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