I'm an ER doctor and father who believes school is as essential as healthcare — and we need to extend our pandemic wartime response to get our kids safely back to school

• Imamu Tomlinson, MD, is the CEO of Vituity and an emergency medicine physician at Adventist Health, Selma.
• As a father and physician, he says the question over whether schools should reopen has loomed large.
• But to him, the real question to address is how we can ensure a safe return to school — and that whole communities should step up and help make it happen.
• This could be through partnerships with local businesses, or, in places where schools cannot safely reopen, establishing programs for vulnerable students.

As an emergency physician, I'm often asked about COVID-19. People want to know if it's safe to go to the grocery store, if homemade masks actually work and if they can catch the disease while jogging.

But recently, the question that looms large above all others is whether kids should return to school in the fall.

As a dad and coach, this is a perplexing question for me. My kids are facing the new school year with anxiety and bewilderment. They dread missing out on friends, favorite teachers, and sports.

As a coach, I worry about kids and how they are faring without sports as an outlet. Unfortunately, many at-risk high school age kids struggle with basic reading skills. Others share a single home computer with parents and siblings. For these teens, I fear that a year cut off from the educational and social support school provides could result in lasting — and maybe even lifelong — damage.

Should children go back to school in the fall? I believe that's the wrong question. Instead, we should ask ourselves how we can all work together to ensure they can return safely. From my perspective as a coach, parent, and physician, I believe that school is as essential as healthcare.

In the emergency department, I've seen firsthand how social determinants of health impact the course and quality of every human life. In today's America, race, gender, neighborhood, sexual orientation, income level, and education can affect health outcomes.

COVID-19 has been a stark reminder of how disease severity and outcomes can be affected by these social determinants and has further deepened the divisions between the healthy and the vulnerable. Young African and Latinx Americans are more likely to die of COVID-19. And in the first three months of the pandemic, the number of households with children experiencing food insecurity more than tripled to 29.5%.

For at-risk children, schools provide some insulation from the effects of poverty and systemic discrimination. A child living in a food desert can receive nourishing meals through lunch programs. In some cases, a school may not only be a place to learn, but also a place for nourishment, shelter, and emotional support.

While the school safety net isn't perfect, teachers often represent lifelines for many vulnerable kids and their families. On top of their classroom duties, teachers often act as mentors, cheerleaders, disciplinarians, surrogate parents, and unofficial social workers. When a Connecticut student's entire family came down with COVID-19, his English as a Second Language teacher took in his newborn brother for several weeks while the family recovered.

For one in six US children living in poverty, these educational and social supports can't be easily replicated through online learning. These children have lost the security that they enjoyed within the school's four walls — not to mention the easy availability of teachers, counselors, and caring adults.

Then there's learning itself. So far, experience suggests that online learning is difficult for even well-resourced districts to deliver effectively. Some families have resorted to "homeschooling" to fill the resulting curriculum gaps.

But even if online learning were perfectly delivered, poor children would still be at a profound disadvantage. It's one thing to learn online in a 5,000-square-foot house with your own desk and laptop under the supervision of a work-at-home parent or tutor. It's quite another to learn online in a 500-square-foot apartment with a shaky internet connection while sharing a laptop with two siblings as both of your parents are away at "essential" jobs.

Indeed, the question about schools isn't only about schools — it's about how our communities are able to come together to support our youth in all the ways necessary to make them successful.

The risk and responsibility for getting kids back to school currently rests on teachers, parents, and individual districts and their leaders. In my view, this is deeply unfair. If returning kids to school represents a social good, it's every citizen's responsibility to pitch in and make that happen.

The coronavirus pandemic is often likened to wartime. During World War II, people made collective sacrifices for the greater good. Millions joined the military. Factory owners shifted to emergency production. And citizens submitted to rationing of everything from gasoline to beef with nary a protest in sight.

I would love to see us come together in the same way to get our kids back to school. This may require personal sacrifice — especially in coronavirus hot spots, where we may need to practice more stringent measures. To become comfortable with dealing with this particular coronavirus, we may have to do things that make us individually uncomfortable.

Public-private partnerships could also facilitate a faster return to school. Many districts are considering having children attend two to three days a week due to physical space concerns. But who says that learning needs to happen in a school building — especially in a world that's suddenly full of empty office space and sports arenas?

In Denmark, the Parken Sport and Entertainment company opened its football stadium to the Copenhagen schools as temporary classroom space. "We all have a responsibility to find creative solutions in a difficult time, and we hope it can help give students some fun memories," said Parken Sport's director. (Personal aside: Both my kids would lose their minds with excitement if their classroom were San Francisco's Chase Center – home to the Golden State Warriors.)

Companies could also ensure that schools are well-resourced during the pandemic. When emergency departments struggled to procure personal protective equipment early in the pandemic, local businesses stepped up. Not only did they send masks and respirators, but they also engineered important inventions like Plexiglass intubation boxes.

Now with schools facing similar supply chain issues, companies can once again extend a lifeline. Corporate partnerships could ensure that less-resourced school districts have access to everything from computers to hand sanitizer. Such partnerships are already in the works. For example, the LEGO Foundation is funding play-based learning programs for out-of-school elementary students.

Finally, in places where schools can't reopen safely, communities can still come together to support vulnerable students. One size will never fit all; solutions will depend on local needs and resources. Options might include volunteer tutors or small-group learning centers. In some cases, it may make sense to prioritize in-person school attendance for young or at-risk students.

As a healthcare CEO, I believe that the best way to address health disparities is by ensuring we attract and retain providers and leaders who reflect the diversity of the communities we serve. This will be exponentially more difficult in the future if we allow school closures to create a "lost generation." Doing so will disproportionately affect our most vulnerable students, for whom school is a safe haven.

It's up to all of us to come together, sacrifice, advocate, innovate, and give our kids the best possible chance for a bright future. Each and every kid should have the opportunity to change the world!

Imamu Tomlinson, MD, MBA, is chief executive officer of Vituity and founder of the Vituity Cares Foundation. He is a former chief of staff for the Adventist Health Central Valley Network, where he continues to practice as an emergency physician.