation for why I believe reopening urban schools is bad policy that will disproportionately harm low-income Black communities in urban cities across Ohio.

The Reset and Restart School reopening plan fails to disaggregate, discuss, and plan for the varying effects that the reopening policy will have on the Black community in the City of Cleveland and other urban Ohio cities where African Americans reside in densely populated school districts.

Glazing over the broad transmission risks of COVID-19 to quickly reopen urban schools is tantamount to dropping a bio-weapon in black and brown communities.

Dr. Richard Montgomery

The school reopening recommendations are not explicit about the fact that in-person learning in urban schools could have a disproportionate negative impact on mitigating the spread of COVID-19 in Ohio Equity Institute communities like Cleveland, Columbus, Cincinnati, and others. By failing to address community health factors in the recommendations, the Reset and Restart School reopening plan provides no insights to local leaders to help them fully understand and articulate the health statistics and risks of school reopenings for urban communities. The representation of chronic health conditions among African American communities makes it apparent that the report’s race-neutral recommendations can be expected to yield significant negative consequences to the safety and health of African Americans and other vulnerable populations.

The plan’s loosely fitted principles leave the expertise to be deployed by school district leaders, who are left to defend reopening in-person schooling when urban school districts with high numbers of low-income African American families have a higher risk for transmission and subsequent negative consequences of COVID-19. The Cleveland Metropolitan School District, for example, announced that it would be engaging in a hybrid learning model where students would attend classes for part of the week and engage in remote learning for the remainder of the week. There are three critical matters related to the in-person component that will likely result in the broad spread of COVID-19 on Cleveland’s east side.
The first matter is the notion that children can return to in-school learning safely based on the data that children get less sick with COVID-19. The American Academy of Pediatrics’ national report on school reopening guidelines argues that “the preponderance of evidence indicates that children and adolescents are less likely to be symptomatic and less likely to have severe disease resulting from SARS-CoV-2 infection.” This statement overlooks an investigation by Qiu et al, (2020) published in the Lancet medical journal in March 2020, indicating that while children may not develop serious symptoms, they do serve as facilitators of transmission and should avoid interactions with vulnerable populations. Urban students are much more likely to share a home with, and thereby transmit the virus to, people who are vulnerable or come into regular contact with family members, caregivers and others who are vulnerable. This has significant implications for what are essentially mass gatherings in urban schools.

The second matter to consider is the concentration of Black residents in urban districts that meet the Centers for Disease Control and Prevention’s criteria of vulnerable populations. We know that 95% of African American children attend urban schools in Ohio’s eight major cities, which means that any outbreak in an urban school district like the Cleveland Metropolitan School District will have a disproportionate effect on the minority communities in the City of Cleveland and other communities that are remarkably segregated and significantly impacted by poverty. The Centers for Disease Control and Prevention lists hypertension, diabetes, asthma, and obesity as conditions that place individuals “at risk for severe ill illness from COVID-19.” African Americans have the highest rates of hypertension, diabetes, and asthma among Americans, and nearly half of all African Americans are considered clinically obese. African Americans are five times more likely than white Americans to be hospitalized with severe symptoms of COVID-19. In Cuyahoga County for example, African Americans rank the second highest (behind American Indians) at 39.8% for hypertension; they rank the highest for prevalence of diabetes in the county at 12.9%; African American children rank the highest for asthma at 17.2%, and more than one in three of these residents are reportedly clinically obese. Overall, the Reset and Restart plan made no acknowledgement of the ongoing health disparities occurring in minority communities or how these recommendations could exacerbate the significant rate of hospitalizations of parents and caregivers.When we consider the morbidities and comorbidities and rates of hospitalization among African Americans parents and caregivers in urban districts like the City of Cleveland, glazing over the transmission risk of younger children and deciding to move forward with in-person schooling is tantamount to dropping a biological weapon into Black and Brown communities.

The third, and likely most important, consideration for why the state should suspend in-person learning in urban districts is the likelihood that parents may send their children to school sick or symptomatic, and without immediate testing capacity, urban districts have no infrastructure to evaluate the difference between allergies and COVID-19. African American workers make up nearly 40% of the essential worker workforce, and many of these workers do not have benefits like paid sick and vacation days, putting them under pressure to send sick or symptomatic children to school. The symptoms of COVID-19 in children are runny nose, cough, fever, vomiting, and diarrhea. A recent survey by the C.S. Mott Children’s Hospital National Poll on Children’s Health showed that 88% of parents send their children to school with a runny nose and cough, 51% send their child with a slight fever, 42% send their child to school if they vomited only once, and 20% will send their child to school with diarrhea. In minority communities that disproportionately occupy low-wage essential jobs without benefits (e.g., sick/vacation days), these numbers are likely to be higher. Guidance that is not situated in the actual behavior of parents of school-aged children will likely result in superspreading events that disproportionately impact minority communities.

Overall, I would like to commend you on the leadership you have shown during this unprecedented crisis. In this climate, equity includes serious deliberation on the health needs of the broader community and ways to avoid the creation of new disparities that can devastate the health and education of urban students and their families.

The impact of COVID-19 on Ohioans is not race neutral, and the policies for reopening our schools should not be race neutral either. In-person schooling in urban districts, even in hybrid form, is policy that could further harm already vulnerable communities, and for the reasons described above, I respectfully ask that Interim Director Himes invoke the statutory authority of the Ohio Department of Health (Ohio Revised Code 3701.13) to suspend in-person schooling for Ohio’s eight major public school districts. Doing so will allow the districts notice to adapt their school year plans in ways that support student health, community risks and equitable outcomes.

I appreciate your consideration, and I am available should you have any questions.

Respectfully,

Richard T. Montgomery, II, Ed.D.

Former Research Assistant Professor, The University of Toledo College of Pharmacy and Pharmaceutical Sciences

Distinguished Visiting Professor, The University of Szeged, Faculty of Pharmacy

Distinguished Visiting Professor, North Sichuan Medical University

Member of the American Academy of Pediatrics Family Partnership Network

Published by

madvocator

Charisse Montgomery is the author of the Super Safe Kids series of books and safety tools. These tools engage children, parents, and their families in improving safety and advocacy in the hospital, the community and the home. A former educator, Charisse Montgomery has earned bachelor's and master's degrees in English, along with a master's degree in Educational Psychology, with research focused on informing and empowering parents of medically fragile children. She completed a graduate certificate in Patient Advocacy and serves on the Board at Rainbow Babies & Children's Hospital.

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