The next pandemic could happen next year. Or in 2033. Or 2052. It might come from one of hundreds of known coronaviruses now circulating in bats. It could be a nasty paramyxovirus, from goats. Or it might be a newly-mutated strain of flu that ravages the lungs of millions. There's no dearth of evolving microbes, capable of producing a new human scourge, on Earth.
But we're not sitting ducks.
To ready us for looming pandemics, experts in education and infectious diseases emphasize that society can, and should, equip our future generations to manage or limit the suffering and despair wrought by disease outbreaks. This is certainly a challenge. But the current generation of adults in charge has struggled to reign in the pandemic, hobbled by a broad lack of scientific literacy, politics, and disinformation. It's paramount to correct these deficits before the next outbreak.
"A more scientifically literate citizen is the goal," said Kelley Le, a former high school science teacher who now directs the UCI Science Project, an educational research group that supports teachers in effectively teaching the sciences.
A pandemic-resilient populace means understanding that pandemics, however terrible, are natural and repeated episodes in human history — not shocking or conspiratorial events. It also means preparing our young for the stresses of living through a pandemic, becoming a critical thinker familiar with how science works, and knowing how to find credible sources of information, while avoiding deluges of today's disinformation.
The alternative, unfortunately, is the vulnerable, unaware, and ill-prepared swath of the public we have today: Where protesters at times vilify pandemic experts, people swallow inappropriate and unproven drugs, and some shun simple measures that dramatically limit deaths.
"There will be another pandemic."
"There will be another pandemic," said Dr. Nina Shapiro, an M.D. and the director of Pediatric Ear, Nose, and Throat at the Mattel Children's Hospital UCLA. She noted the first documented pandemic occurred some 1,500 years ago. It's past time to bake the tools and knowledge needed for dealing with pandemics into our education system.
"Knowledge is power," said Dr. Shapiro. "Especially with our future generations."
Think
If you tediously memorize the minuscule parts of a virus or an animal cell — the Golgi apparatus, the smooth endoplasmic reticulum, the lysosomes — and then pass the pop quiz in biology class, does this prepare you to live through a pandemic, or any pathogenic health crisis?
According to many educators today: No.
Yet, for over half a century, that's how sciences have often been taught. (That's how I was largely taught.) "Historically, a lot of it has been facts and rote memorization," explained Doron Zinger, a former high school science teacher in California and now an expert in teacher education at the University of California, Irvine. The educational results have been disappointing — though this certainly isn't a critique of science teachers themselves, who do the lord's work as grossly underpaid educators and often work within what their school, district, and state requires or gives them to teach, which varies considerably. In science and math performance among K-12 students, "the U.S is in last place" among its science and engineering competitors (like China and Germany), according to the National Science Foundation. The organization calls the U.S. performance "lackluster" and "stagnant."
But the U.S. doesn't have to be stagnant in the sciences. Instead of a memorization-heavy curriculum, schools should prepare kids to contend with the realities of the world, many of which hinge deeply on the sciences, Zinger emphasized. This means understanding climate change, air pollution, viruses, and beyond.
How can this be achieved? The overarching answer is encouraging kids to think. Specifically, to think critically about complex ideas, like why the novel coronavirus keeps evolving, and how that impacts us.
"It's got to be cognitively demanding," said Zinger, who directs the CalTeach program, which prepares college students to teach the sciences. Memorizing things to pass required tests doesn't cut it, he said.
"Rote learning should be reserved for times tables," agreed Catherine Carroll-Meehan, a former early childhood teacher and now the head of the School of Education and Sociology at the University of Portsmouth in England.
What does such critical thinking look like? There should be opportunities for students to understand why something is important, explained UC Irvine's Le. Indeed, teaching pandemic preparedness and its associated concepts would likely require a sea change in American education, given the patchwork of state and federal directives that organize what and how children learn in disparate states and regions. But here are some examples of what education experts say works:
- Investigation and discovery: Zinger recommended an activity that asks students "Did Delta have to happen?", which promotes thinking about why viruses evolve, and how humans currently give plentiful opportunities for viruses to mutate. "Children would have to investigate and make an argument," Zinger said. "That's a valuable learning opportunity."
- Applying knowledge: The Next Generation Science Standards (NGSS) is a relatively recent (2013) science teaching program, voluntarily adopted by 20 states, that includes subject areas and educational strategies aiming to shift science teaching from memorization to asking questions and discovering answers. "NGSS is about the application of knowledge," said Le, who helps teachers use the education program. The goal isn't to simply know that smog is an air pollutant, but to grasp how pollution impacts your air, health, and society, she said. (Though getting school districts to adopt NGSS can be a great challenge. Le said some districts lack the support to make such a momentous educational change.)
- Culturally relevant: Carroll-Meehan recommends schooling that "prepares our children for life in the 21st century." This means teachers should strive to promote thinking about culturally relevant things, like how the COVID pandemic is different from the typical flu, and what this means for our behaviors during a modern disease outbreak.
The common theme is thinking in science class. This doesn't always have to be thinking specifically about viruses. What’s crucial is critically thinking about how scientists know things, and how science applies to our lives. This will give a kid (and later adult) a better shot at contending with complicated real-life scenarios, like the arrival of a highly infectious respiratory virus. "That's the skill we're really talking about here," stressed Ann Reid, a former research biologist who sequenced the 1918 flu virus. Reid is now the executive director of the National Center for Science Education.
"As a society we underestimate the abilities of children."
Importantly, even the youngest school-age children can understand and think critically about concepts like viruses, vaccines, and pandemics. "As a society we underestimate the abilities of children," said Dr. Shapiro, who has authored the forthcoming book Ultimate Kids’ Guide to Being Super Healthy. "I think it's a disservice to future generations." Kids know what a cold is, she said. Even four-year-olds can understand what a really, really, really terrible cold is (COVID), and why no one would want that circulating around their neighborhood.
Who's credible?
Unlike during past pandemics, the internet now exists. Consequently, future generations must know how to wade through the web's hogwash. A well-curated YouTube video can make a confidently-yapping person, perhaps with some sort of medical certification but lacking expertise in viruses, appear as a revolutionary authority on virology and vaccine efficacy. That's a serious, if not grave, societal problem.
"Everyone's opinion is weighted in equal, but not everyone's opinion has equal value," said Dr. Otto Yang, who researches infectious diseases and viruses at the David Geffen School of Medicine at UCLA. And with the deluge of perspectives, ideas, and rants on social media, it can sometimes be challenging to know who to trust. "There's a lack of ability to pick reliable sources of information," Yang added.
Fortunately, even young kids can be shown how to start seeking credible information during a pandemic, said the education expert Carroll-Meehan. For example, teachers can ask a five-year-old who they should seek out to ask for help if they're feeling sick. A man in the supermarket? Someone who flies an airplane? Or a doctor?
Of course, not all doctors or scientists agree on everything, especially amid a fast-paced disease outbreak. While it's normal for scientists to disagree, usually their disagreements play out through peer-reviewed research, and in a much slower fashion. Such disagreement, especially when it unfolds rapidly, like during a pandemic, can be difficult for laypeople to navigate. But people rejecting basic tenants of virology online or spinning outlandish tales on Twitter are the low-hanging fruits of credibility vetting – and children or youth can be equipped to avoid such shoddy sources.
"Everyone's opinion is weighted in equal, but not everyone's opinion has equal value."
This isn't to say nearly every kid, and eventual adult, will avoid the seduction of disinformation. It can be tricky: A small but influential fringe doctors group currently peddles ivermectin online to treat COVID-19. It's simply not fair to the educational establishment to be singularly responsible for cutting the heads off disinformation snakes when the media and internet reward people — via followers and influence and TV appearances — for distorting reality.
"As long as individuals can make money from the number of followers and clicks on their websites, greed and political agenda will trump honesty, truth, and facts," Dr. Andrew Spielman and Dr. Gulshan Sunavala-Dossabhoy, who have written together about pandemic impacts on education, said over email. "It is sad that some would rather believe in bleach, UV, chloroquine, and ivermectin from individuals without a scientific background rather than those that have spent decades conquering previous epidemics." (Dr. Spielman is a professor in the Department of Molecular Pathobiology at New York University College of Dentistry and Dr. Sunavala-Dossabhoy is an associate professor in molecular biology at Louisiana State University Health Center.)
People are drawn to unconventional, anti-establishment ideas. Indeed, it's how art and music flourish and progress. But in the scientific world, particularly in the realms of medicine and public health, rashly bucking the establishment can mean ignoring the best, though inherently imperfect, state of knowledge about a virus. Conventional understandings about respiratory viruses might be boring (like the CDC's repeated recommendations that vaccines and masks work), but educators might remind students that this science is reached by the consensus of many, many disease experts, explained Yang. That's who a pandemic-resilient populace should trust.
"The more people we have proactively listening to good evidence, the stronger we're going to be," said Reid.
It's also critical for kids to recognize that public health recommendations (like when to wear a mask) from credible experts can rapidly evolve during a viral pandemic as the virus evolves. The coronavirus, for example, has mutated into a considerably more contagious and problematic pathogen. And it may do so again. When new evidence comes in, guidance can change, and people may need to navigate more rapid or complicated changes. "Science is continually evolving," said the science education researcher Zinger.
History can't be ignored
If human history were a book, it would be dogeared by pandemics. It's crucial that youth both now and in the future grasp that prolonged disease outbreaks have occurred time and time again, and will keep occurring. The arrival of a pandemic or epidemic should not be a shock. We should expect it, and be ready for it.
"Pandemics are a natural evolutionary event," said Dr. Spielman and Dr. Sunavala-Dossabhoy, citing some diverse outbreaks over the past 2,000 years. There was the Plague of Justinian (541-549), leprosy (12-13th century), the Black Plague in the mid-1300s, multiple cholera epidemics in the 19th century, the 1918-1920 flu outbreak, HIV (1981-present), and the more recent Zika and Ebola outbreaks.
"We should not be surprised we're living amid a pandemic," they said. Yet we can certainly limit disease outbreaks in the future. "We cannot abolish all pathogens, but we can be better prepared to mitigate their spread."
Pandemic Stress
Kids should know that when a severe disease outbreak arrives, there will be times they won't feel good, emotionally or physically. That's normal during crises, says the CDC. Children will almost certainly experience stress, which can cause "feelings of unease, anxiety, frustration, nervousness, fearfulness or helplessness."
Educators are now seeing that students must be able to cope with the emotional challenges of the pandemic. "[The pandemic] is illuminating for us huge needs in schools. We don't educate kids enough about what stress feels like, and how to manage it," said Jennifer King, the assistant director of the Center on Trauma and Adversity at Case Western Reserve University. Stress and anxiety, left unattended, make learning difficult, if not impossible. "We're not able to access the parts of the brain that allow us to take in new information and think about it critically," explained King. "We're in this high-alarm state."
"When kids know they're doing the right thing, they can be assured."
But there is a way to help stressed kids. You can give them knowledge about biology and public health, explained Dr. Maurice Elias, a professor of psychology at Rutgers University and director of the school's Social-Emotional and Character Development lab. And with that knowledge children can take action, perhaps by wearing a mask in certain indoor settings or around vulnerable people to avoid spreading disease. This supports and comforts kids.
"When kids know they're doing the right thing, they can be assured," said Dr. Elias.
When the next pandemic hits, things can be different. Maybe a strong majority of the populace, with a solid schooling in pandemics, critical thinking, and knowledge about who to trust for reputable information, will be prepared to limit the spread of disease. Perhaps society can even quash the next coronavirus before it even becomes a pandemic.
And perhaps understanding pandemics will allow for more effective decision-making. When kids think critically, they also express ideas, said Dr. Elias. They'll learn to listen to each other, and experts, and figure out the best way forward. Knowledgeable kids translate to more reasoning, and reasonable, adults.
"Maybe by the time they're grown-ups they won't all be fighting," mused King.
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