That鈥檚 why, in 2009, I created a nonpartisan, nonprofit organization called the , with a mission to catalyze transformative change in Tennessee education. There’s still more work to do, but since SCORE’s founding we have seen rapid growth and achievement gains statewide. From 2011 to 2017, Tennessee made some of the fastest gains on the , and show that Tennessee鈥檚 recovery from pandemic learning loss was among the most robust of any state.

Today, however, Tennessee faces another wakeup call: the youth mental health crisis. Worsened by the pandemic and exacerbated by social media, this demands urgent attention. 

In this, Tennessee is not alone. The from the Centers for Disease Control and Prevention found more than 4 in 10 (42%) high school students reported feeling persistently sad or hopeless and nearly one-third (29%) experienced poor mental health. More than 1 in 5 students (22%) seriously considered suicide in 2021. 

Often overlooked and untreated, poor mental health has a ripple effect that impacts learning and overall development inside and outside the classroom. Physical, mental and emotional health are intrinsically tied to the ability for young people to realize their full potential. As a former physician, I see a need to examine areas where education and health intersect and to facilitate meaningful discussions that seek solutions to related challenges. That鈥檚 why I established a collaborative health movement called .

Recently, SCORE and NashvilleHealth held a to begin the hard work of addressing the student mental health crisis. Alongside national, state and local leaders, we held meaningful conversations, backed by data and focused on solutions, to spark collective learning and action. Here are five takeaways that we believe can strengthen student mental health and further the discussion.

Increase Access to Data 

Despite a wealth of research, there are clear gaps that limit the ability of Tennessee leaders to assess the mental well-being of youth in our state. In response, the Belmont Data Collaborative released a in April that included a looking at all 95 counties in the state.

Drawing on publicly available datasets, the index makes clear which areas have the highest mental health vulnerabilities, leading to a more comprehensive understanding of risk factors at the county and local levels.

By analyzing community data alongside broader research and external influences like education and economic indicators, education leaders and policymakers can better assess our strategies and move forward in a positive way. 

Develop Local Solutions for Local Needs

Encouraging localized initiatives is key, as positive adult relationships and supportive environments have a significant impact on student outcomes. For example, during the symposium, Superintendent Selina Sparkman of rural Bledsoe County Schools highlighted the effectiveness of its grant, part of a program that helps state and local education agencies deliver school-based mental health programs and services. She shared the of a student who had not been able to eat with his peers in the school cafeteria since starting elementary school but began to thrive after receiving support through Project AWARE.

With mental health challenges continuing to rise in higher education, Dr. Zainab Okolo from The JED Foundation elaborated on the foundation鈥檚 efforts to help colleges address this crisis. Through the foundation鈥檚 technical assistance program, JED Campus, schools achieve in student mental health. Colleges completing the program reported that students were 25% less likely to report a suicide attempt, 13% less likely to report suicide planning and 10% less likely to report suicidal ideation.

Streamline and Share Best Practices 

Through the developed by the CDC, have been able to connect physical, emotional and social health with learning. Other states have done the same: Across the country, similarly effective initiatives are extending across college campuses, schools and communities. Examples include Sandy Hook Promise鈥檚 prevention programs, a learning community of working to develop policy recommendations through the State Higher Education Executive Officers Association and The Jed Foundation, the and Communities In Schools. A Governor鈥檚 Playbook: Strengthening Youth Mental Health, developed by the National Governors鈥� Association, contains examples of successful policies and programs that states can emulate.

Elevate Student Voices

Importantly, students must be included in discussions impacting their mental health. Among Generation Z (11- to 27-year-olds in 2024), greater school engagement is related to more positive life outlooks. For this, there is not a one-size-fits-all solution. Students come from diverse backgrounds with diverse experiences and needs. Initiatives that seek to implement solutions for their mental health must take a diverse range of perspectives into account. These can be much more powerful and accessible when they come from students and peers.

Collaborate to Create Meaningful Change

There are no easy answers or quick fixes to this crisis. By connecting the dots between education and mental health, leaders in Tennessee and across the nation can build more resilient and supportive systems that empower all children to reach their full potential. While schools can play an important role in supporting student mental well-being, the crisis is too big for one group or policymaker to solve. The challenge should not rest solely on the shoulders of schools, educators or health care providers. It demands collective action from all of us, working together, to better understand data, explore research, share best practices and engage in deep discussions. As a member of the Aspen Health Strategy Group, I will be delving deeper into the topic of youth mental health.

In Tennessee and beyond, important conversations connecting mental health and education are gaining momentum. As Tennessee leaders heed the urgent call to support our students, there is a need to better understand the extent of the crisis, continue exploring connections and innovations across health and education systems, and spark collective recognition and action. 

This crisis affects all of us 鈥� our children, our families and our communities. By leveraging data, research and a shared commitment to student well-being, education leaders, policymakers and advocates must continue to collaborate and illuminate the path forward to build a brighter, healthier future for generations to come.

鈥淧lease treat this as you would any illness,鈥� said a from Hendry County School District in Florida. 

The district鈥檚 rules specify that staff and students experiencing coronavirus symptoms should stay home, while those who are asymptomatic and fever-free for 24 hours may come to school with or without a face covering.

Across the country, over 95% of the 500 largest school systems had no mask requirement as of Aug. 22, according to an from Burbio, a data service that tracks school policy. Several, however, do still to wear face coverings for three to five days when they return to campus after finishing a five-day quarantine.

Those policies come after the Centers for Disease Control and Prevention in mid-August eased their K-12 COVID guidelines. Rather than recommending anyone exposed to the virus self-isolate, the CDC now calls for only individuals who test positive or experience symptoms to stay home, effectively doing away with the test-to-stay programs many schools used during the previous academic year. The guidelines still recommend universal masking where COVID levels are high, as they are in several regions of the country, including New York City.

Regardless, the nation鈥檚 largest district will return to school with face coverings optional after lifting its mandate last March. Los Angeles, the second largest school system, will do the same. New York City will also end its requirement that students and staff undergo for the virus. 

Breaking the trend, and are enforcing universal masking as students return students to classrooms. Philadelphia鈥檚 rule, however, will lift after the first 10 days of school.

Benjamin Linas, a professor of medicine at Boston University, advises schools not to put an outright ban on mask requirements, because the policies can be a helpful temporary tool for staving off outbreaks and preventing missed learning.

鈥淪ometimes schools have to close because they have so much COVID that kids aren’t coming [or] there鈥檚 not enough staff,鈥� he told 社区黑料. 鈥淲hen we’re talking about school mitigation and school masking, we’re talking about learning.鈥�

Indeed, an Albuquerque, New Mexico, charter school on Aug. 16 for a week when over 3% of students and staff tested positive for the virus. And Mannsville Schools, a tiny 95-student Oklahoma district, announced a week-long closure starting Aug. 14.

鈥淒ue to an increasingly high number of positive covid tests for both students and staff, we are forced to close for this week to allow time for everyone to get better and not continue to spread the virus,鈥� Mannsville Superintendent Brandi Price-Kelty. 鈥淲e will make up these days with virtual learning days after Labor Day.鈥�

Other areas have set a higher threshold at which school COVID positivity levels trigger policy changes: 10% in Kansas City means until levels drop, according to the district, and 20% in South Carolina ushers a brief pivot to remote learning, according to the .

鈥淭here might be a situation in which you put on masks for 10 days in order to break an in-class cluster and get back to school,鈥� said Linas. 鈥淚 think people could have more in-person learning and more educational opportunities if we acknowledge sometimes you have to put on a mask in response to an outbreak situation in your own building.鈥�

Thanks to vaccines, COVID hospitalizations and death rates are much lower than they were at the height of the pandemic. But because case rates continue to follow patterns of surges and troughs, infections will still be an issue classrooms must deal with for the foreseeable future, he said. 

鈥淭his disease is not yet a common cold, it still does major damage鈥� there鈥檚 still a lot of morbidity. [Masking in classrooms when cases spike] is the least invasive policy one could have other than just doing nothing. And I think it would be foolish to do nothing at this point.鈥�

Students won’t have to quarantine or take a COVID test to attend school if they were exposed to someone who tested positive, according to  from the Centers for Disease Control and Prevention released Thursday. The guidance is in line with a version leaked last week.

Students also won’t have to stay in groups, called cohorting, which was intended to limit transmission and make contact tracing easier. And schools are no longer urged to conduct screening tests of students participating in “high-risk” activities, such as contact sports, band or theater. 

Education Secretary Miguel Cardona said the new recommendations allow families and educators to “head back to school this year with a sense of joy and optimism.” 

But Leah Perkinson, director of research translation and evaluation at Brown University School of Public Health, said it’s important not to forget lessons learned over the past two years. 

“A lot of schools [and] districts might be relieved to turn the screening testing corner if it means that teachers, leaders and staff focus more on the social, emotional and learning needs of students,” she said. “But we’d be remiss if we didn’t take time to look in the rearview mirror and document what worked [and] what didn’t … when we need to stand up school-based testing again.”

Quarantine rules last school year may have prevented COVID from spreading, but they also contributed to high absenteeism, with some students sent home multiple times because they were a 鈥渃lose contact鈥� of someone who tested positive.

Students missed an average of 15 days between September and January alone due to quarantines, according to But now, after more than two years of disrupted learning, new guidance from the Centers for Disease Control and Prevention could keep more students in the classroom.

The agency is expected to update its recommendations to say that those who are unvaccinated can continue to attend school if they wear a mask and test negative five days later, according to multiple news outlets, including and . recommends that those not up-to-date on vaccinations stay home for five days after coming in contact with someone who tested positive. 

鈥淪ince the beginning of the pandemic, [messaging] has mostly focused on encouraging students to stay home as a strategy for keeping healthy,鈥� said Hedy Chang, executive director of Attendance Works, a research and advocacy organization. 鈥淲e think a more balanced approach would be to emphasize that showing up to school matters for health, well-being and learning.鈥�

The guidance would reflect the direction that many states and districts were already moving toward, noted John Bailey, a strategic adviser at the Walton Family Foundation who has monitored COVID policy since the beginning of the pandemic. In July, for example, said students exposed to the disease don鈥檛 need to quarantine if they lack symptoms. Many districts aren鈥檛 requiring masks this fall, and recently backed off last year鈥檚 strict protocols involving daily health declarations and weekly testing. By next week, of the nation鈥檚 students will be back in school, according to Burbio, a data company.

鈥淭he CDC should have released updated guidance in June or July to give schools time to adjust their plans and preparations,鈥� Bailey said. 鈥淩eleasing it this late creates needless frustration and confusion, which just further erodes confidence in both the CDC and administration.鈥� 

Critics have pointed to multiple lapses at the agency since the beginning of the pandemic, such as allowing teachers unions to heavily influence guidance for schools and fumbling updates to mask recommendations for early-childhood programs.

Some experts think it would have been difficult to start the new school year enforcing the same protocols school districts implemented before 鈥� like masking and frequent testing. That鈥檚 despite a highly contagious BA.5 variant, being in the high transmission range, and among young children and .

鈥淭he problem is that these comprehensive efforts are meeting two powerful forces 鈥� exhaustion and apathy from the American people, and the clash of politics and public health in ways I鈥檝e never seen in my lifetime,鈥� said John Bridgeland, founder and CEO of COVID Collaborative, a team of experts that has provided recommendations throughout the pandemic. 

Quarantine policies also contributed to a lack of academic progress last year even at a time when students were back in school, researchers with NWEA, a nonprofit assessment organization, said when they released their latest results in July.

Parents complained about inconsistent rules. Some also violated them. In California鈥檚 , last year, parents knowingly sent a child who had tested positive to school. And three with zip ties threatened a citizen鈥檚 arrest on a principal last fall when the administrator told one of them his child had been identified as a close contact and would need to quarantine. They were charged with criminal trespassing. 

鈥淚 think that school will be much more 鈥榥ormal鈥� than it was even last year,鈥� said Annette Anderson, an education professor at Johns Hopkins University and deputy director of the Center for Safe and Healthy Schools. 

鈥楽eem appropriate鈥�

District leaders certainly hope so.

鈥淎ttendance rates had never been lower, and certainly impacted student learning,鈥� said Tony Sanders, superintendent of School District U-46, outside Chicago. 鈥淭he significant drops in attendance always correlated with spikes in COVID cases, mostly following periods when students were on break.鈥�

The week after winter break, when the Omicron variant was prevalent, attendance fell to 72% in the district.

As the new school year begins, some districts are dropping all COVID protocols, according to .

Some parents, however, still want reassurances that schools will take precautions to limit exposure. Alexis Rochlin, a Los Angeles parent, said her preschooler was quarantined multiple times last year, 鈥渨hich was a huge pain.鈥�  But she鈥檚 comfortable with the county鈥檚 . Close contacts are required to mask for 10 days after exposure and test three-to-five days later. Those who test positive can stop quarantining on the sixth day as long as their symptoms improve and they test negative.

鈥淭hese policies seem appropriate to keep kids safe and limit learning loss. Anything less would be concerning to me,鈥� said Rochlin, who also has a son entering second grade. 鈥淏ut we are in a post-COVID world, I guess, where everyone wants to live with it by ignoring it.鈥�

Disclosures: The Walton Family Foundation provides financial support to 社区黑料. Andy Rotherham is a member of the Virginia Board of Education and sits on 社区黑料鈥檚 board of directors. He played no role in the reporting or editing of this story.

Hiding in Plain Sight: Youth Mental Illness, a two-part documentary that premieres Monday on PBS, presents the raw accounts of nearly two dozen young people from diverse backgrounds who open up about their excruciating life experiences. Through varied stories that touch on issues like abuse, addiction and discrimination, the Ewers hope their film will give their audience an understanding that they came to themselves: Everybody, no matter their backgrounds, is affected by America鈥檚 mental health crisis in one way or another. 

The film, executive produced by renowned documentarian Ken Burns, was screened at the White House Thursday, with First Lady Jill Biden saying, 鈥淲e have so much work to do to help our children heal,鈥� and thanking the filmmakers for shining a light on mental health.

鈥淚t鈥檚 impossible not to be moved by the pain that these young people and their families share,鈥� she said. 鈥淏ut there was so much hope there, too. Because they had all found a way from that darkness towards the light.鈥� 

The documentary can be seen at 9 p.m. ET on Monday and Tuesday and will be available on PBS stations nationally, PBS.com and the . It is part of , called Well Beings, to raise awareness about mental health issues. 

鈥淭he goal of the film, we hope, is that people will find relatability in their own lives through these kids鈥� stories,鈥� Christopher, who co-directed the documentary with his brother, told 社区黑料. 鈥淚 felt connected in ways that I can鈥檛 even describe to each and every person鈥檚 story. Some of them nearly destroyed me as we were filming their interviews because they hit so close to home.鈥�

The young people featured in it range in age from 11 to 27, including a teenager who lost the fight against addiction at the age of 15, a young Native American woman who felt so isolated that she contemplated suicide and a high school freshman who experienced a series of assaults that led to troubling hallucinations. Among them is Billie, a 15-year-old from a rural farming community who endured intense bullying for being transgender. For 14-year-old Xavier, trauma stemmed from an abusive father. 

鈥淐igarette smoke is a very triggering thing from my past since I associate that with getting beat by wooden sticks,鈥� said Xavier, who recalled getting beaten 鈥渇or seemingly no reason.鈥�

begin by the age of 14 and 75% occur by age 24, according to the National Alliance on Mental Illness. 

鈥淭he things my ancestors went through, it鈥檚 shown through alcohol abuse, addictions, non-stable families, toxic relationships,鈥� explains Alexis, a 21-year-old who grew up on a Native American reservation. 鈥淭hat鈥檚 the burden that Indigenous youth deal with everyday, you鈥檙e just born into it.鈥� 

New Centers for Disease Control and Prevention data offer bleak insight into the extent of the problem and how the pandemic has made the crisis even worse for millions of teens, especially LGBTQ youth and girls. In a recent CDC survey, more than a third of high school students reported experiencing poor mental health during the pandemic, nearly 20% reported that they seriously considered dying by suicide and a staggering 9% had actually tried. Even before the pandemic, suicide was a leading cause of death among teens as rates of youth anxiety and depression surged. In 2009, a quarter of high school students reported feeling persistent sadness or hopelessness. By 2019, that rate jumped to nearly 37%. 

Though the project has been years in the making, the film acknowledges how the pandemic has made the crises far more urgent. The Ewers are longtime collaborators with Ken Burns and the trio will continue working together to create a series of films examining the mental health crisis in America.

Over the course of four hours, this first film takes viewers on a journey that for many began with traumatic experiences that led to debilitating mental health struggles, but ended with a message of hope. Despite roadblocks including homelessness, arrests, addictions, eating disorders and suicide attempts, many of the young subjects were able to go on and live happy lives thanks to mental health care and the coping skills they developed.

Yet recovery is a lifelong process. It鈥檚 a lesson that Erik learned firsthand over the course of filming the documentary, he said. Throughout his entire life, he struggled to understand his emotional issues. Although his parents took him to a psychiatrist while he was in elementary school, it wasn鈥檛 until he started filming the documentary that he began to truly address his challenges. The youth in his film, he said, 鈥済ave me an education about myself.鈥�

鈥淚f the film has the power to do that for me, I can only hope that it will have that power for other people as well,鈥� he said. 

Christopher said the youth interviews hit home for his family, too, as his daughter struggled with mental health challenges of her own. Listening to each of the stories, he said, 鈥済ave us the courage and the commitment to see through the proper care for our daughter.鈥� 

As the filmmakers weave the young peoples鈥� individual stories into a cohesive narrative, the result can only be described as a gut punch. With the goal of presenting an unvarnished look into the pervasiveness of youth mental health crises, the documentary is difficult to watch at times. But sugarcoating the issue would be a disservice to those who are struggling, Erik said. 

鈥淚magine a kid out there who is literally watching it and we watered it down, which of course, we had not,鈥� he said. 鈥淏ut if they did, they鈥檇 be saying 鈥榃ow, I鈥檓 a lot worse than I thought,鈥� or say 鈥楾his is bullshit.鈥欌��

The stigma still associated with mental health issues prevents many young people from sharing their experiences, yet the Ewers brothers said their subjects were motivated to open up on film 鈥� and wound up feeling better as a result. They were tired of keeping their suffering bottled up inside and hoped that greater awareness could save lives. 

Alexis, who grew up on the reservation, said that nearly all Indigenous youth are the victims of trauma and abuse to some degree. Yet also embedded in her DNA, she said, is resilience. 

鈥淚 know for a fact that my ancestors and my elders, they鈥檙e rooting for me and they want me to do good,鈥� she said. 鈥淚鈥檒l share my story over and over again. I鈥檒l go through those emotions like a million times if it helps one person.鈥�

Delta was causing cases to spike, and the schools where many Head Start programs are housed typically had mask mandates in place. 

But in February, the Centers for Disease Control and Prevention revised its guidance to reflect lower transmission rates. Mask rules for young children, the CDC said, should be the same as those for the general population.

Now Coyne, a Head Start director in the Boulder area, is confused. 鈥淗ead Start feels like the lone place where masks are required,鈥� she said. 鈥淔or staff, it feels really out of context.鈥�

Members of Congress, including several Democrats, agree.

Earlier this month, the Senate approved that would 鈥渄isapprove鈥� the rule, essentially wiping it off the books. was introduced last month in the House, but it鈥檚 unclear if action will be taken soon. The White House said President Joe Biden won鈥檛 sign it. Officials say the mandate 鈥� which even requires staff and children to wear masks outside 鈥� gives parents 鈥渁dditional confidence鈥� that their children are safe and protects infants and toddlers in Early Head Start programs who can鈥檛 wear masks. It鈥檚 also necessary, they argue, because a vaccine for young children has yet to be approved.

鈥淧arents of children under 5 are in a really difficult position right now. They don’t have the choice to vaccinate their children, so they are dependent on the adults who care for them to do everything they can to continue protecting them,鈥� Sen. Patty Murray of Washington, a Democrat and chair of the education committee, said before the May 3 vote. 

She opposed the resolution, saying it would permanently hamstring the administration鈥檚 ability to mandate masks and vaccines in Head Start in the event of a new,dangerous variant or a future pandemic. , in fact, have reinstated mask mandates or are strongly urging students to mask because cases are rising.

Once a vaccine is available for younger children she said it could make sense to revisit the rule, 鈥渂ut we are not there yet.鈥�

Both Moderna and Pfizer-BioNTech have asked the U.S. Food and Drug Administration to approve their vaccines for younger children. Reviews were scheduled for , but the governors of Colorado and Massachusetts have to act sooner. 

South Dakota Republican Sen. John Thune, who sponsored the resolution, suggested that if Biden can on immigration along the southern border, he should do so for young children. 

鈥淭he scientific evidence for masking toddlers is shaky at best,鈥� he said on the Senate floor, citing the World Health Organization against masking children under 6 and that masks inhibit language and social skills. Children also face of serious illness from COVID, studies show. 

Researchers, however, have found that masks on preschoolers interfere with their development. 

Meanwhile, half the states don鈥檛 have to follow the rule because in two cases blocked it. That leaves the rest of the country in limbo.

鈥淚t鈥檚 messy, it鈥檚 tricky, and that鈥檚 why we go back to Head Start roots 鈥� locally driven with high standards,鈥� said Tommy Sheridan, deputy director of the National Head Start Association, which represents both families and programs. The rule, he said, is making it hard to hire staff. 鈥淭he administration knows this is something that needs to change.鈥�

In December, the association asking for waivers from the rule or solutions that 鈥渂alance safety with local circumstances.鈥�

David White, CEO of WNCSource Community Services, a Head Start grantee serving four North Carolina counties in the foothills of the Blue Ridge Mountains, estimates that his centers have lost about 25 of their 220 staff members because of the vaccine mandate. With early-childhood programs already coping with staff shortages, he鈥檚 concerned about having enough teachers this fall.

If the vaccine mandate makes it harder to attract and retain staff, and if it 鈥渕eans having closed classrooms because parents don’t like the mask mandate,鈥� he said, 鈥渁t some point it becomes counterproductive.鈥�

More than a third of high school students reported experiencing poor mental health during the pandemic, more than half reported being subjected to emotional abuse at home and a quarter said a parent or another adult at home had lost their jobs, according to results from the first nationally representative survey of high school students鈥� mental health and well-being during the pandemic.

Faced with sudden school closures, social isolation and the fear of family loss or illness, 66% of students reported that schoolwork became more difficult to complete after the pandemic shuttered campuses nationwide in March 2020.

Even before the pandemic, survey data suggests that youth mental health had grown bleeker and suicide was already a leading cause of death among teens. The new CDC data point to a situation that鈥檚 grown even more dire, especially for LGBTQ youth and girls, two groups that reported particularly high levels of poor mental health during the pandemic.

In response, public health experts called on policymakers to act with urgency to reverse the trend.聽

鈥淵oung people and their families have been under incredible levels of stress during the pandemic,鈥� Kathleen Ethier, director of the CDC鈥檚 division of adolescent and school health, said during a press call Thursday. 鈥淥ur data exposes cracks and uncovers an important layer of insight into the extreme disruptions that some youth have encountered.鈥澛�

The results come from the Adolescent Behaviors and Experiences Survey, which was completed by a nationally representative sample of 7,705 public and private high school students. The CARES Act-funded questionnaire was conducted online between January and June 2021. Since then, the country has entered a new phase of the pandemic as mask mandates and other public health measures are lifted, but while the . Public health officials acknowledged it鈥檚 unclear how youth well-being has fared since the survey was completed.

The figures are key to understanding the pandemic’s effects on the health and well-being of American youth. Previous evidence has suggested the pandemic has had a deleterious effect on youth and contributed to trends like a surge in teen depression and anxiety, but the national survey is the first to asses the national prevalence of disruptions and adversities like parental job loss, personal job loss, homelessness, hunger and the extent of emotional or physical abuse at home.

They also reveal a promising strategy that school leaders can leverage to put youth on a better trajectory. Youth who feel connected to their school, the survey found, were significantly less likely than those who did not to report feeling hopeless or attempt suicide. Yet fewer than half 鈥� 47% 鈥� of teens reported feeling close to the people at their schools during the pandemic, when millions primarily experienced learning remotely.聽

鈥淎lthough our latest findings present an often-grim picture and there is much work to be done, it is clear that right now young people need all the support we can give them,鈥� Ethier said.

During his State of the Union address earlier this month, President Joe Biden addressed the youth mental health crisis, declaring that students 鈥渓ives and education have been turned upside-down.鈥� His released this week seeks $1 billion to double the number of counselors and psychologists in schools.聽

Based on the CDC鈥檚 survey data, these six charts show the challenges students faced during the pandemic 鈥� while also revealing promising strategies that could help them recover from more than two years of life-altering disruptions.聽

As the pandemic shuttered businesses, many teens were forced to live through the hardships of an economic crisis.

Nearly a third of students reported that a parent or another adult at home had lost their job while 22% of teens reported experiencing job loss themselves. A quarter of teens reported experiencing food insecurity. Among white students 18.5% reported experiencing hunger while 32% of Black students said they lacked enough food to eat. In total, 2% of students reported experiencing homelessness.聽

Teachers and other school officials are generally considered mandated reporters, putting them on the front lines of spotting issues like physical abuse at home. Remote learning heightened concerns that such abuse could go undetected at a moment when pandemic-induced stressors could exacerbate the problem. Indeed, the CDC data suggest that the physical and emotional abuse of teens has grown more alarming during the public health crisis.

More than half of respondents 鈥� 55% 鈥斅爎eported that a parent or another adult at home had subjected them to emotional abuse and 11% said they faced physical abuse. Black students experienced the highest prevalence of physical abuse by a parent, at 15%, compared to 9.8% of white students.聽

Those figures are substantially higher than pre-pandemic levels, when 13.9% of students reported experiencing emotional abuse in and 5.5% reported being subjected to physical abuse by a caregiver. These differences, CDC researchers concluded, highlights a reality that 鈥渋ncreased stress contributes to violence.鈥�

The pandemic鈥檚 devastating emotional toll on high schoolers was clear in the data. Overall, 37.1% of students reported experiencing poor mental health during the pandemic and an even larger share 鈥� 44.2% 鈥斅爏aid they felt persistently sad or hopeless during the 12 months prior to completing the survey.

And while a teen suicide crisis has been billowing for years, the new CDC data show the extent of the problem. While 19.9% of students reported that they seriously considered dying by suicide, a staggering 9% had actually tried.聽

The pandemic-era mental health crisis was particularly grim for girls. Nearly half of girls reported having poor mental health during the pandemic compared to nearly a quarter of boys. Similarly, 5.3% of boys reported attempting suicide compared with 12.4% of girls.聽

A widely reported found an increase in youth emergency room visits due to suicide attempts during the pandemic. In February and March 2021, suicide-related emergency room visits were 50.6% higher for girls and 3.7% higher for boys than they were during the same period in 2019.

Even prior to the pandemic, youth mental health was a critical public health concern. Among high school students nationwide, 26.1% reported feeling persistent sadness or hopelessness in 2009. By 2019, that rate jumped more than 10 percentage points to 36.8%. During that same period, there was a 5 percentage point increase in students reporting having seriously considered attempting suicide and a 2.6 percentage point increase in youth reporting having attempted suicide.聽

CDC data suggest the pandemic has been particularly challenging for students who identify as gay, lesbian or bisexual. Perhaps more troubling, the data were released at a moment when Republican lawmakers have championed legislation that critics say would make life harder for LGBTQ youth. Just this week, Florida Gov. Ron DeSantis , a controversial law that bans educators from offering instruction about sexual orientation and gender identity to children in grades K-3.聽

Nearly three-quarters of gay, lesbian and bisexual teens reported experiencing emotional abuse at home, compared to roughly half of their straight classmates. Similarly, more than a quarter of gay, lesbian and bisexual teens reported an attempt to die by suicide in the last year compared to 5.2% of heterosexual youth.

Although the survey doesn鈥檛 highlight the experiences of transgender youth, previous surveys suggest they also faced heightened risks during the pandemic compared to their cisgender peers, Ethier said.聽

Between January and June 2021, 31.6% of respondents reported using tobacco, alcohol or marijuana, or misusing prescription opioids. Nearly a third of students who said they鈥檇 used such substances before reported using more of them during the pandemic.聽

However, CDC survey data suggest that overall teen substance use decreased during the pandemic. It鈥檚 possible, researchers concluded, that students who attended schools virtually had limited access and greater parental supervision.

Students who attended schools virtually, the survey revealed, were less likely than those who attended in-person to use substances like tobacco and alcohol. For example, a quarter of in-person students reported using tobacco compared to just 9% of remote learners.聽

Because youth get tobacco products from social sources such as friends, access to those products likely decreased during the pandemic, researchers concluded. However, more open alcohol policies like home delivery may have lowered barriers for youth attempting to purchase booze.

The CDC survey highlights the steep obstacles that teens have had to navigate during the pandemic, but it also recommends strategies that could offer a brighter future. While remote learning likely hindered students鈥� feelings of connectedness at school, experts stressed it鈥檚 not too late to make positive changes.聽

The CDC survey reveals that feelings of connectedness at school are critical to youth mental health. More than a quarter of youth who felt connected at school reported poor mental health during the pandemic compared to nearly half of those who said they did not feel close to others at their schools.聽

Youth who said they experienced racism during the pandemic and those who are gay, lesbian or bisexual were less likely than other student groups to report feeling connected at school.聽

To foster greater connectedness and promote positive school climates, the CDC recommended that districts implement programs that focus on social-emotional learning and professional development centered on classroom management and fostering positive relationships between students, their families and school staff. Districts should also analyze school disciplinary policies to ensure they鈥檙e implemented equitably across racial and ethnic groups, researchers recommended.

鈥淭here is much that can be done to make sure that LGBTQ youth and youth from racial and ethnic minority groups feel safe, supported and connected in their schools,鈥� Ethier said, noting the importance of such school efforts specifically designed to improve the mental health of LGBTQ youth and reduce their risk of suicide. 鈥淲hen schools are less toxic for youth at increased risk for severe outcomes, schools are less toxic for everyone.鈥澛�

It鈥檚 a major departure from the agency鈥檚 prior stance, which held that schools should enforce universal masking regardless of virus levels.

鈥淪ince July 2021, CDC recommended universal masking in schools no matter what level of impact COVID-19 was having on the community. With this update, CDC will now only recommend universal school masking in communities at the high level,鈥� said CDC epidemiologist Greta Massetti in a media call.

The change comes as part of a wider reconfiguration in COVID policy now recommended by the CDC, easing masking guidelines for most Americans. Rather than using community case rates as the sole metric to determine risk levels, the agency will now use a new formula that also takes COVID hospitalizations and hospital capacity into account. 

Only in counties where COVID risk is high does the agency now recommend universal masking indoors, though individuals may continue to choose to wear face coverings at lower levels depending on their own personal risk and comfort, officials said. 

While only about of U.S. counties were considered low or moderate risk under the old framework, nearly 60 percent now fall into that categorization, accounting for about 70 percent of Americans. Individuals may check the updated risk level for their county on the CDC鈥檚 .

The change in school masking guidance comes after weeks of movement at the state and local level to scrap face-covering policies. In early February, several states including New Jersey, Connecticut and Massachusetts announced the end of their school mask mandates, and on Tuesday, the Maryland State Board of Education voted to , though the change needs legislative approval before it will go into effect. 鈥嬧�婳f the 500 largest U.S. school districts, currently require students to wear masks, down from 60 percent at the beginning of February, according to data collected by Burbio, which has tracked school policy through the pandemic.

States such as California and New York have yet to announce an end to their school masking rules. But in a small step toward loosening restrictions, New York City students will on school grounds starting Monday, officials announced Friday morning. California Gov. Gavin Newsom said he will announce an end date for school masking in his state Monday.

The CDC鈥檚 move to ease masking guidance represents a broader effort to help Americans return to a 鈥渘ew normal,鈥� even as the virus continues to circulate.

Over 200 million Americans have received their primary vaccine series, pointed out CDC Director Rochelle Walensky, half of whom have been boosted. Many more have a level of immunity due to prior infection.

鈥淲ith widespread population immunity, the overall risk of severe disease is now generally lower,鈥� said Walensky. 鈥淣ow as the virus continues to circulate in our community, we must focus our metrics beyond just cases in the community and direct our efforts toward protecting people at high risk for severe ailments and preventing COVID-19 from overwhelming our hospitals and our health care system.鈥�

President Biden and the CDC have previously speculated the end of the pandemic, even giving the summer of 2021 the hopeful title 鈥渟ummer of freedom,鈥� before the Delta surge quickly proved that COVID would continue to disrupt daily life.

Perhaps with awareness of that history, Massetti emphasized that schools 鈥� and the wider community, too 鈥� should adjust virus mitigation rules based on changing conditions.

鈥淧ublic health prevention strategies can be dialed up when our communities are experiencing more severe disease and dialed down when things are more stable.鈥�

Walensky added, 鈥淲e need to be able to dial them up again should we have a new variant or a new surge.鈥�

Still, some have critiqued the choice to ease masking guidelines as motivated by politics and pandemic weariness. As the CDC prepared to announce updated recommendations, several disability advocates the plan on Twitter.

The new metrics do not take community or school vaccination rates into account, though officials emphasized that vaccination greatly decreases the likelihood of severe illness and hospitalization and thus is indirectly reflected in the new thresholds.

Nationwide, a quarter of children aged 5 to 11 and 57 percent of youth aged 12 to 17 are fully vaccinated against COVID-19, according to data from the .聽Shots for children under 5 will not be available for over a month.

There is a 鈥淐OVID test supply crisis鈥� that will impact Michigan schools, said Linda Vail, health officer for Central Michigan鈥檚 Ingham County, on Wednesday. The state is working to supply testing kits to schools in the highest-risk communities where COVID is most rampant, she . States from Florida to Washington have .

Last week, the Biden administration announced that it was 鈥溾�� on its commitment to keeping schools operating safely in person by providing an additional 10 million monthly COVID test to K-12 institutions nationwide 鈥� 5 million rapid and 5 million PCR.

In December, the Centers for Disease Control and Prevention endorsed 鈥渢est-to-stay鈥� protocols that allow students and staff who may have been exposed to COVID to remain in school buildings, provided they test negative for the virus before walking through the front doors.聽

But where testing supplies dwindle, it can cause in school operations.

Most schools across the country have managed to stay open in the three weeks since winter break. But an average of more than have been disrupted by brief closures or pivots to virtual learning as they navigated high caseloads and staff shortages, according to the K-12 data service Burbio.

Last week, over 980,000 new youth COVID cases were reported nationwide, according to the , the largest weekly total to date and nearly quadruple the highest tally previous to Omicron.聽

To help weather the current surge, 社区黑料 spoke with White House Senior Education Policy Advisor Mary Wall who explained how schools can make use of the newly available testing resources.

This interview has been lightly edited for length and clarity.

社区黑料: Testing in schools is such a key issue right now during the Omicron surge and some officials are saying that they might run out of supply soon. What is your message to school leaders on how to access testing?

Mary Wall: Sure. We’ve really made a lot of efforts to make sure that schools have everything they need to reopen and remain open safely and聽testing has been central to that effort. It was the core investments that this administration made, starting with the American Rescue Plan, that really helped to make sure that schools could be ready for this moment.聽

Across the country there are many, many schools who are implementing testing right now and building on the existing testing programs that they already established. We know that schools are kind of coming at this from a lot of different places and a lot of different levels of experience, so we want to make sure it’s easy for everyone to access both the tests as well as [strategies for] implementing testing in school.聽

The biggest headline is the $10 billion that we invested in the (ELC) program at the CDC. That gave $10 billion to states to set up testing programs for schools and we have seen significant movement from states doing just that.聽

We鈥檙e building on that with the new announcement of the 5 million rapid antigen tests, as well as the expansion of capacity through to reach another 5 million [through PCR testing] with lab capacity each month.

So that $10 billion investment, those 5 million rapid tests and 5 million PCR tests, those are big numbers. I’m curious, what are the mechanics going on here? And what might some school leaders not understand that could be keeping them from accessing tests that are available to them?

Testing can be a challenging endeavor for schools, and schools have been asked to do a lot over the course of the pandemic. We’ve seen it as our charge to make it as easy as possible for schools to tap into resources.聽

With the news we announced last week, we have put out steps for schools to take right away. The first and foremost would be tapping into the state’s existing testing initiatives. Every state has something set up for K-12 COVID-19 testing and it varies by state how exactly it looks. But we have created a resource on the CDC website that is basically a that the school can go onto right now and click to learn more about what their state is doing for K-12 testing. That page will lead them to how to get involved in their state’s program.聽

If they want to make use of the 5 million antigen tests that we are now offering, those are usually requested by state health departments. And they are 鈥� submitting requests to the CDC for those (based on local need). But testing resources fueled by the $10 billion in ELC funds, those are available right now and schools can tap into those right away.聽

Operation Expanded Testing, which is the free lab-based (PCR) testing capacity that we offer as the federal government, that is also available and open for service right now. Schools can go online to the , click on the link for the regional hub, and they can begin the process right away 鈥� and can get started in as few as seven days after that.

We also want to remind all schools that they are able to also connect to other testing providers that operate in their state and use their ESSR [Elementary and Secondary School Emergency Relief Fund] dollars. So there’s $132 billion distributed through the American Rescue Plan for states and school districts. Testing is an allowable use of funds and we’ve seen many school districts [use] that funding stream to set up customized programs in their schools 鈥� and that’s been in large districts and in small districts.聽

That’s fantastic. And after the announcement last Wednesday, what kind of responses did the U.S. Department of Education receive from K-12 leaders?

We鈥檝e been getting a lot of interesting and exciting responses on testing. It kind of falls into a couple different categories.

One is, we’ve gotten a lot of really eager and positive feedback from districts who have already been doing testing. 鈥� Those [school systems] have really been eager to take this to the next level. I know there have been districts who are doing weekly screening, for instance, and are excited to expand that into a test-to-stay a program. There’s others who have been doing diagnostic testing and decided, we really want to expand the screening tests we’re doing in our schools to be on a weekly basis to cover more kids and聽this new investment is going to help enable that.

We’ve also heard from many districts who have not done testing and said that they’re eager to tap into it. They know that the current surge has really seen significant increases for caseloads, including with kids, and they want to make sure they can use this as a key line of defense in their school buildings. And so for them, you know, [our role has] been how can we help you set up testing successfully in your building. We’ve gotten started on this right away by offering technical assistance and support to school districts.聽

We’re offering more this week, we’re going to offer it every week for the next several weeks to make sure that no matter where you are in your testing journey, that if you’re a school who is interested in implementing testing that you’re able to do so. That you not only have the resources to do so in terms of tests, but that you also know how to use them effectively in your building.

Some people would say that the most recent expansion of K-12 testing is a great effort, but that it came too late to help schools respond nimbly to the Omicron surge. [Though of course, there might be subsequent surges.] I’m wondering what your response is there.

I disagree with that assessment. I think that we have made clear our commitment to keeping schools open safely. We’ve made that commitment clear through the American Rescue Plan, which provided $130 billion for K-12 schools through the Department of [Education] and $10 billion for K-12 COVID-19 testing. We’ve seen states take that money and set up testing approaches starting back in April of last year. So we are eager to build on that investment. And we saw across the country that schools who were already implementing testing strategies have been able to use it in this current surge very effectively.

And last question here. Clearly, the White House has put itself on the frontline of this testing shortage in schools. I’m curious whether the Department of Education also sees itself as responsible for helping to remedy the staffing shortages that many schools have been facing recently?

As an administration, we see the staffing issues that are occurring, and we take them very seriously.聽

We passed the American Rescue Plan specifically with the purpose of making sure that we could have more staff in school buildings, both to accommodate mitigation strategies like social distancing, but also to make sure that schools have all the people on hand that they need to make sure that students can come back safely and have their needs met after this completely unprecedented time.聽

First and foremost, we would want to remind school districts and states that they have that $130 billion to spend on additional staff, to retain the staff they have, to pay the staff they have more money, and really make sure that whatever personnel needs they have in response to pandemic can be met.聽

We’ve also really tried to make clear that there are existing flexibilities, either in ways that you approach retirees or others who were previously teachers, ways that you can hire bus drivers, creative uses of bringing more staff into buildings to make sure that we can meet the staffing needs of the school.

In December and January, his 8,900-student district just north of Atlanta partnered with the Centers for Disease Control and Prevention to study classroom virus transmission, ultimately adjusting their distancing protocols to reduce spread. In September, after reading an written by a Harvard University professor that proposed using rapid antigen tests to give healthy kids an alternative to quarantine, he reached out directly to the author asking about the model 鈥� and ultimately implemented the 鈥溾�� scheme in his schools. Now, the district is planning to hold for students this month as COVID shots roll out for younger kids.

But despite a keen eye for the latest coronavirus safety research, Rivera made another move in mid-October that many parents had clamored for, but health experts cautioned against: He lifted Marietta鈥檚 mask requirement.

鈥溾�嬧�媁e tried to get to a solution that we think is good for our community,鈥� the superintendent told 社区黑料. 鈥淐ould I give kids a bit more sense of normalcy back that they haven’t had for two years? I think that鈥檚 a question we鈥檙e grappling with.鈥� 

The move typifies a trend emerging nationwide, as school leaders respond to .

At least a dozen districts that previously required face coverings are now mask-optional, including ; and . Of the 200 largest U.S. school systems, 135 now have mask mandates 鈥� down from 150 on Oct. 1 and lower than at any point this school year since mid-August, according to , a data service that has tracked school policy through the pandemic.

That pattern worries Benjamin Linas, professor of medicine at Boston University.

Over the summer, the health expert used simulation modeling technology to predict how many positive COVID cases would be transmitted in schools, depending on their vaccination rates and mitigation measures. The that he and his team published in August recommended that schools drop universal face-covering rules only once 80 percent of students and staff are fully immunized and community transmission is below 10 cases per 100,000 people. 

Currently, the U.S. averages . And while as many as , of eligible youth have received both shots.

Vaccines for children ages 5 to 11 are expected to roll out in days and as many as with children in the age group plan to have their kids immunized, according to surveys, but a significant share before doing so, they say. About a quarter said they definitely would not vaccinate their children.

With vaccination rates as they currently stand, school buildings are largely full of people unprotected against the virus, Linas pointed out.

鈥淭hat is a setup for trouble in the future, having ongoing smoldering transmission because people are under vaccinated and we’re not wearing masks,鈥� he told 社区黑料. 鈥淭he virus continues, new variants emerge 鈥� those threats are real.鈥�

Other experts, including Joseph Allen, the Harvard public health professor that Rivera corresponded with about Marietta鈥檚 test-and-stay approach, argue that schools should take a more dynamic approach to masking requirements, dropping them when transmission falls. Given the current situation, he advocates for the end of all school face-covering requirements by January, if not sooner.

鈥淚f things change for the worse 鈥� and they might 鈥� then we just pull the masks back out of the drawer. But we must be just as willing to put them away when things look better,” Allen wrote in an October .

At the state level, Massachusetts has set a benchmark that aligns with the Linas鈥檚 recommendation, for any school that reaches 80 percent student and staff vaccination. But new guidance in allows schools to scrap face coverings where community transmission is low and gives districts the option to do the same if they maintain stringent quarantine rules. Neither policy accounts for immunization levels in the school community.

Georgia, similarly, is a state that gives local school leaders the power to set their own coronavirus safety policies. In Marietta, the district鈥檚 program for testing students and staff who may have been exposed to the virus played into the calculus for Rivera鈥檚 decision to go mask-optional.

鈥淭here鈥檚 an interplay between these approaches,鈥� the superintendent said. 鈥淵our approach to masks will impact the distance at which you are identifying close contacts 鈥� three feet vs. six feet, indoors. The number of students who are identified as close contacts, that drives your test-and-stay demand.鈥� 

Because 98 percent of would-be quarantines in his district never ultimately tested positive, Rivera hoped the testing policy, which the district has funded partially through relief dollars, would keep students learning in the classroom, regardless of whether they were wearing masks. 

Out of 281 tests so far administered by the program, 271 have come back negative, the superintendent said 鈥� meaning those students have been able to stay in the school building.

The 鈥渢est-to-stay鈥� strategy has been this fall and is lauded by public health experts. The CDC said in mid-October that they are considering into their school coronavirus guidance.

Regarding masking, the CDC recommends universal use, but in practice, the policies have been much more controversial, with eruptions over the mandates in dozens of districts. 

鈥淚 felt like I’ve had to navigate this path by myself,鈥� said Rivera. 鈥淚 feel like most people sit on either side of it. Either it’s, 鈥楴ope, we have to follow blindly what the CDC says,鈥� or we pretend that COVID doesn’t exist. And I don’t think either one of those is right, there’s a balance in the middle.鈥�

The softened masking rules have had some real benefits, according to teachers in the district. Foreign language classes, for instance, were strained when everyone had to cover up.

鈥淚t is really tough when kids are learning a new language for the first time to pronounce new sounds, not seeing how to form their mouth, or [seeing] my mouth because I’m covered up in a mask,鈥� Wendy Locke, a French teacher at Marietta High School, told 社区黑料.

Barbie Esquijarosa, who teaches English to non-native speakers at the high school, agrees that face coverings make school more difficult for young people learning English. But she also worries that the mask-optional policy presents an added stressor for the students she teaches, many of whom may live with older relatives and lack health insurance.

鈥淭hey come in concerned,鈥� said Esquijarosa. 鈥淭hey鈥檙e wearing [the mask] the whole time. They’ll stay away from the kids who don’t wear the masks.鈥�

What鈥檚 more, many of her students lack transportation, meaning they aren鈥檛 able to participate in Marietta鈥檚 test-and-stay program if they have possible COVID exposures.

Rivera recognizes that the program is accessible only to students with transportation and is working to designate a bus to pick up kids for COVID testing. But as of yet, no such route is in operation. Like many other districts across the country, Marietta鈥檚 bus driver reserves are amid wider facing schools and the U.S. economy.

Elsewhere, some school districts have taken an opposite stance on masking. When the department of health in Douglas County, Colorado moved to remove face-covering mandates, the school district sued on behalf of nine medically vulnerable students 鈥� winning a on the new rule.

鈥淣o parent should be forced to choose between sending their child to school and risking their child鈥檚 health, and no family should have to fear that their child may face life-threatening illness just to access their right to a great education,鈥� Superintendent Corey Wise said in a statement.

Back in Marietta, there has been no increase in coronavirus infections since Rivera dropped universal masking rules. Total infections have fallen from 233 in the first five weeks of schools to 143 in the seven weeks that followed, according to the district.

Still, Linas, the Boston University medical expert, cautions against the mask-optional policy. 

Breathing room now for students and staff may mean breathing room for the virus 鈥� to mutate and evolve 鈥� in the long run, he said.

鈥淚t just doesn鈥檛 make sense to start rolling those dice when we鈥檙e so close to the actual finish line.鈥�

Centers for Disease Control and Prevention Director Dr. Rochelle Walensky on Tuesday evening the unanimous vote of a CDC vaccine advisory panel recommending Pfizer-BioNTech鈥檚 pediatric coronavirus vaccine for use in children ages 5 to 11. Her sign-off means shots can begin Wednesday for some 28 million children in this younger age group. The CDC approval comes after the Food and Drug Administration on Friday for emergency use in 5- to 11-year-olds. Children鈥檚 hospitals and pediatrician鈥檚 offices across the country told CNN that they have and would be ready to administer shots to children as soon as they got the green light. “As a mom, I encourage parents with questions to talk to their pediatrician, school nurse or local pharmacist to learn more about the vaccine and the importance of getting their children vaccinated,” Walenksy said.

Members of a federal advisory panel voted overwhelmingly Tuesday evening to recommend the authorization of a pediatric dose of Pfizer-BioNTech鈥檚 coronavirus vaccine for children ages 5 to 11, setting in motion a process that could make shots available for the age group by next week.

The 17-0 vote, with one abstention, represents a key step toward vaccine access for approximately 28 million U.S. children 鈥� and means that virtually all K-12 students could soon be eligible for shots.

The Food and Drug Administration panel endorsed giving children one-third the dosage for adults in two shots spaced three weeks apart. The group鈥檚 vote is non-binding, but the FDA typically in the days after a decision, according to The New York Times.

Next, the Centers for Disease Control and Prevention has Nov. 2 and 3 meetings scheduled for their own panel of experts to weigh in on the matter, after which emergency use authorization could soon be issued.

FDA committee members cast their votes after considering the efficacy data of the Pfizer-BioNTech shots and the cumulative toll of COVID-19 on children and families.

Shots for kids were 91 percent effective at preventing infection, the pharmaceutical companies鈥� trial showed. Only three out of over 3,000 inoculated children experienced breakthrough infections, compared to over a dozen who had received the placebo.

Immunity and side effects for 5- to 11-year-olds were comparable to those produced by the larger dose in 16- to 25-year-old patients, the data showed. No new safety problems or cases of heart inflammation were observed in the trial. Israeli studies have found myocarditis to occur in less than , so it鈥檚 possible the condition would have been too rare to have been detected in the main study.

However, even in worst-case scenarios where adverse cases run on the high side of what officials expect, the benefits of shots for kids still supersede the potential dangers, according to modeling presented by Hong Yang, senior advisor at the FDA鈥檚 Office of Biostatistics and Epidemiology.

鈥淭he benefits clearly outweigh the risks,鈥� she said.

Over the course of the pandemic, nearly 2 million children between the ages of 5 and 11 have fallen ill with the virus, 8,300 have been hospitalized, and close to 100 have died, making COVID-19 one of the top 10 causes of death among the age group, said Peter Marks, who heads the FDA division that oversees vaccine approvals.

In addition to preventing cases and hospitalizations, minimizing learning disruptions was a key consideration for advisory committee members. 

Since August, over 1 million K-12 students have been affected by school closures due to COVID, Dr. Fiona Havers, a viral diseases specialist at the CDC told committee members during the Tuesday hearing.

鈥淭he school closures and the disruption has been enormous,鈥� said the FDA鈥檚 Jeanette Lee. 鈥淲e have to weigh that against the benefits we would see [from] the vaccine.鈥�

Randi Weingarten, president of the American Federation for Teachers, celebrated the panel鈥檚 recommendation as a win for school safety.

鈥淭his is huge news in our ongoing effort to keep our kids safe from COVID-19. For nearly two years, parents have been living in fear, worried that their child could get sick at school, day care, or in daily life, but now they finally have FDA-approved protection to add to the long list of vaccines we use to keep our children protected from transmissible diseases,鈥� she said in a statement. 鈥淓ducators, school staff and healthcare professionals are eager to work together with parents to help get America鈥檚 kids vaccinated in the places they trust, including public schools and community centers.鈥�

At least one committee member, Cody Meissner, who ultimately voted to recommend the vaccine for authorization, expressed hesitation about how greenlighting shots for 5- to 11-year-olds may play out for school policy. 

鈥淚鈥檓 just worried that if we say yes, that the states are going to mandate administration of this vaccine to children in order to go to school and I do not agree with that. I think that would be an error at this time,鈥� he said during the Tuesday hearing.

Vaccine mandates have become a flashpoint in the ongoing culture wars now consuming school boards nationally. Only a handful of school districts, mostly in California, have enacted coronavirus vaccine requirements for eligible students. The Golden State鈥檚 two largest school systems, Los Angeles and San Diego, are currently defending their policies in court. 

California is also the only state to mandate shots for eligible students, though the policy will .

A third of parents with children ages 5 to 11 said they would get their child vaccinated 鈥渞ight away鈥� once they were eligible, according to a Sept. 30 , while a third said they would 鈥渨ait and see鈥� and a quarter said they would 鈥渄efinitely not鈥� vaccinate their younger children. A by 鈥嬧�媡he COVID-19 Vaccine Education and Equity Project reported that two-thirds of parents with children in the age group said they would immunize them once the shots are authorized.

When shots do ultimately roll out for children, vials will be colored differently to avoid confusion with the more potent adult formula, said William Gruber, senior vice president of Pfizer Vaccine Clinical Research and Development.

Immediately after the FDA panel鈥檚 vote, Ashish Jha, dean of the Brown University School of Public Health, .

鈥淭hey got it right,鈥� he said.

In many cases, CDC numbers clash with locally reported vaccination rates, an analysis from 社区黑料 reveals, including multiple instances of double-digit gaps between local and federal counts. In some counties, the agency鈥檚 data indicate that the share of 12- to 17-year-olds who have received at least one vaccine dose is impossibly high 鈥� 101 percent in Miami-Dade County, Florida, and 104 percent in San Francisco County, California, for example.

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The lack of clarity takes on heightened significance as the country another swath of the K-12 population, with coronavirus shots for children ages 5 to 11 currently under review by the U.S. Food and Drug Administration and expected as soon as early November.

Inaccuracies in CDC data could have implications for the nationwide understanding of vaccine uptake among young people. The youth COVID immunization rate calculated by the , for example, is based on CDC numbers.

鈥淥ur method is to clearly state the source of our data,鈥� Suk-fong Tang, senior database analyst for the AAP, told 社区黑料. But due to time limitations and the vast quantity of information, she said, 鈥渋t is not possible at this time to validate everything that we use.鈥�

鈥淲e work with [CDC] data with the faith that the data really captures the large trends,鈥� the AAP expert continued. 鈥淚t may not be, you know, accurate down to the single-digit counts.鈥�

While the CDC does not publish youth immunization data directly, it releases vaccination rates and raw counts for those over 12 and those over 18 by county. Using those numbers, 社区黑料 calculated the rate of inoculation for 12- to 17-year-olds via a method that Tang confirmed produced a 鈥渉ighly similar鈥� youth vaccination figure as the AAP. (Click to see the math.) Those rates frequently deviated from local reports, indicating possible flaws in the federal agency鈥檚 vaccination counts, population counts, or both.

For example, CDC data downloaded by 社区黑料 Sept. 30 indicate that in Queens County, New York, 86 percent of teens have received at least one vaccine dose, while NYC Health said the county鈥檚 figure was actually 74 percent. In an especially extreme case, federal data for Coconino County, Arizona, indicate a 93 percent one-dose vaccination rate for 12- to 17-year-olds, while Coconino Health and Human Services reported a 57 percent rate.

Coconino County officials explained the gap in an email to 社区黑料, saying they use a 鈥渕ore enhanced data cleaning process鈥� than the state or the CDC.

Other areas such as Fairfax County, Virginia; Marin County, California; and Howard County, Maryland, reported youth vaccination rates that closely aligned with federal counts, differing by under 5 percentage points.

The CDC did not respond to the discrepancies identified by 社区黑料, and did not provide comment when asked for the reasons behind them, despite over a half-dozen requests made over more than a two-week span. The agency did send a link to information on its vaccination data reporting protocols, which that their population counts are based on the Census Bureau鈥檚 2019 estimates, meaning that their percentages could be inaccurate if individuals moved counties in the last two years.聽

Population shifts may not completely account for the discrepancies. Outside experts also said issues such as or delays in reporting data upstream to the federal government could contribute to inaccuracies.聽

鈥楩lying blind鈥�

Data woes have plagued the CDC throughout the pandemic, said Ali Mokdad, who, after years monitoring vaccine coverage at the federal agency, is now a professor of epidemiology at the University of Washington.聽

鈥淲e鈥檙e flying blind,鈥� he said, pointing out that U.S. decisions around Pfizer booster shots were based on data from Israel and Qatar, where vaccination numbers are collected in a more standardized fashion, due to a dearth of reliable U.S. data.聽

From the CDC鈥檚 decision to for breakthrough infections to their for vaccinated individuals, the agency has come under fire at multiple points throughout the pandemic.聽

In past months, the epidemiology professor said, many Americans received by crossing state lines or lying about their vaccination status thanks to lax immunization tracking. 鈥淲e don鈥檛 know [exactly how many people are] vaccinated or not, and what types of vaccines they have received and when.鈥�

That can become a life-or-death problem, said Mokdad. 鈥淲hen you know how many people are vaccinated, you know what immunity you have in your community,鈥� he explained. 鈥淸But if you don鈥檛] know how many people are vaccinated 鈥� you can’t get a handle on how many people are susceptible in your own community and then that will sustain a surge.鈥�

In instances where local vaccination numbers are above CDC counts, it鈥檚 possible that states have been slow to report their most recent immunization data, Emily Pond, a researcher for the Johns Hopkins University , told 社区黑料 鈥� she calls that glitch 鈥渄ata lag.鈥� Where the CDC count is higher, Pond explained, federal overseers may have access to vaccination counts that local departments of health do not, such as coronavirus immunizations that occurred at army bases or on tribal lands through the Indian Health Service.

In Navajo County, Arizona, for example, Assistant County Manager Bryan Layton said via email, 鈥淲e openly acknowledge the inherent challenges of tracking and reporting case data and vaccine rates in a rural county that is home to 3 different sovereign tribal entities: the White Mountain Apache Tribe, the Hopi, and the Navajo Nation 鈥�. The Navajo Nation 鈥� uses a series of service areas that do not necessarily conform to county or state jurisdictions.鈥�

Still, local reports in Navajo County say of residents under 20 years old have received at least one dose of the vaccine, compared to CDC numbers that put the rate for 12- to 17-year-olds at 98 percent 鈥� a gap that likely can鈥檛 be fully explained by Indian Health Service data absent at the local level.

鈥淚 have a red flag when any [vaccination rate] is above, like, 90 percent,鈥� said Pond. Differences between CDC and local figures, she said, can be rather common.聽

鈥楢 lot of moving parts鈥�

To get a better sense of the frequency of discrepancies between local and CDC vaccination rates, 社区黑料 queried a random sample of 10 U.S. counties, a small sliver of the over 2,600 in the full dataset and separate from the analysis of the counties with the highest reported rates. Seven returned data for comparison against federal numbers, some using slightly different age boundaries for youth vaccination than 社区黑料鈥檚 12- to 17-year-old range.

Out of those seven counties, three had rates that diverged from CDC numbers by more than 5 percentage points. Hood River County, Oregon, reported that 72 percent of youth ages 12 to 17 had received at least one dose of the coronavirus vaccine while the CDC reported an 80 percent figure. Sullivan County, Pennsylvania, reported a 23 percent rate for youth ages 12 to 19 compared to a 30 percent 12- to 17-year-old rate from the CDC. And Schoolcraft County, Michigan, reported that 32 percent of youth ages 12 to 15 and 47 percent of youth ages 16 to 19 had received at least one dose, compared to a 13 percent CDC rate for youth ages 12 to 17. Both Sullivan and Schoolcraft counties have populations under 10,000, meaning small inaccuracies could have an outsized impact on their vaccination percentages.

The inconsistencies don鈥檛 surprise Michael Kurilla, director of the National Center for Advancing Translational Sciences at the National Institutes of Health. The U.S. has a decentralized health care system, he pointed out, meaning that providers can鈥檛 easily share data. For example, someone sick with COVID who leaves the hospital too early and re-admits to another facility could easily be counted as two cases, said Kurilla.

Further, the reporting systems themselves are often antiquated, the NIH expert explained.

鈥淪ome places are still paper based, some are using fax to transmit information,鈥� he told 社区黑料, adding 鈥� only half joking 鈥� that it wouldn鈥檛 surprise him if some local health agencies still used floppy disks.

On top of technological woes, the many different settings offering COVID-19 shots can compound reporting challenges, explained Phil Chan, medical director for the Rhode Island Department of Health. It鈥檚 easy to document doses at state-run vaccination clinics, he said, but vaccinations delivered at doctor鈥檚 offices or pharmacies can be harder to track.

鈥淚t鈥檚 a lot of moving parts,鈥� he told 社区黑料. 鈥淭he devil鈥檚 really in the details.鈥�

When those details are mishandled, inaccuracies in the data arise. In mid-September, the CDC adjusted their report of the share of people 12 and older in West Virginia who had received at least one dose of the coronavirus vaccine , after discovering that they had double-counted certain data streams for over three months.

On the flip side, increased data transparency may well translate into increased accuracy. In Maine 鈥� the only U.S. state to publicly report student and staff COVID vaccination data for school districts, according to the University of Washington鈥檚 Center on Reinventing Public Education 鈥� reported by the state for each of its 16 counties align closely with federal numbers.

鈥淲e need to be transparent, you need to show exactly what you do,鈥� said Mokdad, the UW epidemiologist who spent two decades at the CDC.

He wishes his former employer would be more forthcoming about its raw numbers and any possible shortcomings in its data pipeline. In his own COVID research, Mokdad said, he relies on infection counts from the Johns Hopkins tracker, because he finds it more reliable than the federal numbers.

鈥淭here is a big problem at CDC right now,鈥� said the epidemiologist. Mokdad himself was involved in a high-profile incident in 2004 where he co-authored a CDC paper that the number of annual deaths caused by obesity. The health expert said he left the centers in 2008 for unrelated reasons and on good terms with all his co-workers.

鈥淚 criticize CDC because I love CDC,鈥� he said.

According to by the Centers for Disease Control and Prevention, body mass index (a common measure of weight relative to height) in a sample of 430,000 children increased between March and November 2020 at nearly double the rate that it did before the pandemic began. The changes were especially prevalent among elementary-aged children, as well as those who were already overweight or obese.

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Dietician Michelle Demeule-Hayes, the director of at Baltimore鈥檚 Mt. Washington Pediatric Hospital, called the trends 鈥渟taggering.鈥�

鈥淚t鈥檚 never been this bad,鈥� she added. 鈥淪o the research is definitely accurate.鈥�

The CDC鈥檚 findings echo those of other research released in the past few months. by the Journal of the American Medical Association (JAMA) showed that rates of overweight and obesity have soared among children measured in California between the ages of 5 and 17. Two others 鈥� one and appearing in the journal Pediatrics 鈥� found that the weight gain was greater for certain demographic subgroups, including Hispanic, African American, publicly insured, and low-income children.

The spate of publications suggests a national spike in pediatric weight gain as kids have been restricted in their movements outside the home.

Corinna Koebnick, a nutrition scientist at Kaiser Permanente Southern California and a co-author of the JAMA paper, wrote in an email that it was 鈥渟afe to say鈥� that children have gained weight during the pandemic, and that it was unclear whether opening schools to in-person learning will be enough to reverse the trends that have taken hold.

鈥淭he increase in obesity over the 11 months [we] analyzed compares to the increase seen in national data over almost the last two decades,鈥� Koebnick said. 鈥淐hildren who have social and financial disadvantages, who live in school districts with less money or…less access to parks and meal programs may have additional challenges returning to healthy weights.鈥�

Koebnick鈥檚 study used Kaiser Permanente electronic health records for over 190,000 children whose body-mass index (BMI) was measured during a medical visit both before and during the pandemic. Researchers divided patients into three age groups (those between the ages of 5 and 11, 12 and 15, and 16 and 17) and studied their tendency to be overweight (at or above the 85th percentile of BMI for age) or obese (at or above the 95th percentile.)

Children in all three age groups gained more weight during the pandemic than they did before. But elementary-aged kids saw the biggest relative gains, with an average increase of BMI of 1.57, compared with an increase of 0.91 for the next-youngest group and 0.48 for the oldest. Adjusted for height and translated into actual weight, those figures indicate average gains of 5.07 pounds, 5.09 pounds, and 2.27 pounds for the respective groups.

Overall, the portion of 5-11-year-olds who are classified as overweight or obese is now 45.7 percent, up from 36.2 percent before the pandemic. The same figures rose by 5.2 percent among 12-15-year olds and 3.1 percent among 16- and 17-year-olds.

Demeule-Hayes, said that the wave of research on pandemic-related weight gain reflected the reality she and her colleagues face every day. Some patients referred to her, none older than 17, weigh as much as 400 pounds, and it has become typical to treat children diagnosed with what are typically seen as adult ailments, such as hypertension, high cholesterol, diabetes, and osteoarthritis.

Several papers already showcased the rising prevalence of type-2 diabetes. In both Washington, D.C., and Baton Rouge, Louisiana, researchers discovered that pediatric diagnoses of the dangerous and chronic condition approximately doubled in the year after school closures began. Among children diagnosed during that period, one study found that 60 percent required hospitalization for complications like severe hyperglycemia, compared with just 36 percent in the year before COVID emerged.

But Demeule-Hayes said that another common health complication of obesity, obstructive sleep apnea, poses particular risks for K-12 students.

鈥淭here are a whole lot of sleep disturbances with these kids because they’re tired, they’re not getting good-quality REM sleep,鈥� Demeule-Hayes said. 鈥淪o they’re coming home and taking naps, which just perpetuates that sleep-disturbance cycle 鈥� they can’t get to sleep later because they’ve taken a three-hour nap after school.鈥�

Experts are still investigating how the coronavirus changed the lifestyles of both children and adults. have shown that sales of packaged and processed foods shot up in the early months of the pandemic, and suggests that consumption of fresh foods declined. Demeule-Hayes pointed to the monthslong stillness that followed school closures, during which she watched her own young children learn from inside the house.

“Having them be on a computer literally all day, not having any of the recess or the steps outside or even just walking up and down the halls 鈥� they’ve been so, so sedentary,鈥� she lamented. 鈥淧re-pandemic, even if they were getting driven to school, they were still at least walking around the school and walking up one or two flights of stairs to classrooms.

According to tech firm SuperAwesome, the time children spent on screens each day after COVID-related closures began; 40 percent of kids aged 3-9 said they spent 鈥渕uch more鈥� time on screens. Respondents to of Canadian youth reported lower levels of physical activity, less time spent outside, more sedentary behaviors, and more sleep than before the pandemic.

As school districts around the country reopened for full-time, in-person learning, educators have welcomed back students whose lives were meaningfully 鈥� and perhaps permanently 鈥� altered by COVID. The extent of the academic damage is thought to be extensive, and hospital records suggest that many children may have suffered prolonged abuse while separated from their schools. On top of those severe setbacks, the bodily changes that some have undergone may prove long-lasting: Obese children and adolescents are as adults.

Koebnick recommended that parents limit screen time and encourage their kids to exercise and drink lots of water. Demeule-Hayes said that she recognized that some parents might still be leery of outdoor play given the dangers of the Delta variant. Still, she said, there was much that families and educators could do to combat further weight gain.

鈥淎s much as teachers and administrators can work [movement] into school time, they should. For parents, it’s taking walks as a family, after dinner, whenever you can work it in. Our message is always to make changes as a family so there’s not a stigma around a child’s ‘weight issue’; it’s really about making healthy changes for the family.鈥�

Press Secretary Jen Psaki said Tuesday it would be possible for federal relief funds to cover salaries if the governor follows through on withholding pay from superintendents and board members who require students to wear masks.

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鈥淲e鈥檙e looking at a range of options,鈥� she said, adding that any action the administration takes could impact the 鈥渉andful of states that are putting in place measures that make it more difficult for 鈥� leaders in the education field to protect students and their communities.鈥�

But DeSantis shot back, saying it would be inappropriate for the administration to intervene.

鈥淚 think that they really believe government should rule over the parents’ decisions,鈥� he said during a . 鈥淭he parents are in the best position to know what’s best for their kids.鈥�

DeSantis, the White House and school officials in districts such as Broward County and Miami-Dade are taking firmer stands on the issue as the state鈥檚 COVID-19 positivity rates and hospitalizations .

Florida鈥檚 brinkmanship on masks comes as districts across the country are feeling the impact of the more aggressive Delta variant and the pandemic once again is interfering with what parents and officials hoped would be a typical back-to-school season. Last week, U.S. Secretary of Education Miguel Cardona even raised the possibility of a return to remote learning.

鈥淸If] the community spread gets to a certain level, it may be best to have students learning from home,鈥� he said during a Friday town hall in Boston with the YMCA and the Boys and Girls Clubs. 鈥淏ut we鈥檙e going to do everything in our power not to go there. The kids suffered enough.鈥�

Some Florida district leaders say they鈥檙e not intimidated by the governor鈥檚 threats and argue they have a duty to require masks temporarily.

鈥淚 have a moral responsibility to be my brother鈥檚 and sister鈥檚 keeper, even if it means my salary is taken away,鈥� Rosalind Osgood, chair of the Broward County school board, said Tuesday during a special meeting where members voted to keep the mask mandate in place. 鈥淚 wonder if the governor has visited the ICU lately.鈥�

The vote came after more than an hour of passionate arguments from parents and staff members on both sides of the issue.

鈥淲e鈥檙e really lucky that we have such a simple way to protect each other 鈥� by wearing a simple cloth mask over our face,鈥� one mother, with her kindergarten daughter on her hip, told the board. 鈥淵ou have an entire community behind you.鈥�

Another mother said the board is infringing on her right to make decisions that affect her child.

鈥淢y child does not want to wear a mask,鈥� she told the board. 鈥淚f the masks were working, why is my child having to be quarantined from exposure so many times?鈥�

Meanwhile officials in Miami-Dade County Public Schools are still weighing their decision on mask rules, and Superintendent Alberto Carvalho said he鈥檒l listen to the advice of health experts.

鈥淎t no point shall I allow my decision to be influenced by a threat to my paycheck; a small price to pay considering the gravity of this issue and the potential impact to the health and well-being of our students and dedicated employees,鈥� he said in a statement.

鈥楰eep schools open鈥�

Florida is one of eight states not allowing local flexibility regarding mask mandates, according to Burbio鈥檚 . Those who disagree with the governor鈥檚 position have taken different approaches to the issue.

Some are maintaining that they still have a mask mandate in place, but are allowing parents to opt out. In , it鈥檚 sufficient for parents to make the request. But in Alachua County, which includes Gainesville, a doctor鈥檚 note is required.

鈥淚’ve been called a monster, child-abuser, communist, fascist, idiot and other names not fit to print. I’ve been threatened with legal action, protests, militia 鈥榚nforcement鈥� and worse,鈥� Alachua Superintendent Carlee Simon wrote in Monday about her decision to require masks for the first two weeks of school, which began Tuesday. 鈥淐ertainly we鈥檙e concerned about the threat of lost funding, but it shouldn鈥檛 come to that. After all, we want what DeSantis wants: to keep schools open and our kids in the classroom.鈥�

Simon noted that the state its Hope Scholarship voucher program to include those who prefer a school requiring masks. The program previously only applied to students who have been bullied, harassed or assaulted, allowing them to transfer to another private or public school. Broward County board members said that new rule only hurts public schools if more families opt to go private.

Some parents think DeSantis is making the right call.

鈥淭he silver lining of COVID is that it doesn鈥檛 impact kids,鈥� said Bill Gilles, who has two children in the St. Johns County School District, which includes St. Augustine. The district is complying with the governor鈥檚 order.

Children represent less than 10 percent of COVID-19 cases internationally, according to the .

Gilles said he and his wife were more accepting of masks last school year before vaccines were available. But now, young people more likely to become infected are the 鈥渂ar crowd and not the school-age crowd,鈥� he said. 鈥淚t just doesn鈥檛 justify putting burdens on kids.鈥�

According to the state health department鈥檚 data, are 14 percent among children under 12 and 20 percent for 12- to 19-year-olds. About 1 in every 100,000 children in Florida, 17 and under, has been hospitalized for COVID-19, which is roughly double the last peak at .56 per 100,000 in January, to the Centers for Disease Control and Prevention.

But DeSantis said in his comments Tuesday that RSV, a common respiratory infection, is contributing to increased hospitalization rates.

In June, the CDC noted that RSV cases were and that the state has a longer season of the infection than others.

鈥楾he worsening situation鈥�

Nationally, the majority of states are leaving the decision about masks up to local officials, and for some parents in districts where masks aren鈥檛 mandated, that鈥檚 a problem.

鈥淥ur preference is for our kids to be in person, but for everyone to wear a mask,鈥� said Alan Seelinger, a parent of three children in Georgia鈥檚 Cobb County School District. Unlike other metro Atlanta districts, Cobb does not require masks and is no longer taking students鈥� temperatures or asking about COVID-19 symptoms.

A week into the new school year, however, nearly 1,500 cases have across the metro area.

鈥淚t is regrettable that this pandemic was ever politicized, so we simply ask that you employ a data- and science-driven approach in light of the worsening situation we are seeing today,鈥� the Seelingers wrote in their letter to the board last week, sharing a Bible verse about looking out 鈥渇or the interests of others.鈥�

Seelinger, who has two children who still aren鈥檛 old enough for vaccines, would like to see the district renew the option for virtual learning. While the district still allows remote learning, parents had to make the choice at the end of last school year.

Parents in the county who want masks at the district office on Thursday.

鈥淜ids have a right to a safe school, and right now Cobb schools aren鈥檛 safe,鈥� Seelinger said.

Opinions about masks largely fall along partisan lines, with more than three-fourths of Democrats in a recent saying they鈥檒l put on a mask in public all or most of the time, compared to less than 40 percent of Republicans.

In California, one of nine states currently with a mask mandate for schools, the issue surfaced in a recent debate among leading Republican candidates vying to unseat Democratic Gov. Gavin Newsom in a September recall election. All four candidates participating in the debate mask mandates.

The Delta variant, however, has been enough to change some Republican鈥檚 minds. Arkansas Gov. Asa Hutchinson has said he regrets signing a law in April banning mask mandates. He has tried to change the legislation, but lawmakers have declined to revisit the issue. On Friday, a judge temporarily blocked the law, to require masks.

鈥淚 can only hope in my heart this is what happens to Gov DeSantis,鈥� Broward County board member Nora Rupert said Tuesday.

The most obvious early effects of COVID-19 were the ways in which it shrank the spheres of life, work, and school. Within a few months of its emergence last winter, hundreds of millions of Americans found themselves stuck together in crowded homes, adults often sharing couch space with children stranded from their classrooms.

It was an atmosphere, many worried, that could drastically increase the dangers of domestic violence. As parents were left to ride out the economic instability brought on by sudden business closures, most K-12 students were no longer in direct contact with teachers, who are among the most common reporters of physical, sexual, and emotional abuse to children. Worries only grew as complaints of abuse during the pandemic鈥檚 early weeks, with advocates warning that serious mistreatment was likely going unnoticed.

More than a year later, researchers are sounding the same alarm. Studies of both local child welfare agencies and national emergency room visits suggest that while total child abuse reports declined significantly last year, the cases that arose were more likely to result in medical exams and hospitalizations. And with more kids set to return to in-person classes in September, the findings raise the question of whether school systems will be prepared to assist large numbers of children who have suffered invisible trauma over the preceding 18 months.

Jodi Quas, a professor of psychological and nursing science at the University of California, Irvine, is currently studying patterns of abuse in a large, unnamed Southern California county. In an interview with 社区黑料, she said that it 鈥渕akes sense, when you think about family stress and economic insecurity,鈥� that child abuse and neglect would grow more severe during times of intense upheaval.

鈥淲e have just one county, but it does look like kids are more at risk,鈥� she said. 鈥淚t’s the stress and uncertainty. It’s parents either losing their jobs or trying to work at home while engaged with kids in online school. All of those stressors, we’re guessing, contributed to increased anxiety with fewer resources and support systems available.鈥�

With co-authors Stacy Metcalf, a doctoral candidate, and Corey Rood, a pediatrician, Quas leveraged two sets of data 鈥� monthly reports of suspected child maltreatment from the county鈥檚 social services agency, as well as records of medical evaluations at a local child abuse clinic 鈥� to compare the trends between March and December 2020 with those of the same period in 2019. While their research is still under review and must therefore be read cautiously, the figures indicate that the number of abuse reports fell during the spring (-33.2 percent), summer (-13.1 percent) and fall (-24.5 percent).

The decline appears to be related to school closures: While one-third of abuse reports in the county came from school and daycare staff in 2019, the data show that just one-sixth did in 2020.

In , school employees like teachers and nurses are mandated reporters of abuse. A from researchers at Cornell University and the Federal Reserve Bank of Dallas found that time spent in school increases the likelihood that abuse will be noticed and documented. Educators鈥� prominent role is illustrated by the fact that reports typically decrease during the summer. Given the swift separation of students from schools during the past year, Quas said, it was predictable that reports were 鈥渁bsolutely going to drop, and you saw that in the first months of the pandemic.

Though complaints to social services fell, Quas and her team found that the number of children who received medical evaluations at a local child abuse clinic increased by 30 percent. They also measured an increase of seven percentage points in the proportion of children who received examinations once they were referred to the clinic 鈥� in essence, a sign that the cases of serious, hard-to-ignore abuse grew as a percentage of total reports.

鈥榃hat happens in the fall?鈥�

That finding corresponds with evidence from released in December by the Centers for Disease Control and Prevention. That research found that, in the four weeks immediately following President Trump鈥檚 COVID-19 emergency declaration last March, emergency room visits related to child abuse and neglect fell by more than half compared with the same period in 2019. The decline was apparent across all children and adolescents, with visits for kids between ages 5 and 11 dropping by 61 percent.

But the most concerning of those visits, those resulting in hospitalization, stayed steady throughout September 2020. In total, the percentage of all maltreatment-related ER trips that led to hospitalizations of children jumped significantly, from 2.1 percent in 2019 to 3.2 percent in 2020. That average includes increases from 3.5 percent to 5.3 percent for the youngest children, and a near-doubling (from 0.7 percent to 1.3 percent) for children between 5 and 11.

Dr. Elizabeth Swedo, a CDC researcher and one of the brief鈥檚 authors, warned in an email that because of the massive disruptions to the medical system that occurred last year, the hospital data needed to be interpreted with care. Even in normal circumstances, hospital trips can vary substantially by season, and in 2020, the swings were .

鈥淰isits for almost all non-respiratory diseases and conditions dropped precipitously in March 2020,鈥� Swedo wrote, “in large measure due to patients being more reluctant to travel or seek medical care during the pandemic.鈥�

鈥淭hese denominator shifts presented challenges for interpreting data and communicating complex findings,鈥� she added.

Swedo said that local research of the kind that Quas and her collaborators are conducting 鈥渞eally help contextualize the findings from our national study,鈥� adding that it would be critical to incorporate future data released by national resources like the National Child Abuse and Neglect Data Center and the National Violent Death Reporting System.

It鈥檚 still unclear how the factors that may have contributed to worsening abuse and neglect have responded to the gradual improvement in the economy and public health conditions. have shown that quarantines, and particularly lengthy ones, can lead to fear, anger, and symptoms of PTSD. Studies looking specifically at the COVID era suggest that the workers most affected by the pandemic to their mental health, and living under a stay-at-home order loneliness and anxiety.

Even with COVID cases and deaths back on the upswing in recent weeks, more adults and kids are beginning to resume their pre-pandemic routines. But Quas noted that school districts might need to get ready to identify and provide services to a sizable group of students who spent the 2020-21 school year not just isolated from teachers and friends, but also under threat from adults in their homes.

“What I’m thinking about is, what happens in the fall? Not that the pandemic is fully over, but by fall, I think more kids are going to really be back in school after a pretty long period. How do you prep for what we think might be an increase in reporting that could happen then, as kids go back to school more consistently?”

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F谤颈诲补测鈥檚 from the Centers for Disease Control and Prevention puts districts in a tough spot 鈥� do they require all students to wear masks indoors or just those who haven鈥檛 been vaccinated?

District leaders say it would be difficult to implement a policy where masks are optional for some but not others.

鈥淭he return for this school year will require a societal pact to protect one another by ensuring each of us follows the guidance that applies to us,鈥� said Tony Sanders, superintendent of School District U-46, outside Chicago. On Friday, the district announced it would maintain universal mask requirements for the rest of summer school, but would revisit the issue before school starts.

With about a month to go before some schools reopen for the new school year, the latest update aligns with the Biden administration鈥檚 push toward full reopening and eliminates the need for districts to reduce the number of students in buildings in order to maintain social distancing 鈥� a strategy that created most of last school year. Surveys show parents are growing more comfortable with the idea of full in-person learning this fall. But for some, the issue remains unusually divisive. Some say they don鈥檛 feel safe letting their children return without mask mandates in place and others say they won鈥檛 return because of mask requirements.

鈥�2019 or bust鈥�

, including California, Connecticut, Hawaii and Virginia, still have mask mandates, even for those already vaccinated.

In response to the updated CDC guidance lifting mask requirements for those already vaccinated, California announced Friday that it would keep 聽in place for students this fall to 鈥渆nsure that all kids are treated the same,鈥� according to a statement from the state鈥檚 public health department.聽But then on Monday, officials tweeted that they would leave those decisions up to local districts. Requirements in other states could change in the coming weeks as well.

鈥淲e expect our updated guidance 鈥� to align closely with the CDC鈥檚 recommendations and to continue making the health and safety of children a priority,鈥� said a statement from the New Mexico Department of Education. The state relaxed requirements for vaccinated children and adults in May, but kept the rule in place for schools. And Oregon is now recommending, rather than mandating, mask use in its .

In states that lifted mask mandates earlier this year, districts that continue to require them are seeing increased pressure from some parents to relax the rules. In Florida鈥檚 Broward County Public Schools, board members faced accusations of for requiring students to wear masks. A spokeswoman said the district is reviewing the CDC update and will discuss any changes later this month.

Nevada will require different mask rules depending on students鈥� grade level 鈥� a May policy that sparked and calls from parents in the Clark County School District to leave mask decisions up to them. According to a state directive, masks for students in third grade and below are optional, while students over 12 are eligible for vaccines. Therefore, only fourth and fifth graders will be required to wear masks, but the policy may be updated further based on the new guidance, according to the state.

In Medford, New Jersey, east of Philadelphia, Kristin Sinclair said her 7-year-old son won鈥檛 return to public school if masks are required.

鈥淚t鈥檚 2019 or bust,鈥� she said. 鈥淚f it doesn鈥檛 look normal, I鈥檓 sending him to private daycare or I鈥檒l quit my job and homeschool.鈥�

Others, however, aren鈥檛 ready for students to go maskless. from the National Parents Union shows 45 percent of parents who kept their children out of school the entire year want all students and staff to wear masks. And a third of those who stayed with remote learning this year want all students to be vaccinated before they鈥檒l feel comfortable sending their children back to school.

But in general, parents are less hesitant for their children to return to in-person learning than they were in the spring. A poll released last week shows almost three-quarters of parents are somewhat or totally comfortable with sending their children back to class.

鈥楽tarting to follow the science鈥�

Experts that have been pushing for a full return to school welcomed the update.

The CDC is 鈥渇inally starting to follow science,鈥� said Dr. Daniel Benjamin, a pediatrics professor at Duke University in North Carolina. 鈥淩emote instruction for all K-12 students is malpractice.鈥�

He applauded the recommendation that schools should remain open regardless of community-level transmission rates. But while the guidance still lists quarantining as a possible mitigation strategy, Benjamin said vaccinated students and those without symptoms don鈥檛 need to quarantine if they鈥檙e wearing masks.

鈥淎t the moment, the CDC complicates this simple message,鈥� he said.

Some experts wonder how the guidance will impact COVID-19 testing programs. Districts, such as Los Angeles and San Antonio implemented extensive testing programs last school year. And the Colorado Department of Public Health and Environment a new testing program for schools this fall.

But the CDC said at this point, such programs are more valuable in communities with high levels of transmission and that vaccinated students and staff don鈥檛 need to be tested. Benjamin added that science doesn鈥檛 support widespread testing if districts continue to require masks.

Testing does have some merit, he added, among unvaccinated and unmasked students and for those participating in sports and extracurricular activities, such as band.

The guidance comes as some states are seeing in positive cases, driven by the Delta variant. But officials stress the increases are largely concentrated in states with low vaccination rates and that almost all due to COVID-19 are among unvaccinated people.

The CDC guidance removes any speculation that schools will need to separate vaccinated from unvaccinated students. That would have been a 鈥渟cheduling nightmare,鈥� especially in middle schools where roughly a third of students still aren鈥檛 eligible for the vaccine, said Tom Phillips, executive director of the New York State Middle School Association and a former superintendent.

Districts where administrators have drawn clear lines between vaccinated and unvaccinated students have faced some pushback. In June, a New Hampshire high school for marking unvaccinated students鈥� hands with a Sharpie at the prom. And the Southfield Public Schools, north of Detroit, faced charges of discrimination when it accepted from an organization picking up the cost of prom tickets only for vaccinated students.

Separating students by vaccination status 鈥� which have already suggested for sporting events, businesses and churches 鈥� would create 鈥渁n atmosphere that stigmatizes students,鈥� Phillips said, and would be 鈥渉armful to the entire school community.鈥�