advertisement

what if there is an outbreak at a school?

the province of ontario has already offered some details of what classrooms will look like when schools reopen in september.

what if there is an outbreak at a school?
ontario premier doug ford, left, and education minister stephen lecce walk a school hallway in whitby last week before making an announcement regarding the government's plan for a safe reopening of schools in the fall due to the covid-19. nathan denette / the canadian press
the province has already offered some details of what classrooms will look like when schools reopen in september.
but the question remains: what happens when there’s an outbreak in a school? expect more information on monday, when at least one school board plans to release more details about its protocols.
here’s what we know and what we don’t know.
q: are outbreaks in ottawa school inevitable?
a: it sounds very likely.
“in a city the size of ottawa, there will be cases in schools,” dr. brent moloughney, ottawa’s associate medical officer of health, said last week.
q: that sounds dismal.
a: there are things that can be done to reduce the risk of transmission in schools. they include letting parents know that their child should not go to school if there are symptoms, limiting the number of contacts, wearing a mask where tolerated and distancing as much as possible.
there will be processes in place to investigate and control transmission if — and when — it happens, said moloughney.
“it is really around a balance of how to reopen schools while reducing risk as as much as possible. then if a case occurs to identify it and be able to respond,” he said.
“these will contribute to making schools as safe as possible. but we need to prepare for and plan for that there will be cases.”

advertisement

advertisement

q: what is being done and who is involved?
a: ottawa public health and the school boards, with input from the province, are working on the protocols. the ottawa-carleton district school board’s protocols are to be released on monday.
q: what has the province said so far?
a: the province wants its ministries, local school boards and schools, local public health and other stakeholders to understand their roles and responsibilities when outbreaks happen. responses to outbreaks are to be rapid, proactive and consistent, with “low thresholds for action.”
protocols for the steps they will take to take where covid-19 is suspected are to include notifying parents or caregivers if their child begins to show symptoms while at school, including the need for immediate pick-up and an area to isolate the student until pick-up.
the province recommends that if a student begins to experience symptoms of covid-19 while attending school, they be immediately taken to a separate room until they can be picked up. in addition, where possible, anyone who is providing care to the student should maintain a distance of at least two metres.
if a staff member develops covid-19 symptoms, they should return home and self-isolate immediately. if they cannot leave immediately, the staff member should be isolated until they are able to leave.
powered by
canadian centre for caregiving excellence

advertisement

advertisement

as well, kits containing alcohol-based hand rub, gloves, surgical masks, eye protection, and a gown along with instructions on use should be available in case a student, staff or essential visitor becomes ill while at the school.
cleaning or disinfection is required of the space and items used by a person with a suspected infection.
q: will positive cases be reported?
a: yes. according to the province, school principals are mandated to report infectious diseases to their local public health units under the health protection and promotion act. public health units may recommend closing a school, provide notices or make other recommendations such as additional testing, self-isolation or cleaning advice.
if a staff member’s illness is determined to be work-related, an employer must provide a written notice within four days of being advised that a staff member has an occupational illness, according to the occupational health and safety act
.
q: what are the teachers’ concerns?
a: there are a lot of unknowns.
teachers will have three pd days before school starts on sept. 3, said susan gardner, president-elect of the ottawa carleton elementary teachers’ federation of ontario. teachers are expecting to learn as much as they can about recognizing symptoms and when and how they should respond.
powered by
obesity matters

advertisement

advertisement

“we’re not experts in the health field. it’s a big responsibility to look for symptoms when students are wearing masks,” she said. “is it every sniffle? is it every cough?”
although the province has announced that it is hiring 500 nurses for schools, with about 5,000 schools in the province, that amounts to having a nurse for half a day each week, she said.
there are other questions.
given that multiple teachers will be visiting each class — increasing the possibility of exposure and spread of the virus — it’s still unclear what will happen when someone in the school tests positive.
there is also the question of what will happen if a family member of a student or teacher tests positive and whether that would lead to testing and self-isolating for the entire school or the cohort.
teachers also want to know who is responsible for lesson plans if a teacher is away because they are self-isolating. elementary teachers are responsible for creating long-term plans and filing them with their principals, but occasional teachers do no have the same responsibility, said gardner.
meanwhile, teachers were given classroom assignments last spring. but class numbers will be changing as parents report to the school board whether or not their children are at school. school boards are expecting to have numbers by the end of the week. it’s still unknown how many families will opt for distance learning. for teachers, it means assignments may be shuffled and new lesson plans will have to be drawn up.

advertisement

advertisement

q: will schools be responsible for contact tracing?
a  they will have a role to play. schools will be expected to develop “rapid response capability,” according to the province.
when a positive case is identified, public health units conduct contact identification and follow-up with those who have been in contact with confirmed cases. schools must keep daily records of anyone entering the school setting, when they entered and left and their contact information.
contacts will be informed that they have been exposed, and will be provided with public health guidance.
q: what about testing?
a: schools will follow current provincial testing guidance. ottawa public health will provide the steps to take when a student tests positive.
q: day camps have been shut down for two weeks with just one case. will this happen with schools?
a: not necessarily. schools are similar to child care facilities and day camps in that they will use a mix of distancing, mask use — depending on age — and cohorting to limit the number of contacts. the difference is that in schools there are multiple cohorts.
q: what are cohorts and how will they make a difference?
a: cohorts are “social bubbles” of students, and they will play a role in reducing risk of spreading covid-19. elementary students at the ottawa-carleton district school board, for example, will remain in one classroom with the same group of students all day, including lunch and when they go outside for recess.

advertisement

advertisement

high school students will be divided into two cohorts. cohort a will attend school two days one week and three days the next week. cohort b will do the opposite. the school year will be divided into four “quadmesters” and students will take two classes at a time.
cohorts may also make it possible to keep schools from shutting down completely if there is a positive case.
a positive case may lead to some temporary closures to identify whether there has been a chain of spread of infection, said moloughney. but the risk may be very limited. protocols may vary depending on various scenarios and the sizes of schools, and there will be some discretion, he said.
moloughney uses the example of a high school with 1,500 students.
“you may not need to close the entire facility if you think the risk is only to one cohort or two cohorts. those at highest risk would be in self-isolation and then we assess risk beyond that cohort and react accordingly.”
the province has said that outbreak interventions should be “scaled, adaptable and measured.” among the factors to be considered: the number of cases; confidence in cohorting implementation; the number of cohorts affected; local epidemiology and the needs of vulnerable student populations.

advertisement

advertisement

q: will class sizes be reduced?
a: this is the biggest area of contention. last week, for example, toronto public health urged the toronto district school board to keep elementary class sizes smaller than normal.
ottawa public health said it “supports having the number of students within a classroom to be as small as possible, in order to facilitate physical distancing, and to maintain distancing and limit the mixing of cohorts in common areas such as hallways and washrooms
.”
the province has insisted the measures it has already announced, including making masks mandatory for grade 4 and up, investing in more custodians, hand sanitizer and nurses, as well as more teachers in the hardest-hit jurisdictions, will help keep students safe.
education minister stephen lecce also announced lats week that the province was spending $20 million on “robust testing of asymptomatic students, particularly in high school, where the risk is higher.” but no details have been released.
“our plan is the best plan in the entire country,” premier doug ford said on friday, while at the same time acknowledging that things can change, and the plan has to be flexible.

q: how does everyone play a role in preventing outbreaks in schools — even those who don’t have school-aged children?

a: infection is a loop between the community, schools, then back to the community, said  ashleigh tuite, an infectious disease epidemiologist and mathematical modeller at the university of toronto.

“if we have fewer cases in the community, there’s less chance we’ll introduce covid-19  into our schools, where we could see outbreaks,” she said.

to use the whack-a-mole analogy, it’s easier to keep covid under control in schools if there are fewer moles to whack.”

080920-0703ashleightuite003_79255300-w

q: what has happened in other jurisdictions?

a: israel has been cited as an example of how not to return to school.
schools in israel re-opened in late may. safety measures at the time included masks for children in grade 4 and higher, windows to be kept open and frequent hand washing.
but classes were large and physical distancing was a problem. as the weather got hotter, the israeli government allowed everyone to stop wearing masks for four days and closed the windows to allow air conditioning to keep temperatures down.

infections “quickly mushroomed into the largest outbreak in a school in israel, possibly the world,” said the new york times about what happened at gymnasia ha’ivrit high school in jerusalem.

“the virus rippled out to the students’ homes and then to other schools and neighbourhoods, ultimately infecting hundreds of students, teachers and relatives.”

all the students and staff were tested and had to wait in line for hours. teachers who taught multiple classes were hardest hit. some were hospitalized.

the israeli education ministry later shut down schools with even a single case, closing 240 schools and quarantining more than 22,520 teachers and students. re-opening schools was identified as a major contributor to a second wave of covid-19.

the school year in israel is scheduled to start on sept. 1. recommendations for the reopening have included creating cohorts of 10 to 15 students, staggering school schedules, online classes for some students, mandatory masks for older students and frequent sanitizing.

q: could what happened in israel happen in ontario?

a: it’s not outside the realm of possibility, said tuite. but she points out that there were some factors at play in israel that led to these outcomes.

“these were very large overcrowded classrooms. people weren’t wearing masks because there was a heatwave.”

even if schools are perfectly set up, positive cases will still appear, she said.

“if cases do get in, as they very likely will, what do you do to minimize it? schools have never been zero risk. there is a risk associated with every action.”

q: will ontario’s schools be safe in september?

a: there are both academic and social harms to children is schools stay closed, points out moloughney.

“we’re looking to make school as safe as possible. we’re reopening while we have covid (in the community) so the question becomes how to design and weigh reopening schools in a way to make it as safe as possible.”

comments

postmedia is committed to maintaining a lively but civil forum for discussion and encourage all readers to share their views on our articles. comments may take up to an hour for moderation before appearing on the site. we ask you to keep your comments relevant and respectful. we have enabled email notifications—you will now receive an email if you receive a reply to your comment, there is an update to a comment thread you follow or if a user you follow comments. visit our community guidelines for more information and details on how to adjust your email settings.