Work-Life Balance in the COVID Era: Sending Your Kids to School vs Remote Learning

Program announcer

Welcome to the Peds Ethics Podcast, where we talk to leaders in pediatric bioethics about a hot topic or current controversy. Here's your host, John Lantos, from the Children's Mercy Bioethics Center in Kansas City.

Dr. John Lantos

Hi, everybody, welcome back. This is the Pediatric Ethics Podcast coming to you from Children's Mercy, Kansas City. I'm John Lantos, director of the Children's Mercy Center. Bioethics Center and in these podcasts we talk about issues in pediatric bioethics, some related to COVID, some more general. This week we have two faculty members of the certificate program who are going to talk about some of the decisions they face as staff who are working from home and who are making decisions about whether to send their school-age children back to school. whether kids should go back, whether online education is preferable. And I'm going to start with just a little background on this. Then I'll introduce our two guests and we'll have a conversation. There are lots of good reasons to reopen schools. Everybody knows that kids do better with face-to-face education, that online learning is tough. People know that parents do better when their kids are in school. Parents can keep their jobs. and their sanity. We know that online education can exacerbate health disparities or educational disparities because poor people tend to have less access to good internet services and so have more trouble with online education. There are risks. Kids spread disease, although kids generally have more mild disease than adults, but they could spread it to teachers who could spread it to their friends families most spread is from kids who are symptomatic not asymptomatic so experts say we could with careful screening limit the risks of spread but we really don't know what will happen or how it will differ from school to school or community to community so With that background in mind, we've been having discussions in our bioethics center with some of our faculty and staff who, as bioethicists and parents, are facing these decisions. What we've decided to do is touch base with two of those parents periodically through the fall and see how the decisions evolve. So we're thrilled to have with us today Professor Jeremy Garrett, who's a research associate in bioethics, assistant professor of philosophy at the University of Missouri-Kent, Kansas City. And Vanessa Watkins, who has a master's in public health, has completed the certificate training program in bioethics and is program director of the certificate training program. Welcome, Vanessa and Jeremy. It's great to have you with us.

Jeremy Garrett

Thanks for having us.

Dr. John Lantos

Thanks, John. Vanessa, could you tell us a little bit about your situation? You have kids at home. How old are they? What is the school telling you about the options?

Jeremy Garrett

Sure. So my husband and I have two kiddos in elementary. So we have an incoming second grader, incoming fourth grader. The school district where we go in the suburban Kansas City area is offering two choices. So they did a preference survey asking if you prefer to go in-person, having a blended or hybrid approach, or to be virtual. And in that preference survey, we actually chose the hybrid option. But when the sort of rubber hit the road, they gave us two choices, and you could choose either in-person or virtual. Hybrid disappeared in a sense. The district, though, does have gating criteria. So the gating criteria do involve hybrid at some level, depending on how the public health metrics are doing at that time. Do

Dr. John Lantos

you have a sense of what hybrid actually means? No.

Jeremy Garrett

I actually do. In the case of my district, the in-person hybrid model means that in two days of the week, your children would go to school. The other three days are sort of independent study. I think there are some teachers that are going to be trying to live stream so that in theory they could be with that same group of kids all week. But I think that's the minority of teachers that are working in my district. So I think. There'll be two days where the kids go to school, three days kind of like what we did in the spring, which was parents mostly doing the learning and the teaching.

Dr. John Lantos

Real homeschool rather than online education.

Jeremy Garrett

That's my understanding. Although some of this is still evolving and it's in our district. I think we still have another week before teachers are assigned. to the children. And I think they're still trying to sort through which teachers, because teachers were given the choice whether or not they wanted to teach in person. So I think they're sorting through whether or not how that's all going to work out. But my understanding is that they've had enough students wanting to be online and pairing up with teachers that want to teach online. The thing that I think is really fascinating, though, is that I think we're all going to probably be virtual for the beginning, in which case I hope that all the teachers are ready to teach online.

Dr. John Lantos

And Jeremy, what's going on with you and your family?

Jeremy Garrett

Well, I also have an incoming second grader and fourth grader like Vanessa, and I also have a son who's going into seventh grade, so he's in the middle school environment. Our choices were similar but a little bit different in that the original choices we were presented with were a fully online or a fully in-person education for the fall. Then at some point, the school district determined that maybe a hybrid would be better for those kids who are in middle school or high school while keeping the full in-person format for the elementary students. So what we're looking at right now is you can either choose to have your child attend in-person two days a week like Vanessa's school district with three days online, or you can have them entirely online. The elementary students have remained in a fully in-person versus fully online choice. That's the option that our school district has chosen. And we're on the Missouri side of Kansas City in a district just north of downtown Kansas City.

Dr. John Lantos

And so for both of you, you have the choice. You can choose to send your kids to school or you can choose to keep them home. So how are you making that choice? What goes into your decision?

Jeremy Garrett

For my family, we've had plenty of time to think about it, having not come back to school since spring break. My children, I think our second grader, she really needs a peer model where there's peers around you, motivating you. And both children, I think, really miss their teacher and missed having their peers. I do think that K-2 is a challenge to do with an online format. So that's one of the things that we took into account. My husband and I both are still working from home and shared a lot of the duties in the spring. I wouldn't say that that was a permanent teaching situation. I think we had a lot of emergency environments that we were, you know, working on the fly. But I think if we were to think about doing this long term, that would be more difficult to do that virtual teaching at home while we're both working full time.

Dr. John Lantos

So it sounds like a combination of the kids' psychological needs and and your work-life balance

Jeremy Garrett

that's a very similar calculation to what my wife and i have undertaken with our children we too think that it's really hard to imagine our kids being entirely separated from their peers physical presence with their peers for months on end having now done that since march especially with our middle school son he's at a very vulnerable stage of growth where entering middle school and forming his own identity and getting some independence and not having really any connection to friends that he can hang out with is just something that we thought was too much for his long-term development and growth. And he'll be going two days a week. He'll only be going with half of the students in the school. The other half of the students will go on different days. So we felt really comfortable at the end of the day that... The risks have been minimized about as well as they can. He's very good at wearing masks. Our elementary students are as well. And they actually attended a couple weeks of summer school this summer. So we got to test out a little bit what it would be like. This year, summer school was quite lower than the normal enrollment for summer school. So we felt comfortable doing that. And it went OK. And we think that our district, at least, has done a pretty good job of trying to address the worries. But yes, at the end of the day, it's just hard to imagine doing that with three children, trying to be their teacher at home, managing all of the different Zoom calls and requirements, especially since it sounds like many of those would be done at certain times and would reduce the flexibility of families to do them kind of on a schedule that would best suit them. We were really concerned that we might have three different calls that the kids have to be on at about the same time. managing all of that would just be a full-time job in itself and quite frustrating for everybody involved. We've made the tough decision that we're going to put everybody in and see how it goes, although I worry that, like Vanessa said, that we may end up in an all-online situation soon if cases rise in the area and the school district makes that decision for everybody.

Jeremy Garrett

Yeah, I agree with everything you said, Jeremy. I was just going to say, like in our particular county, the cases, I think the 14-day rolling average is about 10.3% right now, which we really do need to get below 10 for us to be in that hybrid state that I mentioned earlier. Otherwise, we'll be in a remote-only situation.

Dr. John Lantos

Well, and a lot of people say you should get below one.

Jeremy Garrett

Right.

Dr. John Lantos

Risks are all relative. What's your biggest worry about the risks? Is it... that your kids will get it, that they'll bring it home to you? Do you care for your parents? What goes through your mind when you second guess?

Jeremy Garrett

For me, we've got, I think my mom is 80. She lives within a mile of us, and we actually see her quite a bit, although in a modified format now. So that is a concern. I have two major concerns. One is consistency. I know that there's going to be times that we're going to be... changing because of somebody's going to either get sick or somebody in their cohort will get sick. Something is going to change and we aren't going to have the same schedule. I'm just certain that's going to happen at some point. So that consistency is going to be difficult. And then the idea that someone will get sick that we know, whether or not it's in my immediate family, could be one of the kid's friends, or it could be a teacher or close relative. So I think we've been somewhat shielded. We know people that know people. But no one that we directly interact with to date has had it. And so I think we're living in a little bit of a bubble. We've been very lucky. So haven't been directly affected yet. And I know that will change once the kids go back. It's just a sense I have.

Dr. John Lantos

So you anticipate that having kids go back to school is going to lead to more community spread and higher rates of infection?

Jeremy Garrett

Well, that's a tricky one because I think that... And my thinking has changed over the last couple of weeks since kids have gone back to school. The one I'm thinking about, I think I saw in the Boston paper, and it was 40% higher rate of children spreading than they had previously thought based on the South Korean study. I think if we're being smart, like Jeremy said, the kids aren't comfortable wearing masks. I think if they're cohorting the kids, particularly the K-6, I think that's a much easier group to keep safe. The middle school, high school kids, I think, are going to be spreading the way that they interact. They're mobile. They have cars. I think that will probably contribute to community spread more so than the elementary age, in my opinion. My kids are playing outside with neighbors now. And so in theory, and quite a few of those kids are going to be doing the online program, I'm not sure how much my two kids are going to spread in the community. But I do think that some of the older middle school, high school kids, I think those are the ones that are going to probably cause more of that.

Dr. John Lantos

Jeremy, do your kids play sports?

Jeremy Garrett

My son is actually intending to run cross-country and track this year if those are held. We've seen the protocols for how they're planning to handle that and feel comfortable. Our son knows he's very good at social distancing already, so he tends to hang out in the back of the group anyway. He's very self-aware of the situation. I think we feel comfortable with that. It's also a fairly short season. And so we're talking about a month's commitment that's really important to his identity and development. And so we're going to proceed if the school district allows, which is actually really a decision of the state athletic association to make that decision. So if sports are happening, he will be running cross country this fall. But like Vanessa said, I think it's a very complicated decision. And my biggest worries are honestly that we just don't know for sure what the long-term effects health-wise might be for anyone that gets infected and whether there is going to be any kind of permanent damage to lungs or any other organ system. Or the unknowns here are kind of what my biggest concern is. We don't see a whole lot of people outside of our household. And The risk of transmitting it to others is pretty low for us. But I do worry, as Vanessa said, that some people that are close to us, including maybe teachers or peers, might get this and might have a particularly bad outcome. The psychological effects for the kids at that point could be quite profound.

Dr. John Lantos

So where do you look for reliable information about risks? Who do you trust?

Jeremy Garrett

You know, having... Working at Children's Mercy, I've been watching all of the town halls. So they did one that was targeted to parents, and I watched that, and that was the end of June. And then they had one that was more targeted to school professionals. I went ahead and watched that one, and that was pretty informative and instructive. I don't think there's a lack of information out there, and there's always some new study coming out about new data. And I've been following what's coming from the state of Kansas because that's the side of the state I live in or the side of the state line I live on. And so that's looking at what they've been doing in terms of masking and the counties that have been wearing masks have been doing better in terms of the spread. So I think those are the key places. But I think there are certain things that are good to be doing. And then there's some misinformation, too. But I think the majority of people I know are following the good sources.

Jeremy Garrett

Yeah, ours is very similar to Vanessa. I think working at a children's hospital like Children's Mercy with well-known experts in infectious diseases who've been doing a painstaking job of trying to address these in public forums and employee forums and has been really helpful for me in trying to think through this and also having the professional literature that I'm regularly combing through anyway, addressing this topic in many ways has been quite helpful in sorting out what's good data, what's really going on versus some of the the fear-mongering that you can see in various places or the less credible studies and interpretations of those that have been offered in various places.

Dr. John Lantos

Well, this is great. This is a real snapshot of two parents struggling to figure out what's best to do as schools start to reopen in the first fall of the COVID pandemic. As I said at the beginning, we're going to be checking back with Jeremy Garrett and Vanessa Watkins periodically. Through the fall, on some of the podcasts, we'll bring in outside experts to give their opinions about policies and about the choices parents face. Jeremy and Vanessa, any final comments before we wrap this up?

Jeremy Garrett

We did have one other point I wanted to make that I forgot to slip in there when Vanessa was talking about the risks for high schoolers and middle schoolers. And that's just that having observed my regular trips to the local high school track for my running in the evening, I've observed quite a bit of behavior that worries me and makes me think that having kids in school may not actually lead to as high of community transmission as not having them in that structured environment. And that just seems to be the kids. when they're not in the structured environment, are gathering anyway and in more dangerous ways without masks, getting in close proximity to one another, playing sports, hanging out in different places. And so it'll be really interesting, I think, that we'll have this kind of experiment going on in the country to see the districts that made certain decisions, other districts that made other decisions, comparing rates of transmission, And especially if there's any kind of sophisticated contact tracing to kind of figure out where that happened, whether it happened in school or whether it happened outside of school, will be really instructive. Unfortunately, I'm not sure we're going to have that in time to really affect the decisions that schools are making this fall. But I do think afterwards, we'll have a rich trove of data to draw on. My sense is without the adult supervision of teachers or coaches that they're going to actually, in some cases, make riskier decisions when they're gathering informally on their own. So limiting that by having them in a structured environment for eight to 10 hours a day may actually turn out to be neutral or actually beneficial with respect to lowering the transmission rate.

Dr. John Lantos

That's a great point that kids are going to gather anyway, whether they're in school or not. It's just what kids do. Vanessa?

Jeremy Garrett

I think the idea that, I think, Jeremy, you're absolutely right. Kids have to go somewhere. And that's been in my mind ever since the beginning of when schools were closed. And I totally don't have a problem with the reason that they closed in the beginning. But the kids do have to go somewhere. And I think the alternative place that they're going are not necessarily a preference to being in school in safe ways. Something I've been thinking about, too, is this idea that kids need to go to school to have socialization. And I think that the way that the school will run safely in the fall is going to be a lot different. It's a lot different looking than we're used to. So I'm aware that my kids will probably still continue to play outside with the neighborhood kids because there's going to be a very structured... You're going to be with those maybe 10 to 20 kids. Recess, I'm not 100% sure what it'll look like, but... I know that you aren't going to be commingling with all the kids in your grade. You know, you won't be interacting with all of the adults at the school that you typically do for obvious reasons. So it'll be an interesting dynamic where the kids go to school, have some learning, hopefully have some fun, hopefully have some socialization. But I do think that that socialization piece will be a lot different this year. And I, you know, maybe there's people that can speak to that better than I can, but it'll just be a little different.

Dr. John Lantos

Well, we will keep following up with you as well and see how, as this evolves, you think about the balances and the trade-offs. Thanks so much for taking the time, and we look forward over the next few weeks to welcoming back Jeremy Garrett, who's a research associate at the Children's Mercy Bioethics Center, Vanessa Watkins, who's the program director for the certificate program. Thanks for joining us. I'm John Lantos. From Children's Mercy in Kansas City.