Ontario pediatric hospitals release full-time school guide, with older grades wearing masks

Ontario pediatric hospitals release full-time school guide, with older grades wearing masks

TORONTO — Ontario’s pediatric hospitals have updated their recommendations for a safe return to school full-time, offering guidelines on the logistical challenges facing educators this fall.

Among the key recommendations from doctors at Toronto’s SickKids hospital and other health officials from across the province is that high-school and middle-school students wear masks when distance can’t be maintained, however younger children aren’t expected to wear them.

Dr. Jeffrey Pernica, the medical director of infectious diseases at McMaster University in Hamilton, says there’s a “lack of evidence” on whether the routine use of masks in a school setting provides more benefit than harm.

“Being in school is not the same as going to a grocery store or restaurant and that is why the guidance should not necessarily be the same,” he said.

Pernica says masks, when not worn correctly, may increase the chance of transmission rather than decrease it, and there are concerns with proper storage of masks when not in use.

They can also distract children and pose a barrier to communication by taking away non-verbal facial cues in speech, he said.

“Many adults find it challenging to wear masks for a full day so it seems unreasonable to ask children to do the same.”

The doctors noted that their guidelines are based on current epidemiology. If that changes within a given region, the recommendations will also change.

While there have been recent talks of returning to school on a part-time basis, with distanced-learning supplementing the rest of the week, the doctors would prefer to see full-time, in-person schooling.

That would be best for children, from educational, mental health and social development standpoints, says Dr. Sloane Freeman of Unity Healthy Toronto.

Freeman says parents are already reporting a decline in the mental health of their children since being out of school since March, while behavioural problems have increased.

Freeman also pointed out how some children rely on school as a safe place.

“When children are not in school, there are fewer opportunities to monitor and identify children at risk of abuse and neglect,” she said. “Another significant concern when we think about distance learning or educational disparities (is) children with socio-demographic risk factors face barriers to online learning.”

Dr. Michelle Science of SickKids says ”a bundle of measures” will eliminate risk of COVID-19 transmission within schools rather than one specific precaution.

Things like daily screening for symptoms, physical distancing when possible and cohorting younger children —keeping them with the same group throughout the day to eliminate mixing between classes and years — should also be in the return plan, she added.

Dr. Chuck Hui of the Children’s Hospital of Eastern Ontario in Ottawa, says a distance of one metre instead of two might be enough among elementary-school students, though two metres is still ideal among older kids.

“It’s difficult to enforce distancing during important developmental play in younger children.”

Screening, whether done by a parent at home or someone on school grounds, would help make sure sick kids aren’t coming to class in the first place, Science said. Hand hygiene and environmental cleaning are other important safety measures.

The doctors say evidence is mounting that young children don’t play a “significant role” in spreading COVID-19, compared to teenagers and other adults. They also say young children may be less susceptible to getting the infection in the first place.

Dr. Ronald Cohn, the president and CEO of SickKids, says multiple reports around the world suggest children account for 5 to 10 per cent of COVID infections. The 0-19 age range is represented in 7.5 per cent of infections in Canada.

Teenagers, however, seem to spread the disease at a similar rate to adults, Cohn added, which is why the doctors included mask-wearing recommendations for high-school students and teachers when distance can’t be followed.

While young children are likely to experience mild or no symptoms, a multi-system inflammatory syndrome could be related to the novel coronavirus, Cohn said. But he notes that condition is “extremely rare” and treatable.

“It is, however, important to emphasize that we are still lacking conclusive data, especially as it relates to the transmission of COVID in children,” Cohn said. ”And we need to carefully watch and evaluate emerging evidence.”

Cohn says they’ve had “open and constructive dialogue” about reopening schools with the Ontario government, which is expected to unveil its plan for a return to school in the coming days.

Wednesday’s document came six weeks after SickKids unveiled its initial recommendations, and five weeks before the school year is set to begin.

Ontario Premier Doug Ford said Wednesday getting children back to school safely will be a “tough challenge.”

“Everyone’s nervous when you’re dealing with kids,” he said. “There’s going to be two million kids going back to class, and (about) 140,000 teachers — that’s concerning.”

Dr. Ari Bitnum of SickKids says there’s “no question” schools are going to need more resources — like employing screeners and more teachers — for the recommendations to work.

Science said employers should put in place supports for parents to stay home when they have a sick child. That would extend to school staff as well, she added.

Cohn said a full-time, in-person return to Ontario schools in September can only happen if the prevalence and transmission of COVID-19 in the community remains low.

Placing an exact number of what the rate of transmission should be before reopening, or before having to close down again, is hard to do, however.

“We should focus on … putting out fires as they come up, rather than shutting down everything based on a specific number,” said Bitnum. ”You could have a scenario, for example, where there’s 300 cases in a particular small region and the attention needs to be focused on that region rather than the province as a whole.

“I think the strategy of robust testing and mitigation when local outbreaks occur is a strategy we should aim for.”

This report by The Canadian Press was first published July 29, 2020

Melissa Couto Zuber, The Canadian Press

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

county
After unsuccessful attempts to contact owner, Throne property going to tax sale

Bidding will be closed as of the first council meeting in February of 2021

Alberta has 3,651 active cases of COVID-19. (File photo)
432 new COVID cases sets another record Friday

Central zone holds steady at 126 active cases

Damien Kurek
COLUMN: Local MP Damien Kurek on ensuring that there is a plan for recovery

‘Canadians deserve answers, and the Official Opposition has been there trying to get them.’

Heart
Online sessions help participants improve heart health

Heart Wise offers effective strategies to manage cholesterol and blood pressure

"We are looking seriously at the spread and determining what our next steps should be," says Alberta’s chief medical officer of health, Dr. Deena Hinshaw, as the daily number of COVID-19 cases continues to climb.
427 new COVID cases is highest in Alberta ever

Central zone has 126 active cases of COVID-19

B.C. Liberal leader Andrew Wilkinson, B.C. NDP leader John Horgan and B.C. Greens leader Sonia Furstenau. (Black Press Media)
VIDEO: One day until B.C. voters go to the polls in snap election defined by pandemic

NDP Leader John Horgan’s decision to call an election comes more than a year ahead of schedule and during a pandemic

This photo provided by Air Force Reserve shows a sky view of Hurricane Epsilon taken by Air Force Reserve hurricane hunter team over the Atlantic Ocean taken Wednesday, Oct. 21, 2020.   Epsilon’s maximum sustained winds have dropped slightly as it prepares to sideswipe Bermuda on a path over the Atlantic Ocean.  The National Hurricane Center says it should come close enough Thursday, Oct. 22, evening to merit a tropical storm warning for the island.  (Air Force Reserve via AP)
Hurricane Epsilon expected to remain offshore but will push waves at Atlantic Canada

Epsilon is not expected to have any real impact on land

A voter places her absentee ballot in the ballot box, Wednesday, Oct. 7, 2020, at Merrill Auditorium in Portland, Maine. THE CANADIAN PRESS/AP/Robert F. Bukaty
American voters living in Canada increasingly being counted in presidential race

The largest number of Canadian-based American voters cast their ballots in New York and California

A composite image of three photographs shows BC NDP Leader John Horgan, left, in Coquitlam, B.C., on Sept. 25, 2020; BC Green Party Leader Sonia Furstenau, centre, in Victoria on Sept. 24, 2020; and BC Liberal Party Leader Andrew Wilkinson Pitt Meadows, B.C., on Sept. 24, 2020. THE CANADIAN PRESS/Darryl Dyck, Chad Hipolito
British Columbia votes in snap election called during COVID-19 pandemic

NDP Leader John Horgan called the snap election one year before the fixed voting date

Nunavut's provincial flag flies on a flag pole in Ottawa, on Tuesday June 30, 2020. The annual report from Nunavut's representative for children and youth says "complacency and a lack of accountability" in the territory's public service means basic information about young people needing services isn’t tracked. THE CANADIAN PRESS/Adrian Wyld
Nunavut’s young people ‘should be expecting more’ from government services: advocate

‘The majority of information we requested is not tracked or was not provided by departments’

Ryen Williams, 11, with a lost miniature horse at JJ Collett Oct. 23. Photo by Don Williams
UPDATE: Owners found

Father and son found him while out for a walk at JJ Collett

A Le Chateau retail store is shown in Montreal on Wednesday July 13, 2016. Le Chateau Inc. says it is seeking court protection from creditors under the Companies’ Creditors Arrangement Act to allow it to liquidate its assets and wind down its operations.THE CANADIAN PRESS/Ryan Remiorz
Clothing retailer Le Chateau plans to close its doors, files for CCAA protection

Le Chateau said it intends to remain fully operational as it liquidates its 123 stores

U.S. border officers at the Peace Arch crossing arrested two men on California warrants this week. (File photo)
Ottawa predicts system delays, backlogs unless court extends life of refugee pact

Canada and the United States recognize each other as safe places to seek protection

Conservative member of Parliament Michelle Rempel Garner, left to right, Conservative Leader Erin O’Toole and Conservative Deputy Leader Candice Bergen arrive to hold a press conference in Ottawa on Thursday, Oct. 22, 2020. THE CANADIAN PRESS/Sean Kilpatrick
No-confidence showdown over sweeping Tory motion on government handling of pandemic

The Conservative motion is to be put to a vote Monday and has the support of both the Bloc Québécois and NDP

Most Read