Elementary school COVID-19 outbreaks have reached an all time high. Why ‘we must do everything we can’ to protect in-person learning

The COVID-19 outbreaks in elementary schools in Ontario are at the peak of the pandemic, surpassing the peak of wave three when soaring cases forced schools across the province to switch to apprenticeship in line after the April spring break.

The province reported 219 active COVID outbreaks in elementary schools on Tuesday, according to a number of experts, signaling the need for better protections to keep students in school and prevent further learning losses and disruption for them. families.

And with some public health units already identifying the potentially more transmissible new variant of Omicron linked to schools, experts point out that additional public health tools, including take-home COVID tests for students, are critical at this point in time. the pandemic, especially with elementary school students only recently eligible for vaccines.

“In order to protect in-person learning, we have to do everything we can,” said Amy Greer, epidemiologist at the University of Guelph. “We have tools at our disposal to make indoor environments, like schools, safer and we are not actively using them in a way that helps mitigate risk.”

On Monday, Toronto Public Health announced that it was investigating a case of the Omicron variant at Precious Blood Catholic School in Scarborough. And in southwestern Ontario, a number of schools are linked to a large cluster of COVID cases that likely involve Omicron and are under investigation by the Middlesex-London Public Health Unit.

The Ontario Scientific Advisory Table on COVID-19 is expected to release a scientific brief on rapid testing, including in schools, on Wednesday.

Earlier this fall, the province has promised State-funded schools will have access to take-home COVID test kits, expanding existing programs in Toronto and Ottawa. The self-collection kits aim to encourage more students and staff to get swabbed, thereby improving testing uptake and allowing for faster contact tracing after a positive test, reducing the risk of outbreaks in schools. schools.

In the same October announcement, a “test-to-stay” approach was launched for students using rapid antigen testing to help prevent layoffs across the school.

Experts say the two programs are being rolled out too slowly and unevenly across the province, with local public health units tasked with implementing the testing program to stay on. And Greer, a Canada Research Chair in Population Disease Modeling, suggests the province go further by regularly introducing rapid tests for students given current high infection rates in children of age. school.

“We should roll out rapid tests for students attending school in person to be done regularly at home two to three times a week,” she said. “Catching positives on (such tests) will reduce the risk of introduction (COVID) in schools.”

The province hopes to complete shipments of take-out PCR (polymerase chain reaction) test kits to school boards by this week. And before the winter break, each student will receive five rapid antigen tests to use while on vacation.

The province also said in areas at increased risk of potential spread of COVID, local health units can offer rapid screening for antigens schools for unvaccinated and asymptomatic students who are not high-risk contacts. Sudbury Local Health Unit does this, claiming that the increase in rapid testing makes it easier to track and prevent the spread of COVID.

Toronto mother Bronwen Alsop says she is frustrated that her son’s entire school was closed last week due to a COVID outbreak of six cases and wonders why Toronto’s public health has not yet implemented the test to stay.

“Shutting down an entire school with just six cases is unacceptable,” said Alsop, whose son Liam is in kindergarten at McMurrich Junior Public School, adding that he and his classmates have tested negative.

Liam is in a class for deaf and hard of hearing students at the school, located in the Wychwood neighborhood. And the move to distance learning has been a challenge for him, said Bronwen, founder of the Ontario Families Coalition, which advocates for in-person learning.

“Virtual learning is terrible for kids with hearing loss and it really robs them of precious time so they could learn in person. ”

The Stay-in-the-Province testing strategy aims to keep children in schools with multiple cases of COVID, ensuring unvaccinated asymptomatic students regularly undergo rapid screening for antigens while in school. Confirmed cases or high-risk contacts should self-isolate and undergo PCR testing.

But TPH and other public health units have yet to implement test-to-stay, which has been used in Europe and the United States.

Instead, TPH is using PCR testing as part of its investigation of school outbreaks, which has prevented dozens of schools from being closed. This school year, TPH made recommendations for school-wide PCR testing in 58 schools. Ten schools were made redundant.

TPH says if school-wide PCR tests identify multiple new cases of COVID, it can lead to the dismissal of an entire school. But if no new cases are identified, the laid-off cohorts continue to self-isolate, while those who stay in school will watch for any new symptoms of COVID.

When whole-school PCR testing is done after a shutdown, cohorts can return to class earlier than the usual 10-day layoff period.

“The use of the PCR test allows a more precise detection of COVID-19”, explains the spokesperson of TPH, Dr. Vinita Dubey, deputy medical officer of health, adding that the objective is to “continue to learn in person for the as many children as possible ”.

TPH investigations, which can lead to the partial or total closure of schools, are done on a case-by-case basis, with the aim of stopping transmission in schools. Various factors are taken into account, but there is no set number of cases that determines the closure of a school. This is why, for example, McMurrich was closed with six cases, while at the same time, the junior and senior public schools in Swansea remained open with 15 cases.

The ripple effect of a few cases of COVID in a school can be immense. For example, at McMurrich, five classes self-isolated following six cases among the students. Yet the entire school of 550 students was fired by TPH on November 28. On Monday, the school reopened.

Toronto schools currently closed include Transfiguration of the Notre-Seigneur Catholic School and Wilkinson Public Junior School. Province-wide, eight schools were closed Tuesday, and 836 had a reported case.

In Toronto, the rapid antigen test is recommended by TPH to students and staff after returning from a school-wide dismissal. They receive five kits for testing twice a week for two weeks.

Dr. Alanna Golden, former child mental health social worker and practicing primary care physician in Toronto, says, “At this point in the pandemic, it seems somewhat surprising that we are still resorting to school closures. whole while there are a handful of cases. associate. “

She says the data suggests children can stay safe in the classroom even after close contact exposure using the test-to-stay strategy.

“At the end of the day, if there is a better way to keep kids in the classroom that’s as safe as quarantining them, why wouldn’t we do it when we fully understand what the academic risks are and not academics associated with having children outside of school.

“Plus, the impact on families is huge. How are people supposed to work? … The ripple effect of an entire school having to stay at home, as well as the parents of that whole school, is insane.

In Guelph, Greer understands the impacts on families – she is currently at home with her two young daughters who are self-isolating after one of them was exposed to COVID in her classroom.

Given the current number of cases, she said the dismissal of class cohorts will likely continue for some time because with no rapid test rollout, this is the only way to break the chains of transmission.

She notes that while one group of scientists see the test to remain as an “extra layer of protection,” another is concerned that the rapid tests may not be good enough and that if a case is missed, it could lead to secondary transmission.

“I think there is a place for rapid testing in this situation,” she said. “We’re not going to do this forever. We have a small window where we are trying to get these groups vaccinated, at the same time we are seeing a rapid increase in the number of cases in unvaccinated children. For me, if there had ever been a time to do it, this should have been the time.

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