Rally to Shine a Light on COVID Safety in the Boston Public Schools

Families, school nurses and allies will gather at the Massachusetts Statehouse on Wednesday afternoon at 4 PM to Shine a Light on COVID Safety in BPS.  Members of Families for COVID Safety (FamCOSa), the Boston Teachers Union, Boston Education Justice Alliance (BEJA) and other groups will call on the Boston Public Schools and Governor Baker to take proactive steps to stop COVID spread in schools and communities.

I will speak at the rally and invite you to join us.

Massachusetts is currently experiencing a surge of the Delta variant and Omicron is spreading. Racial and socioeconomic disparities of vaccination rates persist. COVID outbreaks occurred in schools without leading to substantive policy corrections. A mental health crisis among children is concerning. Achieving higher vaccination rates is an urgent priority, along with making rapid tests freely and widely available. Free high-quality masks, KN95 or KF94, must be delivered to our impacted communities. Safety standards that mitigate airborne/aerosol transmission through ventilation and/or air filtration must immediately be implemented.

That’s all I have for today. If you have any comments, please feel free to leave them below! And remember, my blog is entirely free. Thanks, Phil

Come run with us

Certainly the news this morning looks bad. Professor Trevor Bedford from the Fred Hutch presented data on Twitter yesterday suggesting an Omicron surge is almost definitely coming. Meanwhile, Dr. Abraar Karaar from Stanford University made a convincing argument that the White House’s COVID response has been very weak, and certainly not centered on equity. Will the Biden administration do better with Omicron?

All that being said, I encourage my friends, family, and patients to refocus on your personal health. Today I want to write about exercise.

I am a strong believer in running and walking. I really think this can help each of us. If you can run, run, as much as you can. If you have knee problems or other health issues that preclude you from running, then walk! Walking in nature is one of the best medicines there is.

Every Saturday morning for the past two months I have been participating in the Park Run around Jamaica Pond in Boston. Park Run is an amazing organization which brings weekly free 5K races to cities around the world.

It’s been exciting to see progress. Over the past 6 weeks I’ve seen my time improve by 12 seconds, down to 25:07. Now my goal is to do more long runs as well as sprint workouts, to continue to improve. I’ve also made some new friends at the 5K.

Certainly we don’t want to catch COVID in a group run, but getting fully vaccinated will go a long way toward protecting us. Outdoors, transmission is uncommon. People rarely wear masks at Park Run, but we quickly spread out once the race starts.

There’s lots of things in life we cannot control. A sense of helplessness leads to fear and anxiety. We should improve our health by running and walking every day. This will have a long term payoff.

The Jamaica Pond 5K starts at 9 am tomorrow. The weather at race time is projected to be in the low 40s! Please join us.

And if you don’t live in the Boston area, you can go to the Parkrun website – there probably is a 5k near you.

My friend Jeffrey, who sometimes runs the race barefoot.

We need comprehensive state and federal plan to tackle root causes of homelessness

My new letter in the Boston Globe:

Re “Wu drafts plan for Mass. and Cass”: People suffering from homelessness, mental illness, and substance use disorder need stability and medical treatment. Although placing them in the Roundhouse hotel or in a temporary cottage at the Shattuck Hospital is a reasonable first step, we need a comprehensive plan to end homelessness from Governor Baker and President Biden. The root causes of the homelessness crisis, such as inequality, racism, and poor education, must be addressed, or the crisis such as what we see at Mass. and Cass will persist. Each of us has an obligation to become an advocate and speak out for justice.

What’s the deal with Vitamin D?

Some time ago, one of my patients came in for a checkup. Several years before, her 25-Hydroxy vitamin D level had been 13 ng/ml, which the lab had noted to be “insufficient.” She was then given ergocalciferol 50000 unit caps twice a week for 8 weeks. Her level was rechecked and had gone up to 43. Her most recent level was 22, which the lab noted to be “sufficient.”

When I saw her, she was intermittently taking cholecalciferol (vitamin D3), 25 mcg (1000 units) daily. I advised her that the evidence base surrounding vitamin D was limited, and while we could recheck a level or consult with endocrinology, I wasn’t convinced that supplementation was needed.

Later that evening, I took some time to review the literature regarding vitamin D. The bottom line – while severe vitamin D deficiency can lead to bone problems, there is controversy regarding vitamin D supplementation.

Optimal vitamin D concentration for skeletal health and extraskeletal health has not been rigorously established. Experts favor a level of 20-40 ng/ml, but I don’t think there is solid outcome data underlying that.

Certainly, vitamin D deficiency can be an issue, if there is low intake or reduced sun exposure. If the level is very low and prolonged, patients can get demineralization of their bones, which puts them at risk for fractures. For normal adults, the goal is to have an adequate intake, 600-800 IU (15-20 micrograms) of vitamin D daily.

Certainly there are nuances to this, and vitamin supplementation is a huge industry ($$). In addition, scientific research is ongoing. When I searched for “vitamin D deficiency” on pubmed I found >35,000 papers.

Any vitamin D experts out there care to weigh in?

Get some sun. Hard to do in winter.

Boston School Committee

I’m very grateful that the Boston School Committee has granted me an interview with their Nominating Panel on Monday. I decided to apply for one of the open committee positions after we published our op-ed in the Boston Globe regarding COVID in the schools. I want to help improve the health and safety of our schools. This is more important than ever in the context of the new variant, Omnicron.

https://youtu.be/EgUKrkyQ1Ac

The Boston School Committee is responsible for:

  • Defining the vision, mission, and goals of the Boston Public Schools (BPS);
  • Establishing and monitoring the annual operating budget;
  • Hiring, managing, and evaluating the Superintendent; and
  • Setting and reviewing district policies and practices to support student achievement. 

Although I certainly don’t have a background managing a budget of $1.3 billion, I do have other experiences which would be valuable to BPS students. My public health work has included work in Botswana, South Africa, Mozambique, Namibia, Uganda, Zambia, India, the Dominican Republic, Cuba, Mexico, and Peru. I also have extensive experience working in underserved communities in the United States.

My main goals as a committee member would be to reduce COVID transmission in the public schools and to advance racial justice and educational equity. In addition, I would hope to improve the music, art, foreign language, and athletics programs in the district.

Finally, I would push for a major focus on mental health for students, teachers, and others in the BPS community. As many people know, I am living with bipolar disorder and am a vocal advocate for health and healing. Practically speaking that would involve an “all hands on deck” push for mental health in our schools and neighborhoods. We need therapists, support groups, and music and dance groups to help the BPS community overcome their fears and experience hope and joy once again.

Improving the quality of our public schools should be our top priority. It requires attention and action from each one of us. Together, we can get the job done.

My great-grandmother, Lora (Rauh) Lederer, who died in 1948, was a staff member of the Cincinnati Board of Education for more than thirty years. I hope to follow in her footsteps by helping improve the public educational system of Boston. If you have any suggestions on how we can improve our schools, please email me at lederer@gmail.com or leave a comment below. Thanks!

Lora Lederer (1878-1948)

World AIDS Day

I’ve been involved in HIV/AIDS for a long time. My mother was an HIV nurse in downtown Detroit in the 1990s, and I’ve worked on the epidemic in Boston, Philadelphia, San Diego, Mozambique, Namibia, and other countries. I’m sad for the millions of deaths from AIDS globally and the inequity which made it happen. Many of my patients have done well, but I fear others have fallen through the cracks, because of our broken health care system. 

What I would say is this: we each need to speak out – and sing out – for justice. That means access to PrEP to prevent HIV infection. We need lifesaving ARVs for everyone who is infected with the virus. We need scientific innovations, like new ARVs. Long-acting injectable cabotegravir is a good start, but we need longer acting ARVs as well. And most of all, we need an effective HIV vaccine.

Meanwhile, people with HIV need access to lifesaving COVID vaccines, in Sub-Saharan Africa and everywhere. Omicron is making that obvious. We are all interconnected.

However, biomedical interventions like pills and vaccines are not the solution by themselves. People need much better public schools, and jobs, so they can thrive. We need communities free from violence and discrimination, to put an end to HIV. We need healing.

If you don’t like the road you’re walking

This morning, I went for a walk in the arboretum with my friend, a cardiologist, and our dogs.

As we hiked up a hill, we talked about a variety of issues, from how to prevent coronary heart disease to electric cars. But most importantly, we spoke about burnout and depression among healthcare workers and the need for cultural change in American medicine.

Can we organize and create a single payer / Medicare-for-all system, which we so desperately need? I think if that is ever to happen, we need health care workers to feel interconnected and hopeful – an esprit de corps, if you will.

For that to occur, we must reclaim our physical and mental health. Peer support, nutritious diet, and physical activity can help.

I invited my friend the cardiologist to join me at the Jamaica Pond 5K runs on Saturday mornings. I’ve enjoyed the races this fall, as I’ve gradually gotten in better shape. Perhaps he, and you, will run with me at an upcoming 5K.

Because it was Dolly Parton who said, “if you don’t like the road you’re walking, start paving another one.”

My dog Margo, who loves to walk with other dogs

Why a CDC investigation of Boston Public Schools COVID-19 outbreaks is needed now

The message dinged our phones on Oct. 27: “Not great news, but a friend just shared there are six confirmed COVID cases in the fourth-grade class.”

The group chat of parents and caregivers of third-graders at the Manning Elementary School in Jamaica Plain is usually about misplaced homework and after-school activities. This was something else, and it eventually became clear that the Manning School was facing the largest COVID-19 outbreak of the year in Boston Public Schools — now surpassed by the CurleyK-8 School in Jamaica Plain and Orchard Gardens in Roxbury in total cases.

Please read the rest of our new Boston Globe op-ed and sign our petition – thank you.

Freedom

Tonight in orchestra rehearsal we worked on the hypnotic piece, “Freedom,” by Milad Yousufi.

Yousufi was born in 1995 during the civil war in Afghanistan. At that time the Taliban were ruling Afghanistan, and music was completely banned.

I encourage you to learn more about this young, powerful composer. We (the Me/2 Orchestra) plan to perform Freedom, along with selections from Mozart and Berlioz, on January 23 at Boston’s Symphony Hall.