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It鈥檚 a Wednesday night, and the DeKalb County, Ga., school district鈥檚 medical advisory committee is having its debut moment, so to speak.

The committee has been working with the district for about a year now, helping to shape its back-to-school plans, inform its upcoming decisions about COVID-19 vaccinations and testing, and increasingly, play a public-information role, as embodied by tonight鈥檚 meeting.

When the Zoom public forum goes live, the screen is a pleasing cross-section of medical experts in this diverse district: Doctors, disease experts, pediatricians, academics鈥攜ounger and older, Black and white. They鈥檙e the same folks parents in the district take their kids to, and the same ones who work in nearby hospitals.

The public meeting starts with the basics鈥攚hat is the COVID-19 virus, anyway? Why do masks seem to prevent transmission?鈥攂ut it will conclude with much- more specific information and myth-busting for parents, like what to do when a child gets sniffly during the approaching cold-and-flu season.

Some of the committee members鈥� responses are sobering reminders of the seriousness of the pandemic.

鈥淥ne myth that drives me crazy is that kids don鈥檛 get sick. They absolutely can get sick, and some children die from it, and they can have serious illnesses even if they aren鈥檛 hospitalized,鈥� warned Dr. Veda Johnson, a professor of general academics and pediatrics at Emory University School of Medicine, midway through the meeting.

As the weeks and months of the pandemic have stretched into years, more districts are relying on arrangements like DeKalb鈥檚 to help them answer the ever-increasing number of questions and to boost confidence that their decisions find the right balance between keeping kids safe and keeping them learning.

Cheryl Watson-Harris, the DeKalb superintendent, decided to set up the medical advisory committee shortly after assuming the reins at the suburban Atlanta district in summer 2020. Formerly in the No. 2 spot in the huge New York City schools, she鈥檇 witnessed the summer surge there and the accompanying death and hospitalization of students and staff.

She knew that her new district, with more than 93,000 students, was heading toward a similar situation, and determined she would get access to the best information she could.

鈥淚n a district like mine that is so incredibly and beautifully diverse, including diversity of thought, I would never be able to please everybody. So as a superintendent, I felt it was very important to have as much of a scientific and clear way of decisionmaking so that I wouldn鈥檛 have to float in the wind based on politics or just the varying perspectives on what should be done,鈥� she said. 鈥淎nd I am an educator; I am not a medical professional, nor am I a scientist in that regard.鈥�

From big to small decisions, districts鈥� medical advisory panels weigh in

The pandemic has put superintendents in a near-impossible situation. They have had to wrestle with difficult health-related decisions on masking, mitigation protocols, 鈥渢est to stay,鈥� and vaccination policy. And they鈥檝e had to do it while sorting through the morass of conflicting or unfeasible government recommendations and getting controversial new policies through U.S. school systems鈥� delicate and slow-moving arrangement of local board governance.

It鈥檚 unclear just how many districts have formally established a medical advisory committee to help them with those difficult tasks, but those that have detail a number of decisions that they鈥檝e relied on their panels to help with.

Take Massachusetts, where says if schools hit a vaccination rate of 80 percent, they can move to make masking optional. It seems clear and direct, but there are a multitude of questions local leaders have to process before they can act on it, said David Fleishman, the superintendent of the Newton, Mass., district.

鈥淲ell, what do you do with that? Who do you consult? What about the 10-15 percent of kids who are not vaccinated, is that a sound thing to do? I鈥檓 not in a position to make that judgment, and depending on your community, you can imagine people are going to feel differently,鈥� Fleishman said. He set up his medical advisory group in February of this year.

The panels serve a different function from the more typical community advisory groups comprised of parents, teachers, and other local constituents. They鈥檙e designed to weigh in on research and districts鈥� mitigation plans with the kind of professional knowledge laypeople don鈥檛 possess. They often have access to the newest research on COVID-19 coupled with the analytical backgrounds to make sense of it. Sometimes, too, they鈥檙e the ones who remind school leaders that there are questions about COVID that just don鈥檛 have clear answers yet.

The committees don鈥檛 actually set policy themselves鈥攖hat would bump up against the governance and decisionmaking powers of school boards and superintendents. But they do weigh in, often forcefully, and sometimes their recommendations are prescient.

In the Howard-Suamico, Wis., district, for example, Superintendent Damian LaCroix decided at the beginning of the school year to make wearing a mask a recommendation. (His district鈥檚 medical advisory committee had urged a requirement.) But mid-September, as rates increased, LaCroix reverted back to a mask requirement.

Florida鈥檚 Orange County district鈥檚 medical advisory panel, begun before the 2020-21 school year, helped the district devise ways to keep band practice and football games going, and to troubleshoot small-seeming but consequential details, like keeping students hydrated when shared water fountains are off limits, noted Pam Gould, the vice chair of the county school board.

In Orange County, she said, the committee has also supplied critical anecdotal trend data of its own. Every day, its members are in hospitals, clinics, and other settings where they are directly observing the course of the virus. That鈥檚 important because Florida this summer and , which has led to delays in getting accurate figures to school leaders.

鈥淲ithout that boots-on-the-ground perspective and access to that data, we would not have the information we need to make these decisions,鈥� said Gould.

In Newton, Fleishman says, some of the recent questions include whether to permit students and teachers to sing in music classes even with masks on. (His panel has so far recommended that it should only be done outside or if 6-feet social distancing can be maintained.)

Overcoming obstacles

The committees generally meet in private with one or two board members, the superintendent, or other central office liaisons. (The Howard-Suamico district also included a student representative, whose participation led to a pop-up vaccination clinic for eligible high school students.) A few, like Orange County鈥檚, are organized as board subcommittees and therefore open to the public.

The panels typically include pediatricians, general practitioners, epidemiologists, school nurses, and sometimes academics or representatives of the large local health systems or hospitals. In general, said Johnson of the DeKalb committee, district leaders interested in creating their own panels should reach out to whoever they think can effectively serve on the panels, including parents in the district who are themselves medical professionals.

The biggest challenges to putting such a group together she said, is that educators and health professionals often feel awkward navigating one another鈥檚 worlds.

鈥淭here are a large number of pediatricians and others who would like to be a part of something like this,鈥� Johnson said. 鈥淭hey just don鈥檛 know how, and the schools don鈥檛 know how to reach out to them and galvanize them.鈥�

And there can be discomfort over territory, too, from board members or district leaders who are wary about encroachment.

鈥淭hey鈥檒l say things like 鈥榮chools are not doctors鈥� offices.鈥� So you have values systems that come into play, where they prohibit or discourage them from partnering with resources in the community,鈥� Johnson said.

Building district leaders鈥� confidence

Have the panels, where they鈥檝e been successful, helped tone down some of the high-pitched drama that has boiled over into school board meetings nationally?

In a word, no, superintendents say. But having the panels has bolstered their confidence in their plans, because they are able to point to a strong rationale for their decisions.

鈥淚f I could say anything about the committee, it鈥檚 that I鈥檝e never felt like I was alone,鈥� said Watson-Harris. 鈥淎nd I felt as though whatever decisions we鈥檝e made with our expertise in terms of school management and education, we also had the added level of confidence from the medical advisory team.鈥�

LaCroix of the Howard-Suamico district agrees.

鈥淚 will tell you there is clearly knowledge and understanding that the committee exists, and depending on [community members鈥橾 point of view, they think it鈥檚 a good idea or they wonder why that group has that degree of influence,鈥� he said. 鈥淏ut I believe the school board feels like [the panel] plays a valuable role in being a thoughtful, informed, educated group who can advise us. 鈥� Even when we鈥檝e had disagreements, the committee has been respectful, and stayed the course.鈥�

Doctors and nurses who serve on the committees aren鈥檛 shielded from strong community responses, either, which is another wrinkle district leaders have to consider. In the Elmbrook, Wis. schools鈥攖he model for Howard-Suamico鈥檚 approach鈥攖he panel鈥檚 feedback was instrumental in helping that district offer-in-person learning in the 2020-21 school year. But the district closed the panel in June after members got abusive messages, said Chris Thomas, the district鈥檚 chief strategy officer.

鈥淯nfortunately, this advisory board became a part of the partisan politics in our community, and we did not feel it was acceptable nor appropriate to put our medical professionals in the middle of the crosshairs of our community for their voluntary service,鈥� he said.

Asked if she鈥檚 gotten nastygrams as a result of her work, Dr. Johnson of the DeKalb medical advisory committee chuckled. 鈥淥h yeah, absolutely,鈥� she said. 鈥淎nd I鈥檓 inclined to answer!鈥�

She鈥檚 even gotten pushback from other non-committee doctors who advocate a lighter touch on mitigation measures than what the panel and school district have chosen. But she鈥檚 gotten some heartfelt thank-you messages as well.

The full range of opinions was on display when DeKalb held its Zoom meeting in September.

In the chat, some parents urged the district to return to remote learning given the state鈥檚 high rates of COVID-19 transmission and child hospitalization. Some pressed the district to expand testing locations or begin surveillance testing in schools. At least one anti-masking parent served up an odd mix of religion and conspiracy theories about masking, urging the district to rely on 鈥渢he divine immune system.鈥�

But beyond all that, the most telling moment came at the end: a quick profusion of messages in the chat from attendees who had up to that point been observing silently.

鈥淭hank you,鈥� one typed. Said another: 鈥淧lease do another event like this.鈥�