Contagious Conversations / Episode 22: Helping Our Kids Through COVID
Transcript
Claire Stinson: Hello, and welcome to Contagious Conversations. I'm your host, Claire Stinson. Every episode we'll hear from inspiring leaders and innovators who make the world healthier and safer for us all. Contagious Conversations is brought to you by the CDC Foundation, an independent nonprofit that builds partnerships to help the Centers for Disease Control and Prevention save and improve more lives.
Joining me today is Anna King, National PTA president and Elizabeth Rorick, National PTA deputy executive director of government affairs, strategic communications and training. Anna King has over 20 years of leadership experience at all levels of PTA, is a dedicated and passionate child advocate, a mother of three and proud Nana of eleven. She believes everything is possible for all children, and being an inclusive association is key to better serve students, families and communities across the country. Elizabeth Rorick has been with the National PTA for more than 12 years, representing PTA before Congress on a vast array of children's education K-12 issues, including special education, early childhood and children's behavioral health.
In this episode, we will discuss the impact of COVID-19 on schools and education and how mental health has been affected for parents and children. Welcome, Anna and Beth.
Anna King: Hi, how are you?
Elizabeth Rorick: Hi.
Claire Stinson: Thank you both so much for being here today. We're really looking forward to this discussion. So Anna, I'll start with you. The National PTA is described as the nation's oldest and largest volunteer child advocacy association. You have over 20 years of leadership experience at all levels of PTA, and your term as the 57th President of the National PTA started this year. Tell me about the role of the National PTA.
Anna King: It is an amazing role. I have the distinct honor of leading this amazing association that's full of dedicated and passionate volunteers from across the country. We get to work hand in hand with our amazing staff, our wonderful staff. We get to create policy and make change that inspires our families to be engaged in our communities and to make sure that our children have everything that they need to be successful.
Claire Stinson: A really important mission. So can you tell me, how has COVID-19 affected your role as National PTA President?
Anna King: We continue to do the work of the association through our advocacy piece in our family engagement. We just do it virtually now. The tough part about doing it though, is having the ability to connect with leaders and members personally. We miss being in our school buildings and connecting with our families and working with our staff in person, but it doesn't stop the work, the work is forever going. We have just been able to find different ways to connect. And with our leaders being frustrated and emotionally exhausted, I'm actually in a unique position of attempting to motivate through all of the frustration and getting our leaders refocused on our mission, which is to make every child's potential a reality by engaging in empowering families and communities to advocate for our kids. And that's important. And so the work keeps going, it has just changed that we're not in the school buildings and we're not making these personal connections in person, but we're finding different ways to do it virtually.
Claire Stinson: That's important to remember. The work certainly does go on. Beth, let's turn to you. What is your role at the National PTA?
Elizabeth Rorick: My role is Deputy Executive Director of Government Affairs, Communications and Training. So that's three separate departments. The first is government affairs. So I oversee our lobbying team and all of our folks that work on our advocacy efforts on Capitol Hill. I also oversee the team that is responsible for our brand management. National PTA is over 125 years old. So it's an important brand to protect. Overseeing the media component as well as editorial Our Children Magazine. And I also oversee our training department, which is all of our trainings and leadership development and tools that are offered to our membership.
Claire Stinson: A really important role. So, let's talk about COVID-19. The pandemic has certainly put a spotlight on adult and children's mental health, but it can be difficult to know how to prioritize mental health and reduce the stigmas surrounding it. Talk to me about the importance of mental health during this pandemic for parents and children.
Elizabeth Rorick: Well, I think that what I've seen in our work at the National PTA is there is an ongoing conversation about mental health and its importance in everyone's overall wellbeing. We need to focus as parents and as advocates, not only on a child's physical health, but also checking in on their mental health. And what we do know is that this pandemic has put a significant strain on many of us, on many of us as adults, especially on our children. And it's important to support the mental health of these kids before and after these challenges arise in their life. And it means that mental health should be an everyday priority, and a constant checking in, and woven into our everyday family routines. So my hope is at the end of the podcast, the families that are listening, parents, children, advocates alike, have an even better understanding that in order for our kids to thrive, both in the classroom and in life, they must be healthy, not just physically, but mentally and emotionally as well.
Claire Stinson: Really important points right now. Thank you so much for sharing that. Anna, I'm a parent and I worry about my child's health and safety all the time during this pandemic. I know you are a parent as well as a grandmother. How do you think COVID-19 is affecting education during this pandemic?
Anna King: Speaking as a grandparent, I've had the opportunity to see how my children have been with their children doing school virtually. And it has really shined a light on many of the inequities that we have across the country. We know that our families, and our students, and our schools are dealing with the impacts of learning loss, but we also have family members and friends who have lost loved ones from COVID-19. Our goal at National PTA is to be that guiding, thoughtful resource for every child as we navigate this new normal, because that is what it is, it's this new normal. And as Beth said, we have to do this by bringing the tools and resources that we have from PTA to make sure that our families have them, so they can navigate through this new normal. It's hard. It's not easy. Our children right now need us more than ever, and so do our teachers in the school buildings. And we just have to find a way that we can navigate through that collectively together as a team.
Claire Stinson: Absolutely. And you know, what Beth said is important as well, we need to focus on mental health, right? So what advice would you share for parents who are worried about their child's health and safety in schools right now?
Anna King: Don't stop being invested. Our families should be working side by side with staff members, and principals, and school board members inside of the schools. Our families should share the information about their children with their teacher, and have these ongoing dialogue about how they can help with their children being successful. They can check in with their children to see how they're doing. And parents should be concerned about safety plans, and health plans that the schools have.
Parents should be at the table discussing what that looks like and we have to encourage our families to develop strong family-school partnerships. That's what's going to be key right now. It's going to take us both working together side by side to make sure that our kids are mentally ready to be back into school and that they feel supported through the families and the teachers. And as our nation, as we are dealing with the pandemic, that's just one thing that we're actually dealing with. We're having this unsettling increase in school shootings and in school violence, which is another aspect of why parents should be at the table and understanding what's going on in their school. That strong family-school partnership is key right now.
Claire Stinson: So true. And it sounds like this is just such a great opportunity for parents to become more involved.
Anna King: Mm-hmm.
Claire Stinson: So, Beth, I know the National PTA is focusing on healthy minds during this pandemic. Tell me about that.
Elizabeth Rorick: Yes, we were so pleased, October of this year, just earlier this month to recently launch our healthy minds initiative to help our families prioritize mental health. What we're doing is we're actively providing students and families with tools to address grief and loss in the COVID space and how to talk about social-emotional learning, talking about service learning, and other pressing mental health topics. We have a new webpage that houses all of our free Healthy Mind resources. And we're really proud that we have their Healthy Minds toolkit. It is not only in English, but it's also translated in Spanish. And overall, we're looking to integrate all of these various deliverables across different platforms, whether it be social media, web or even podcasts like this. So we encourage the audience to check out these resources at pta.org/healthyminds.
Claire Stinson: That sounds like a really important toolkit. What has been the response so far?
Elizabeth Rorick: Overwhelming response of hearing from families, teachers and parents, and students alike of how helpful it is in navigating what can sometimes be a very scary process. We all, as parents, I think in speaking for them, know what to do when our child should fall down and break their arm. We know exactly how to handle the situation. But parents of all walks of life, of all demographics may need assistance in navigating a space where their child is registering, is having issues, is having mental health issues, are having social-emotional issues. And I think that this toolkit is a great resource for those families that are just getting the news or just registering to them that their kid may need an additional piece of help. So, so far, so good.
Claire Stinson: That's wonderful. It sounds like our listeners should definitely check out that toolkit. So it sounds like we're all parents, we all have a lot going on. How can parents prioritize mental health with everything going on right now?
Elizabeth Rorick: So COVID has taken a toll on not only the kids, but the parents as well. And I know that as a parent, we sometimes forget to focus on ourselves. So, we need to encourage all of our parents and caregivers alike to try basically three key things to help them prioritize their own mental health. So what is a realistic expectation? None of us are perfect parents, right? There's no book on how to be the perfect parent.
We need to be kind to ourselves, give ourselves grace, and set realistic expectations and boundaries, especially in the COVID sphere, is a very wonderful thing. I know for me, it's really helpful to make time for myself as a caregiver and a parent to carve out time, to do things that I enjoy and recharge or decompress. And then, this has been a really long process for knocking on, I think, 19 months that we've been in this COVID atmosphere. So it's important for us to celebrate the successes, despite everything that may be going on around us, to celebrate ourselves, our families, our kids, all of our wins, whether it's big or small that we're celebrating and you'll feel so much better once you do.
Claire Stinson: Absolutely. And it's important to recognize and remember that this has been really hard on everyone. And these are important reminders for parents, so thank you for sharing that. What can we do to reduce the stigma associated with mental health?
Elizabeth Rorick: We've come such a long way around the mental health sphere of receiving a mental health diagnosis, whether it's your own diagnosis or someone in your family, we have come a long way, but there's a significant amount of work that does need to be done around the stigma. I think it's important to talk openly about mental health and to seek treatment if necessary, and to educate ourselves and others around us. And the scary thing about the stigma is buying into it, right? And not listening to it. And we should see that asking for help is really a sign of strength as opposed to it being a sign of weakness. So it's important that we check in on our friends, on our family members, and on our kids and make sure that they are okay, and if they're not okay, to absolutely be proactive in doing something about it.
Claire Stinson: Important reminders. Thanks for sharing that. So Anna, turning to you. From what you've seen yourself and heard from parents, teachers and administrators, can you tell us how COVID-19 is affecting classrooms this academic year?
Anna King: Yes. I was humbled last night to attend our National Teacher of the Year event. And I was in a room full of these amazing, inspiring teachers. And I got to sit by a lovely Teacher of the Year from Alaska. And we had a discussion about how she was doing, how did she feel she was doing in her classroom this year. And she said that she needs more resources. She feels like they're playing catch up. And I've had the same conversation with my daughter. She feels like my grandson has fallen behind, because he learns when he's in person. What we know that has happened over the last 19 months, as Beth has said, is that we know that our schools are under-resourced. We know that they don't have what they need to be successful. We know that there are great disparities, quality to access with educational opportunities.
And what has shown throughout this pandemic over and over again is that we have inequities in our schools and our communities. It's not like they haven't been there. They've been there. We've just had the light shine on them more. National PTA, early this year in 2021, we had the opportunity with Learning Heroes, where we commissioned this national poll exploring parents' perspectives on learning during the COVID-19 pandemic, understanding what their concerns were for their children. Only 52 percent of parents surveyed believed that their child will be prepared for the next grade. 52 percent. 63 percent of parents polled believes that their child is behind where they would be in a normal school year. 61 percent of the parents reported being worried that their child was not making much academic progress as they would in a typical school year. 43 percent of the parents reported less confident than the previous year that they understand how well their child is achieving academically.
And time and time again, when we're able to do polls, you heard Beth give some results from a poll that we did and she talked about it for mental health, and underscores that a strong partnership between families, teachers, and administrators are more important now than they've ever been, because we have to address the impacts of the pandemic. And I heard that over and over last night, speaking with educators from all around the country, about the importance of making sure that our children have what they need to be successful, and then having a conversation with them to say, but you have to work with parents. The only way that we're going to be successful is if we work together in these strong partnerships.
Claire Stinson: Those are stunning statistics. Thank you for sharing that from the poll. It sounds like this partnership between parents, teachers and administrators is just more important now than ever before.
Anna King: It absolutely is. When they're in the school, they're with the teachers. When they're home, they're with us. And so we both have them at a certain amount of time. And as a grandparent, seeing how my children are trying to do the best that they can working with their children, despite everything that they're going through, the one thing that I've seen them step up to the plate with even more, is making sure that they're intentional when they connect with their teacher. They call them, they'll text them to see how their students are doing, how my grandbabies are doing, and even more so, I've seen them build relationships with educators. And educators are building relationships with our families, which is extremely important.
Claire Stinson: True. And it sounds like although this has been really hard for parents, teachers, and administrators, there is opportunity for betterment with that partnership and to strengthen these relationships.
Anna King: Absolutely.
Claire Stinson: Thank you for sharing that. So Beth, National PTA conducted surveys and listening sessions with parents as part of a project with CDC and the CDC Foundation. Based on what you heard, it's fair to say that most parents and children are under a certain amount of stress right now.
Elizabeth Rorick: Yes, that is absolutely what we found. We conducted some surveys and listening and learning sessions as a benchmark earlier this year, in consultation with HCM Consultants and Edge Research. And it is absolutely fair to say that most families are indeed under stress. The survey and listening sessions demonstrated that our parents continue to juggle multiple worries as their children returned to school this fall. We heard from them directly verbalizing that they're trying to manage households, raise their children, and maintain their full-time jobs. We polled public school families with students in grades K-12, and it fell across all demographics in different areas of the country. We also conducted hour-long listening and learning sessions where we had direct conversations with parents across the country. We had seven sessions that were conducted in English and two that were conducted in Spanish. And what we found directly from the listening and learning sessions and speaking to parents is that parents are currently prioritizing the social-emotional learning of their kids above all else.
And there are two groups that are struggling. The first are parents of young children, and the second, are parents of color. And then in addition to the findings of the listening and learning sessions, we also found from the survey that parents recognize that there are real benefits of in-person learning, but they're conflicted about actually sending their kids back to school and they're worried about the health risks that exist inside the school building. This was particularly amplified with parents of color, and they expressed a distrust in districts and schools to implement safety precautions with fidelity. And overall, parents do not trust other parents to keep their kids home when they're sick or to follow precautions. That's a very, very troubling data point that we have spent a lot of time with at National PTA. Some of the other key findings of the survey show that 50 percent or half of the parents want their child to attend school in-person, instead of doing a hybrid or a virtual approach.
But it's important to know that that number decreased after the CDC’s mask guidance was updated on July 27, 2021. And that also is a lower number among Black and Latino parents. Another key data point that we found from the survey, is about one quarter of parents feel very comfortable sending their children back to school this fall. While notably White parents were significantly more comfortable with having their child return to school, and that is more significantly comfortable than Black or Latino parents.
We also found that parents were most concerned about their children contracting COVID-19 at school, but they're also extremely concerned about future disruption in returning to remote learning. So concerned about a circumstance where there may be a COVID outbreak and their kids have to go back to a remote learning setting. In keeping children safe at school overall, parents rank children staying at home when they're sick, cleaning and disinfecting and hand-washing as the highest priorities. A lot of really great data points around parent mindsets about returning to the actual school building. We hope to revisit the survey to see where the parents that we polled earlier, where they stand now and how their attitudes have shifted.
Claire Stinson: Wow. That's really interesting. And it sounds like you had so many different perspectives represented in those surveys, so that's really important information for National PTA and for parents, teachers, and administrators as well.
Elizabeth Rorick: Absolutely. We love going into the, being in the field and learning from our parents, asking them, surveying them, and having real conversations about what they're going through. This is a really unique time for us, COVID is unique to everyone, and I think being able to take away real data from the field and say, this is how our parents are feeling is something that we think provided a lot of value to the conversation.
Claire Stinson: Absolutely. A really important listening session, so thank you for sharing that.
We’ll be right back with Anna King and Elizabeth Rorick.
Since this episode is focused on how mental health has been affected for parents and children during the pandemic, please access the Healthy Minds toolkit at pta.org.
And now, back to our conversation with the National PTA.
So Beth, how can we recognize the signs of a parent or a child who we see struggling emotionally and what can we do to help them?
Elizabeth Rorick: Yeah. And I would just urge all parents to just go with our gut. We know our children as parents and caregivers. It's usually pretty easy to notice when your kid is making a shift away from their usual and authentic self. It's really important to look and see that our kids are not taking additional steps to become even more isolated. So are they isolating from their friends and family? Are they looking for ways to hide? Are they spending more time in their room that is not more than we are all spending alone in our rooms doing our work and trying to manage through the pandemic? But also, are there signs of bullying or cyberbullying on social media? Are they preoccupied in the social media space and do they seem to be worried? We need to look and see if there's changes in their physical activity and eating habits. And then focusing on to see whether or not there's a lack of interest in activities that they usually love, like, for example, my kids, they love and adore soccer.
I would be very concerned if there was a shift away from that. Or if there was a shift away from their interest in practicing in the backyard, or we're pulling away from not wanting to go to practice. Something else that you should look at is, is there evidence of self-harm? Are they doing things to themselves that can harm their health? And then lastly, are there changes in their academic performance? Are their grades slipping? Is there a lack of interest in their homework? That's a key area to look at as well. So we can listen to our kids by listening to them. You need to listen without judgment, obviously, and identify ways to support them, whether it's through free resources or actually getting them help from a medical professional. And that we need to be empowered on our own to take action and advocate for our own kids.
Claire Stinson: This is a really valuable discussion for parents. I'm so glad you all joined today to share your perspectives. These are important signs to look for. And it sounds like parents can also check out that Healthy Minds toolkit you mentioned earlier as well, right?
Elizabeth Rorick: Absolutely. It breaks it down into steps and meets parents where they are. And we think it's a valuable tool.
Claire Stinson: That's great, an important resource. So Anna, turning back to you, I'm sure there have been countless lessons learned for the NPTA and schools during this pandemic. What lessons have you learned and how has the role of the NPTA evolved during the pandemic?
Anna King: Well, during this pandemic, one thing for certain is that we have all been reminded of how resilient we are as families and especially our students and our educators in our school communities, because they came into something that was never even thought of. There's no plan that you can create for these things. During this pandemic, we've seen some amazing things that our volunteer leaders in our PTAs across the country have done to help our community stay connected. We have had our PTAs help expand the access to food banks by creating locations for families to pickup food when they didn't have any. They were able to manage meal and food deliveries that directly delivered to our family's homes. They partnered with existing local community organizations to help reach more people with a collective impact. They went above and beyond. We learned that through this resilience, our PTAs were thinking outside of the box, not just with food insecurities, but with also helping our families bridge the digital divide in our communities.
We have families, parents driving in Starbucks, being parked in Starbucks parking lots, McDonald's parking lots to use the internet. And when our leaders saw that across the country, they stepped up. They were able to put hotspot buses in key locations that help expand Wi-Fi access to many of our families in their communities. Some even provided individual hotspots for families to use in their home, with headphones and keyboards. So they were able to complete their schoolwork. We had PTAs that provided resources for social and emotional wellbeing for our students and families in our communities. By thinking outside the box, once again, and crafting outdoor spaces for our children and our staff, they were able to provide materials to help guide our counselors on how to navigate the mental health needs of our students. But most importantly, at National PTA, we were able to provide all of those resources through grant opportunities.
And it's important to know that everything that we've been through, there's something that we should learn. Even if we're walking across the street, we should learn how to walk across the street properly. But what has been amazing is watching how our volunteers have stepped up. And thought about not just having PTA in the school, but having it outside of our communities, and giving the resources to our families, to help them help our children. And that's key. That is so important right now during this school year.
We need more of our families to be engaged with one another to the best of their abilities. And we have had some amazing leaders from across the country just do that. They thought outside the box and they made it their own by being engaged with our families, and our staff, and our teachers and providing them with everything that they felt that they needed to be successful. Advocating on a national level, we're still going to advocate on the federal, state and local levels for all of the resources that we need to make sure that our schools are safe, that they have infrastructure. We want to make sure that our social and emotional needs of students and educators for our staff is there. And you heard Beth talk about the great things from the resources that we've learned from these polls, is helping us to take that data to create resources where they're needed and provide our leaders with those resources to help our families.
Claire Stinson: Thank you for sharing that. It sounds like NPTA really does have their ear to the ground, and you guys are really listening to parents, teachers and administrators, and you're really seeing the opportunity there. And it's wonderful to hear.
Anna King: Oh, I agree. We're working together.
Claire Stinson: Absolutely. So Anna, how has the role of educators changed during COVID-19?
Anna King: They've had to think outside the box. Nobody understood what this pandemic was and how it would affect them in their everyday teaching in the classroom. And once again, being able to sit across the table and sit beside teachers to talk about how hard it was. It’s changed, our educators across our country had to shift gears, right? They had to learn how to teach virtually. Some of them had to learn with professional development of how to do things differently. It's critical that our parents and our teachers engage. I'm going to say this again, in a one-way communication to keep in touch with one another, because the most important thing that our parents and teachers can do is they connected. Our educators have had a hard time and our families. And I'm just going to say for myself as a grandparent. Seeing a teacher on a screen where her classroom has 17 students, and this was a classroom of nine-year-olds, having them stay focused for eight hours, four hours here, two hours there, and two hours here, to help them stay focused on trying to learn through a screen was extremely hard.
And my heart was just full of passion for this teacher, my grandson's classroom, because he's very active. And so for him to stay in a seat, and for her to grab his attention during COVID-19 was extremely hard. And now that the kids are back in the classroom, they're having to learn again over not being in the classroom for a year to how to sit in the classroom, how to maintain themselves. So educators are not only having to revamp their teaching styles, but they're also having to, as Beth said, they're having to take time for themselves. And I heard that over and over last night, how our teachers are trying to find time for themselves just to have a grace period of understanding that this is going to be hard. But they're so passionate and dedicated to this profession. It’s so fulfilling. And I heard that again, over and over last night of how everything has changed, but it has changed, I heard a teacher last night say, "Even though it's hard, it's changed for the better."
And I asked her why she said that. She said, "Because now the world has seen the inequities that we have already known that existed. And we see people stepping up and helping us more." And I just thought that that was a moment in time where I'm like, wow, she's right. She's absolutely right on how this has affected them in the classrooms and how hard it is, but how they take the little simple moments to make sure that they are successful in their classroom, because they want our kids to be successful.
Claire Stinson: Wow. That's powerful. Thank you for sharing that. And arguably teachers have had one of the hardest jobs of anyone through this pandemic. So I'm sure their role has shifted so much through this pandemic, but it sounds like the passion and the drive of these educators is really showing through. So Beth, turning to you, do you see an opportunity for a larger focus and spotlight on mental health for teachers, parents and students in the future?
Elizabeth Rorick: Yeah, of course I do. COVID was forced on all of us and we need to look at it as an opportunity. National PTA has been in the mental health and social-emotional learning space well before COVID came along, but we do see this as an opportunity to stay committed, to finding new and engaging ways for parents and students, and our PTA leaders and families to give them the resources that they need, not only to survive COVID, but any other mental health crisis that may come our way. So we're deeply committed. We were before, and we remain committed afterwards.
Claire Stinson: Thank you for sharing that. So, a question for you both as we end today, any other general advice you all would share with parents who are listening to this podcast right now? Anna, I'll start with you.
Anna King: Well, National PTA has a podcast called “Notes from the Backpack,” and it was designed to help our parents have inside scoop so they can help their children while they're in school to build these relationships and to ask these hard questions to best support their children's education and development. And it's also, if we can say anything, I'm going to say, stay connected to your schools and to your teachers. Build that relationship. Get to know what they need in the classroom, and let them know what you need in your home to make sure that your children are successful. It’s key right now that we do this together as a team and not apart. We can't be in our silos anymore. Teachers here and parents here. We have to find that common good and meet in the middle to make sure that all of our children reach their fullest potential.
Claire Stinson: Really important advice for all parents that are listening to this podcast right now. And Beth, what advice would you share?
Elizabeth Rorick: We've remained committed. National PTA, we're over 125 years old here, and we want to safeguard the education experience for parents and kids. We want our kids to be healthy and safe, and we want to make sure that our students, families and schools alike have what they need during this important time. We urge everyone that's listening today to go online and see our resources. They're free. Our educational programming is at pta.org. We're also active on Facebook, Instagram and Twitter. And we just thank you so much for allowing us to have the chance today to share the findings of the work that we've done in the field that tell us so much about parent mindsets in the COVID space. And we look forward to partnering with you in the future. So thank you for your time today.
Claire Stinson: Thank you both so much for joining us today. Your dedication has certainly shone through in this interview. We really appreciate your efforts.
Anna King: Thank you for having us. And I'm going to ask people to go to pta.org/podcasts to listen to those amazing “Notes from the Backpack.” Great information to help you navigate through this upcoming school year. Thank you for having us, this has been so much fun and I get to do it with Beth. She's amazing.
Elizabeth Rorick: I like you very much as well, Anna.
Claire Stinson: Thanks for listening to Contagious Conversations produced by the CDC Foundation and available wherever you get your podcasts. Be sure to visit cdcfoundation.org/conversations for show notes and bonus content. And if you like what you just heard, please pass it along to your colleagues and friends, rate the show, leave a review, and tell others. It helps us get the word out. Thanks again for tuning in and join us next time for another episode of Contagious Conversations.
Contagious Conversations is developed by the CDC Foundation.
The NPTA Healthy Minds toolkit is supported by the CDC Foundation by way of the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) and as part of a financial assistance award totaling $447,531 with 21% funded by CDC/HHS and 79%, funded by non-government source(s). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.