Medical Experts

To: Concerned Parties

I am writing to express my concerns related to online school.

There are several areas of concern:

1. Quality – School districts have not had time or resources to develop optimized educational programing, so quality is variable.
2. Quality variation has the potential to significantly exacerbate existing inequality in educational attainment. The younger the child, the more difficult this is to overcome.
3. Children with special needs, such as autism, require specialized services which are critical to their long-term development and are difficult to deliver online. It is important that children with special needs obtain the support they need at a young age, as early intervention is the key to success.
4. Economic impact – particularly for women, who bear a disproportionate burden of attempting to home school while also trying to remain employed in a challenging economic environment.
5. Mental health – We have significant concerns for the mental health of children and adolescents who are isolated from their peers. We recently deployed video visits in pediatrics to provide care for our families at home, and immediately noticed that one of the very top diagnoses for those visits is anxiety. 
6. Developmental concerns – Young children should be developing social and emotional skills at a critical time. Teenagers should be developing independence from their parents. Both require peer interactions in person, outside of the home.
7. Obesity – we are seeing increased childhood obesity as children depend on physical education and organized sports for exercise and to maintain a healthy weight.
8. Malnutrition – Many children rely on subsidized school lunch programs. This will be an even greater concern as unemployment rises. 

Here is supporting information from the American Academy of Pediatrics:

https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Return-to-School-During-COVID-19.aspx

Summary from the BBC with international data:

https://www.bbc.com/future/article/20200603-how-covid-19-is-changing-the-worlds-children

From the Brookings Institution:

https://www.brookings.edu/blog/education-plus-development/2020/05/13/wheres-the-rallying-cry-americas-children-are-unequally-prepared-to-absorb-the-impacts-of-covid-19/

Thank you for your consideration,

Elizabeth Vilardo M.D., M.B.A.

President and CEO Sutter Bay Medical Foundations (PAMF, SPMF,SEBMF)