OPINION: I’m a School Nurse in New York, and I’m Worried

This op-ed by Anna MacEwan is part of the ‘First Person’ series of stories on Chalkbeat.org, first published on November 10, 2020.

Like many New York City public school parents, I’m concerned about another coronavirus wave coming as the weather grows colder and flu season bears down. As a nurse practitioner who runs a school-based health center, I am also concerned that the city is encouraging an influx of students to return to campus at precisely the time we should be most cautious.

School-based health centers serve more than 375 schools citywide, and our mission is to increase access to health care for children and teenagers. Although we address illness and injury that may occur during the school day (as any school nurse’s office would), our overarching goal is to provide wellness care, such as immunizations, check-ups, and sports physicals. We help students manage chronic conditions, such as asthma and obesity, and we promote sexual health and mental health.

Since school buildings reopened this fall, I have been there, focusing on the safest possible operations for our K-12 campus in downtown Brooklyn in spite of my frustrations (read: rage) with the chaotic way the city rolled out its reopening plans. The health center has been decidedly slow. So far, there haven’t been many students or staff with concerning COVID-19 symptoms during the school day, although a positive case reported in our school community recently has members of the affected classroom quarantining per city guidelines, and we are closely monitoring to see if any other cases arise. The school has had routine monthly coronavirus testing, but that is done separately from health center operations.

These public health measures have been manageable, thanks in part to the low attendance numbers, since most of our students are learning from home on any given day. There are so few students in the building — from 150 to 280 each day, out of a school population of 1,300 — that I don’t have the chance to offer wellness care on scale with a typical school year. Sure, we’re keeping up with flu shots and other vaccines, but our numbers are down. As much as I’m concerned that our services are reaching fewer students, I believe that a quieter, emptier building is safer during the pandemic.

I worry that could change, with the city giving parents a single two-week window to opt back into in-person learning. Many parents are understandably frustrated by the ultimatum, since the city initially promised parents would be given this option on a quarterly basis. But the decision is more than just unexpected; its timing makes it potentially risky.

Without other opportunities to return to campus, more parents may opt in, sending their children back to the classroom on or about Nov. 30, on the heels of Thanksgiving. It’s in stark contrast to what some private K-12 schools and colleges of all kinds are doing. Many of those schools have decided to shut their doors and operate only remotely for the holiday season. The rationale for closing in-person classes between Thanksgiving and (or through) January: In spite of public health advice, many people will travel or congregate for the holidays, so returning to school buildings would be a riskier endeavor than it has been so far. In addition, colder temperatures outside will mean that keeping the windows open won’t necessarily be an option (though many private schools also have state-of-the-art HVAC systems to keep them safer).

While these building closures may prove to be a significant disruption for private school families, they illustrate how small, affluent schools can make well-considered choices to protect their communities.

Prior to opening, the city’s public schools received adequate ventilation inspections only after an uproar from teachers and parents, and principals faced an extended opt-out period that forced them to redesign class schedules again and again. The city’s approach has pitted school administrators, parents, and teachers all against each other during the pandemic response, when the vast majority in each of these groups just want to support each other. Now, a single opt-in period at the brink of winter holidays and as case rates rise nationwide threatens more than inconvenience and competing priorities: It could be a public health risk.

I’m imagining many public school parents rushing to opt in: those who were about to do it anyway, those who were on the fence, and maybe even some who weren’t planning on it, but realized this would be their only chance to do so. Will this mean a large influx of students into the blended model, which includes in-person learning? Of course schools still have to maintain safe numbers and distancing in each cohort, so might this actually mean less in-person time for each student choosing on-campus learning?

Maybe I’m wrong, and the new opt-in rules won’t cause an influx of returning students, or if they do, the result won’t be an increase in COVID-19 cases. Maybe our health center will be as quiet as it’s been since the campus reopened. Still, it seems a harsh and unnecessary administrative move based on “maybes.”

Anna MacEwan is a nurse practitioner with a background in pediatrics and emergency nursing, and has been working in New York City schools since 2011. She is an advocate for universal health care and lives in Brooklyn with her 12-year-old daughter.

First Person is where Chalkbeat features personal essays by educators, students, parents, and others thinking and writing about public education.

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