BALTIMORE -- The eighth graders at Baltimore Design School have just one more class period separating them from a holiday weekend, the excitement palpable as the doctor attempts to get their attention.
Dr. Panagis Galiatsatos grew up not far from the school, he tells them, a son of Greek immigrants who dreamed of serving the city that took them in. “Tostitos!” one child called out as Galiatsatos patiently explained how to say his name.
“You can call me Dr. G,” he says. “It’s also my DJ name, if you ever want to go to the club with me.”
This intrigues the students, some of who believe that all scientists somehow work for the government and have an agenda, according to their health teacher, Erin Nutsugah.
But that’s the beauty of “Ask an Expert” day in Nutsugah’s classroom, the final exercise in her two-week unit about the coronavirus. With Dr. G’s help, she said, the kids may shake off their unconscious biases about the health care system, get their questions answered by a knowledgeable source and see a pathway into the medical field they may otherwise have overlooked.
Nutsugah, a 10-year educator who teaches such topics as mental health, nutrition, substance abuse and reproductive health, said she felt compelled to cover COVID-19 in class this year and offer students a way to make sense of the public health crisis. There was no state or district curriculum for her to follow, she said, so she created one with support from the Johns Hopkins Health Education and Training Corps.
“It’s vital we all understand what we’re dealing with, because we’re still dealing with it,” Nutsugah said. “It surprises me what they do and don’t believe.”
Public health experts have long worried about the effects of misinformation and disinformation on getting the public vaccinated, saying that just a few malicious actors have convinced millions of Americans that the shots are neither safe nor effective. The conspiracy theories, lies and misconceptions about the vaccines and about the virus in general have spread so far that they have trickled down into the youngest of minds.
Enter Galiatsatos, who specializes in lung and critical care treatment at Johns Hopkins Medicine and coleads the institution’s Medicine for the Greater Good initiative — a partnership between Hopkins, schools and communities that aims to promote health and wellness through education. Along with several of his Hopkins colleagues, he created a free curriculum and educational program to teach K-12 learners about the science behind the disease.
He helps train and deploy Hopkins students studying medicine, public health and nursing into classes to lead sessions, a way to reach even more schools.
No question is too big or small for Galiatsatos or his trainees, who say they take each one seriously and never try to shame a student for what they believe or don’t understand. Galiatsatos said they’re not there to argue: They’re there to arm students with the science they need to become ambassadors for public health.
So far, the more than 160 student volunteers of the Johns Hopkins Health Education and Training Corps, also known as the HEAT Corps, have logged more than 2,200 sessions in some 200 classrooms, with several in Baltimore and others as far away as Guatemala, India and Sudan. Galiatsatos visits more on his own, including a recent stop at Navajo Preparatory School in New Mexico, where he helped answer parents’ questions about booster shots and how to safely gather during the winter holidays.
A joint venture of Hopkins-affiliated researchers, clinicians and educators, the HEAT Corps curriculum launched in July 2020, and has been revised and compressed in the months since. It’s funded with annual contributions of $200,000 from Johns Hopkins University and $100,000 from Hopkins Health System, and it received a two-year, $300,000 per year grant from the Baltimore City Health Department in July to deliver the curriculum across the city’s public school system.
The idea stemmed from the number of teachers calling on Galiatsatos for help during the initial months of the pandemic as school buildings closed and students expressed worry over how long they would be stuck at home. He had existing relationships with schools from his work with Medicine for Greater Good and had previously visited classrooms to talk about topics such as lung health and air pollution. Now, could he come back and explain this new world to them?
In Nutsugah’s classroom, it takes a couple minutes and a bit of charm, but Galiatsatos soon captivates the students. Through fist bumps, jokes and kid-friendly analogies, he earns their attention. By the end of class, nearly every student had spoken up.
At this point, he’s an expert at teaching kids about COVID-19. Since the coronavirus arrived in early 2020, he has visited — virtually or in person — more than 200 classrooms to challenge students to think about how they can advocate for public health.
“So, you’re here to convince us to get the vaccine?” asks Priyasha Morris, who sits near the front of Nutsugah’s classroom.
No, Galiatsatos says. But that doesn’t mean they’re off the hook.
“I was invited by your teacher to help you do something no other generation has done before,” he said, daring them to think of themselves as characters in a Marvel movie. “What role can you play, right now, to end the pandemic?”
“Wow,” a student responds.
Annette Anderson, assistant professor at Hopkins’ school of education, helped design the COVID curriculum.
“We are fond of saying, we built the plane while we were flying it,” she said. “We were parsing it out to make it appropriate, but also being responsive because we were all trying to figure it out at the same time.”
Anderson said keeping up with the pandemic’s latest twists and turns poses a challenge for the HEAT Corps, which updated the curriculum at the beginning of the school year with more information about variants, for instance. The curriculum designers engage in lively debates about what to include and what to omit, what qualifies as too graphic and what’s age-appropriate for children, she said.
The curriculum shouldn’t be considered a “catchall,” Anderson said. For example, it briefly touches on the theory that the coronavirus likely developed out of animal-to-human contact, known as “zoonotic” spread, one of the curriculum’s vocabulary words.
Though the virus’ zoonotic spread theory has not been proven definitively — even some federal officials in the U.S. contend the virus could have been developed and accidentally released from a lab in Wuhan, China — Anderson said the designers consulted their experts and stuck to what they considered the most plausible and scientifically sound scenario.
“We’ve had to be very careful with how our product aligns, or hews, with certain ideologies,” she said. “We’ve been intentionally clear about what our program does and doesn’t do.”
Galiatsatos also instructs HEAT Corps volunteers to be honest about their own knowledge gaps. That helps lessen some of the pressure associated with teaching such a contentious topic, said Ndeye Silla, a graduate student working toward her master’s degree at the Johns Hopkins Bloomberg School of Public Health, who led a virtual session for third to fifth grade students in October at St. Jerome Regional School in northeastern Pennsylvania.
It can be difficult to engage students remotely, said Silla, especially about a virus that continues to evolve.
“It’s important to be honest and explain it as best we can,” she said. “I say, ‘Even though I’m telling you this information, it could change. I know it’s hard to understand. Even for adults, it’s complicated.’”
Silla and co-leader Britney Murray’s session at the Catholic school covered the basics: what COVID-19 is and how it got its name, how it spreads and what can be done to blunt its impact. They used visual aids to demonstrate what a “superspreader” event looks like, reviewed vocabulary words such as “contact tracing,” “herd immunity,” and “self care,” and explained the differences between the three vaccines available in the U.S.
When Silla and Murray opened the floor to questions, kids took turns raising their hands and sharing the problems they had been gaming out in their heads. The questions ranged from the practical (”If you get the vaccine, can you still get the virus?”) to the hypothetical (”What would happen if you can’t tell you’re sick, but you go get the vaccine?”)
Even for such young kids, some of their concerns mirrored those of adults.
“What if you have the virus, and then you touch your friend?” one girl asked.
“What happens if you spread the virus, and you don’t know if you spread it?” another boy questioned.
Murray encouraged the students to apply the information they had learned about social distancing, hand washing and mask wearing, which she and Silla emphasized repeatedly.
“It seems like we’re saying a lot of the same things, but these things are really powerful,” she told the class.
With some of the older kids, the questions sometimes veered into more challenging territory.
During a session with sixth, seventh and eighth graders at St. Jerome Regional, one student asked why people had to wear masks after “20 years of research” showing that they don’t stop the transmission of viruses.
“Viruses are smaller than spit and germs,” the student said. “It’s like throwing sand through a chain-link fence.”
The co-leaders of that session, Chanel Lee and Barath Biyyala, said that research shows masks do reduce virus transmission, especially if everyone in a close-contact situation wears them and they’re fitted properly to people’s faces.
“When you wear face masks, it minimizes viral load,” Lee said. “They actually do protect you and other people from getting the virus.”
Added Biyyala: “We’re confident about the effectiveness of masks.”
For some questions, the volunteers acknowledged that there were no easy answers. One student asked why she never contracted COVID-19, even though her parents did; another wanted to know how much longer they’d have to wear masks.
At Baltimore Design School, students asked if the vaccines contained tracking devices, if they could rewrite a person’s genetic material and if they could cause cerebral palsy.
No, no and no, Galiatsatos responded, cautioning the kids to be skeptical and trust science’s limitations.
“As long as there are human beings, there will be other humans that will want to pump out misinformation and keep others from doing the right thing,” he said. “You always got to be careful what you read.”
But among children of all age groups, no matter what school they attended, where they lived, or how they thought about COVID-19 and the vaccines, there was one question that united them, coming up again and again: They want to know when the pandemic will be over.