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宵枚:让孩子在家远程教学,还是返校---一位一线医生的无解回答

(2020-07-17 20:33:06) 下一个

(几个星期以来,白宫和许多州政府都在指示秋季开学。一石激起千层浪,有学生的家庭无限纠结。一位朋友今天问我,到底应该如何做,去学校有没有危险。我一向对朋友直言。但由于我已经没有子女在校读书,由我回答这个问题,可能会有隔靴搔痒之嫌。所以我在这里改写一篇大约10天前一位朋友送来的帖子。原帖是英文,我改写成中文。希望能帮助一些朋友在做决定时,有个参考。

这是杜克大学医学院附属医院一位医生的观点,她针对由于许多父母不得不做出艰难的学校决定,说出自己的心里话和打算。这位医生亲身救治COVID-19病人,又有两个年幼的孩子。她能够在人人似乎自顾不暇之时,直抒胸臆,给广大家长提供了有益的参考,感谢感谢。同时我也要感谢在第一时间转发这个帖子让我读到的一位杰城朋友,因为有这样的朋友,我们的社区好很多)。

这位医生说-----

关于秋季开学,将会有很多讨论和辩论。今天,2020年7月2日,北卡的威克县宣布,他们将安排儿童一周实体课堂教学,两周远程教学。我希望杜克大学所在地点教堂山学区很快就会效仿,或者制定一些类似的混合计划。有朋友一直不断地问我这个问题,“哎,你是一名治疗COVID的医生,您如何考虑将您的孩子送回学校呢?” 这里,我的回答只代表我自己的,非常个人化的意见,不反映我的雇主,也和杜克无关。我了解并赞赏与我处于同一职位的许多同事,他们各自有不同的看法。但是既然有很多人不停地问我,下面就是我作为父母和一线医生的答案。大致如下。

 

我为我的孩子下学期选择远程学习,不去实体学校。原因是多方面的:

  • 这个疾病吓到我了。我在照顾了COVID患者四个月之后,了解了很多。但是对COVID,很多人的病情进展不一样,治疗方案也并不确定。众所周知,Covid会引起肺,心脏,肾脏,大脑和凝血系统的并发症。这是现在我们对COVID急性期的了解。我们不知道,还没有知道,得了这个病对病人将来的长期影响可能是什么。无论如何,我不愿意我的孩子去冒这个险。
  • 发病率与死亡率。我以前谈过这一点。是的,实际上很少有孩子死于COVID。但是许多年轻人仍然会得病,而且病得很重,会插管,上呼吸机,会有需要用ecmo---人工肺来呼吸。还有孩子得了小儿多系统炎性综合征, 会得川崎样疾病伴冠状动脉瘤。这些并发症都会有后遗症。仅仅因为没有死于covid,并不等于病人会恢复到原来的健康。
  • 我们还要考虑到老师和学校工作人员。天哪,我们怎么能问他们这个问题?经过几个月的谨慎庇护,我们现在要求他们跳入“狼窝”,要与成千上万的有家庭联系的儿童互动。(###据说,7月份,佛州参加COVID测试的青少年儿童,有三分之一的结果是阳性。)老师接触的学生越多,您的风险就越大。相信我,如果我们不采取措施,就把校门打开,想象我们一切会正常,我敢保证,我们将会看到有老师,校车司机,学校餐厅的工作人员,和其他学校员工以及他们的家人陆续患病,并且死亡。(####这些老师,校车司机,学校餐厅的工作人员,和其他学校员工以及他们的家人都是没有经过严格医学训练的人员啊!他们和学生们的互动,是和在商店里仅有几分钟付费的短暂接触,绝对不能划等号的呀!)
  • 我会继续让我的父母照顾我的孩子。如果我们严格隔离,我觉得是安全的。但是,如果孩子们回到学校并与来自数十个家庭的数十个孩子互动,那么他们回家后,我的父母从孩子们那里染病的风险就会成倍增加。
  • 我坚信,我们将孩子留在家里并不会对他们的成长造成多大的不利影响,因此我们应该这样做。我们社区也有很多人,他们的生活,职业和经济状况,造成如果让孩子继续留在家里,会受到比较大的影响。我们家不会。我们甚至可以远程教学长达一年,都不会对我的孩子,我的职业或经济状况造成伤害。所以我选择将孩子留在家中。我这样做,也可以使必须把孩子送到学校的家庭相对更安全一些。(###因为一部分孩子不去学校,就减少了学校拥挤,减少了老师必须面对的危险,也使学校里保持社交距离比较有可能做到)。

我承认我非常幸运,我的工作使我能够仅用一部分时间在临床看病,而另一部分时间能够远程完成我的研究工作,并照顾到孩子在家学习。我的父母住在附近,愿意帮我,在我必须在医院工作的几周里,他们愿意并全心全意地帮助我的孩子在家上学。

对于任何一个单亲家庭,或者两人都不能在家里工作的职业父母,或者没有大家庭支持的家庭,有ESL的家庭,有IEP的孩子,孩子需要特殊照顾的家庭等,留家还是返校,这无疑像是一个可怕的噩梦。

至于怎样能够更好地兼顾安全和学习进度,我真的没有答案。我不希望孩子因为父母负担不起家庭教育,不能聘请所需要的老师而过分地在学习上落后。但是我也不想看到孩子患COVID,更不希望老师因为必须在疫情下面对面地授课而患病身亡。

必须看到,这些不能面面俱到的方案,似乎会加剧贫富之间的差距,也可能会加大成绩好坏的差距。

但是,显而易见,任何涉及到增加面授时间的计划,一定会使孩子和老师面临更大染病的风险。坦率地说,这些老师的薪水不足以逼迫他们去赴死,不足以弥补他们的损失,让他们的家人去冒生命危险。

我个人不能回答这个问题。我觉得这个问题现在无解。

 

(学习这位医生的帖子后的想法:在疫情没有有效控制的时期,如果可能,家长要想尽办法减少孩子去学校面授的时间,或直接不去学校,改成网上教学,可以减少孩子生病的危险。这样做,对减轻学校的负担,老师和其他同学的负担,也是有好处的。所有的家长,都要尽自己最大的力量保护自己,保护孩子,保护家庭。对英语是第二语言的家长,也可以用google translate了解本地法案的大概。)

 

附上英文原文。

7/2: SCHOOL. There has been much discussion and debate about what school will look like next year. Today, Wake county announced that they will have kids in a rotation of 1 week in person/ 2 weeks remote. I expect Chapel hill will shortly follow suit,
Or have some similar hybrid plan. I  keep getting asked this question repeatedly from friends — “well, you are a COVID Doctor. What do YOU think about sending your kids back to school”.  My answer is my own, deeply personal, and not reflective of my employer. And I recognize and appreciate that many of my colleagues in the same position as me have different views. BUT. Since so many keep asking me, here is my answer, as both a parent and a frontline covid doctor. Do with it as you choose:

My family is electing to remote school next year. The reasons for this are multi-factorial:
-this disease scares the shit out of me.  After 4 months caring for covid patients, we certainly know a lot more. But a lot of it isn’t reassuring.  Covid is now known to cause lung, heart, kidney, brain, and clotting system complications.  And that’s just what we know about the immediate effects. We have no idea — NONE — what the longer term effects might be. I am not willling to risk the health and vitality of my kids to find out what those long term side effects might be
-morbidity vs mortality. I’ve talked about this in prior posts. Yes, very few children actually die of covid. BUT many young people still get very very sick. Intubated. Put on ecmo. Pediatric multisystem inflammatory syndrome. Kawasaki-like illness with coronary artery aneurysms. These are serious issues with long term effects.  Just because covid doesnt kill you; it doesn’t mean you will ever be quite the same either.

-the teachers and staff. My god, how can we ask this of them?  After cautiously sheltering in place for months, we are now asking them to basically jump into the lions den and interact with hundreds of children with thousands of household contacts. The more exposure you have, the more risk you have.  Trust me, we WILL see teachers and bus drivers and cafeteria workers and other staff — and their family members— who get sick and die.
-I want to continue having my parents involved in my kids life. If we strictly isolate, I feel safe doing so. But If the kids go back to school and interact with dozens of kids from dozens of homes, the risk to my parents increases exponentially. 
-I do strongly believe that since we CAN keep our kids home without significant detrimental effects, we SHOULD. There are so, so many people in our community whose lives and careers and finances  will be devastated  by having to do remote learning.  We will not be.  We can do so for a year without undue harm to my kids or our careers or our finances.  I choose to keep my kids home so that families who absolutely cannot do so have just a little bit more safety at school.

I acknowledge that we are EXTREMELY privileged for me to only work part-time clinically and am able to do my non-clinical work remotely and help home school.  And my parents live here and are willing and fully engaged to help us home school during the weeks I absolutely have to be in the hospital. 

This seems like a goddamn nightmare for any family with a single parent, two working parents who cannot work from home, families with out extended family support, and families with ESL, kids with IEPs, exceptional children, etc etc. 

I have zero answers as to how to make it better. Zero. I don’t want kids falling behind disproportionally because their parents cannot afford to home school or hire tutors. I also don’t want to see kids sick from covid and dead teachers.

Any plan than is less than 100% not in-person seems doomed to only worsen and exacerbate the achievement gap between the haves/have nots.

But — Any plan that involves more in person time also puts kids and teachers more at risk. And these teachers quite frankly  do not get paid enough to risk their and their families lives.

I have no answer. It is impossible.

(####Many thanks to this respectaful and honest unknown doctor).

 

 


 


 

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亚特兰大笔会 回复 悄悄话 戈壁红柳:沉重的选择!
亚特兰大笔会 回复 悄悄话 回复 '梅华书香' 的评论 :
宵枚:谢谢阅读。疫情肆虐,多多保重!
梅华书香 回复 悄悄话 大作分享了!!
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