Dear Governor Brown,

Thank you for your efforts to address the pandemic in our state.   We appreciate your efforts to include input from scientists, epidemiologists and physicians in making these tough decisions.  As physician moms, we support the use of evidence-based medicine, sound public health epidemiology and thoughtful consideration of the broad implications of any decision on our diverse communities.  We are writing to you today to address shared concerns and advocate for solutions, specifically in regards to school closures.

We understand that school reopening decisions are extremely complex and nuanced.  We know that you are concerned with the well being of the children in our state, and we fervently share this concern.  After all, the future stability of any community is hinged on the health and well being of its tiniest members.  

In addition to meeting academic needs, schools offer a safe haven for many children, where meals, stability and guidance are assured.  We are quite concerned about long term effects on children who may increasingly be experiencing hunger, neglect, abuse, isolation, depression, anxiety and emotional distress.  While we know that these increases are multifactorial in relation to the negative effects of the pandemic, we also know that in person schooling is a place where these things can be observed and remedied and where these children can be best supported.  Teachers and schools are essential services.  The educational, psychosocial & emotional needs of our children must supersede the need to go to a gym, bar or other non-essential services.

We support and understand the need to use epidemiologic thresholds of COVID-19 infections in order to inform decisions on school reopening.  However, as a group, we are concerned that under the current circumstances these metrics will be unattainable.  We would like to make suggestions of ways that policy level decisions can influence community transmission rates and improve the chances that the children of Oregon can return to in person school.

There are countries around the world who have found a way to drastically reduce COVID-19 transmission rates, even in the face of transmission greater than what is occurring in Oregon at this time.  In most cases, this was achieved by using a comprehensive plan of three major steps (adapted from WHO guidance):

1. A strong focus on suppressing transmission by governmental leaders with a comprehensive long term plan
2. An empowered, engaged community that takes individual behavior measures in the interest of others
3. Strong government leadership and coordination of comprehensive strategies that are communicated clearly and consistently

We know that this will not be easy,  but we must believe that reducing community transmission is possible.

A recent article in the New England Journal of Medicine titled “Reopening Primary Schools During the Pandemic” makes compelling statements about the importance of prioritizing in person primary schooling.  The authors state “The safest way to open schools fully is to reduce or eliminate community transmission while ramping up testing and surveillance.” They go on to say “The path to low transmission in other countries has included adherence to stringent community control measures — including closure of nonessential indoor work and recreational spaces.” As physician mothers, we strongly agree with this article and feel that it is unconscionable to allow adults the freedom to go to bars, gyms, social gatherings and other non essential services at the cost of the education and safety of our children. “The fundamental argument that children, families, educators, and society deserve to have safe and reliable primary schools should not be controversial. If we all agree on that principle, then it is inexcusable to open nonessential services for adults this summer if it forces students to remain at home even part-time this fall.”

We take comfort in knowing that our country is not alone in this pandemic and that there are strong leaders in the international community who are committed to helping us.  Recent words from Dr. Tedros, Executive Director of the WHO, give us hope that we can reduce community transmission and find a way back to a sustainable situation:

“There are no shortcuts out of this pandemic.  We all hope for an effective vaccine, but we need to focus on using the tools we have now to suppress transmission and save lives.  We need to reach a sustainable situation where we have adequate control of this virus without shutting down our lives entirely, or lurching from lockdown to lockdown.  I want to be straight with you, there will be no return to the old normal for the foreseeable future.  But there is a roadmap to a situation where we can control the disease and get on with our lives....It can be done, it must be done.  No matter where a country is in its epidemic curve, it is never too late to take decisive action.  Implement the basics, work with community leaders to deliver clear public health messages.  We must use these tools to bring the pandemic under control and we must do it right now.”

We know that this will not be easy, but we do believe that reducing community transmission in Oregon is possible with a consistent approach and strong, unified, public health messaging.  We have not received this from federal leadership, but Oregon can choose to do better.  Governor Brown, we want to partner with you in making this state a safe place for children again.  We will present you with a proposal of suggestions in the coming days that we feel are essential steps at reducing community transmission.  We propose as the necessary first step, that bars, gyms and other non essential services for adults must be closed.  As physicians and as mothers we know that reducing community transmission is a must and is our best chance at giving some semblance of “normal” back to Oregon’s children who deserve nothing less.

Respectfully Signed,

Arian Nachat, MD   Emergency, Hospice, Palliative and Pain Medicine

Rebecca Hicks, MD  Pediatrics and Population Health

with supporting signatures from:

Marcy Lake, DO – Family Medicine

Dana Simpson, MD – Clinical Genetics

Tricia James, MD – Internal Medicine

Roxanne Thomas, MD – Family Medicine

Rachel Graves, MD – Family Medicine

Erica Delgado, MD – Internal Medicine

Tovi Anderson, MD, PhD – Family Medicine

Eileen McCarty, MD – Child & Adolescent Psychiatry

Christy Rivers, DO – Pediatrics

Keren Rosenblum, MD – Ob/Gyn

Rachel Rackow, MD, MPH – Palliative Medicine

Erin Wallace, MD – Psychiatry

Elise Newman, MD – Palliative Medicine

Erin Rodgers, MD – Pediatric Anesthesiology

Pamela Scherer, MD – Dermatology

Angela Lennon, MD – Pediatric Endocrinology

Terry Moy-Brown, DO – Emergency Medicine

Nisha Desai, MD – Dermatology

Nicole Harrington Cirino, MD

Jody Tate, MD – Critical Care & Sleep Medicine

Andrea Matsumura, MD – Sleep Medicine

Andrea Chakrapani, MD – Dermatopathology

Chandni N Merchant, MD – Internal Medicine

Megan Madden, MD – Neurology

Christy Buckman, MD – Otolaryngology

Annameika Goldring, MD, MPH – Emergency Medicine

Sandra J Krussel, DO – Psychiatry

Elizabeth Reding, DO – Internal Medicine

Simona A Parau, MD – Internal Medicine

Corinne Klykov, MD

Jeanne Robinson, MD – Internal Medicine

Lesley Raphael, MD – Anesthesiology

Heather Long, MD – Pediatrics

Amany Bashir, MD – Family Medicine

Bina Patel, MD, MPH - Family Medicine

Lara Bickford, MD – Emergency Medicine

Cristina De Castro De La Cruz, MD – Internal Medicine

Aishwarya Deenadayalu, MD – Pediatrics

Cecille Herrera Reuther, MD – Psychiatry

Joanne Wu, MD, MPH – Family Medicine

Catherine Wong, MD – Cardiology

Sarah Kehl, MD – Allergy / Immunology

Alivia Cetas, MD – Breast Surgery

Leslie Sanchez-Goettler, MD – Internal Medicine

Amanda Holland-Yang, MD – Emergency Medicine

Jennifer Rupert, MD – OB/Gyn

Krystal Samuel, MD – Cardiology

Paula Bednareck, MD MPH – OB/Gyn

Daniela Ghetie, MD – Rheumatology

Emmanuelle Pare’, MD – Maternal Fetal Medicine

Anne Wang, MD – Gastroenterology

Kimberly Shields, DO – Family Medicine

Lisa Bayer, MD, MPH – OB/Gyn

Shannon Hopson, DO – Endocrinology

Marcy Drury-Brown, MD – Pediatric Endocrinology

Erin Finter, MD – Orthopedics

Kathy Shaw, MD – Family Medicine

Abigail Lenhart, MD – Internal Medicine

Sanjay Chakrapani, MD – Radiology

Katherine Au, MD – Ob/Gyn

Kelly Vranas, MD – Critical Care

Jenny Malcom, MD – Pediatrics

Ee Lin Wan, MD – Internal Medicine

Rhonda Keller, DO – Internal Medicine

Maria Isabel Rodriguez, MD, MPH – OB/Gyn

Levana Amrock, MD – Anesthesiology

Jennifer Norton, DO, MS – Emergency Medicine

Emily Puukka Clark, MD, MS – Family Medicine

Lynda Tang, DO – Palliative Medicine

Lindsay Cook Stanley, MD – Internal Medicine

Michelle Berlin, MD, MPH –OB/Gyn, Public Health

Breanne Wilson-Brown, DO – Family Medicine, Sports Medicine

Anne Gross, MD – Emergency Psychiatry

Fayza Sohail, MD – Family Medicine

Cara Kawahara, MD – Family Medicine

Kimberly Wings, MD – Ophthalmology

Kate Ropp, MD – Anesthesiology

Tracy Geanne, MD – Pediatrics

Kathryn Moyer, MD – Pediatric Gastroenterology

Amelia Baker, MD, PhD – Family Medicine

Vivian Schiedler, MD

Simmy Varghese, MD – Internal Medicine

Astrid Peau, MD – Pediatrics

Andrea Veryser, MD - Internal Medicine/Hospitalist

Chris Orr , MD – Endocrinology

Chloe Allen Maycock, MD – Anesthesiology

Kate Broadman, MD - Pediatrics

Carolyn Coghill Piszczek, MD – Ob/Gyn

Lyndsey McCartney, MBBS – Family Medicine

Drea Klunder Petersen, MD – Genetics

Mary Olsen, DO – Pediatrics

Leslie Carey, MD – Hospitalist

Emily Chase Nguyen, MD – Orthopedics

Skye Powell, MD – Hospitalist

Sophia Lannon, MD, MPH – Maternal Fetal Medicine

Maureen Baldwin, MD, MPH – OB/Gyn

Kristin Neuhaus, MD – Dermatology

Sarah Powers, MD – Pediatrics

Dafna Lohr, MD

Heather Penny, MD – Family Medicine

Sonia Sosa, MD – Family Medicine

Rachel Young, MD – Family Medicine

Alicia Welder, MD – Emergency Medicine

Weiya Wysham, MD – Gyn Onc

Jennie Champion, MD – Pediatric Critical Care

Nancy Grant, MD – OB/Gyn

Monica Demasi, MD – Family Medicine

Alizah Rotramel, MD – Colorectal surgery

Elke Leeukopf, MD – Palliative Medicine

Katherine Dempster, MD – Internal Medicine

Sarah Julane Wolff, DO – Family Medicine

Megan Lear Mudrick, MD – Family Medicine

Terry Moy-Brown, DO, MPH – Emergency Medicine

Andrea Payne Osterlund, DO – Internal Medicine, Bariatric Medicine

Bita Naji, MD – Family Medicine

Sara Taub, MD – Pediatrics, Hospice & Palliative Medicine

Priti Khanijou, MD – Palliative Medicine

Ronda Keller, DO – Internal Medicine

Karen Oyama, MD - Pathology

Maria Ximena Traa Kiely, MD, MPH – Colorectal Surgery

Catherine Wagoner, MD - Pediatrics

Sarah Rodriguez, MD – Gastroenterology

Kimberly Workman, MD – Orthopedic Surgery

Mona LaBar, MD – Pathology

Rowan Casey-Ford, MD – Family Medicine

Sahra Rahimtoola, MD – Internal Medicine / Hospitalist

Cynthia Horak, MD – Emergency Medicine

Kara Detwiller, MD – Otolaryngology

Anika Denali Luengo, MD – Ob/Gyn

Janelle Meyer, MD – Hematology / Oncology

Katie Sharff, MD – Infectious disease

Renee Prins, MD – Medical Oncology/Hematology

Annie Mack, MD – Internal Medicine / Pediatrics

Megan Madden, MD – Neurology

Sophie Snow, MD – Emergency Medicine

Dawn Dillman, MD – Anesthesiology

Jennifer Garner, MD – Emergency Medicine / Urgent Care

Michele Babicky, MD – Surgical Oncology

Siobahn Gray, MD – Emergency Medicine

Kathleen Oldread, MD - Pediatrics

Gina Westoff, MD - Gynecology/Oncology

Safina Koreishi MD, MPH - Family Medicine, Preventative Medicine

Arija Iverson, MD - Pediatric Hospital Medicine

Lisa Reynolds, MD - Pediatrics

Emily Steinbis, MD - OB/Gyn

Laurel Bradford, MD - Pediatrics

Emily Rangel, MD - OB/Gyn

Eliza Hayes Bakken, MD - Pediatrics

Ronda Keller, DO - Internal Medicine

Anne Weinsoft, MD - Internal Medicine

Jennifer Coffman, MD - Psychiatry

Shirin Doratotaj, MD - Pediatrics

Paula Lee-Valkov, MD - Radiology

Rebecca Neborsky, MD - Family Medicine

Cynthia Worden, MD - Family Medicine

Anu Brixey, MD - Diagnostic Radiology and Pulm/Critical Care