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Students practise physical distancing at École élémentaire catholique Jonathan-Pitre on Aug. 19, 2020 in Manotick, Ont.Dave Chan/The Globe and Mail

Ontario students with signs of illness will be asked to stay home from school, but a test for COVID-19 will only be recommended, not mandated, for them to return to classrooms.

The protocol is part of provincial guidelines shared Wednesday to help Ontario school boards and public-health units manage potential coronavirus cases.

The 21-page document joins a patchwork of guidelines from officials across the country who are preparing themselves for potential sick children and COVID-19 outbreaks in the fall. Ontario and Alberta are among provinces that have recently shared their plans, with just days left to go before schools are set to open their doors.

According to Ontario’s guidelines, children who start showing symptoms of COVID-19 while at school will be isolated until they can be picked up by a parent or guardian. The student will then be asked to consult with their primary health care provider, who will recommend testing for COVID-19 if necessary.

Public-health units will inform schools of any positive case of COVID-19 detected in their community. Students who have confirmed cases of COVID-19 will have to isolate for 14 days and until symptoms of the virus disappear. Those who obtain negative results will be allowed to return to school 24 hours after symptoms disappear.

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However, testing results are not mandatory to permit a student’s return to class. Those who do not get tested for COVID-19 will have to stay home for 14 days and until symptoms disappear.

“We want to be sensitive to the fact that children don’t always get sick from COVID,” said David Williams, Ontario’s Chief Medical Officer of Health, during a press conference Wednesday.

“We want to be cognizant of what’s going on in the community. If there’s no COVID circulating in the community, that’s not always your first go-to diagnosis. If you have widespread influenza, you need to look at that,” he added.

As parents across the country await final details regarding health and safety protocols for the fall, provinces have also begun outlining what they consider an outbreak, how they will contact parents, and how they will handle COVID-19 symptoms in the midst of influenza season.

If a case of COVID-19 is detected in an Ontario classroom, local public-health officials could ask the entire class cohort to isolate for 14 days. The same will be done for the confirmed case’s close contacts.

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Local public-health units will declare a school outbreak if two or more cases of COVID-19 that are epidemiologically linked are detected in the span of 14 days. At least one of the cases needs to have been contracted on school grounds.

Public-health units are also responsible for contact tracing, and for choosing which actions must be taken to prevent further spread of the virus during an outbreak. This could involve monitoring student and staff movement in the school, or temporarily shutting down an entire building if there is a risk of widespread transmission.

If a school is forced to close, all students will have to be tested for COVID-19. The outbreak will end after 14 days without school-related transmission of the virus. Certain cohorts could return to school buildings before the outbreak is declared to be over.

The province has asked all schools to inform parents of COVID-19 cases on their websites, while withholding information that could identify the infected student or staff member.

In Alberta, a COVID-19 outbreak will be declared in a school where two or more cases of the virus are detected in the span of 14 days, regardless of whether they are epidemiologically linked or not. Alberta Health Services will be responsible for advising the school of confirmed cases and for contact tracing.

Schools will send letters to parents alerting them of confirmed cases or outbreaks. Public health will instruct the case’s close contacts, which could include classmates and teachers, to self-isolate. Any further steps will be taken at the discretion of public-health officials, and the province must be involved in any decision regarding the closing of schools.

Daily self-assessment tests are also being recommended in provinces including Ontario, Alberta and British Columbia, to ensure students remain home if they are showing symptoms of the virus.

In British Columbia, Ministry of Education spokesperson Stephen May said students and staff will not be allowed to come to school if they have “even the mildest symptoms,” including a runny nose.

“This includes symptoms of cold, influenza, COVID-19 or other infectious respiratory disease-like symptoms,” Mr. May said.

Sherene Khaw, a spokesperson for Alberta’s Ministry of Education, said that a runny nose could be the symptom of a pre-existing condition. Children should be tested to confirm if that is the case, after which the runny nose could be considered part of “the student’s baseline health,” she said, which would allow them to keep attending school.

On Wednesday, Ontario officials acknowledged that flu season could complicate symptom detection, but asked that all students stay home if they are feeling sick. The province also said it was relying on the “professional judgment” of teachers and principals to determine when a child should be sent home from school.

Globe health columnist André Picard and senior 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.

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