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Ontario Premier Doug Ford takes a question from the media during an announcement in Ajax, Ont., on July 28, 2020.

Chris Young/The Canadian Press

Toronto Public Health has raised concerns about Ontario’s back-to-school plan, advising that maintaining normal class sizes in elementary schools means children will not be physically distanced and will face an increased risk of spreading coronavirus.

In an e-mail to the Toronto District School Board, Vinita Dubey, the associate medical officer of health, wrote that “the number of students in the classroom should be smaller than usual class sizes.” Smaller classes, Dr. Dubey wrote, means that “if someone in the class gets COVID-19, their risk to spread it to others will be smaller compared to a larger class.”

The e-mail, a copy of which was obtained by The Globe and Mail, was forwarded by interim education director Carlene Jackson to trustees on Thursday. The school board had requested guidance from public health on its back-to-school plan, which included full-size elementary classrooms prescribed by the provincial government.

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Parents and educators in Ontario have been frustrated by the school reopening plan released by the provincial government last week that does not lower class sizes in elementary schools, and instead restricts students to their class group for the entire day, including lunch and recess. The plan on elementary-school class sizes is similar to many of those in other provinces.

In Ontario, most Grades 1 to 3 classes must have 20 or fewer students, while the average class size in Grades 4 to 8 is 24.5, which means some classes could hold more than 30 children, making physical distancing virtually impossible.

Earlier on Thursday, Mr. Ford said he wants to see smaller classes in elementary grades but defended his government’s back-to-school plan. “Do we all want smaller classes? 100 per cent. But I think the plan is phenomenal. It’s the best plan in the entire country, bar none.”

The concern from Toronto Public Health goes further than a statement released earlier this week by Toronto’s Hospital for Sick Children and other Ontario pediatric hospitals that encouraged the government and school boards to “consider” their guidance on school reopening.

Among its recommendations in a guidance document released last month, the pediatric hospitals wrote that smaller class sizes should be a “priority strategy as it will aid in physical distancing and reduce potential spread” of COVID-19.

Asked to respond to Toronto Public Health’s concerns, Alexandra Adamo, a spokeswoman for Education Minister Stephen Lecce, said the reopening plan was developed with the “best medical and scientific minds in the country.”

As evidence emerges, the plan will be adapted, she said. “We will never hesitate from taking further action to protect the health and safety of Ontario’s students and education staff,” she said in a statement Thursday evening.

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An online petition to reduce class sizes has garnered more than 170,000 signatures, and Ontario’s three opposition parties, parents and educators have all called on the Premier to revisit the plan and cap class sizes at 15 in elementary grades, as well as hire more staff.

Dr. Dubey wrote that in kindergarten-to-Grade-3 classrooms, where masks are not required, smaller classes “will particularly be important to ensure students can be spaced out and reduce transmission.” Further, she said, teachers would have more control over small classrooms to maintain public-health measures, and it would ensure that at times when students gather to wash their hands or line up to go outside, physical distancing can be maintained.

“While some distance may be beneficial over no distance (eg. 1 metre compared to no distance), keeping two metres apart as much as possible is still strongly recommended by public health,” she said. “This includes ensuring that desks are adequately spaced apart, especially because students will be at their desks for much of the day.”

Ryan Bird, a spokesman for the TDSB, said the board will be discussing public-health’s concerns with the ministry of education.

The school reopening plan also included high-school students in 24 boards, with relatively large enrolments, attending school every alternate day in cohorts of about 15. In smaller districts, where class sizes are typically lower, high-school students would attend full-time.

Families in Ontario have the option of remote learning at all levels. The province has made masks mandatory for students in Grades 4 to 12, while younger students are encouraged, but not required, to wear them.

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The government has previously announced that it is providing $309-million in funding to school boards for cleaning, public-health nurses, masks and other personal protective equipment.

The Education Minister on Thursday called the plan “a living document,” which can be strengthened over time. He pointed to a $30-million investment to hire more educational assistants and teachers to keep class sizes low, and said 90 per cent of Grade 1 to 3 classes are already capped at 20 students. Parents and educators are particularly concerned about class sizes in grades 4 to 8.

“We will continue to step up in significant ways to respond to the risk as it emerges,” Mr. Lecce said.

NDP Leader Andrea Horwath called Mr. Ford’s plan “bargain basement,” saying that it fails to keep children safe.

“Time is running out, but it’s not too late,” she said. “If I were premier right now, I would be capping class sizes for all students, and hustling to get temporary classroom spaces, teachers and education workers lined up for all those classes.”

In defence of the province’s plan, Mr. Ford said kindergarten classes with 30 students have both a teacher and an early childhood educator, “so it’s really down to 15” children in each cohort. However, the group would be in the same room, which educators say would make physical distancing impossible.

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Green Party Leader Mike Schreiner accused Mr. Ford of “cherry picking” the medical experts’ recommendations.

“The Premier is dangerously ignoring the reality that all 30 kids will still be crammed into the same classroom,” Mr. Schreiner said. “It’s time for the Premier to take responsibility. A safe back to school plan has to address class sizes.”

When asked if Ontario is considering moving classes to alternative spaces to reduce sizes, such as gyms, libraries or other locations, Mr. Ford said, “We encourage, when weather’s permitting, to go outside.”

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