Op-ed: How Doug Ford can send children back to school safely in September

Toronto's COVID transmission rates are approaching the necessary lows – if we keep it up, the science suggests we can return children to school full-time under very safe conditions

I’ve been working as a physician in COVID assessment centres and mobile testing units for the last five months. I’ve learned that we are going to need to live with COVID. I’ve learned that we can. 

A fundamental part of living with COVID is restoring stability and structure for play, learning, and social development for our children. With just six weeks to go before Ontario schools re-open, the question on every parent’s – and teacher’s – mind is, ‘Can we go back to school? Is it safe?’”

These questions can feel overwhelming. But they need not be. The bottom line is that children, teachers and their families will be safest in schools if the transmission in our communities is kept low or absent. 

What we need is clear leadership. And so far, it hasn’t been coming from the Ford government or Minister of Education Stephen Lecce.

They have proposed that individual schools create contingency plans for three scenarios: full return, a hybrid model of in-class and online learning and full e-learning. No school has the bandwidth to create three separate plans. Nor is it necessary. 

The difference between Toronto and say, New York City or Phoenix, Arizona is one of public policy, health care infrastructure and human behaviour.

Continued testing, contact tracing and public vigilance will drive our numbers down towards zero. 

The provincial government can decide to send children back to school fulltime in September and can ensure that policy, resources and public behaviours will make that safe – and even fun. 

If schools are permitted to work on one plan between now and September they will be able to do it confidently and safely.

In the city of Toronto, our community transmission rates are approaching the necessary lows.

This past weekend daily cases dropped below 20 per day. The estimated reproductive rate for the virus (“R”) has fallen to 0.56 with a possible upper limit of 1.03. This means that two people must be infected to transmit the virus to one new person. The estimate of “R” is very reliable when testing is vigorous and accurately samples the whole population.

Ontario is still testing approximately 20,000 people per day. Sampling methods could still be improved, but Toronto Public Health reports that the majority of test results are returned within 48 hours and contacts are notified within 24 hours of results. The speed and vigour of this process make a difference. It is driving the case numbers down.

If we keep it up, the science suggests we can return children to school under very safe conditions. 

A study from Geneva published in the peer-reviewed journal Pediatrics in late May surveyed all patients with COVID 19 in the city between March 10 and April 10. Of  4,310 cases, only 40 were among people less than 16 years of age.

The investigators studied the household contacts of each of these children and could not find evidence of child-to-child or child-to-adult transmission. This detailed study suggests that, even in the same household, children typically do not transmit the infection to each other. 

In Denmark and Norway, children returned to school in the context of low community transmission rates – and no increase in infection rates in either schools or the larger community was seen.  

In both these countries, schools were resourced to allow children to return with smaller class sizes and aggressive hand washing protocols. These parameters are similar to the Toronto District School Board “Option A” allowing for full return five days per week with smaller class sizes. 

Collaboration with local health care partners and institutions could add immeasurably to safety. But local leadership will be key. School leaders must be given latitude to adapt to local school needs and schools must also be adequately resourced.

For example, a safe return to school will be harder in Toronto’s poorer communities where both classrooms and housing are in short supply. The risks of transmission are higher for poor communities and communities of colour in our city where households share rooms and bathrooms. Resource allocation to schools needs to address this pro-actively and preventatively. 

Toronto’s political and health care leaders are creating the conditions needed for safety in September.  

We’ve had great leadership in the City at the public health level over the last few months. Staying the course, these rates will drop even lower in the coming weeks.

Yet, with the explosion of disease across our border and traumas suffered in long-term care homes fresh in our minds, there is deep anxiety among parents regarding return to school.

We need to be determined about our public health and hygiene practices. We need to continue to test aggressively into the fall. We need education and health care sectors to partner and collaborate. And we need to support the most vulnerable. 

We can do this. 

Suvendrini Lena is a neurologist and Assistant Professor of Neurology and Psychiatry at the University of Toronto. She holds a Masters in Public Health.


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2 responses to “Op-ed: How Doug Ford can send children back to school safely in September”

  1. responding to return to school safely:
    the key “if” factor is the government’s proposal to fund ppe costed to $0.07 /student/day
    that’s it
    7 cents
    every person who approves this or votes for this MIST have their children first in line first day back
    …or adjust the plan, or the funding
    long term care facilities and now schools ….

  2. Schools WILL be a cesspool of Covid 19 by November and here’s why: You haven’t taken the human factor into account. Children will not follow the protocols consistently enough for them to be effective. On the contrary, children’s and teen’s natural proclivities will make all the safety measure ineffective. Why? Because children will unconsciously and even consciously not abide by the protocols. They will forget to wash their hands, they’ll touch their face and mask to readjust it, or they’ll pull out their nose or even remove the mask altogether because of the heat and moisture inside the mask. Even if only for a brief few seconds, this could expose them to an infectious dose of Covid 19. I’ve seen adults pull this nose move! 3 employees of the pharmacy at Shoppers Drug Mart with their noses sticking out of their masks! Just yesterday I was in Home Depot wearing my mask – where masks are mandatory – and I saw 3 employees not wearing theirs! One female employee talking to another with her mask around her throat, a male sitting at a workstation with his mask in the same position, and to top it off a male employee in the rental department with his mask on his forehead as he served customers! What makes you think children won’t do the same? Of course they will!
    Additionally children and teens will want to interact with each other and remembering to do that consistently will be close to impossible, especially for smaller children. They’ll be running, jumping, jostling, rough housing, laughing too close, whispering too close, sharing their snacks – eating and drinking, and more. How do you eat or drink with a mask on without exposing yourself? It seems impossible. Do you really think that kids who haven’t seen each other for months won’t instinctively hug each other, or at least make some sort of incidental contact? Dream on. Or kids car pooling to high school together or hanging out in the parking lot at lunch or on their spares, or jumping into a car for a Starbucks or McDonalds
    run? Let’s not forget the vaping groups outside the school! Now there’s a sweet way to contract Covid 19!
    Plus classrooms are notorious for poor ventilation. In my school there is an entire area of 14 classes that at one time were one gigantic shared space called the Open Area, a “brilliant’ idea of the 1960s. After a while of the impact of the unbearable noise level of nearly 500 students in one gigantic room, the decision was made to split them into separate rooms, which was done by putting up partition walls between the support columns. However, a proper layout wasn’t designed. Adequate hallways were not created. There are many rooms that are only accessible by walking through other rooms! And the worst part of all is that the HVAC was not redone when the walls were put up! The ventilation and air quality is awful because many of the rooms are missing supply or return air vents and some are missing both! There are no doors between many of the classes, only curtains! The windows are screwed shut! Some rooms have no windows at all! How do you spell Covid Superspreader Environment? I spell it In School Learning Before Vaccinations and my classroom is a prime candidate for some or many, including me, to get sick or die!
    And even if all these protocols are followed, the atmosphere of the school will be one where everyone is constantly on edge.There will be no interactions that aren’t overshadowed by distancing, mask wearing, sanitization, inadequate ventilation, and prolonged exposure, and the potential consequences of not doing so, or even the consequences if they are followed because there are no guarantees. Classrooms will not be areas of creativity and learning but of tension and fear, and understandably so. This isn’t chicken pox, this is a fatal disease that anyone could contract by walking into a school and spending time there. If I said to you “Hey, if you go into that building over a period of time, or if you’re unlucky even once, you could contract a fatal disease and be dead in weeks, or spend your life suffering the consequences of it, or giving it to someone you love,” would you do it? I sure as Hell wouldn’t! No one in their right mind would, but that’s what Ford and Lecce are expecting millions of Ontarians to do come September.
    Add to all this that Premiere Ford has said that teacher won’t need PPE – nor will PPE be provided – because they’ll be more than 6 feet from the students AND that masks will be optional for students is unbelievable! That no further funding will be allotted for further cleaning practices and custodial staff, cleaning supplies, partitions, PPE for students and staff, mandatory mask use, let alone HVAC retrofitting? How can this not be a disaster?
    And what will happen when someone does contract Covid 19? Will the entire class be quarantined? The entire school? It’s a nightmare waiting to happen.
    By November or December at the lastest, the disaster of open schools will be obvious, just as it has become so in almost every other nation that has tried it to date. Any solution other than remote learning is foolhardy at best and heinously egregious at worst. By then it won’t matter that people are inconvenienced or that the economy needs boosting because of the countless illness and subsequent deaths of students, teachers, support staff, and all the family members who contract Covid 19 from students, teachers and support staff who contacted it themselves in Ford’s and Lecce’s fatal experiment! It’s tantamount to conscious genocide! If even one person dies or is maimed for life by Covid 19 because of Ford and Lecce’s decision, they both should be thrown in prison for negligent homicide and sued to the fullest extent of the law by the grieving families who lost loved ones due to this altogether avoidable tragedy. I just hope my family isn’t one of them and hope the same for all families in Ontario.
    REMOTE LEARNING IS THE ONLY SOLUTION UNTIL AN EFFECTIVE VACCINE IS DEVELOPED! Students and families will ultimately recover from the inconveniences of remote learning, but if their child or parent or family member dies due to in school learning the cost is devastating and unrecoverable. I’m also a parent and I’ll have to deal with the problems of remote learning too. It’s not the province’s responsibility to provide solutions, nor is it my responsibility to put my life on the line because someone is unhappy about the consequences of the Covid 19 pandemic. I didn’t sign up 30 years ago for a job that had life or death ramifications! Exposing people to Covid 19 in a knowingly dangerous environment is no different than saying “There may be an active shooter situation at some point this school year. You or someone you know and love could die, we don’t know when, who, or how often it will happen, but it is still likely to happen at some point. All you have to do to avoid it is stay at home.” Why would anyone decide otherwise?

    C Powell, Burlington, ON.

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