The entryway of Mission High School on March 16, 2020 Photo by Lydia Chávez

While San Francisco has been very successful at keeping cases and deaths from COVID-19 low compared to other major cities, we have failed in our duty to safeguard the health of our most precious resource: our children and adolescents. With public schools closed for nearly one year, children in San Francisco are experiencing an unprecedented public health crisis affecting their mental and physical health.  

Pediatricians are seeing horrifying increases in depression, anxiety, suicidality, and sleep disturbance. Our pediatric patients are also suffering from excessive weight gain and new onset of high blood pressure, pre-diabetes, and fatty liver disease.

Children with specialized learning needs who should be receiving services such as occupational and physical therapy from their school sites are not able to access these resources. And children who are struggling with learning are not even being evaluated to determine which supports they need so that they can make academic progress. Many children who were previously enthusiastic learners have fallen behind or are failing classes, and others have simply stopped attending school at all.  

To address this crisis, we must reopen our public schools and offer in-person learning opportunities to all children in San Francisco this spring. While school reopening is a complex process, a critical next step is to immediately offer vaccination appointments to San Francisco Unified School District (SFUSD) teachers and school site staff.

There is robust data to show that schools can operate safely without vaccinating school staff as long as appropriate mitigation measures are in place including masking and social distancing. However, after 12 months of public health messaging that we are safest at home, teachers, other school personnel, and parents are understandably frightened.

We now have vaccines that are safe and extraordinarily effective at protecting recipients from serious illness. And, as of the past two weeks, we also have strong data to show that vaccines help prevent transmission, or spread, of the virus to others. Given the remarkable efficacy of the vaccines authorized in the United States, it is not surprising that San Francisco teachers want to be vaccinated before returning to their classrooms. In addition, many parents feel safer sending children back into classrooms knowing that adults at school sites are vaccinated. As healthcare providers, we are certainly much less anxious about in-person work now that we have been vaccinated. 

There are 10,000 SFUSD employees, between teachers and staff.  We (infectious diseases doctors, pediatricians and internists) urge the Department of Public Health, city leaders and the major health systems in San Francisco to come together and devise a plan to offer the first vaccine dose to all San Francisco Unified school site employees this week.  

The second dose can then be administered the weeks of March 22 and 29, depending on whether the initial vaccine was from Pfizer or Moderna, respectively. With an appropriate duration of time for reach full immunity, public schools in San Francisco for children from K-12 can be re-opened full time in mid- to late April. 

The return to school this year — with the safety that vaccination will provide to our educators — is imperative for San Francisco children. Without a coordinated and urgent effort to vaccinate teachers immediately, children in San Francisco may go 18 months without access to in-person education. Our children deserve better and we all deserve a society that values children and safeguards their health and educational opportunities.

As Nelson Mandela said, “There can be no keener revelation of a society’s soul than the way in which it treats its children.” We can and must do better for the children of San Francisco. With the vaccines, that time is now. 

Amy Beck MD MPH, Associate Professor of Pediatric, UCSF ,Tonya Chaffee MD MPH, Professor of Pediatrics, UCSF  , Sarah Doernberg, MD, MAS, Associate Professor, Division of Infectious Disease, UCSF , Monica Gandhi MD, MPH, Professor of Medicine, Division of HIV, Infectious Diseases, and Global Medicine, UCSF , Vanessa Thompson, MD, Associate Professor of Medicine, UCSF , Maya Vijayaraghavan, MD MAS, Assistant Professor of Medicine, UCSF 

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34 Comments

  1. Why do all of these assertions that schools can open safely ignore the fact that the majority of SFUSD students will be taking Muni to get to school? Essentially, our buses are part of the school site that will factor under that “as long as appropriate mitigation measures are in place.” Have any of the authors of this considered that? Have they been on a bus during this pandemic?

    1. Families will receive their SFUSD lottery assignment for next school year on March 19 – less than 3 weeks away. If parents don’t know what the commitment for reopening is, how many with options will choose to stay and roll the dice? How many will take the parochial school or private school offer, and how many will leave the city for districts that have committed to opening just right here in the Bay area? The Superintendent should have committed to having safely ventilated classrooms (indoors or out) long ago, and should have public plans for how all schools function. Plans can be changed, but not having a plan a year in just a failure.

    2. People are riding the muni safely. Wear a KN95 mask. Open the window Or find alternate transportation.

    3. Because… children are at EXTREMELY LOW RISK for not only infection, but also SPREAD. Of course the CDC and medical community as a whole have considered these and other concerns, like exposure risks outside of homes and schools.
      Are you a teacher ?

    4. Have *you* been on a bus or train in the past year? My kids were still taking the bus last March 13th. Transit directors have figured out a few things since then. With just about everyone wearing a mask and windows open or air filters, public transportation is minimally risky.

  2. Wouldn’t we concentrate on vaccinating special needs and PK-2 teachers/staff first, and then 3-5? Because there are absolutely no plans to bring back MS/HS kids this school year.

  3. Going to school isn’t a Gordian knot for most organizations, but a few elite power holders within SFUSD and the union have chosen to make it that way. Teachers should be vaccinated just like everyone should be. The teachers have had access to vaccines.They jumped in front of so many people including Muni Drivers who have been working this entire year, and now they are refusing to to work 4 half days instead of 2 full days.The way the union has treated to public as an ATM machine and won’t even give reasonable well-thought out plans, has been very hurtful.Many people no longer trust the union and I can understand why.

    1. Kittie, this just isn’t true. ALL front line workers need to be vaccinated. Teacher’s Unions have no control over funding for vaccination programs or vaccine administration. SFUSD and the Teacher’s union have already agreed on a plan to vaccinate teachers and staff.

      The Mayor and DPH however, have failed to provide ACCESS to vaccines. Why? You can’t blame unions for that.

      Unions would agree that ALL frontline workers need priority AND access. There’s no reason to pit one group against another, we’re all in this together!

      1. Agree that teachers don’t make the vaccination plans. But they are eligible as of Feb 24 and I know several SFUSD teachers who already got their first shots. They just haven’t set up exclusive vaccination facilities for SFUSD which certainly would make things speedier.

      2. Putting teachers first means putting someone else last. There just aren’t enough vaccines to go around. The Mayor and The City don’t control vaccine distribution, you should look at someone else, like maybe the laws of physics, why more vaccines haven’t been made yet.

      3. Andy, I completely agree. All front line workers need to be vaccinated for this to work. I am a teacher and I have been vaccinated and I’m ready to return. We are in this together.

    2. UESF did not “jump in front of ” anyone. For better or worse, we do not set public health policy. Others make those decisions. Teachers have been eligible in SF since last week, and in Alameda County (where many of us live) since the previous week. The problem is there is no systematic way to obtain an appt. You have to repeatedly spin the roulette wheel on MyTurn and other sites and hope some appts. have just opened. People in other industries and subgroups are receiving access codes that open up more appts., but teachers are not.

      The union had reasonable, well thought-out plans, but SFUSD did not, therefore the delay. Instead, they were seeking a waiver to send everyone back vaccine-free during the highest disease threat level. The city sued the district, and the district then largely adopted the UESF plan.

      And if by “treated [the] public as an ATM machine” you mean that the union advocates for full funding of students and schools, that would be a fair accusation. If you have a strong argument for less funding for urban public schools during a time when the city is being filled with tech companies and their employees who are enjoying unprecedented earnings, great. But union members are not getting wealthy. I am 50 and a veteran teacher, but if I lost my long-held Oakland lease, I would be hard pressed to find decent and affordable housing in the Bay Area. Without the union, many teachers would be long gone.

      When you say that many people don’t trust the union, I take that to mean that you don’t. But the union is the only thing standing between our kids and an outsourced, for-profit education free-for-all.

  4. If vaccines will expedite the return to in-person schooling, I’m all for it. So far, the teachers’ union has not indicated a willingness to go back to in-person teaching without *extensive safeguards in place that would leave most kids out of school buildings most days and most hours, even with teachers fully vaccinated. I’m scared we’ll push all the other frontline workers to the back of the line and then teachers, like in Oregon, will still say they don’t want to go back…

  5. Thank you for this editorial. I am incredibly eager to return to in-person teaching. Not just because it’s necessary for the kids but because I have been working nonstop adapting to distance learning. It has been exhausting, completely consuming.

    I wanted to respond to this statement: “However, after 12 months of public health messaging that we are safest at home, teachers, other school personnel, and parents are understandably frightened.” What people don’t seem to understand–or seem to forget–is that teachers have been working, many of us for years, in overcrowded, barely sanitary environments, ones quite different from other workplaces.

    In the past decades of teaching, I’ve have gotten sick–from my workplace–5-6 times a school year. And that’s with an immune system that is pretty tough. When on vacation, I don’t get sick. Ever. I recover from those 5-6 illnesses quickly, luckily, as I don’t have the luxury of actually taking time to heal with my work load. I have friends and family who work in quite a range of other kinds of workplaces. Not one of them gets sick as often as I do. None of them is ever in the situation of having 150 young people cycle through their tiny classroom over the course of a day, each set of 30 sitting for about an hour in the same place.

    Our workplaces are not at all like other people’s workplaces. Grocery stores, for example? People move through as fast as they can and don’t sit in the same place for an hour. Hospitals? They are literally constructed with health and safety measures in mind. Find me a hospital where a worker doesn’t have easy access to hot water and soap! These are just two examples. So please, please, stop ascribing teachers’ reluctance to return to some kind of collective neurosis. We know what our workplaces are like. They are not safe.

    And, again, thank you for pushing to get us vaccinated.

    1. I am very confused by the idea that school sites — which many of us visit or volunteer in with our kids — are these hothouses of unsanitary conditions, akin to, I don’t know, meat-packing plants or prisons? Or urgent care clinics where there are literally COVID-19 patients coughing all day? Your anecdotal data on getting sick with other viruses, that transmit in different ways, does not apply to this virus. Early on in the pandemic, we thought it did. Viscerally, it makes sense, kids are “germ vectors.” But now we know that unlike flu, unlike rhinovirus, SARS-CoV-2 does not transmit as efficiently in kids which means school is unlikely to be where you catch the virus. And with masks on the kids, and on you, your risk is tiny. And in any case your biggest risk is not the 150+ students you may see each day, but the friends on staff you hang out with in the breakroom during lunch. With a vaccine and prevalence rates similar to the ones we’ve had during this pandemic, you are more likely to die of a lightning strike than COVID-19. There should be no hold up on full day, 5-day, in-person schooling once teachers vaccinated.

    2. Jennifer, If your school buildings aren’t up to snuff , then your union should hold the district accountable for wasting a billion bucks a year on silly jobs like “Thought Partner” and “Instructional Reform Facilitator” and “Professional Collaborator”. We all know that your union likes to create sillly jobs so the president can generate more union dues, but we the parcel tax payers are tired of paying for nothing. Hold your union accountable to get that money to fixing building. We aren’t giving you any more money. You’ve bled the homeowners dry. If you are getting sick 5- 6 times per year then you don’t have the great immune system you think you do, and you might be in the wrong line of work. You had a year of paid vacation at the expense of homeowners. Time to get back to work like everyone else. You got to skip in front of cancer patience for the vaccine and then your school board mouth pieces whined about you having to go to Oakland to get vaccinated even though it was the SFUSD incompetents that didn’t get the code to its teachers on March 2nd. Put on your big kid pants, put on a mask, put on a face shield, and go to work or stop collecting a paycheck from the parcel tax payers.

      1. Did the unnamed “Parcel Tax Payer” seriously just say that s/he thinks teachers just had a year of vacation? For real?

  6. The SF Board of Education has been focusing on the most arcane of progressive pet projects (e.g., re-naming schools and removing test-based admittance to Lowell) instead of getting schools re-opened.

    This board should be recalled for their favoring of political pet projects over the interests of the students. Furthermore, Board VP Alison Collins in particular has shown her family bias by focusing on closing Lowell to academic testing for entry, yet completely ignoring that SOTA also has test-based entry requirements (would that have anything to do with the fact that her own kids attend SOTA?).

    Sign the petition to recall this board!

    1. Great points, Pat. I think it’s an absolute SHAME that Lowell won’t be the sanctuary for serious students in the sea of chaos that is SF public schools. I went to SOTA myself (it was shared with McAteer back then which was a typical “wild west” institution…not the case anymore), and I certainly had to take a test to get in. The SF School Board has lost the plot.

  7. Teachers are already getting vaccinated. Students who are dance teachers at studios are able to be vaccinated. Private school teachers and admins are getting vaccines. What is the hold up for SFUSD teachers and staff? Meanwhile my senior is suffering, depressed, I’m spending a fortune in therapy for her. Imagine the kids who don’t have my kinds of resources. Why can’t we get this together?

    1. Jessica, SFUSD teachers are currently eligible and receiving vaccines. It may take a while to get to every single SFUSD staff member (which lends weight to the suggestion above to prioritize those slated to return), but SFUSD teachers have been getting vaccinated and will continue to be.

    2. Jessica, I don’t mean this rude; but do you really think that high schoolers have a chance of reopening this year? I don’t have any inside scoop, so take what I say as regular gossip, but I have heard that high schools might not even be open in the fall. This board seems intent on completely destroying everything that was joyful before they came into town. Now little kids are left with nothing but joyless piles of homework that never gets graded and watching videos of some boring white lady in New York teaching about reading and writing.In my opinion it’s criminal, but I don’t see any end in sight.

  8. “There’s no reason whatsoever why the vast majority of young Americans shouldn’t be back in school immediately. The only reason most Americans don’t have that choice is Joe Biden sold out America’s children to the teachers unions. His position is morally excusable.”

    Both Breed and Newsom fear recalls for their mishandling of the pandemic and are sucking up to Republicans to diminish that threat. What else did we expect when dutiful hacks are elevated to positions of power where they have to run a public health response during a deadly pandemic at population scales?

    1. I don’t think it’s Mayor Breed’s fault that schools aren’t open. If she had the power to reopen them on her own, why did the city have to sue the school district?

  9. The time to say we need to do X, Y and Z was April when they got billions to reopen. Then you have one month to mobilize teachers and parents to volunteer, go into the site, hire people with the money, and get it done. After that, no excuses, open for all kids in person. They’re raising objections they raised in April and never volunteered or asked others to volunteer. While we’re waiting they destroyed Lowell and spent money renaming schools which could have been spent tutoring poor kids to close the achievement gap and sending literature as to how nonwhite immigrants from Nigeria and 70 other nations outperform whites by studying long hours, and working hard to convince all kids to study long hours, rather than destroying Lowell, which was one of the best high schools in the U.S. and will now be barely above average. #10 to average. Also, restore 8th grade algebra and don’t rename any schools. If they half cared about finding solutions we’d at least have sports now like baseball and softball with parents driving kids to practice. Give me a break! New York City , France, Florida, Australia, Texas opened 7 months ago with very few cases and very few teacher deaths resulting. There have been more child suicides and drug overdoses in Nevada than there would have been teacher deaths, and children’s lives are more important because they are younger.

  10. Even if teachers were all vaccinated tomorrow that would not mean schools would reopen to pre-pandemic schedules. Unfortunately there is no apparent plan for grades beyond TK-3 to return to in person learning. Correct me if I am wrong but there was never a definitive statement made that middle and high schools, or even all elementary grades would return once teachers are vaccinated. If a framework exists that addresses the scheduling logistics of upper grades returning to in-person learning, why hasn’t it been shared? Vaccinations for teachers, yes, but it seems more and more like either a stalling tactic or an excuse for not having anything else in place.

    1. Yeah, this is all really looking like just one more excuse to stall. Gabriela Lopez is blaming the March 2nd debacle on the mayor and the governor, but it would be SFUSD Human Resources that would have access to teacher contact to let them know the code for the vaccines. It can only be the fault of the incompetent higher ups in SFUSD. I do feel sorry for all the teachers, families and students. I also feel bad for everyone paying parcel taxes for schools that don’t even really exist. The board needs to be recalled and there needs to be accountability for all the people hurt in this mess.

  11. Teachers already can get the vaccine however the is a two fold problem in them getting it right now.
    First the whole “alert system” doesn’t work at all, the system where you put in your phone number to be alerted when appointments and vaccines are available, yeah never received a single text so far. Meanwhile wife found out of facebook where to get appointements, which I got 2 for my elderly parents. And then later found out other places to get appointments, which I grabbed ones for my wife and I (I am in fact a teacher). So teachers basically have to do their own leg work to find an appointment or stand in line at SF General for a walk in.
    Second is San Francisco basically is not requiring any sort of proof of eligibility for phase 1B. Sure on their website they say if you volunteer instead of get paid you qualify, they even go so far as to say if you’re looking for work in the profession and haven’t gotten it you qualify, lastly they even state that you do not need to show any proof at all! So literally anyone and everyone can lie either say they are a teacher or they are looking for work as one, or a food handler of some sort, or emergency service worker. So yeah phase 1B priority quite literally is not being enforced in San Francisco, I’m not sure how it works elsewhere though, as I’m sure most teachers in SF may not live in SF.

    Now all that said, I have a very strong objection to any prioritization of people other than hospital workers, and by hospital workers I mean those who are actively treating patients who come in while sick/injured not GPs doing “remote appointments”, not therapists, and certainly not administrators. Those people where you go to if you have COVID are the only ones who should have had priority to get the vaccine. Making some tiered system of who’s job is “more important” is just asinine. Who’s to say that someone working Burger King (yup phase 1B priority) is more likely to spread COVID than someone who hops on BART, then takes a Muni to their job working a cash register at a store (not food)?

    Bottom line is teachers need to not get handed everything on a silver platter, find their vaccines just like everyone else. It’s really not that hard, they just have to be willing to do more than “looked at a webpage once, nope, nothing”

    1. At SFGH they do check eligibility documents. Also, while anyone and everyone may be able to lie, I don’t think that’s happening in large numbers. But I agree with you; teachers are now prioritized, let them hit refresh on MyTurn, or follow the right people on Twitter, or whatever, to get the vaccine, just like everyone else. I’ve now arranged for four of our in-person educators to get vaccines — I did this because I wanted them to get vaccinated and because I kew they were *in person, with my kids, teaching, and therefore did not have time to jump online and immediately book an appointment, as the distance learning teachers do. It was not that hard, and teachers who are not yet in person should NOT be complaining about the effort involved. If they can teach a zoom class, they can create a Walgreen’s login or sign up on MyTurn.

  12. This is just ridiculous. As being a student, I prefer to continue online learning. I do not feel safe mentally going to school with hundreds of people, and not knowing who everyone comes in contact with. Foolish parents will also be making a big mistake by sending their kids to school. Also just vaccinating teachers doesn’t mean schools can be reopened. Kids need to be vaccinated before they can return to school so that everyone can feel safe and know they don’t have to worry about catching any virus. I highly condemn reopening schools.

  13. It would help if we all showed support for teachers by having all of those other employees who are working from home, including my wife, to return to their respective workplaces. We are in this together.

  14. Even with vaccines, they have no intention of opening or even given a viable plan.

    The “Gordian Knot” =
    Vince Matthews working for Eli Broad to expand Charter Schools+
    Susan Solomon working for CTA to make more money +
    Gabriela Lopez smiling at herself on Zoom and listening to her own voice.

  15. Alison Collins seems to enjoy tying Gordian knots around our schools in the middle of a pandemic. For some reason she is obsessed with Lowell, but is ok with SOTA being a merit based admissions. Could that be because her own kids go to SOTA and she wants to control who gets in? Don’t worry Alison, we didn’t think your kids got into SOTA based on merit, but we all know it wasn’t a lottery either.

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