COVID was a generation-defining global trauma. Though the virus itself hit seniors hardest, the pandemic may have hit young people longest. Learning loss continues to affect young people today. Abdul reflects on the nature of learning loss and its implications for the future of public health interventions. Then he talks to economist Prof. Thomas Kane about the long term impacts of COVID on learning loss and what parents, teachers, and schools can do to catch up.

TRANSCRIPT

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Dr. Abdul El-Sayed, narrating: The Biden administration names the first ten drugs that Medicare will negotiate with pharmaceutical companies. The Department of Health and Human Services calls on the DEA to reclassify cannabis. Mental health spending jumped during the pandemic, a new study finds. This is America Dissected. I’m your host, Dr. Abdul El-Sayed. [music break] Today, we’re talking about COVID learning loss. Now, look, if you followed the social media wars over this, you might be thinking Abdul, have you gone over to the dark side? No, no, I haven’t. And the fact that there’s a dark side here is the problem. To understand why. Let me use an analogy. Think about a surgery. It’s a pretty wild concept. In order to heal someone, we put them under anesthesia to knock them out. And they’re so out cold that they can’t even breathe by themselves. Which is, by the way, where most of the surgical complications happen. Then we literally take a knife to their skin and cut them open. We do real physical harm to them. We cut their skin. Then there’s subcutaneous tissue, then several layers of muscle, then the thin sac on the membrane that holds their internal organs and then literally cut into their organs. And thousands of people do this willingly every single day. Why? Because we know that we have a chance to heal them by taking something out that’s making them sick, even if it comes with all that trauma. Now, if you haven’t connected the dots already, here’s what I’m trying to tell you. When it comes to our health, we’re willing to bear pretty serious side effects if in the grand scheme, it’ll do more good than harm. And surgery’s not the only place in medicine where we do it. Think about chemotherapy. We literally inject people with extremely poisonous chemicals designed specifically to kill cells in the hopes that it’ll kill more of the bad cells than the good ones. The side effects are grueling, hair loss, unbearable nausea and vomiting, pain and fatigue. But we do it because we know that if we don’t kill the cancer, it could kill us. We do all that for individual health. But what about when it comes to the public’s health? What about those side effects that sometimes come with efforts to save millions of lives? The reason this topic has become so controversial is because the very existence of learning loss is often used by COVID deniers and public health skeptics to argue that pandemic era measures like lockdowns, masks, and school closures weren’t warranted. Conveniently, the same people making these arguments usually also pooh pooh the vaccines, deny COVID death rates, and pretend that the entire pandemic was blown out of proportion. You know that same one that killed 1.1 million people in America? Yeah, that one. But the existence of a side effect for a treatment in this case, the treatment being unprecedented efforts to prevent a highly transmissible, highly deadly virus from spreading amongst us doesn’t itself suggest that the treatment wasn’t justified. The question ultimately, just like in surgery, is what that treatment was meant to prevent. And that’s because a burst appendix will literally kill you if someone doesn’t physically cut you open and take it out. A cancerous growth in your abdomen will do the same if you don’t hit it with high dose poison. And so will COVID if we don’t stop it from spreading. No one would use a surgical wound to argue against life saving surgery. So why do we do it with public health? But on the other side of the argument, folks are also doing something kind of absurd. The fact that a surgical wound was sustained to take out a burst appendix doesn’t mean that it’s not a wound all the same. We wouldn’t ignore the wound, let it fester and get infected because someone thought that the surgery wasn’t necessary. And just like that wound, I worry that one side of our public debate has conveniently tried to ignore learning loss for fear that it might undermine public health. Because let’s face it, the kids are not all right. Estimates suggest that we’ve wiped out nearly two decades worth of progress in American academic performance. Kids who sat at home through the pandemic can be years behind when it comes to reading and math abilities. And it’s particularly bad for America’s poorest kids. The kids for whom education is supposed to be a lifeline. Black and Brown kids, poor, rural white kids. These are the ones who are left furthest behind with the least opportunity to catch up. Add that to an ongoing youth mental health crisis in which rates of depression, anxiety and suicidality have skyrocketed, a trend that began well before the pandemic, but that it definitely put an exclamation point on. What frustrates me most is that it doesn’t seem like we’re rushing to make up for those gaps. That we’ve either accepted learning loss as a necessary cost of the pandemic that cannot be recouped. Or are too afraid to admit that it even exists because of what it might mean for a highly online retrospective debate about the pandemic. But instead, we should be sewing up the surgical wound left by the pandemic, racing to make up that learning loss, particularly for the kids who need it most. And that’s the argument our guest today made in his recent article in The Atlantic. Professor Thomas Kane is an economist who focuses on education. He’s the Walter H. Gale professor of education at the Harvard Graduate School of Education. He’s faculty director of the Center for Education Policy Research, and he joined me to share the details about COVID learning loss and what he thinks we need to do about it. It also happens to be his birthday today, so please wish him a happy one. Here’s my conversation with Professor Thomas Kane. 

Dr. Abdul El-Sayed: Okay. Can you introduce yourself for the tape? 

Thomas Kane: I’m Tom Kane. I’m a faculty director of the Center for Education Policy Research at Harvard. 

Dr. Abdul El-Sayed: So uh we were talking just a bit ahead of the recording, and uh you said something which I really appreciated, which is, I’m glad you want to cover this. And I um feel like it it that was a statement that was really loaded by a lot of the internecine political battles over the question of Covid learning loss as a thing and what that meant about what we did in the past. Can you can you talk a little bit about that politicization and then really the conversation we ought to be having about the future? 

Thomas Kane: Abdul that this is so important that because of the polarization, much of the debate so far has been focused on should we have closed schools during the 2021 school year and did we keep school schools closed too long? You’re very familiar with both sides of that argument, but the fact was that there was a lot of uncertainty back in the fall of 2020 about the role that schools would play in terms of spreading um the virus. And different communities came to different decisions, are are duly elected, whether we agreed with them or not. Our duly elected school boards and appointed district leaders made different decisions about whether to keep schools closed. But in that debate we’ve sort of ignored the question of, okay, so what are different communities responsibilities for helping students catch up? Normal school is not going to be enough in the areas that were closed for much of 2021 school year. And different districts made different public health decisions. And so different districts have different amount of work to do to help students catch up. And that’s what’s been missed. Like, I think we we’ve gone back to normal school and I think a lot of parents think, okay, now my kids are back in school, things will be fine. But what people are missing is that, you know, if a district missed most of the 2021 school year, students are not going to catch up without substantially more instructional time. Like we can’t just add ask teachers to speak faster like to to cover, you know, 150% of the material they normally would have covered. So that’s–

Dr. Abdul El-Sayed: You mean you can’t you can’t play you can’t play the lesson at 2x speed and think that you’re going to catch up?

Thomas Kane: Right, exactly right. Kids like, you know, that, you know, hypothetically, we could figure out more efficient ways of teaching the py– Pythagorean theorem or, you know, maybe there’s a, you know, a faster way of teaching how to add fractions with unlike denominators. But the fact of the matter is, we’re not going to figure that out quickly in the short term. And so teachers are going into classrooms with the lesson plans they had with the textbooks they had, and each of those units envisioned a certain amount of time. And, you know, we either need to drop units or give kids more time to cover that material. 

Dr. Abdul El-Sayed: Yeah. Implicit in what you’re sharing is that you can both believe that school shutdowns were justified and that there was Covid learning loss that resulted from them. 

Thomas Kane: Correct. 

Dr. Abdul El-Sayed: In fact, it hinges on believing that otherwise what you risk doing is cementing a level of learning loss for kids. And I just stepping back for a second. There is no intervention, no public health or clinical intervention that is side effect free. And I think it behooves us as public health professionals to be able to fully articulate, admit and engage with the consequences of the side effect of a justifiable public health intervention so that we learn from it and do it better next time. And then, just like we would in clinical medicine, we need to treat that side effect right? And the existence of a side effect does not undercut the value of the intervention. Right. And so this is the hard part I think we keep going back that there was such a moment in our public discourse in 2020, 2021 that we seem ossified in this, like we’re doomed to repeat the different talking points of that debate rather than to learn from the choice that was fully justifiable in the moment, given that we had a highly transmissible, highly deadly disease that was wreaking havoc in our population and then asking how do we do it better the next time, and how do we heal the consequence of the intervention? It’d be like saying, I’m going to do a surgery but you know what? Because I had to cut into the patient to do the surgery, I’m going to go ahead and have to justify the surgery in the first place and maybe not actually stitch up the patient. 

Thomas Kane: Right. No. 

Dr. Abdul El-Sayed: You had to do a surgery, cut the patient open, do the surgery, and then stitch the patient up, right? 

Thomas Kane: Yes. 

Dr. Abdul El-Sayed: And then ask, okay, did I need that big of an incision? Did I Did I did I could I have used a different suture mechanism? Are there different ways I could’ve done the surgery? That’s how we got to laparoscopic surgery, right? And and and we learn from those things. But it’s like we just keep rehashing whether or not the surgery was needed and we’re missing the point. So I just really, really appreciate you making that point. 

Thomas Kane: So, Abdul, can I add to that? Um. Because the of course, I agree with everything you just what what you just said, but it’s even more tragic than that. That these public health measures were taken on behalf of all of us. You know, I’m I’m over 60. And so I certainly, you know, likely benefited from the public health measures that were taken for all of us. And, you know, many others did. But the people who are paying the price are kids. 

Dr. Abdul El-Sayed: Mmm. 

Thomas Kane: Um. And and it’s not just any kid. It was the higher poverty school districts that lost a lot more ground during the pandemic. They stayed closed longer and they lost more ground per week closed. And so we have in this the longest lasting and the most inequitable consequences of the pandemic may end up falling on kids if we don’t get our act together in trying to to now help, as you say, stitch up the patient like to to–

Dr. Abdul El-Sayed: Yeah. 

Thomas Kane: To deal with the side effects that these public health measures created. 

Dr. Abdul El-Sayed: I want to on that point, let’s walk through what some of the evidence is showing us. Um. Just what is the top line on COVID learning loss uh again how much? How do we quantify that learning loss? And what does it tell us about the overall state of children’s education following the pandemic? 

Thomas Kane: So the first wave of news about learning loss came in the form of states reporting, oh, there was a 10% loss in proficiency in math or a, you know, a 7% loss in proficiency in reading in Texas and a 15% point decline in some other states. And there are two things that are difficult about those kinds of numbers. Number one, they don’t immediately translate into, okay, so what’s the magnitude of the catch up effort we’re going to have to, you know, wage. And number two, each state has its own definition of proficiency. So it’s hard to it’s impossible to compare, you know, what a X percentage point decline in Texas is relative to an X percentage point decline in Massachusetts. And so what we did, I and my coauthor, Sean Reardon at Stanford and a group of other researchers, what we did was we took all the state test scores for every school district in 41 states around the country, and we put them on the same scale. And so we measured the losses on the same scale, and we reported the losses in terms of years of schooling loss. So we said, okay, what was the the number of test score points that were lost? But let’s compare that to the typical amount of growth students make during a grade. Just to give people a sense and of just how big the losses were and nationally, the loss, the average loss was about a half a year’s worth of learning in math and about a quarter of a year’s worth of learning in in reading. Now, that might sound like not so bad, but those averages hide some really gigantic losses in some districts. So like Richmond, Virginia, lost the equivalent of more than a year and a half in math. They lost almost a year and a half in reading. Same in St. Louis, same in New Haven, Connecticut. You know, very large losses in Baltimore. So many districts saw very large losses even while, you know, Newton, Mass, where I’m sitting right now, lost more like, you know, a quarter of a year. So there were very unequal losses. It’s not just that that the average was about a half a year. What parents should be doing is focusing on learning, okay, what were the losses in my district? Because it could be that the losses in my district were much, much larger than then these national average losses that I’m reading about in the newspaper. 

Dr. Abdul El-Sayed: Yeah, I want to get to that. But can you talk just a little bit more about the predictors of more learning loss? And you you named a couple of urban centers relative to a relatively affluent suburban center. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: And that’s that’s that’s highlighting some of the flavor of this. But um can you tell us a little bit about what what were the characteristics of districts– 

Thomas Kane: Yes. 

Dr. Abdul El-Sayed: –that were hit hardest? 

Thomas Kane: So the first thing so we’ve been working on this, and I’m sure there’ll be more research in the future trying to understand this. But here’s what I what we know so far. Is that school closures played a big part, um but they weren’t the only thing. So school closures, on average, the districts that were closed for longer lost more ground. Number two, for each week that schools were closed, the losses were larger if it was a high poverty district, then if it then if it were a low poverty district, you could imagine some of the potential reasons for that um related to Internet access, the kinds of jobs parents had, um things like that. But there were other factors too. So so our team put together data on um, you know, throughout the pandemic, Facebook was doing a survey of, you know, um I think it was 25,000 households each week asking them about their activities in the prior week. And we saw that in the areas where there was a greater disruption to um family’s social and economic lives like so where families were reporting that they basically didn’t leave home uh during the prior week and that they, you know, were not attending social gathering. Those places saw larger losses. And it also seemed like the areas with higher death rates saw somewhat larger losses. Um. So a part of it was schools. But another part of it was just, you know, what was happening in to families in the you know, in the social and um their social and economic lives. 

Dr. Abdul El-Sayed: So what you’re painting here is a more complete picture of the ways that school closures actually interacted with the implicit devastation of the pandemic itself and the pathology that it wrought upon folks to create what what is the learning loss that that we identified? And– 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: You know, it makes sense that these things sort of interact. If you’re in a community with a higher death rate, the probability that they’re going to they’re going to close the schools out of fear of the consequences is higher. And so there’s there’s not just an interaction between these two things. There’s actually a mutual causality of these two things. Right. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: That that that when the pandemic takes a higher toll on a community, the implications of being able to open a school back up become a lot more dire, whether that’s because of staffing or teaching uh and the impact on those children who are more likely to have watched a family member or a friend or peer affected by the pandemic. Even in those circumstances, it changes their ability to learn and the consequences of that experience on them. I want to ask also, you know, this is this is not this was a global experience. But how bad does American learning loss look relative to other peer countries? 

Thomas Kane: So there was there were losses around the globe and in many other places they saw the same thing we saw in that there was an increase in inequality. That that the impacts on learning uh student’s learning were larger in higher poverty communities. So so I’m not saying what people might say, Well, gosh, we already knew that there was an achievement gap and that, that higher income communities have higher math and reading scores than lower income communities. I’m not saying that. I’m saying that that existed before and it got worse during the pandemic that that the inequality that existed in 2019 was worse by 2022, and that there really were substantial losses in some communities, much larger losses than others. And that’s that’s the tragedy, is we’re not you know, the recovery effort has been undersized from the very beginning. And we and we can talk some about like why that’s the case. But that that’s the shame here is that while we’re sorting out, you know, whether or not schools should have closed or we’re squandering an opportunity in our obligation to help students catch up. 

Dr. Abdul El-Sayed: Can you talk about the role that the ongoing teen mental health crisis has played in this? So, you know, I want to be clear. When we talk about teen mental illness, it got a lot worse during COVID. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: But it had been getting worse for a decade prior. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: And I want to ask you, I mean, to what degree does school uh as an experience coupled with the pandemic, as an experience, shape what we’re seeing now and how it’s almost impossible to decouple these things but what have we learned about the overall impact on teen mental illness? 

Thomas Kane: So um so I had a you know, my younger son was a freshman in high school during during the 2021 school year. He had just started a new high school when during that year, which was brutal, it was it was brutal to watch. You know, he was somebody who always enjoyed school but he’s a very social kid. And it was hard to see him wake up. It hard to get him to wake up in the morning. His grades were horrible. His you know, there’s no question that it had a gigantic impact on on his mental health during that year. And certainly I still see lingering effects. Um. Now, that’s just in the anecdote, but we see it in the data, too, that attendance, you know, absenteeism has been higher since the pandemic, that that chronic absenteeism rates are much higher now than they were in 2019. That, I think, has consequences for um poor achievement. Like so there was a report that came out a few weeks ago that I found extremely alarming, and that was during the ’22/23 school year. There was one assessment company that that a lot of school districts use, uh the NWEA map assessment. They reported that during the 22/23 school year, students were not only not catching up, they were learning at a somewhat slower pace then before the pandemic, which which I don’t have the evidence for this yet. But but one thing I’d like to investigate is to what extent was that related to attendance? Like that if, you know, 5% of students are absent each day, it’s just a different 5% every day. You know, that’s going to be really hard to manage a classroom and keep people, you know, uh moving forward because you’d be constantly reteaching and trying to help uh students who were absent yesterday catch up. So that’s that’s the main place I see it uh is in terms of of absence rates. Um. I know that, you know, uh disciplinary incidents were were way up in the that first year back. I think those have started to settle down again. But absence rates remain quite high. [music break]. 

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Dr. Abdul El-Sayed: So we’re here at the start of a new school year, and we know that for a whole generation of kids, they’ve been academically stunted to some degree or another. And let’s not forget right, that the point that you made about the widening of those disparities, poverty is the biggest predictor. But because race is a predictor of poverty in this country, you’re talking about achievement gaps that are going to take on a very clear racial disparity and exacerbate that disparity in this country. And the schools that are best equipped to actually catch up are the ones that suffered the least. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: And the ones that are least equipped to catch up are the ones that suffered most. Um. What are some of the policy proposals that have been floated to actually try and catch kids up from what happened during the pandemic? 

Thomas Kane: So um, one thing Abdul to remember is that there were three rescue passages that Congress passed, and the first two President Trump signed. The largest of the three was signed by President Biden in March of 2021, the American Rescue Plan. But if you totaled them up, it was a $190 billion dollars for school districts to help catch up in K-12. And that those dollars were targeted by income. So high poverty school districts did get more federal money to help with the catch up. But the tragedy is the catch up efforts have been undersized. So school districts have done things. They’ve boosted summer school enrollment from, say, 10% to 15 or 20%. Um. They uh provided tutors to like 5% of kids and might provide like 20 sessions over the course of the school year. And that might sound like a lot, but it’s nowhere near enough. Like, so here would be, here’s one example. Richmond, Virginia, as I mentioned before, lost more than a year and a half in math. Their school superintendent in the spring of 2021, while schools were still closed, proposed lengthening the school year he saw at that time, gosh, kids are losing a ton of ground. There’s very high absence rates, low quality instruction while kids are learning remotely. We’re going to have to extend the school year to help kids catch up. And thank goodness we have all this federal money. Let’s do it. The school board turned him down. They said, look, teachers, parents, everybody’s too worn out. Let’s not extend the school year during the 21/22 school year. They said, let’s do it in 22/23. Then when 22/23 came around, they they again said, yeah, you know, we’re not ready to do that. Finally, just a couple of weeks ago. They added 20 school days. So four weeks for two out of 54 schools in Richmond. 

Dr. Abdul El-Sayed: Hmm. 

Thomas Kane: So let’s do the math on that. So [laugh] kids lost the equivalent of 270 weeks um days, 270 days. So 180 days is a year. So a year and a half is about is 270 days. They added 20 days for two out of 54 schools. 

Dr. Abdul El-Sayed: Hmm. 

Thomas Kane: So that’s that’s less than a day for the average student in Richmond, which is– 

Dr. Abdul El-Sayed: Yeah. 

Thomas Kane: –one 270th of what they lost. Every district can tell you, okay, here’s what we’re doing. Richmond, we added 20 school days in a couple of our schools. Everybody can describe what they’re doing, but nobody can say that even on paper, their plans are going to add up to the magnitude of the learning loss students have received and and and I don’t see any way that most districts are going to catch up without adding to the regular school year. They already have the teachers, they already have the buildings. That was one of the challenges with trying to hire enough tutors. They were trying to do it in the midst of a hot labor market. And it’s it’s hard to go out and hire that many new tutors and, you know, get them trained and deploy them. So we already have the buildings, we already have the teachers, we already have the schools. We had the dollars to pay teachers more. It was just that most school districts just thought didn’t realize they needed to do that. Like there was one of the it was less politically popular. And what districts didn’t realize is they were going to have to get down to the less politically popular options if they were ever going to catch up. They did the politically easier things to do, like tutors and voluntary summer school without realizing, gosh, that’s not going to be anywhere close to enough. 

Dr. Abdul El-Sayed: You know, it’s really interesting because you would expect that making up for the lost time would be popular. What do you think explains the pushback? 

Thomas Kane: I honestly, I think a big part of it is just um routine. You know, families were, you know, had their plans, um teachers had their plans. Now, of course, I’m not going to say like teachers deserve more pay for a longer school year, time and a half, or maybe even double time for the extra. 

Dr. Abdul El-Sayed: No doubt. 

Thomas Kane: Those extra weeks. And the good news was districts had the money. It just has not happened. There are few places that have done it. Um. Ironically, you know uh, you know, one of the states that has done more than other states, believe it or not, is Texas. Um. The state said we will we will provide extra funding um for school districts to extend their school year from 180 days to 210 days. We’ll pay for half the cost of that additional 30 days if the district is willing to use their own money or maybe the federal money to pay for those extra days. And a number of districts around Texas did it. And we’re going to see when the spring ’23 results come back if if the Texas schools are are catching up faster than other schools. 

Dr. Abdul El-Sayed: I’m wondering, I mean, based on what you’re saying, I think the answer to my question is pretty clear. But you know I’m a father of two young children. And I’ll be on a summer vacation–

Thomas Kane: What what what what are their ages? 

Dr. Abdul El-Sayed: So five and six months. 

Thomas Kane: Okay. 

Dr. Abdul El-Sayed: And my five year old is about to start kindergarten, and she’s been in preschool now for like two and a half years. I got to tell you, summer vacation is the worst because aside from the time when we’re actually on vacation, it’s this like–

Thomas Kane: [laugh] That’s right. 

Dr. Abdul El-Sayed: –endless shuttle from different camp to different camp to different camp to try and provide the childcare that school usually provides. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: And if somebody told me, hey, there’s an opportunity for you to take a referendum type vote on abolishing summer vacation, I would vote yes in a heartbeat for so many reasons. Right? Because I know that– 

Thomas Kane: Yes. 

Dr. Abdul El-Sayed: You know, even even my kids progress on the things that she had been making progress on. She clearly backslid over the summer. And as much as Sarah and I try and uh substitute, we’re just we’re just not the same thing as as school for the day um and so I’d vote for it in a heartbeat. I guess I wonder if there is an opportunity in this moment, given this issue, to more permanently transform the nature of a school day like, you know, the notion that that high school kids are starting at 7:30 and elementary kids who wake up at 6:30 are starting at nine. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: Makes zero sense. Like the notion that um we are not thinking about school time and school activities as being sort of baked in and things that we should just fund um doesn’t make any sense. The fact that we have an insanely long summer vacation that harkens back to a time when kids used to have to go and partake in the harvest. And I understand that in some– 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: –communities that’s still the case, and that would be fine. They could make those those decisions for themselves, but that this is still a norm in the United States of America where, you know, some infinitesimally small number of people are involved in in farming uh on a year to year basis. Like all of these things that makes zero sense. And they’re just anachronisms that you’d think that in this moment of a huge educational crisis we might be willing to solve. But it seems to me like like we’re just not um. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: What is your perspective on that? 

Thomas Kane: So so. Abdul. I think that’s exactly right. Um. This is an opportunity to rethink our basic assumptions about what’s the right school calendar. Um. And here’s a hopeful spin on this. Um. And that is, I think, the $190 billion dollars in federal money had people focused on temporary solutions, got people focused on, okay, how are we going to spend that money in the next couple of years? You know, there’s only one more year. So they they’ll they’ll need to obligate those funds by September of ’24. So basically, we’ve got one more school year and one more summer to spend those dollars. And that’s been the focus. But we need to start talking now about the policy changes we need to have in place in the fall of ’24 when those dollars run out, because they’ll be a lot of kids who are still behind at that point. And lots of that stuff would require legislation. So to extend the school year would either require school board votes or or state legislative votes. Um. And we just need to get started now. So I hope more states think about this, this kind of policy that that Texas did. They didn’t require districts to extend the school year. The state said, okay, well, we’ll pay for up to 30 additional days. We’ll pay half the cost of up to 30 additional days. And a lot of local school boards took them up on that. And I hope more states think about that. And there are other things that we ought to be planning for in the future, because it’s crystal clear to me and it’s going to become crystal clear in the coming weeks when these state test scores come back that a lot of kids have not caught up. And people will start to realize, oh, my goodness, we really under did it. 

Dr. Abdul El-Sayed: Mm hmm. I want to ask you about the lasting consequences of this learning loss. Um. What what do we think they’ll be? I mean, you talked about the extended disparities, which are just a sordid thing to have to think through. But what do we think will happen to this generation of COVID kids, right. Who had their education stunted as this collective trauma that they all faced? 

Thomas Kane: So one thing so remember, Abdul, there are four high school graduating classes, about 12 million kids that have already graduated from high school since the pandemic began. So the the 2020 through the ’23 graduating classes, they’re already out in the labor market. And there’s been a 20% decline in community college enrollment over the last four years. That’s that’s not even long term. Those kids are out there right now. And so just think about it. If you were in high, graduating from high school, say you were a senior in the 2021 school year, you didn’t have your high school guidance counselor to talk to about college. And even if you did, like, you were looking at online classes. And so there are kids are out there in jobs and or at home, and there’s no adult’s responsibility to reach out to them. So the long term consequences are already out there. And we need to help reconnect those folks to college. But for everybody else who’s still in in K to eight and in high school, there will be other consequences. So we’ve already seen, for instance, there’s been about a I think it’s a 9% decline in the number of kids taking AP calculus courses. There’s been a 20% decline in the number of kids taking A.P. chemistry. Um. I think it’s 10% or 12% in the the number of kids taking A.P. bio. So those courses that have like precursor courses that require you to have taken and passed earlier grades, um uh courses in earlier grades, we’re already seeing declines in those areas. And so a lot of those things will have I think we’re likely to see a decline in the proportion of people majoring in science and engineering, in math, in college as a result of it. Now, to so those are like the the very concrete measures. To get a broader picture of it we looked and we said, okay, when these same test scores were going up, I think a lot of people don’t realize that we were making progress from about 1990 to 2013 or so. There were substantial increases in achievement in some much larger in some states than others. And we did an analysis. It’s available on our this website we created, EducationRecoveryScorecard.org, where we said, okay, well, what happened to the income, educational attainment, arrest rates, teen motherhood rates for students born in states where test scores were rising? And how did those improvements compare to the students born in states where test scores didn’t rise as much? And because based on that, we might say, well okay, let’s use those to predict what’s going to happen now that test scores have have seen a big decline. And so based on that, we predict there’ll be about a $900 billion dollar loss in lifetime earnings, um not per year, but in the present value of lifetime earnings for the people who were enrolled during the 2021 school year. If we don’t reverse it and we’re already seeing in the short. If you don’t believe that we’re already seeing in the short term these declines in community college enrollment declines and you know, the number of kids taking AP bio and and and AP calculus, the kinds of courses that get you into, you know, the the higher paying STEM careers. So um so there will be long term consequences. And uh so a lot of parents might say, but wait a minute, everybody’s in the same boat, so maybe we shouldn’t be worried. Well, not everybody’s in the same boat. Remember– 

Dr. Abdul El-Sayed: Yeah. 

Thomas Kane: The kids in Newton, Mass. didn’t lose very much. And it was the kids in Boston and Lynn and Lawrence and Richmond and Saint Louis and New Haven, that that lost a lot of ground. And um so it’s not just that there’s a loss in earnings, it’s a very inequitable impact. It’s primarily on the lower income uh kids. 

Dr. Abdul El-Sayed: Yeah, you know, I, I hadn’t thought through the implications for STEM fields, but you’re right. When every kid in a class writes a a less good essay, there’s still an easy distribution in that class in terms of the best essay and the worst essay, even if the median and the mean quality of the essays drop. The hard part about the STEM fields is that you just have to have a certain level of rigor. You either know the answer or you don’t know the answer. You know uh, in organic chemistry, molecules interact in a particular kind of way. You either know how they do or you don’t. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: And so you can’t just grade the class on a curve because, well, every you kind of just have to know it. And the point that you’re making is an important one, especially considering the the I think the more sinister aspect of this is not just that the learning loss took place. It’s that it seems that kids are learning at a slower pace thereafter. The ability to catch up on these STEM fields becomes that much harder. And then people just don’t take those classes. 

Thomas Kane: Right. 

Dr. Abdul El-Sayed: And when people don’t take those classes, they miss out on all those opportunities and all the career trajectory that that opens up for them. And, you know, as a I mean a, it’s an interesting um externality of this, this outcome on a public health podcast, because well we kind of rely on people knowing science to explain science. 

Thomas Kane: Right. 

Dr. Abdul El-Sayed: Which is kind of what got us here in the first place, right? Is that so much of what differentiated our COVID outcome and COVID process was a function of having an incompetent public health work, not workforce. Our workforce was fantastic. It was an incompetent public health infrastructure to support our workforce, not enough people, not enough um uh uh support for those people. And that itself is what led us to to having to take some drastic actions in particular circumstances. And it’s funny because, you know, everybody is quick to blame the public health apparatus for a lot of these choices. But I’d argue that had the public health community felt more confident in its about ability to respond at scale, we may have been able to buy ourselves out of some of these more drastic um interventions. And that’s the thing that people don’t really think through, is that in other countries they were able to open schools uh back up a lot faster because their public health infrastructure was better funded to be able to handle the the rates and keep them low, to be able to open up school in the next year. In our uh country, we didn’t have that ability. And so a lot of folks looked at it and said, we are not controlling this virus adequately. We cannot allow uh these schools to potentially [?] and therefore, the best measure here is to close them down, which is which is ultimately it is a it is a Hail Mary throw. And I believe that given where we were with the virus, it was a very justifiable decision. But I also believe that we were where we were with the virus in the first place because we had not invested adequately, which is a function of being able to train. And so it’s part of what you’re sharing here is that unfortunately, there’s a recursion effect of all of this, which is there’s a whole generation of young kids who are just going to be less prepared for fields like this one, and um we may suffer the consequences yet again. 

Thomas Kane: Yeah. 

Dr. Abdul El-Sayed: As a society. 

Thomas Kane: And and so um so two things to to to say in response to that Abdul so so yes, like the the state and local public health resources. Um. You know, for tracking virus and keeping people safe were were not where they needed to be. But there was a lot of federal leadership in the develop of a vaccine development of a vaccine. 

Dr. Abdul El-Sayed: Right. 

Thomas Kane: And so forth. In education, there’s been no federal leadership like we provided the $190 billion dollars to K-12, but we’ve just sort of let, left it to them to figure out what to do with it. In fact, like the American Rescue Plan law gave states very little authority to either approve or disapprove a district’s plan. So if a district, you know, came in and said, you know, we’re going to spend it on across the board salary increases or we’re going to spend it on an HVAC, or we’re going to spend it on, you know, basically um allowing districts to bank some of the dollars for future um expenditures. There was very little a state could do about it. So every every district was out there trying to find its own vaccine, trying to find its own, you know, answer to the problem of learning loss. And we got um we got the predictable result from that. Um. The other actually, if anything, the federal guidance was misleading because at the time the American rescue plan passed, districts were only required just nobody knew at that point just how bad the learning loss would be. That was March of ’21. I think a lot of people were still hoping, well, gosh, like, you know, maybe in per– maybe remote schooling will be 75% as good as in person. You know, we just didn’t know. So districts were only required to spend 20% of the dollars they got on academic recovery. There’s no way that many districts were going to catch up spending only 20% of that on on academic recovery. It was going to be way too little like many districts–

Dr. Abdul El-Sayed: Yeah. 

Thomas Kane: –would have had to spend all of it and more on academic recovery and and following the federal guidance, they didn’t. 

Dr. Abdul El-Sayed: Hmm. Well, uh Professor Kane, we really appreciate you um shedding light on what the impact of COVID learning loss has been and what some of the dynamics look like and also what it’s going to take to solve it. Uh. And we appreciate you uh sharing your insights with us today. Our guest today was Professor Thomas Kane. He is uh the Walter H. Gale professor of education at the Harvard Graduate School of Education uh and an expert on COVID and learning loss. Thank you so much for your time. 

Thomas Kane: Thanks, Abdul. [music break]

Dr. Abdul El-Sayed, narrating: As usual, here’s what I’m watching right now. You hear that? That’s the wailing and gnashing of teeth of Pharma CEOs who make millions of dollars a year because the federal government had the audacity to name ten. Yeah, only ten drugs. The prices for which they’ll begin to negotiate in 2026. First, a quick briefer on the policy. One of the more exciting features of the Inflation Reduction Act was that it, for the first time, allows Medicare to negotiate prescription drug prices. But not all prescription drugs are eligible. The Department of Health and Human Services can pick ten drugs every year that meet very specific criteria. They have to have been on the market for a while. Seven years for traditional drugs and 11 years for biologics. There can’t be a generic or biosimilar on the market, and they have to be covered by the Medicare prescription drug program. And the negotiated rate, by the way, only applies for Medicare beneficiaries. But that hasn’t stopped Big Pharma from throwing a fit. They’re telling us that the program will stop them from innovating new medications, that it’ll raise the prices of other drugs and that it will lead to shortages in the drugs that are negotiated. It’s all, of course, bullshit. Pharma companies spend more on marketing than they do on research and development. They very well might raise other drug prices, but that will get harder to do because of a few key stipulations in the Inflation Reduction Act. Specifically, it restricts annual increases in drug prices beyond the rate of inflation. And basic logic dictates that if you make less profit for a unit of a certain product, then you might want to make it up by selling more of that product. The new drugs that HHS named include some really important ones. They include commonly used medications for arthritis, diabetes and heart disease. These are drugs that millions of beneficiaries use every single day. And there are some really important spillover effects, too, meaning what this policy does, even if it doesn’t touch other folks, could affect the prices that they pay. Even though the negotiated rates may only apply to people on Medicare, the posted rate could help insurers of all types negotiate similar rates too. So this, in the words of one Joseph Robinette Biden the third is a big effing deal. In other news, the Department of Health and Human Services has called on the DEA to reclassify cannabis from its current schedule one down to schedule three. Schedule one drugs are those with no currently accepted medical use and a high potential for abuse. That’s not cannabis, but it does illustrate the catch 22 here. Because cannabis is currently schedule one, it’s nearly impossible to do research on its medical benefits, even though there’s current evidence that shows several possible benefits, including for pain relief and seizure disorders. And it’s so hard to do that research because designing definitive randomized trials requires federal funding, which of course you can’t get for research on cannabis, which is currently a schedule one drug. Why? Because there are no proven medical benefits. You get the picture here. And yet medical marijuana is legal in 39 states. If I have to remind you, that’s 39 out of 54 out of five and recreational marijuana is legal in 23. And the fact that so many states have legalized cannabis, despite the fact that it remains a schedule one drug. Well, it’s created an increasingly untenable situation. Schedule three drugs, on the other hand, are those that have moderate to low potential for physical or psychological dependance, which is a much better fit. That said, this move wouldn’t solve the fact that cultivation, production and sale of cannabis would still be illegal under federal law. Nevertheless, it would ease several restrictions. The DEA has yet to ever go against a recommendation from HHS. So that’s really good news. And we can expect a rescheduling decision in mid 2024. We’ll be watching. This next piece of news should come as a surprise to just about nobody. But a new study in JAMA found that mental health spending jumped during the pandemic. It’s not just about people needing more of it. See, the pandemic also ushered in major changes in policy that facilitated the expansion of tele mental health, which vastly increased the availability of online mental health treatment. Tele mental health has a lot of advantages. It’s not just that it’s more convenient, but it sidesteps a lot of the unfortunate stigma that still exists when it comes to mental health, because you can access your therapy from the comfort of your own home. You’re not worried about who might find out. Efforts to pull back on some of these pandemic era regulatory changes have been met with major pushback from providers and patients alike. And I’d be willing to bet that they’re here to stay. That’s it for today, on your way out don’t forget to rate and review the show. It really does go a long way. Please do me a kindness, please. Also, if you love the show and want to rep us, don’t forget you’ve got one more day to take advantage of the Labor Day sale at the Crooked Media Merch Store. [music break] America Dissected is a product of Crooked Media. Our producer is Austin Fisher. Our associate producers are Tara Terpstra and Emma Illick-Frank. Vasilis Fotopoulos mixes and masters the show. Production support from Ari Schwartz. Our theme song is by Taka Yasuzawa and Alex Sugiura. Our executive producers are Leo Duran, Sarah Geismer, Michael Martinez, and me. Dr. Abul El-Sayed, your host. Thanks for listening. [music break] This show is for general information and entertainment purposes only. It’s not intended to provide specific health care or medical advice and should not be construed as providing health care or medical advice. Please consult your physician with any questions related to your own health. The views expressed in this podcast reflect those of the hosts and the guests and do not necessarily represent the views and opinions of Wayne County, Michigan, or its Department of Health, Human and Veterans Services.