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Catch up: Q&A with André Picard and Nicole MacIntyre

COVID-19 and school: In less than a month, millions of children will return to school as Canada enters the next stage of its pandemic response. With some provinces offering online learning, many families are agonizing over whether they should send their children back amid growing concern about class sizes, mask rules and safety protocols.

Reopening schools

Nicole MacIntyre: Do you think Canada is ready to open schools?

André Picard: We have to get kids back to school, and we have to figure out how to do it as safely as possible.

Nothing is 100 per cent safe. But I would also say, if you look at our data, our cases are coming down in most of the country and we are doing relatively well. There’s probably not a better time to go back to school.

If there's a second wave coming, then we will have to adjust.

We have to figure out how to get kids into school as safely as possible and then have a Plan B – what happens if cases take off again? At what point do we shut it down again? We have to be ready for both.

Kids need school for a whole bunch of reasons. Parents need kids in school for economic reasons.

Kids need to interact – it’s good for their mental health, for their development. There are all kinds of good reasons, but it’s all about getting the balance right.

Nicole: What is that balance?

Andre: There are a few basic things.

I think that the number of children is really, really important to have enough space for physical distancing. Physical distancing is our number one tool. If you're not near anyone, you are not going to be infected.

Then, we have to have the basic hygiene measures: Wash your hand, wear a mask, use your hand sanitizer.

Third is a little more complicated. We need to figure out how to have cohorts or pods to limit the number of interactions. Every interaction is a risk. The smaller the [cohort or pod], the fewer interactions you have. The other really important thing about pods and class sizes, is when there is a case, we don’t have to panic. It’s going to be easier to track and trace, and limit the spread.

It’s not about having no cases; that’s impossible. It’s about limiting the number of cases and limiting the harm. That’s what we want to do while having the benefits of education.

Watch the highlights of the Q&A

Globe health columnist André Picard and deputy national editor Nicole MacIntyre discuss the many issues surrounding sending kids back to school. André says moving forward isn't about there being no COVID-19 cases, but limiting their number and severity through distancing, smaller classes, masks and good hygiene.

The Globe and Mail

Are masks safe for kids?

Nicole: My eight-year-old will wear his mask for about 45 minutes before he starts complaining that it makes him feel bad, and his head hurts and it’s hard to breathe. Some readers have asked, are there going to be health consequences of children wearing masks?

André: The short answer to that is no, you’re not going to be unable to breathe. You’re not going to get carbon monoxide poisoning. People do 12-hour surgeries wearing masks and they don’t drop dead.

It’s going to be uncomfortable for kids, it’s going to be a bother. They’re going to yank at them. That is fine. You don’t want perfect to be the enemy of good.

Our colleague Wency Leung wrote a great piece about masks for kids with some good tips: Make the kids pick them themselves, have something they like, make sure it’s comfortable and that the elastic doesn’t yank at their ears. Make it as easy as possible for the kids to wear them so they become second nature.

What criteria should be used for reopening schools?

Nicole: In the U.S., there’s been some kind of criteria – a bar that’s been set – for when it is safe to open schools. We haven’t seen those same rules come out in Canada; can you just talk a little bit about both: What guidelines have come out and how they would apply in Canada?

André: There’s really good guidance out of the U.S., [whereas] the provincial back to school plans are so obtuse and useless. There’s no practical information. What the Americans do really well is synthesize information and tell you “here’s how to choose.” That’s what we need.

The guidance I really like is the Harvard School of Public Health’s red light, green light system. If there are more than 25 cases per 100,000 population, then that’s a red light and you absolutely don’t go back to school. Yellow light means there are 1 to 9 cases per 100,000, and maybe go back, but be cautious. Green light means you should be fine going to school.

Where’s Canada? Most of Canada is yellow, so we’re not doing too bad. But yellow light is supposed to say “Be cautious, be ready to stop.” That’s the attitude we have to have. Now is a pretty good time to go back. But let’s be careful. Let’s be really vigilant. If the numbers shoot up, we have to be ready to shut it down again.

Worldwide, how have school reopenings gone?

Nicole: Some countries have reopened schools, and it’s gone very well; in some places it’s gone very poorly. Can you talk to us a little bit about some of the global examples of return to school?

André: Overall, it’s gone pretty well in schools. There have been some disasters, but most countries are doing this well overall.

Two extreme examples come to mind.

One of the first countries to go back was Denmark. They did everything right. They have small classes, testing of children, low community spread. There have been very few cases in their schools and their daycares.

The thing to remember about Denmark is they don’t have classes of 30 to begin with. They have classes of 15. It’s better for education, it’s better for health. The other thing is they ride their bikes to school; they don’t take buses.

The other example that’s really been singled out is the huge cluster in a middle school in Israel. What I think we can learn from that is that when you’re arrogant, you’re gonna pay the price.

They didn’t enforce mask rules, they were very loosey goosey about the distancing. We don’t know what was going on in the community, but I don’t think they were taking it too seriously in the community. They did everything wrong.

I think there are important lessons at both ends of the spectrum. Hopefully we will lean more toward learning from Denmark.

Then we have countries where it’s a little more complicated like South Korea. They never closed their schools, and recently they have had to because they had big outbreaks again that started getting to school. The reminder from South Korea is you have to keep up with these measures. The virus is always looking for an opportunity to sneak in.

Is the ventilation in schools good enough?

Nicole: What do we know about ventilation and the role it’s playing in spreading the virus? What should we expect from our schools, knowing that we’re going back in about three weeks?

André: I think parents have to be careful to not get too hung up on this. The virus circulates in the air, but the big risk is somebody coughing in your face. So again, we have to keep that context.

A lot of these HVAC systems are out of date and probably need to be updated. That's 50 years of neglect. The reality is we are not going to fix it overnight.

As much as possible, let’s have open windows. There’s lots of talk about bringing air purifiers in there – they are probably helpful a little bit.

But again, I always come back to: If there’s fewer kids in the class, this stuff matters less. It’s all about the numbers more than anything else.

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