Sick Kids weighs in on when students should return to school.

News 100 blueBy Pepper Parr

July 29th, 2020

BURLINGTON, ON

 

Every household in the city that has children attending a school are faced with the questions:

When schools re-open will our children be in the classroom?

It is a very personal family decision – that is compounded by the realities of the modern family where Mom and Dad both work.

Once the parents are back at their desks – the kids have to be in school.

While the Premier of the province is doing his best to keep the public fully informed he is also being very cautious and quite loud when he learns of some of the really stupid social behaviour.

He wants students back in schools but he also wants to be certain that he gets it right the first time.

The public is wary of a government that wants things opened up for the sake of the economy – the parents want to be assured that there children will be safe.

The Hospital for Sick Children released a report today that represents the views of the medical community.

Sick kids picture

With a world class reputation – parents can take some comfort in their views on when students can return to school and what the conditions should be.

SickKids has released new proposed guidelines for reopening schools in Ontario come September, including recommendations like staggered lunch times, no large assemblies, and mandatory masks for older students.

It suggests various health and safety protocols for schools that take a student’s age and developmental considerations into account.

The group says it is recommending the use of masks for high school students, with consideration for middle school students, whenever physical distancing can’t be maintained. Around 61 per cent of the authors agreed masks shouldn’t be required for elementary school kids.

“[Mask wearing] probably will diminish the infectivity of some individuals with COVID, however there are also a number of potential harms,” said Dr. Jeffrey Pernica of McMaster Children’s Hospital, saying that masks could distract and interfere with learning, especially for those with articulation problems, neurological issues, or kids who are learning a second language.

He also said that masks would have to be worn correctly in order to be effective, adding that it could be “impractical” for teachers to enforce.

The doctors aren’t recommending that elementary school children wear masks, saying that they could be a distraction and interfere with learning.

Most of the doctors also agreed that if community transmission is low, masking should not be mandatory for students returning to class.

Group of students MMR

This is the number of students who will fill a classroom under COVIID19 conditions. Will they wear masks?

“The lower the level of COVID in the community … the less benefit there is with masking — but the harms remain the same,” Pernica said. “This is why our recommendations are what they are right now.”  Pernica also added that if the levels change, so will the recommendations.

Dr. Sean Ari Bitnun, a physician at SickKids, further emphasized that one single measure wasn’t going to mitigate things — success relies on the package.

“If we’re not focusing on any of the other recommendations, we are bound for disaster,” he said. “It really is the bundle effect that is going to create a safe environment for teachers and students.”

When it comes to physical distancing, the document says its role “should be discussed with students of all ages,” but added it would not be practical to enforce for kids in elementary school, especially during play times.

Instead, the report says “cohorting” — where kids would avoid mixing with other classes and grades — could be used as a strategy.

“Two metres is optimal, but the transmission at one metre is not significantly different,” said Dr. Charles Hui of CHEO.
Other recommendations include:

Implementing strict screening for students and employees who are symptomatic or have been exposed to the virus.
Teaching kids how to clean their hands properly with developmentally and age-appropriate material.
Arranging classroom furniture to leave space between students.

Students playing instruments

The wind instruments won’t get taken out of their cases this school year.

Having smaller class sizes.  Cancelling choir practices, performances, and band because of the high risk of transmission from wind instruments.

Continuing sports and physical education classes, but cleaning sports equipment and delaying team and close contact sports.
Implementing a regular cleaning schedule.

The doctors said that it would be up to each school to figure out how to implement changes when it came to aspects like running school libraries or preventing masses of students from rushing out into the hallways at the end of the school day.

Dr. Bitnun also called for local public health units to closely collaborate with schools, saying that “there will undoubtedly be positive cases with the children and for teachers.”

‘Putting out fires as they come up’

The document stresses that opening schools safely — and keeping them open — will be directly impacted by how the virus is spreading in the community.

The recommendations reflect a mark of less than 200 new confirmed cases a day, and experts say that “may evolve” as the epidemiology of COVID-19 changes and new evidence emerges.

The doctors said they haven’t identified a specific level of community spread that, if breached, would means schools would have to close.

“A specific number in isolation doesn’t really have value,” said Dr. Bitnun. “My view, and I think this is shared by the others, is maybe the most important thing is to have a robust system of testing and contact tracing … in other words, we should focus on, to paraphrase, putting out fires as they come up rather than shutting down everything based on a specific number.”
Staying home could impact already vulnerable students

The experts quoted in the document continue to push for full-time instruction, saying that remote learning would be “insufficient to meet the needs” of youth.

“Thinking about developmental impact and mental health impact has to be in the same equation as the potential harm of COVID,” said Dr. Sloan Freeman, lead pediatrician at St. Michael’s Hospital.

There are risks to Ontario schools reopening full-time but ways to mitigate them, experts say

Going back to part time, they said, would affect working parents and caregivers, and mean bringing more people into the loop, like babysitters or grandparents.

Not going back, doctors say, could impact already vulnerable students the most.

boy behavior

Difficult children will find it hardest to cope with the changes.

“Medically complex children or children with severe underlying medical or behavioural illness, I think those families are disproportionately affected by what is going on in terms of isolation and trying to manage at home,” said Dr. Jeremy Friedman, a pediatrician at SickKids. “I think that those families, more than any others probably, will not be able to withstand the sort of time period we’re talking about for [when] this pandemic has moved into a more stable phase.”

“The sad irony is that I think that the children who are perhaps the most fragile and most at risk, those children, those families are the ones that probably need to have the normality and the routine,” he said.

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