Evidence-based guidance on school reopening drives AAP advocacy

Over 12 days, the Academy went from issuing COVID-19 interim guidance on school reopenings to being represented by AAP President Sara “Sally” H. Goza, M.D., FAAP, on the topic at the White House. Wearing a mask and seated one spot away from the first lady, Dr. Goza emphasized schools’ important role in supporting children's health and well-being, even beyond academics. However, any reopenings must be done safely and with the proper funding, she said.

While the Academy’s guidance was grounded in science and was an update from its previous version, the timing of its release catapulted it onto the national stage. It became a main headline in the 24-hour news cycle, capturing the attention of a country combating a pandemic and wondering how schools would navigate the months ahead.

The issue also was swept up into an overarching political narrative, with some politicians using it as a clarion call to reopen schools for in-person learning no matter what.

In the days following the White House meeting, the Academy joined groups representing teachers and school administrators to further drive home the message that returning to school is critical but must be done safely. This time, those opposed to returning to in-person learning used the Academy’s joint statement as a justification to caution against any reopening.

The substance behind the AAP’s guidance had not changed, but the political climate continues to be fluid and emotionally fraught for parents, teachers, students and staff.

As AAP President-elect Lee Savio Beers, M.D., FAAP, wrote in an op-ed for CNN online, "When public health expertise is reframed to fit political interests, it harms those who have the most at stake and the least opportunity to advocate for themselves: children."

'We must be guided by the science'

The voices of pediatricians, educators and superintendents coalesced around the same message that safety must be prioritized, and the spread of the virus within a community must be considered.

"Science should drive decision-making on safely reopening schools. Public health agencies must make recommendations based on evidence, not politics," the organizations said together. "We should leave it to health experts to tell us when the time is best to open up school buildings, and listen to educators and administrators to shape how we do it.

"For instance, schools in areas with high levels of COVID-19 community spread should not be compelled to reopen against the judgment of local experts. A one-size-fits-all approach is not appropriate for return to school decisions," the organizations said.

AAP leaders and chapter representatives echoed these messages across local, state and national media outlets.

"We must be guided by the science," said Dr. Goza in an op-ed published in the Atlanta Journal-Constitution.

Advocacy for robust school funding

Beyond issuing the guidance and speaking out in the media, the Academy leans on its guidance to inform its advocacy to lawmakers in Washington, D.C.

One of the AAP's main advocacy priorities has been urging Congress to provide schools with the funding to safely reopen, regardless of their timeline, recognizing that schools in COVID-19 hot spots might not be able to reopen right away.

The AAP is asking Congress to provide:

• $175 billion for K-12 education through the Education Stabilization Fund, which was created in the coronavirus aid bill to support schools during the COVID-19 national emergency, including $500 million for the Bureau of Indian Education.
• $25 billion for the Individuals with Disabilities Education Act, Title I and other programs that support marginalized students, such as children with disabilities, who are most likely to be affected by missing in-person instruction.

In late July, Sean T. O'Leary, M.D., M.P.H., FAAP, vice chair of the AAP Committee on Infectious Diseases, testified virtually before a House subcommittee on reopening schools. Dr. O'Leary walked through the key elements of the AAP's school guidance and the need for robust federal education funding.

"We call on our leaders to provide the resources necessary to ensure that funding does not stand in the way of safely educating and caring for our children," Dr. O'Leary said.

At press time, Congress had yet to pass legislation with additional funding for schools.

Ever-evolving landscape

As with many elements of the pandemic, the conversation around school reopenings is evolving, making it necessary to be nimble and responsive to the landscape of the moment.

The Academy's interim guidance is reviewed regularly and is based on the developing nature of the pandemic and emerging science.

Policymakers and lawmakers in the nation's capital and across the country are turning to the Academy for its child health expertise amid a complicated global health crisis, and the AAP's advocacy will continue to follow the lead of its evidence-based policies.

When writing about school reopenings in her op-ed, Dr. Goza made a point that also rings true for the work ahead: "This won’t be easy. But if we truly value our children, we will find a way to adapt to this new normal with innovation, science and expertise, the same way we have conquered other challenges."