Covid Mental Health

I listened to Dr. Laura Murray, a psychologist at John Hopkins University discuss mental health issues caused by the pandemic (Covid Mental Health Q & A podcast). My big takeaway was the idea of humans processing the risk of contracting Covid-19 has moved from the acute stage (hurricane) to a chronic stage (car accidents). The mind perceives chronic risk differently that acute risk and we need to be aware of this. Most people when they get into a car do not think, X number of people die or are injured in vehicle accidents every year. For example, my family no longer wipes down all groceries before bringing them into the house. Other takeaways are as follows:

  • Use self-disclosure to ease students into talking about their feelings, or perhaps instead of using the word feelings, use “thoughts” instead.
  • Students are only being observed/interacting with their parents instead of a variety of adults like teachers and coaches.
  • Recent CDC surveys are showing a higher rates of mental health issues during the pandemic and this is natural in these uncertain and stressful times.

Talking Education On Kun.UZ News

I would like to thank Alisher Ruziohunov a reporter for Kunuznews for giving me the opportunity to talk about education in the Uzbekistan media. It is nice not to focus dealing with the Covid-19 pandemic and discuss best practices in education. Here is the transcript from the interview in Uzbek. (

NPR’s Advice for School Reopening Plans

National Public Radio had a comprehensive article for parents on evaluating the risk of sending their children back to school “How Safe Is Your School’s Reopening Plan? Here’s What To Look For.” It also helped clarify and prioritize my thinking on our mitigation of risks if we return to campus.

  1. Stay At Home If You Are Sick. We need to encourage students and employees to stay at home if they have any symptoms of Covid-19. The CDC does not recommend schools to screen people coming onto campus because it should be the job of the parents to do this. The article also reminds us if the parents are sick, the children should stay home as well. We also need to be more generous with our sick leave for employees. We are building new, air-conditioned entries with temperature-measuring cameras. I believe this is a good reminder for people to stay at home if you have symptoms.
  2. Masks These must be mandatory for both adults and children. Adults disperse air particles greater than children and studies show adults transmit more to children than vice-versa. CDC does not recommend face shields instead of masks, but does say they can be combined. Schools should schedule “mask-breaks” outside during the day.
  3. Physical Distancing Schools need to adapt their spaces to maintain a 6-foot (1.8 meters) and it is recommended to hold classes outside and keep cohorts small and in bubbles, isolated from other groups of students. Plexiglass barriers as recommended for reception and high-traffic areas. Their efficacy in the classroom is in doubt because of air flow around them.
  4. When a student or employee becomes ill. Schools need detailed protocols that include immediate isolation and testing if possible. With or without testing, people need to stay isolated for 10 days from the onset of symptoms. If someone does test positive, contact tracing needs to be done as soon as possible. Establishing stable cohorts or pods is vital to prevent a whole-school shutdown.
  5. Testing It would be ideal for weekly testing for everyone, but at the moment that is not possible. We can arrange for relatively big numbers of foreigners to be tested at the Tashkent International Clinic with results ready is about 24 hours.
  6. Air Circulation – Getting fresh air indoors is the solution here, or holding classes outdoors.
  7. Cafeteria – Staggered lunch times or in-classroom dining are the best practices.
  8. Outdoors is best. Frequent mask breaks and recess outdoors is the best practice. Non-contact and outdoor sports like cross-country running are advised, contact team sports are not recommended. It is OK to take off masks if athletes are breathing hard, as long as they are distanced and outdoors.
  9. Disinfecting Surfaces Hand hygiene is the key here, so lots of alcohol-disinfectant dispensers and sinks will be important. The benefit of harsh disinfectants over soap and water is up for debate.

“Schools should focus cleaning efforts on high-touch surfaces like doorknobs, bathroom doors and sink areas multiple times a day. And some opportunities for touching surfaces could be eliminated. “Classroom doors can be left open until class starts so that each student does not need to open the door,” Tan says. Cleaning desks is less of a worry, Miller says, because students don’t touch one another’s desks that often.

It’s important to thoroughly clean bathrooms that children routinely use, says Hewlett. These are high-touch areas and can get crowded. Miller says, “Bathrooms must have strong exhaust fans,” as airflow dilutes virus that may accumulate in the air.”


A Conversation with Siddharta Mukherjee About the Pandemic

Siddhartha Mukherjee is the author of

Siddhartha Mukherjee is a cancer physician, researcher and author spoke with Sam Harris about the Covid-19 Pandemic on August 13. The podcast helped me clarify my thinking about the virus and reopening school.

  • Covid-19 is unusual in that asymptomatic people can spread the disease. The only other disease I can think that is like this is HIV. Because of this, testing plays a vital role in controlling the spread of the virus.
  • All organizations (governments, CDC, WHO, businesses, etc.) made many mistakes throughout this pandemic. From the WHO recommending not to wear masks, to the CDC producing tests very late, to Chinese officials withholding information, to the US government applying a travel ban within 24 hours from Europe, driving many Americans together at crowded airports, etc. We have learned much in the past six months are learning more about this now, not-so novel coronavirus.
  • A key statistic is the number of deaths, which are not dependent on the amount of reliable testing in a country.
  • The overall case fatality rate (number of people with Covid-19 who die) is 0.7% and this rate is pretty steady around the world. Rates are higher for susceptible populations, including elderly and co-morbidity conditions.The good news is 99.3% of people that contract Covid-19 survive, the bad news it is 7x more deadly than a regular influenza.
  • The immunology of this coronavirus is not normal. One study shows up to 1/3 of people generate antibodies against coronavirus, but doctors are not sure if they are totally immune and how long it lasts. Another study shows 40% of people tested, naturally have T-cells that recognize Covid-19. These are not antibody producing cells like B Cells and it is a mystery as they have never experienced this virus before. A final peculiar trait is the reaction of the innate part of the human immune system. Some people do not produce interferons to signal the immune system to kick in, and they do not do well with the virus. Other people’s innate system produces too many weapons against the virus that also causes a severe reaction.
  • Another factor of this disease, is we are not sure of the long-term effects of contracting coronavirus. So even though most people will have a mild form of the disease, there may be long-term effects, including vascular damage, changes in the microsystems of the brain, etc. So we cannot say that this is just a version of influenza that is a little stronger. For example, patients may develop vascular problems 10-20 years in the future. We just don’t know at this time.
  • He believes a vaccine can be developed and he trusts authorities (FDA,others) that it will be safe. Protecting the vulnerable people will be the first priority when a vaccine is produced.
  • His advice on school reopenings…he is not convinced that schools can reopen safely, especially in the USA with lax enforcement of hygiene and distance measures.

International school Head Tenures

The “globe” logo for Littleford & Associates

Remember the Patterns and Statistics – Based on Littleford & Associates’ experience, board turnover, chair turnover and the loss of institutional memory account for 60% of the cases of heads being “fired”. Another important and related statistic is that is the third or fourth chair who fires the head 80% of the time. However, about 30% of the time heads are fired because they make too many changes that are threatening to faculty too quickly before they build that reservoir of political capital. That results often in teachers making an end run to the parents or board members directly to complain about the head. Missteps made early on are often impossible to correct. With the virus driving feelings, passions and decisions, all heads are at risk but new heads are especially vulnerable, and if they do not survive, there will be a new expensive search, another transition, and a loss of at least two to three years of momentum and progress. 

Littleford & Associates “Keeping in the Loop” newsletter, June 25, 2020

I am completing my first year as director of the Tashkent International School and really enjoyed the experience, despite the Covid-19 pandemic. Moving to a new school is tricky and learning the school culture, 150 employees, 500+ students, and 300+ families is a lot to take on. Added to this is a new country and government system which in Uzbekistan, being a new country, is rapidly changing. I attended several John Littleford’s webinars during the pandemic thanks to AAIE. John always gives his blunt, sometimes provocative opinion, but he always backs it up with data. Everyone of his periodic newsletters has insightful tidbits for international school leaders. The average tenure of an international school head is 3.7 years, which in my opinion is too short. I feel to really make a difference in a school, a leader needs at least 5 years.

“don’t worry about surfaces” Covid-19 Interview with Dr. Osterholm

I referred to Dr. Michael Osterholm’s 2005 article in a previous post that helped my thinking about this pandemic. National Public Radio’s Fresh Air program featured an interview with him. Osterholm’s publishing company is putting out a new version of his 2017 book, “Deadliest Enemy: Our War Against Killer Germs“. He is the director of a disease research center at the University of Minnesota. From the interview, I learned the following key points.

  • The public is confused about this coronavirus and what is safe and what is not safe. Dr. Osterholm looks at decades of research of influenza transmission via surfaces and states that “clearly surfaces play very little role in the transmission of viruses”. We have gone overboard with disinfection. The transmission “is really all about air, and breathing someone’s air borne virus.
  • No one needs to be frightened of their environment, it is the air that they are breathing. He does not worry any more about food, packages, doorknobs, railings, than he would during the regular cold & flu season. He still recommends washing hands regularly. “It is the air that we share with each other that is critical.”
  • He also doesn’t think the antibody tests are worth doing because they are very poor.
  • Science does not understand the causes of influenza pandemic waves. Why they occur, why they stop, why a second wave comes.
  • Only 5-7 % of the USA population has been infected with this coronavirus. This virus will not stop transmitted until it reaches 60-70% of the population and we develop immunity. Think about the disruption and pain the past 4 months. We have a long way to go.
  • The big question is the race to get a vaccine which is the other way to end this epidemic. Recent polls show however, that 30% of Americans would not take the vaccine, which is part of the anti-vaccine movement.
  • Pandemic fatigue worldwide has set in. However, influenza pandemics last for many months and even years, and it will be difficult to keep physically distancing while a vaccine is being developed. He also reminds us that an 18-month lockdown would bring devastation on many fronts. He says we need to balance reopening with distancing and hygiene measures.
  • I am sadly not surprised at the number of death threats Dr. Osterholm has received by the public. This is part of the anti-science drive in American culture.
  • Being outside greatly reduces the risk of transmission. Wind dissipates the virus rapidly.

Dr. Osterholm runs the Center for Infectious Disease Research and Policy at the University of Minnesota. Their Covid-19 webpage has lots of good information.

How The Pandemic is changing International Schools

I look forward to the AAIE (Association for the Advancement of International Education) briefing on Saturday mornings. The executive director Mark Ulfers and his team always have provocative articles to stimulate my thinking. This week’s article is from Foreign Affairs, a 2005 piece entitled “Preparing for the Next Pandemic” by Michael Osterholm, an infectious disease expert from the University of Minnesota. The article looks at the big picture of global pandemics. With the earth’s population at an all-time high, almost 8 billion, we should expect more zoonotic viruses, jumping from animals to humans and wreaking havoc. Thankfully the Covid-19 pandemic is not as deadly at the 1918-1919 Spanish Flu, which killed 50-60 million people. However, it is a reminder that infectious disease is the biggest killer of humans.

The population explosion in China and other Asian countries has created an incredible mixing vessel for the virus. Consider this sobering information: the most recent influenza pandemic, of 1968-69, emerged in China, when its population was 790 million; today it is 1.3 billion. In 1968, the number of pigs in China was 5.2 million; today it is 508 million. The number of poultry in China in 1968 was 12.3 million; today it is 13 billion. Changes in other Asian countries are similar. Given these developments, as well as the exponential growth in foreign travel over the past 50 years, an influenza pandemic could be more devastating than ever before.

Osterholm, Michael “Preparing for the Next Pandemic, Foreign Affairs July/August 2005

At the time of the article, the SARS epidemic of 2003 was fresh. This was another virus originating in China from unhealthy conditions in animal markets. Osterholm’s observations of the negative psychological effects, the downturn in global travel and the economy, slow-acting governments, etc. are playing out 15 years later from Covid-19. His calls for preparing for the next pandemic went unheeded. Governments need to be prepared with stockpiles of PPE, research/development and production of vaccines and anti-viral drugs, etc.

Even if an H5N1 pandemic is a year away, the world must plan for the same problems with the same fervor. Major campaigns must be initiated to prepare the nonmedical and medical sectors. Pandemic planning must be on the agenda of every school board, manufacturing plant, investment firm, mortuary, state legislature, and food distributor in the United States and beyond. There is an urgent need to reassess the vulnerability of the global economy to ensure that surges in demand can be met. Critical health-care and consumer products and commodities must be stockpiled. Health professionals must learn how to better communicate risk and must be able to both provide the facts and acknowledge the unknowns to a frightened or panicked population.

Osterholm, Michael “Preparing for the Next Pandemic, Foreign Affairs July/August 2005

I think the long-term impact of this pandemic on education will be the use of online delivery of content as standard practice. The idea of engaging modules of precise learning objectives that students can access at anytime from anywhere will be present in all schools. It makes sense. Why design an engaging lecture or lesson plan, use it once for a class of 20 students and then it is gone forever. Teachers will be able to revise and improve their content over time. The flipped classroom will become the norm and class time can be devoted to discussion, assessment, sharing ideas, relationship-building, etc. It might be an exciting time in education. I also see what Scott Galloway is predicting, that big tech companies will be coming into education to really shake it up. I don’t think you can ever replace the human interaction and supervision that schools provide, but regarding content delivery, this will certainly change.

If I had the time and energy, I would love to lead the school in designing a couple of flagship online courses that could be taken by anyone. They would be focused on local resources that are unique to Tashkent. Perhaps an Islamic Art and Architecture course, or a Soviet history or the ecology of Aral Sea and Tian Shan Mountains. Other schools could join to create a network of online courses that would enrich school’s curriculum offering and make a more global, interconnected international school world.

During the pandemic, both AAIE and CEESA (Central and Eastern European Schools Association) have had weekly webinars, connecting leaders from schools all over the world. It has been some of the most rich professional development I received in my career in international education. This might be the opportunity to continue this and build upon it, having more collaboration between schools for faculty, administration and students.

The First Graduate of TIS

The first graduate of the Tashkent International School

The 2019-2020 school year is our 25th anniversary and we’ve been hearing from many former teachers and students. I was curious at the start of this school year to find out where the first graduate of the school. Sarvar Bobojanov is living now. Sarvar was a scholarship student in the first years of the school. He was the lone graduate in the Class of 1998 because the other 4 classmates in his grade, left the school in grade 10 and 11. He was the only one left at TIS in the 1997-1998 school year. As the first graduate, he garnered one entire page for himself in the yearbook (see photo above). Sarvar is pictured in the courtyard of the second campus of TIS. We rented some classrooms with a local school at 23 Chekov Street from 1995 – 1998.

It was delightful to find Sarvar through a quick internet search. He is living here in Tashkent and is a successful director of a juice and dairy product business. I invited him to come by and visit our school. He was last on our campus when he spoke to the graduating class of 2005.

My Latest Reading and; Thinking about the Pandemic

I was disheartened listening to the New York Times Science & Health Reporter Donald G. McNeil on The Daily morning podcast. He is pessimistic and concerned about the progress of our fight against the coronavirus. In the USA, there are 20,000 cases per day and 1,000 deaths per day with the number of cases rising in 21 states. He pointed out the latest science on the virus shows indoor (no wind) transmission through tiny droplets in our breath is a big factor in the spread. This is not only through coughing and sneezing, but also talking loudly, laughing and singing. The CDC estimates 1/3 of transmission is via asymptomatic people. Both of those facts are a challenge for school. McNeil is particularly worried about the next big wave of Covid-19 cases. In the 1918 Spanish Influenza and other influenza epidemics, a more lethal and bigger wave of infection took place. 1/3 of all deaths from the 1918 pandemic took place between September and December. The only good news was the rapid development of a vaccine, with 150 candidates in testing. Governments are already supporting companies to build factories to produce huge amounts of doses once a safe and effective vaccine is found.

New Findings on Asymptomatic Spread

The findings, published in Annals of Internal Medicine, suggest that asymptomatic infections may account for as much as 45% of all Covid-19 cases, playing a significant role in the early and ongoing spread of Covid-19.

Science Daily (through AAIE Covid-19 Briefing #17
Courtesy of World Health Organization Uzbekistan

As you can see from the chart above, the number of daily cases in Uzbekistan has increased in June and has reached the highest numbers we’ve seen since mid-April. I speculate that the loosening of restrictions and the end of Ramadan celebrations are the causes of increased infections. Uzbekistan has reached over 5,000 cases, with around 1,000 active cases and 19 deaths. There are a small number of cases outside of quarantine centers here in Tashkent, 10 were confirmed on June 14.