Meeting

Reopening U.S. Schools During a Pandemic

Wednesday, September 9, 2020
Mike Blake/REUTERS
Speakers

Superintendent, Los Angeles Unified School District; Member, Council on Foreign Relations

Chancellor, University of Houston System and President, University of Houston; Member, Council on Foreign Relations

Commissioner of Health, State of New York; Member, Council on Foreign Relations

Presider

President and Chief Executive Officer, Henry Luce Foundation; Member, Council on Foreign Relations

Speakers discuss the different approaches U.S. states are adopting to reopen schools and universities amid the COVID-19 pandemic, including the metrics used in decision-making and potential contingency plans.

SILVER: Welcome to today's Council on Foreign Relations meeting “Reopening U.S. Schools During a Pandemic.” We're very fortunate today to have three CFR members with a range of expertise to talk with us here. We have Austin Beutner, superintendent of LA Unified School District, Renu Khator, chancellor of the University of Houston system and president of the University of Houston, and Howard Zucker, commissioner of health in New York state.

Welcome, everyone, and thank you so much for taking the time to talk with us today. As a parent of two small children, one of whom went to zoom school today, and one of whom went to in-person school today, and as a former college president, I have so many questions that I want to ask you. But I want to make sure that we give you all a chance to actually set the scene for us. So, I wanted to ask you each if there are three things that you're thinking about, that you wish we were all thinking about in this moment, and going forward, and Howard, we'll start with you.

ZUCKER:  Sure. So, I think a few things that I've been thinking about is about the way to make sure that all kids stay safe, particularly in K-12, as well as in college. That's the first issue that I think is critically important. The second issue is the combination between flu and coronavirus as we go into the autumn time of year and how to address them; make sure that those who need to be tested are tested, particularly since younger kids tend to spread things among themselves as little kids, I should say, and also the congregate setting in colleges. And obviously the third issue in many ways is how to get us back to a new normal or get us into this new normal to be able to move forward as a society and to balance all the different issues at play right now.

SILVER: I hope you're going to tell us how to get back to the new normal, but we'll get to that. Renu, about under three percent of U.S. colleges and universities open fully in person this fall, unprecedented to say the least. I know you all opened with a hybrid model, we could call it, on August 24. Can you talk a little bit about what you're thinking about every day? I'm assuming there are things keeping you up at night. What do you think should be keeping us all up at night?

KHATOR: Right. So, thank you. First of all, in our University of Houston system there are 76,000 students and four institutions of different types. One is research flagship and other three are access providing. I'm also president of the flagship—47,000 students there. Right now, what we're thinking is how is it we provide a safe learning environment, how we make campus a safer place for those who want to come here than wherever they might be. But we are again, the same as we heard before, we are thinking about new normal.  How can we help get to new normal? And that means many of our researchers actually started to convert their technologies and applications to see how is it that we manage and mitigate the virus, as well as how is it that we find solutions to it, like finding a better air quality system because we have all kinds of departments and disparities, and things like that, and how the virus affects others.

So, we are thinking from different dimensions, not just what the new normal is going to be, but also what will lead us to that new normal, hopefully sooner than later? And then of course, our eyes are always, a third thing, our eyes are constantly on what is the region going to need in order to rebuild the economy and in order to have a more just society because these are the issues we are grappling with. So, don't face this time in panic. Come, make the decisions that have to be made, but then also keep an eye on what is it that we can do consistent to our mission.

SILVER: Austin, maybe over projecting my experience is apparent here, but I think we saw very starkly, and really across the board, the different experiences for different families in different communities and socioeconomic levels, the way in which the K–12 system really impacts everybody's life, not just the lives of children and not just the lives of those with children. Can you talk a little bit about this from this kind of system's perspective? What is it that you wish we were all thinking about? Even beyond the basics of health and safety, which of course have to come first.

BEUTNER: Sure, well, I like your turn of phrase, which is we all have a stake in public education. In Los Angeles, we serve the needs of about 700,000 students. We have 75,000 employees who do that each and every day across 700 square miles. More than eighty percent of families we serve live in poverty. And surveys tell us more than two-thirds of them have lost work due to this crisis. So, we're serving high-needs communities and the three things that we try to keep in mind we did back in February we do today. Our first one we can do to address the learning needs of students. The second is how we can provide a safety net for students and families we support because we are that lifeline to so many. And how do we take care of our employees during all of this because they're the ones who take care of the students and family. So, the same three things guide us even in this crisis. We have to do some things differently, but the same three things guide us.

SILVER: I think that safety net, I think that schools provide, and also colleges and universities, in many cases, has become visible in a way to the broad swath of population in a way that perhaps it wasn't. Even there are things of course that schools do that are perhaps even invisible to families in terms of providing safety net. We've heard a lot about mental health, for example, in this period, of mental health of students and the social supports. Renu, and then Austin, can you just reflect a little bit on what this has made you think about both the kinds of supports that we were providing collectively as a society pre-pandemic, what you see as the needs now, and perhaps what you see as the need going forward.

KHATOR: You know, we too often get comfortable in what we are doing and thinking that, you know, we're doing the best we can and then the pandemic hit and we realized many things. We realized what technological needs of the students were. We just thought students would have the needed technology and we knew that public schools, because we do have several public schools in our neighborhood, who we have been working with for last three, four years in trying to get their achievement levels high. And our attention turned to them for technological need.

And then we realized so many of our students really did not have either the proper equipment or they didn't have the connection for WiFi or broadband. So we could offer the classes, but they really couldn’t take them, so we had to immediately address that. Mental health became a big issue. For us for couple of months, there was more or less not much that people reached out to us and then we saw a huge jump as they started feeling comfortable and then use a long road. And it's not just with the students, we realized that they were needs outside of it. We opened a testing facility on campus. We realized our community really needed the testing facility.

We realized also that the homelessness, the food hunger, because we have what is called a Cougar Pantry. And, you know, we had to think about it. What are we going to do about students who were really relying on that, so we had to open that one up quickly. We realized that we couldn't really shut the doors of our residence halls. I know many universities did, and maybe they could afford to. We realized these students have no place to go, or if they have place to go, that's far less safe than what we could do. So, throughout the pandemic, we actually kept our residence halls open and at least thousand students, even at the lowest time in the summertime, we had at least a thousand of students who are staying with us.

Then we also started looking at what were the disparity needs that the distrust for all kinds of medical information and our College of Medicine, which by the way, starting one brand new we started it, starting one in any time is just a such a hard thing. We started one this year during pandemic, but our brand-new faculty and students they just committed to the mission. And we realized that they really needed to reach out to the community in that sense. But even in so many other areas of the university, we realized that the relationship we had with the community really needed to be stronger, that we needed to figure it out: how to navigate this pandemic together.

So, in many different levels, and we're not talking about sports right now, but we will probably talk at some point time but many, many levels has been such complicated issues to juggle and I always keep reminding myself, okay, don't get overwhelmed. We are trying to do imperfect solutions to impossible problems. But we know that it's not going to be perfect. We can't wait till that time. We have to, in a crisis situation, you got to use the best information move forward. And then you see what comes next day, day to day week to week.

BEUTNER: Just to echo that: the safety net. So, many of the challenges society faces present themselves in schools, and an ordinary day we serve a million meals we call the school lunch program. When school facilities were closed, we became a food relief center. Throughout the communities we serve, we've provided almost sixty million meals now to children and adults. So, you go from child meals at school to food relief for the community because it's the right thing, because we're capable of doing that. To the point Renu is making, the connection students need to have with the school, we think of the digital divide is existing somewhere between North and South Dakota, where there aren't cell towers.

Well, in urban district serving families living below the poverty line that divide exist because they can't afford a plan. They don't have access. So, we had to provide devices, computers, to every one of our students and internet access. Who would have thunk that we are one of the largest providers of internet access for free to students and families in the nation. But we had to. A challenge society faces nestled itself in schools and more recently, we have launched an ambitious effort to provide testing for the coronavirus to students, teachers, and family members who may have come in contact with someone with the virus.

Again, the challenge comes to schools. It's a place where it may be solved, but it's so far beyond the traditional reading, writing, arithmetic, and making sure our textbooks are up to date. We've had to think of this as an opportunity to provide that safety net where we're able to do so to keep families connected, to keep children and adults fed as we embark on this next chapter to make sure we provide free safe reopening of schools.

SILVER: You all mentioned a thinking about a new normal. And it seems like embedded, Austin, Renu, of what you just said, there are at least three more CFR member meetings to talk about everything from technology, infrastructure, and technology distribution to food and hunger and food infrastructure and food distribution infrastructure. So, I'll just leave that to the staff and we'll maybe come back to those things. And Howard, Renu mentioned trust. It seems like one of the biggest challenges that we have had as a society throughout the pandemic, is trust, trusting information, trust in each other, trust within communities. Obviously, some places have been able to muster that trust in ways that others have not. Can you can you talk a little bit about that from the public health perspective?

ZUCKER: I think that we live in a society right now where there is a lack of trust among many, many people, there's lack of trust in institutions, and clearly there's been the challenge is a lack of trust in government. Sitting in seat of government, I think what we do and what Governor Cuomo did was to provide information, provide the facts. And that's why in the course of this pandemic, particularly early on in March and April, the governor was out there, his team was out there, we will all share the information, good or bad information. And I think that by providing the data, providing the information, it establishes, it helps establish, a trust between the community and government. I think also, there's the trust between individuals to feel that everyone's working together on an effort to overcome the challenges of this pandemic. I do think that hopefully going forward as part of that new normal, we can maintain that trust in those who provide information to help us as a society.

SILVER: And can I stick with you for a second? I want to delve a little bit into what we're all seeing, which is the challenge of our society at various levels to make decisions under uncertainty, conditions of uncertainty, which are ongoing rolling conditions of uncertainty, persistent conditions of uncertainty. And obviously trust is a huge part of what might make us able, better, to make decisions under uncertainty even when we don't know exactly what the right answer is, if we trust each other to have that conversation. But I wanted to actually turn to something that is also very kind of pragmatic on the ground, which is geographic scale. At what geographic scale are we to be making, what kinds of decisions in your view? What really belongs at the federal level, state level, county level, district level institution level? And how do we generate the kind of information so that the various different levels can make those decisions? Obviously, that's a huge question to pick whatever piece of that you'd like. And then I'll turn to our other two panelists who have the kind of institution level and district level view of that question.

ZUCKER: I think an ideal situation, if things were perfect, you would want at the largest scale, you would want this to be pulled together at a federal level. And that this information is provided across the states and even on a larger scale at a world health organization or global level, to put forth the challenge that we're facing the information, and then as it works down as an overarching plan, then each state could sort of be working together with other states. That's not what happened in the situation, as we know. And so then it fell to the states and, you know, from I could speak for New York felt to us, particularly since we were at the epicenter on this issue is to figure out how to address this and then, as you just mentioned before information came in, but all the data was not available at that time, not because wasn't available to New York, it was not available to anyone. Information was changing.

The science, we were learning more and more about the virus and more and more about the science. As that information came in, we had to adjust and make the necessary changes. Again, it goes back to providing information to the public, providing information to the other experts, and to make a decision at that point in time. So, then it fell within states and we pushed forward, whether it's the issues of hospitalizations, the issues of testing, and we had to move forward to address that for the people of New York. And then it goes down to obviously the county levels and further down to working with the hospitals and with individual communities and organizations that work with those communities as well.

SILVER: It seems like one of the big stressors beyond the public health stress itself, beyond the health and safety stresses, that individuals and individual families are feeling like they have to make decisions under conditions of uncertainty with limited information. I think I'll speak for myself: a lot of us wish we could just be told what we should do. Should I send my six-year-old to school? Should I send my middle schooler? Knowing even if there isn't perfect public health information, that feels like that that kind of decision shouldn't be at the individual level in some fundamental way, at least to me having to make those decisions.

ZUCKER: Well, I think, you know, as what we launched today in New York, or yesterday, in New York, the governor mentioned that we are going to have a report card for the schools to get and provide all the information. I think that it will help the public make a decision, because everyone has a different level of risk. Everyone will decide how much risk they want to take and nothing's without any risk. So, the best way to help community is to provide them with the information. The best way to do that is to provide them with the data that you're receiving, and that's where the government push forward with a COVID-19 report card for all the schools in the state to be able to have all that information. You should be able to type in your address, your school. We will have all that information. And we will provide that on a dashboard to the public just like we did with the other issues of testing and results and, and the number of deaths and number of cases in the hospital etcetera. And I think that will help the public be able to make a decision based on their particular circumstances.

And I think the reason I raised that particularly with schools is because some people may have one child at home, both parents are perfectly healthy, relatively young, and someone else may have five children at home and their grandparent is living there who just got out of the hospital with a serious medical condition. So, everyone has to weigh different aspects, but we can do as government is provide the information so that they can make an informed decision. I think that's what anyone would want. If you step away from the education part and I put my hat on as a doctor, when I provide patients with information for them to make a decision about the health, you want to provide them with the data, give them the information, you have recommendations based on expertise, and then they have to weigh sometimes some of those risks as best as they can.

BEUTNER: I was going to say just to pick up on that same thread. We are also sharing school level information about COVID. But it is more than our testing program. We brought in health insurers because they have real current data on the impact the virus is having on their service members, which could be our students and families or it could be much broader. We brought in Microsoft to enable us with a set of tools. We have brought in three different universities who are looking at the epidemiological modeling, and looking at, as Howard mentioned, the ever-changing science. So of course, to synthesize a lot of different pieces we've got, let's see three universities, two different testing companies, two different health insurers, and one tech giant in a partridge in a pear.

We brought together lots of different organizations who have information to try to synthesize it for our school community because it's not enough just to say there's an incidence or not at a school. The context matters. And so we're trying to be that place to better inform the families we serve. Here's everything we know, in an unbiased manner, and allow people to make the best possible decision. To the broader point Howard's talking about a moment ago--the role of different levels of government, the tools and resources--we shouldn't have different municipalities, different localities scrambling to serve or to find. That ought to be ubiquitous. How you implement those tools and resources and a local decision about very local, very individual for a family or a school, or a neighborhood or a school district, use the tools and resources. Make a decision that's right for the community you serve with the tools and resources. We shouldn't have local organizations scrambling to find them.

SILVER: So it sounds very clearly like we need information flowing up from the from the street level, if you will, information point down from the federal government, enabling individuals to make choices by providing the tools and resources to the institutions and organizations that will surround or envelop those particular families as they make their decision. Renu, I know that you when you opened—

KHATOR: —I was just going say, institutionally, you know, trying to make a decision, it does make it harder when you get different signals from different levels of government. But then I also understand that during times of crisis, that information is coming fast. And also it's changing very fast. So, you have to have that adaptability. For us, we were lucky in the sense that we have Texas Medical Center, world's largest medical center, right there in Houston. We had a lot of experts that way. We had our own college of medicine to be able to help us guide. I serve on NCAA's Board of Governors, I had their, you know, best people, their medical experts, guiding from there and of course then all other elements from city and from state. But then at the end of the day, I think there are two components that become important: one is you got to make sure you have transparency of data, and that's what we heard. You got to provide information you can just hold and think you are the best decision makers have that transparency, have that communication, have that honesty so that people can trust.

Second thing very important is that you got to give people flexibility and options for choosing because we are not the society where we would like to be spoon fed to say this is your option. And I think, at least in our setting, we started reopening the university by completely putting a very...our strategies are about flexibility and compassion. Think about compassion because people are going through different types of anxieties. Young professors, they're teaching from home and they have children at home. But they also are trying to teach and learn while they are never taught online.

So, you have to find a compassion of both ends of it. But then our goal was always how do we create a safer environment on campus than it is outside. Now, if you still you choose, given all the data and given all the option, if you choose that you do not want to come, we have to respect that. And then we have to accommodate that because these are again times, maybe next month, maybe two months from now they'll feel comfortable. So, for us students can start taking online but they wanted to switch to face to face they can because we completely retrofitted our classrooms into high-flex models, all technology so that when you're teaching even face to face, you can also access it online. So, people do have option going back and forth if they felt personally vulnerable.

And I would say you do need a little bit of luck as well. Actually, a lot of luck during these times, and so far we've been lucky things have been moving, kind of in the right direction. Houston is moving the right direction, and University of Houston has been lucky as well on many fronts. But these are the challenges. And I feel sometimes I get exhausted just running constantly during the day, sometimes from balcony, trying to see the bigger picture, and then coming down running at the ground level, trying to just find the solutions to little things. So, I mean, I think honesty, trust, hope, and calmness, all of these are part of really good strategy as you try to take your institution forward. 

SILVER: When trying to sort of squint our eyes and imagine how this whole experience would have been, or would be now, if we had flexibility, compassion, transparency, communication, and trust embedded into all of our institutions and all of those levels. Seems like we would be in a very different place. So, thank you. Thank you for that, Renu. I wanted to turn us a little bit towards the future. Before we open it up to questions from members, which we'll do in a couple of minutes here, we'll mention the new normal. I don't think this is the new normal that we all want. So, the next new normal, as we think about what's the next new normal? What is one long term change that that you would like to see as a result of this? Fast forward, maybe Howard can tell us how long, but let's say a year from now. So, opening schools a year from now, what things do we want to either have already fundamentally changed or have entrained to fundamentally change even if it takes longer than a year to realize it? Austin, I'll start with you.

BEUTNER: Let me look at the glasses half full. The health challenge is enormous. But I'm going to wish that away for a moment and look at the next chapter in public education. I'm going to assume that everyone stays with us in this journey. So, the lack of adequacy, the need to make schools the center of a conversation stays with us, but one thing that we have been really forced to look at is how we engage students differently. The old pedagogy of a student in a classroom where we measure attendance because they're sitting there, we see them there, and we assume therefore they're engaged in learning, not always the case. That becomes a digital connection.

The burden is on us to make it interesting to engage students. And so, we took the opportunity over the course of the summer to try some rather different experiments. We brought in Fender who donated instruments we had 1,000 now 3,000 students taking virtual guitar lessons. We brought in Snapchat where we tried to meet students where they are, so Alicia Keys Russell Westbrook created a book club. Alicia Keys talking about Brown Girl Dreaming and within moments 500 students of ours downloading the book to participate in read alongside her.

We brought in James Cameron to take us on a voyage of the Titanic weaving in literacy, math, science, and the voyage of discovery. And you know what we found? Students were captivated by it. It's a different way to learn. If we can bring that knowledge and experience back, maintain the connection, which we've never had before, directly with every student and family, when we go back to the classroom, which we know is the foundation of public education, we know it's the best place for learning to occur. But if we can bring that engagement, that creativity and using the tools and technologies, one to one is at least two and a half, if not ten. So, I think there's a better future for public education. We take some of those learnings forward with us. And I'll leave it to Howard and Renu the other doctors to make sure that we've got a vaccine or at least a treatment that's one hundred percent effective before.

SILVER: I think we can all just go ahead and say we wish for a vaccine and what you say to executives, technology, infrastructure questions that hopefully will be the topic of the next member meeting. Howard.

ZUCKER: So, I think there's two parts to this one is school what will happen in the future, where K-12 and then for college. I think there is a silver lining here because I've always felt that, I'm a pediatrician, you can carry many messages to adults through children's school. This is a wonderful environment to teach children right things to do and sometimes bring those messages to others. I think that we will be able to see an environment where children are much more sensitive to the needs of being sure that they are, if they're sick, or they're not feeling well, to stay home from school.

As a parent issue, there's a tendency to send your child to school and say well, he has a little bit of a cold, a little bit of fever, I'll send them. I think that in the future people going to think about that differently because of the relationship that they have. I think there are many messages about good public health practice, about washing your hands, just like we do with other things with children, we can teach them about those messages moving forward. So that is at the K-12 level. And as I was mentioned before, parents not sending their kids to school, per se.

At the college level, I think there is an increased amount of interest in understanding of what public health is all about: how much one virus can actually shut down the world, and how many other things could literally shut down the entire world and in many ways, countries and countries, but infectious disease can do that. So that's one aspect. And I also think that the relationship of young adults working with others working with those who are older, recognizing that we're all in this together. We are part of a big society and that we have to work together. And I do see a silver lining in this as we move forward very much looking at this as the after the pandemic. So, it's like pre-pandemic, and then post-pandemic, and we'll look at things differently about public health. Much like after September 11, there was before-911, we say pre-911, post-911. We looked at homeland security a little bit differently after that. So, I think there's going to be many positives that come out of this, despite the difficult and troubling times we're going through right now.

SILVER: Renu, can I add a B to yours, which is what do you wish all your students would take away from this experience?

KHATOR: Right. So students are also in the public too. You know, in terms of one thing: the genie is out of the bottle. This whole experimentation with technology, many, many assumptions that we held very true to ourselves have been really tested and broken right now, too. And we are studying that. For instance, all of these flexibility in admissions, no SAT, no ACT. We can't have those, right? In terms of grading policy, complete change. We're going to see how these people proceed and how they work and maybe these assumptions will get broken. In terms of technology, I have seen it myself, professors in March, arguing deeply. Oh, there is no way I can teach my engineering. This and this content cannot be taught. I need people here.

Now, I see them using their technology and getting through there. Now, of course, everything isn't turning into technology, but I can totally see us having very different ways of serving the educational needs of our communities. And also I can see if it is not, exactly remotely, but then we I can also see that allowing that in depth, immersion into lot of things that technology is going to be right in our faces. So, things will change. As for students, I always tell them, I say just make sure you understand that this is not the end. We are going to come out of it. We have come out of it previously from global pandemics. I mean, and I have been reading a lot now, back then I'm a political scientist. We will come out of it.

And when we come out of it, we are going to need new thinkers, people who really can absorb these changes right now and who can see differently so that they can create a more vibrant economy and so that they can create a more just society, both things. We have been part of the old, even though we realize we are part of this breakup, we are not going to be the part of those who build it. So we are going to need you more than ever. And believe it or not, the interest in medical school has been enormous and even getting more, but our interest in universities, our enrollment was up twenty-seven percent in summer, and it is up now although all my budgets were based on we're going to really lose a lot of students but people want to be here.

We started offering micro credentialing because we knew so many people are out a job, what can we do for them to upskill their talents? Enormous interest in that, too. Would we have thought about doing that before? Yeah, maybe you know, at slow speed, everything got put on fastest speed. In some ways, I think we're going to learn a lot. And there will be profound transformational changes we'll see. Some of those changes, we don't even know what those will look like.

SILVER: I'm glad this meeting is recorded, Renu, so that I can play that back to myself on a dark day. Thank you. So at this time, we're going to turn to members ask them to join our conversation with their questions, a reminder that this meeting is on the record and the operator will now Thank you, Laura, remind you how to add a question to the queue?

STAFF: We'll take the first question from Esther Dyson.

Q:  Hi, good afternoon. I'd love to hear more about what are the benefits that might happen afterwards? Vis a vis just the inequity in education between poor children in poor neighborhoods, children in rich neighborhoods, are we going to be able to serve them better with this electronic stuff? We're seeing they don't have computers, just a little more about that. And what we should change based on what we've learned.

SILVER: Austin, do you want to take that first?

BEUTNER: Sure, and thank you, I think it's the right question to be asking. This crisis has exacerbated the challenge that exists in so many of our communities. If you look at the students who are struggling the most now it would be those learning English, those with differences or disabilities, those from families who don't have the support at home maybe because they're living in poverty, maybe because everyone in the family has to be at work somewhere else. That gap has widened. Now, connecting those families for the first time ever is a start, but it's a small start. There's more that needs to be done. We're trying some strategies, for instance, to provide one-on-one support tutoring for students that didn't exist before because we realize this type of engagement doesn't really foster one on one. We could have a private conversation, Marco, you, and I, and everyone else would probably drop off or at least start doing emails to make something else. So more needs to be done. I think it's clear now we have even more data to confirm the gap between haves and have nots that so many public institutions try to close, try to serve, has only been made wider by this.

And one of the things that we're spending a bunch of time on now is how we recover from this. What needs to be done differently so we don't fall back into old habits or think that what we were doing before was sufficient? And that will be one of the great challenges which stay with us in public education. It won't be just the digital divide to be closed, it will be what do we do for students for whom the absence from school mattered the most? What do we do for students who didn't have access at home during this pandemic? What do we do for social emotional support? Renu mentioned earlier, there were acute mental health needs in our schools before. They've only been made more acute because perhaps someone in the household loss work someone became sick or god forbid something worse. So, the challenging going back is recognizing the same old same old won't be good enough when we go back.

SILVER: And this question that you raise of how do we address what's been exacerbated? And for whom? And how do we think about that as a society? And again, at what level of government? Do we want to address that? Those are essential. Howard, can I just ask you to bring in perhaps the kind of statewide, rural and urban, set of questions because of course there's unequal access to tech and tech infrastructure and different kinds of inequalities that come up in a rural environment versus an urban environment.

ZUCKER: I think they're I think this is even broader than just the education issues. One of the things I've noticed is there are many, there's always been many, health inequity. I think that what has happened with this pandemic is that the issues that we saw before have just been both crystallized and have been made even more apparent and so health inequities that we see particularly in socioeconomic challenged communities primarily and translate into educational problems because the child who is sick, the child who is not getting the necessary care, ends up home doesn't get the necessary learning and then they end up falling behind in school, and I think they become more challenged.

Going back to your question about the technologies and in rural and urban areas, what I do believe that we will find from this pandemic is that we will utilize many more of the technologies that are available to improve people's health and provide care to those who don't have easy access to health care whether it's because of just the distance that they are from a healthcare facility, or just because they are not tied into the system as well as they should be. So I think these technologies will allow us to move forward and I think that there are many different companies that are working on this. There are many different public-private partnerships. We are already looking at many at the state level to test and to see how they pan out in the near future.

KHATOR: I can just add something? That's a great question. We have the best experts writing for me the white paper on different dimensions of what the new normal may look like and so on. But one thing I keep thinking, now this is the time to really instead of bringing the society into the university. We will have to take university out into the society. For instance, should I be bringing more parking lots? Maybe not maybe I should be building more collaboration centers in some of the communities where then if the remote learning remains or technology remains that well integrated so that those people who have digital divide can also find that access, but also can have opportunity to do other kinds of things. I mean, I've got ideas, you know, what kinds of things we could do. So, all I'm trying to say is that we don't have the answer yet because we are still in the middle of the eye of the hurricane right now. From sorry, from Houston hurricane comes so quickly to mind. But as we come out, and as we start to recover, there will be things out there that we haven't thought about, but they needed to happen. So, I'm always looking for that positive silver lining. What can we learn and how can we serve better our mission? So, thank you, Esther, for that question.

SILVER: Thank you, Laura. We'll take the next question.

STAFF: We'll take the next question from Jay Vogelson.

Q: I'm Jay Vogelson. I'm an international arbitrator. You know, Bob Woodward's new book is coming out now. And he has lots of recorded tapes of discussions with President Trump. One of them that hit the news this afternoon was that President Trump admitted that he knew about the virus in January. He knew the extent of it. But he downplayed it all because he was afraid of starting a panic. If you had known in January that the virus was here and coming in the strength that it is, what would you have done differently?

SILVER: We have a volunteer, Howard.

ZUCKER: So, I think that there's many, many aspects to that question. I think number one, is the issue of testing. The only way that you're able to address this problem is to scale up the amount of testing. We have done a dramatic job with that in the state of New York. We're doing eighty thousand to one hundred thousand tests a day. But if I knew about this in January, we would have obviously pushed the testing quicker. You know, it took the CDC until actually, much later. And we ultimately had our own test at the end of February to be able to test people in the state of New York and that was the first test outside of CDC. And there was a long lag time for the CDC to even get up to scale. So, I think testing is number one.

Education, communicating the message, you know, the governor, once we had a case and the governor was communicating the message to the public. But if we knew what was going on in January, we would have taken the necessary steps to address that. And I believe that going back to what you just raised, I haven't heard about that information that you just presented. But this also goes back to a federal issue that if the president knew that this virus was coming into the United States back in January, and as we've learned about New York it came in through from Europe then the necessary steps would have been taken by the federal government to protect not just New York, but the entire country on this issue. So that's one issue: testing.

And we would have scaled up many of the equipment that was needed the ventilators, the protective equipment. We were rushing to get all of our equipment available and out to the to the hospitals in the communities and having more time always makes things a lot easier to address those needs. So, I think that there are many different parts. Those are just a few of the issues. As I mentioned, letting the public know about what was going on. I wish we knew, I wish I knew, that the information that now I'm hearing that the federal government did know.

SILVER: Renu, Austin, did you want to add one thing that you would have done differently if you had known that much earlier?

KHATOR: Sorry, Austin. No, you go first. I just heard my name. Sorry.

BEUTNER: Go ahead.

KHATOR: I was just going to say that what we did in March, we took the, you know, we everything in eight days, we took nine thousand courses online, we probably would have prepared better as how to handle we probably would have prepared better how to, you know, provide a safe learning environment. But it's easy to say right now what we would have done, you know, had we had more information, it also depends on what kind of information or quality of information with what kind of options, you know. So, with all of that, I'm sure we did our best when we got the information, we would have done even better than best if we had the information beforehand.

BEUTNER: I would echo my colleagues’ comments and just put framing in slightly different way, which is information gives you horizon. It allows you to plan for whatever you can see down the road. You think about a toddler learning to walk they bump into things because they're watching feet. As you age, you start to look down the sidewalk a little bit and you don't bump into trees anymore. And I think all of us have been burdened without that ability to see the horizon. And if we'd been able to see the horizon in January, I think, you know, each of our plans might have been differently, whether it was more ventilator sooner or testing sooner, planning for online sooner, all those things. But it comes back to where we started this conversation, which is clarity of information at all levels, and sharing that information is invaluable, because as leaders of organizations or parts of those teams, we all need to look to that horizon. Because if we're just watching our feet every day, we're gonna bump into trees. But if we can look together, we're going to come out this much, much better.

SILVER: Thanks, Laura. We'll take the next question.

STAFF: We'll take the next question from danah boyd.

Q: Hi, there. Thank you guys so much for sharing your experiences with us today. You know, one of the things that's always impressed me about K-12 education in particular is that you provide a lot of community services that are not necessarily visible to the public. And a lot of those things aren't necessarily getting the public attention. So while we're talking in many ways about making certain that poor children have access to food, one of the things I don't hear conversations about are things like how to make certain that young children who are being abused at home get the necessary social services. And I'm curious, how are you preparing your teachers, other members of your community, to look out for the children who are most at risk, who normally you have the ability to do so in the classroom? And now it's a totally different game.

BEUTNER: Yeah, again, danah, thank you for that question. The challenge in society comes to schools. When we are in a congregate setting we don't just measure attendance. We don't just measure progress in an academic manner. We can put eyes on a child and say are you healthy? Are you happy? Are you engaged? Do you have a bruise on your forehead? Where did that come from? And all of those guides are leaving us because online is not the same. So, we're going to face a challenge going back. In the interim, the tools we can use are generally a poor substitute because there's no substitute for being together. That's the foundation of public education, the socialization that occurs, the safety net, the counseling, the socialization of young children, learning to solve conflict and learning together.

We've seen whether it is the tragic killing of George Floyd and other societal issues present themselves to society as a whole during this and we weren't in the best place to have those conversations with students. We weren't together. We had to find different ways, we had to find resources to provide for teachers and those who are in conversations like this with students, but there's still no substitute for being in school which takes us back to that imperative of connecting the health system with the education system with all the other supports a community can provide so that we have children and teachers safely back in schools as soon as we can.

SILVER: So often, what should we be doing now to plan for when there is a return to in person, the kinds of perhaps additional ramped-up support that school communities are going to need? As you say, notwithstanding the support, of course, that they need now, that perhaps some of that is just simply impossible to replicate online. And then, you know, back to Esther's question, how do we think about if we're headed towards a more technology-mediated school experience for students of all ages? How do we how do we start to develop those kinds of tools and replacements for that person? pulse check?

BEUTNER: Yeah, you know, the first place to start and this is a hard conversation is an honest one about the adequacy of funding for public education. In Los Angeles, we're asked to make do about $17,000 a year to invest in a child, New York. About $30,000 a year. You can see the challenge and lack of adequacy because I can take you to a school and you'll see a math class of forty kids, you'll see a school library without a librarian. You'll see schools without full time nurses or counselors or social emotional support that is needed in schools. And it's disconnected. I'd be curious about Howard's view, what he sees in New York where it is a little more connected, at least institutionally, because that service is best provided in schools.

It's where children are. We should be looking at, the Marshall plan is over used, I don't want to use that. I wish I could do something better. But we can't go back to the same old same old because it was not adequate before. We had children struggling before the pandemic, it will be worse. So, we can develop plans and strategies, but it starts with a lack of adequacy and funding and we hope at the federal level there's a recognition of this because there's a lot of talk about job recovery. But there is no economy in the future without a well-educated workforce who are in our schools right now, and for many of our students, there's a path out of poverty. For all it's the foundation of a bright future. But those supports have to be present in schools each and every day.

SILVER: So, it sounds like you really feel that there needs to be a major intervention and a real planning effort afoot now.

BEUTNER: Not just planning because I think planning absent the funding to deliver on it, is aspirations and wishes, I think we all share those same aspirations and wishes. But this is also a time to have a real conversation about whether schools are adequately funded to do what they need to do to support students who need that support each and every day.

KHATOR: I agree with Austin. Just from the university point of view, wanted to point out, for instance, we have a center and our researcher David Francis has a $10 million grant that he's working on. How can we overcome instructional barriers for students? So there's a lot of research out there, but one of the things does come back to the funding of public education and its value and how it's treated as a common good and invested in that, and because that is exactly as Austin says, it is the foundation. And we know that those things we do offer. We have a different clientele, of course, you know those students, some of them can take online and be supported with mental health, but there are a lot of issues that obviously cannot be. And if the funding is there, the planning is there, I think as we start to come out of it, we will be much better equipped, and we'll do what we need to do because we are bound by mission. But I think both of those things will definitely help us tackle it better and to take it farther.

SILVER: Thank you. And thank you danah for the question. Laura, we'll take the next question.

STAFF: We'll take the next question from Alice. Alice, please identify yourself and then proceed with your question.

Q: Hi, I'm Alice Tepper Marlin, retired now but used to head up and founded Social Accountability International. I'm fascinated by all of your ideas and opportunities for the new normal. And have two kinds of questions about possibilities for that. One has to do with obesity. One of the things we've learned recently about COVID-19 is that one of the underlying conditions that is most linked to the likelihood of receiving it and the severity and the death rate is obesity. So, of course, we know that's the case with other diseases as well. But this is a learning opportunity and a real opportunity to change things. What all of you think we could do in the education system, in food provision, and in the regulatory and leadership role of government to reduce obesity among our children as well as our adults.

SILVER: Hi, Alice, thank you. Howard, I think that one goes to you.

ZUCKER: I appreciate that question because you are absolutely correct. This issue of obesity is something which not only was a problem prior to the pandemic, but I, too, notice that was one of the major comorbid conditions that caused the problems and particularly increased in mortality among those who developed coronavirus. I'll talk a little bit about what we're doing in the state. We have worked very hard on the issues of obesity as part of our prevention agenda. And we were trying to attempt to tackle this from multiple fronts: education, better nutrition, decrease the amount of fast food that's available to children, more information to both children and adults.

But it also goes back to what we were speaking about before: this health equity issue because all these things sort of tie together. They end up swimming in the same pond. If someone ends up unable, they can't afford food, they end up going to get fast food--it's something cheap, it's not nutritious, they end up with obesity, they end up with multiple other medical conditions, they end up a sick, they end up not getting to class and then their education suffers. So, we are tackling this from multiple fronts in the state. But I think that more information about this is helpful. I think when it comes to this issue about the pandemic, I think when this is over, and we start addressing some of these things, we'll have to list out all the public health challenges that we faced and highlight this issue about how obesity contributed to yet another problem in addition to all the other problems that we've seen, both in children and adults. So, I appreciate that a question and I think we will tackle them.

BEUTNER: Can I add just to take a practical piece from a school standpoint because the issue of health equity we see every day? Part of it is making sure our students, children in our schools, have access to a place to recreate. Los Angeles is under par compared to many big sprawling urban communities. And for most students we serve, the park is actually during the week called a field or gymnasium. But those are locked on weekends, we don't receive funding from the state or anywhere else to have them open on the weekend. Now, Howard's a doctor, you may be this kind of doctor would say, hmm, if the kid's active five days a week, that's good, let's keep them active and allow those parts to be open. So, there are solutions out there if we can think of think of it as a system. So, if he's communicating about the need to be active, that's fantastic. Let's make sure our field is unlocked and staffed. So that students can come on Saturday and Sunday and continue to be active and all of a sudden the pieces are connected. So, I think some of the solutions are right in front of us. If we can tackle that issue of adequacy, tackle the issue of connecting it to a place where students can receive the health equity deserve.

ZUCKER: But, to have that park unlocked, it also has to be also your safety piece again, and-

BEUTNER:  It all comes. Yeah.

ZUCKER: Right. So, someone said, well, I got lock up, because if the child goes in there, and then it's not a safe environment. So, all of this sort of—

BEUTNER: —Yes, locked in staffed, and there's going to be programming so the whole picture needs to be made complete. But when the student has no access to the park on the weekend, we see the consequences.

KHATOR: I think universities and medical schools can add a lot to this as well in terms of the training, you know, instead of training for disease prevention, it would be good to train for public health. And I think this pandemic may do that. And the reason I'm telling you is as we started our College of Medicine with a very particular admission because we have so much medical things going on in Houston. And that is what can we do to prevent these diseases and obesity becomes really important one. So a piece of our College of Medicine screening is that every freshman medical student is paired with a freshman student from nursing, from psychology, from social work, from optometry, from pharmacy and the entire team adopts a family in a poor neighborhood and we have right adjoining to us is a poor neighborhood.

Now their job is during their four years to really be navigating that family to take care of themselves and see that can you what can you do to prevent diseases, obesity being part of it. So, I think that kind of training, which I'm very excited because I think 120 students in one year will be in four years 480 student teams working with 400 and students, eighty student families and visiting their home and trying to just help them. Obviously, they're not prescribing. But I think some of those kinds of things when universities reach out in the community also can play a very big role in terms of obesity, but many other things that can be prevented.

SILVER: We've got about two minutes left. So, I'll just say one of my big takeaways from this conversation is how much we need to be thinking in complex intersecting systems. And we went from school reopening, which seems like on the surface of it, it ought to be, if not a straightforward question, a somewhat linear question to very much mapping a wide range of systems. I feel like I need a person behind me with one of those giant sheets of paper who can help draw out a systems map. We'll leave aside that I can't have a person behind me. That's a whole other issue. So, let's maybe turn to the panelists and I'll ask you each to give us a last word and you guys can decide if it's going to be hopeful and future looking or if it's going to be immediate term. We'll start with Howard.

ZUCKER: So, I guess my message will be a hopeful message because I actually believe in the inner strength of everyone and the positive energy that most people want to put out there. And I think from the standpoint of whether it's health issues or education, I think we're going to look back five years from now and realize that there will be solutions, creative solutions, that will come forth as a result of this pandemic. And I think they will come from the generation that are these kids who are in high school right now, in college, and graduate school, and they're going to look at this and they're going to take their creative minds and come up with solutions, both whether it's the issues that we've addressed, or other issues that we haven't even thought about, and provide solutions to a society to make it better.

SILVER: Thanks. Now to Austin.

BEUTNER: I'll pick up on that word solution and my hope is the tone of this conversation which is connecting the system's thinking about a path to renewal and renewal being better than where we came from. And if we take the same mindset that each of our organizations have been forced to come up with during COVID, which is we don't have perfect information, but we know we need to do something different and do something that is better, and if we apply it to what we used to do, I think we're going to come out of this with perhaps a renewed commitment, from my perspective to public education, and a brighter future for all the children in our schools.

KHATOR: Well I have absolutely no doubt that we are going to come out of it stronger, better, having tested our resiliency, having done things that we didn't think possible or possible in two generations. I think that the generation that's going to become leaders and take from this entire experience is really going to give them a very a new perspective. So, I'm very, very, very hopeful. We just need to figure it out: how to survive through this crisis. But we have to keep hope and we have to keep going.

SILVER: Let's make the future better than the past and certainly better than the present. Thank you, Howard, Renu, and Austin. Thank you so much for diving into this conversation and we look forward to coming out the other end with a better new normal. And thank you to the members who've joined us today. Please note that the audio transcript of today's meeting will be posted on the CFR website. And with that, we'll close the meeting. Thank you so much to the CFR staff and certainly to the panelists.

(END)

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