‘We are flying blind’: With hundreds of COVID-19 cases in Ontario schools, why numbers alone don’t tell the whole story
|Toronto Star 12 Oct 2021 at 11:17|
Just days into the school year, mother Marie Tattersall’s heart sank when she opened the email from Toronto’s King George Junior Public School saying it had its first COVID-19 case.
“And so it begins,” thought Tattersall. “I was kind of shocked it happened so fast.”
She had hoped the school would make it to Thanksgiving without a case, giving her 10-year-old daughter Sydney a chance to settle into classroom learning again and build back relationships.
Moments after that first email, the questions began surfacing for Tattersall: What class is being sent home? Does anyone in that class have siblings? What class is the sibling in? Who do they play with? How did COVID get in? How far did it spread?
Like scores of other Ontario parents whose children’s schools have experienced COVID cases, Tattersall found it difficult to get clear answers. School boards and health officials say privacy legislation limits what they can disclose, including details about the origin of a case because it could identify the individual. But Tattersall and other parents say more information is needed so they can make informed decisions about whether to leave their kids in the classroom or keep them home — especially at a time when elementary and secondary schools have the most ongoing outbreaks of any sector in the province, by a large margin.
Elementary and secondary schools are the , with 121 as of Oct. 8, three times higher than other workplaces. Elementary schools, where the student population remains unvaccinated, overwhelmingly top the list.
The province defines a school outbreak as two or more confirmed coronavirus cases in students and/or staff with an epidemiological link within a 14-day period, in which at least one case could reasonably have been acquired in the school, including during transportation and before- or after-school care.
At King George, the school’s first email to parents about a COVID case in a student appeared on Sept. 14. A flurry of emails followed until Sept. 16, when an outbreak was declared by Toronto Public Health (TPH), and parents were told a kindergarten and Grade 2/3 class were in self-isolation. Later that night, the principal emailed the school community saying another case was detected and an additional class was self-isolating, but didn’t say which one. Sleuthing parents discovered the second impacted class was another with second graders. By Sept. 25, the school had 11 cases, which affected three classes, whose students were told to stay home.
Because Tattersall didn’t have the answers to her troubling questions, she pulled Sydney out of her Grade 6 class and kept her home until Sept. 23. She understands officials can’t disclose the identity of a child with the virus, but wishes parents were immediately told what classes were impacted and how the virus was spreading.
“I need the lay of the land so I can do a proper risk assessment for my child. And then it’s up to me. I’m her mom … It’s my job to protect my child.”
Ryan Bird, a spokesperson for the Toronto District School Board (TDSB), says grade information of the impacted King George classes was not initially shared with the entire school because of concerns about privacy. But moving forward, it will be.
The information provided to the school community typically includes whether it was a student or staff member who tested positive, and the impacted grade, he said. Specific information — how long to self-isolate, if there’s a need for testing and any additional precautions — is shared by TPH and the school with the directly affected class. By comparison, the Toronto Catholic board shares with the school community if there’s a positive case among staff or students — sometimes it just says a person — but not the impacted grade.
Colin Furness, an infection control epidemiologist at the University of Toronto, said public health departments are very wary of releasing any information that might identify a case, especially when it’s a child. But he said it would make sense if they provided more non-specific information, such as how many cases there are on a school floor and roughly where the cases were.
“You wouldn’t be able to narrow it down but you’d have a better situational awareness,” he said. “That would probably help quite a lot. I can certainly see why parents would want that … not in terms of being able to out people but simply to assess risk.”
“You have this really horrible collision of needing to protect children’s privacy on the one hand and having a situation like a rumour mill and panic and stress on the other. It’s lose-lose,” he added.
Based on her discussions with other parents, Tattersall believes the outbreak at King George, which has about 260 students, started in a kindergarten class and then spread to Grade 2 via a sibling or siblings — a scenario the TDSB and TPH are unable to confirm for privacy reasons.
The outbreak at King George has since been resolved. Of note, the school is located in the Runnymede—Bloor West Village neighbourhood, which has one of the , at 81 per cent.
It can be challenging to navigate public health guidelines, which present various scenarios for families to think about when sending their kids to school. Considerations include whether individuals test positive, whether they have symptoms and whether they are vaccinated.
While the chain of infection at King George remains unclear, siblings can play a role in transmission. Last year, TPH guidelines stipulated that when a student is sent home to self-isolate with their entire class because of a COVID case, the siblings of those students must also stay home. But in the summer, the province updated its COVID guidance for schools, and TPH amended its COVID screening tool, which is a checklist used by parents each morning before school. Now when a student is self-isolating and has no symptoms, siblings can go to school, so long as they too don’t have symptoms.
Tattersall worries this change created a “loophole” and “allowed COVID to find a foothold” inside King George. Her concern is that a child sent home to self-isolate with the class could unknowingly have COVID and be asymptomatic (getting definitive test results can take several days). In the interim, the student self-isolating at home could pass the virus on to a sibling who’s also asymptomatic and who then goes to school, risking further spread.
“We are flying blind with a broken (daily health screening tool) that does not include siblings needing to stay home too,” she wrote to TPH.
Tattersall believes amending the screening tool is key to preventing outbreaks, along with , better personal protective equipment for teachers and smaller class sizes that allow for more physical distancing.
The Star asked TPH why it is safe for siblings of close contacts to remain in school this fall, while earlier this year TPH said siblings of close contacts should also stay home. TPH did not directly answer the question.
TPH’s associate medical officer of health Dr. Vinita Dubey said in an earlier email the agency is “ carefully monitoring COVID-19 activity and is working with its school partners to carefully assess these circumstances daily based on the most current scientific evidence and local data.”
Dubey said in Toronto, most cases in students and staff were not acquired in schools, and have been linked to household transmission.
“The limited transmission in schools has shown that the public health measures that are being implemented in these settings such as masking, distancing, (infection prevention and control) protocols and vaccines are working,” she said. “The best prevention of COVID-19 outbreaks in a school setting is to reduce community transmission and the introduction of COVID-19 into the school setting.”
Dubey added that when an adult is not vaccinated, “they often spread it to the children in the household, which can result in cohort dismissals and students missing out on in-person education. TPH understands the value of in-person learning for the mental and physical development of children and their families, and vaccinations are the best way to minimize interruptions in schools.”
When the province updated its guidance, it allowed for public health units to implement additional measures based on what was happening in their communities. That’s why rules around siblings of close contacts vary. For example, in Peel, . Last year, there were nine school outbreaks that had 10 or more cases in Peel; of those, six outbreaks involved multiple siblings, or other household members, such as cousins, who attended the same school and were part of separate transmission chains in the school.
Just a couple of weeks ago, the Wellington-Dufferin-Guelph public health unit updated its rules and now requires siblings of close contacts to stay home.
That move coincided with an outbreak at École Saint-René-Goupil in Guelph, where 18 students and one staff member tested positive for COVID between Sept. 13 and 29. The outbreak appears to have started in a classroom and spread via siblings to other classes. In the end, four classes and several bus routes were affected, and about 250 students had to isolate, according to Mikale-Andrée Joly, spokesperson for Conseil scolaire catholique MonAvenir, the French Catholic school board.
Having siblings self-isolate, as per the updated local health guidelines, may in future “help circumvent transmission from one class to another,” said Joly.
The outbreak at Saint-René-Goupil was declared over on Friday.
What is happening at St. Benedict Catholic Elementary School in the Ottawa area also illustrates how just a few COVID cases inside a school can affect hundreds.
On Sept. 19, less than two weeks into the school year, Michelle Coates Mather, who has a daughter in Grade 1 and a son in Grade 3 at St. Benedict, received an email from the school’s administration informing her a single case of COVID had been detected in a kindergarten class.
The next day, another letter from the school told her a second case “not connected” to the first had been detected elsewhere in the school. The letter contained no information on if the individual was a student, staff member, parent or visitor to the school.
On Sept. 22, the school reported another kindergarten case, while Ottawa Public Health sent its own letter stating that “an individual associated” with the school had tested positive for COVID.
Two days later, public health declared an outbreak at the school limited to a kindergarten class and a kindergarten extended-day program, while the school revealed three other new cases in a kindergarten class, as well as a Grade 2 and a Grade 4 cohort.
Two days after that, a Sunday, the school reported new cases in two kindergarten classes, a kindergarten extended-day program, as well as new cases in Grade 2 cohorts and a bus route.
“My reaction to this letter was ‘What does this mean? Do I keep my kids home from school? Have they been impacted? Should I get them tested?’” said Coates Mather. “This is not about placing blame on children. It’s about risk assessment for our family.”
On the evening of Sept. 28, nine days after the first case was detected, public health sent a letter to parents saying it was declaring an extension to the outbreak and closing the school of more than 700 students.
At that point, Coates Mather says she and other parents were left unsure of what to do next. She knew her own kids had been playing with children in the affected cohorts, and yet the message she was getting from public health was that she and her family did not need to isolate, nor get tested. Still, to be on the safe side, she and her family decided to lie low for the rest of the week and get the kids tested anyway. Luckily, both tested negative.
As of Oct. 8, the outbreak at St. Benedict had resulted in 37 infections, according to Ottawa Public Health. The agency told the Star it could not disclose additional information about anyone who has tested positive and referred the newspaper to its COVID dashboard. As of Friday, in-person learning was expected to resume on Tuesday.
“To me, it’s about how we manage the panic. Because people were panicking,” said Coates Mather. “I do think there is a lack of proactive sharing of information that could help us to make informed decisions.”
School outbreaks are stressful for teachers, too. Kim John, a learning support teacher at Lord Elgin Public School in London, said she had to get a COVID test and respond to nine surveys gauging her risk of exposure because her job requires her to teach several grades throughout the school.
“It’s stressful … I’ve been tested once, but it’s like you’re waiting. Do I have to get tested again?”
The school announced its first COVID case on Sept. 21, and within a week 10 more were detected. On Sept. 29, the Thames Valley District School Board closed the school and moved all classes to virtual learning. There are now 18 cases linked to the outbreak at the school, according to the Middlesex-London Health Unit.
“I think that initial case scared parents. It kind of set fire and I think parents got very nervous,” she said.
The school board had to push the planned reopening date of Oct. 5 to Oct. 12 “due to additional cases of COVID-19,” according to a letter sent to parents.
Dan Flaherty, a spokesperson for the Middlesex-London Health Unit, said cases at Lord Elgin include individuals from multiple classrooms and families, but noted there is no clear explanation about how spread occurred.
“What several cases have in common are the school and the community in which they live, so the outbreak is likely due to a combination of both factors,” he said.
John, meanwhile, is eager to get back into the classroom and hopes the outbreak will be the last the school is forced to deal with.
“It’s scary for the parents because they need to work, they need the kids to be here, and we need our kids to be here,” John said.
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