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Dr. Anne Gervais has seen a stream of anxious parents at her clinic in Gatineau in recent weeks. They have been seeking medical notes that would exempt their children from attending physical classes when school returns in Quebec. In-person attendance will otherwise be mandatory in the province.

That has put the family physician in a bind. She wants to follow public-health guidelines about what qualifies for an exemption – conditions such as severe asthma and cancer, depending on the case – and her patients mostly don’t meet the standard. “The students don’t necessarily have a severe illness,” Dr. Gervais said.

On the other hand, she feels uncomfortable with the role of bad cop in which Quebec’s back-to-school plan has cast her, determining who can and cannot receive online learning in the middle of a global pandemic.

“I think we should use doctors as guides, not as police,” she said.

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Dr. Gervais is far from alone in struggling with the province’s approach to getting kids back into classrooms this fall. Although Quebec was Canada’s COVID-19 epicentre, with more cases and deaths than any other province, it is moving more aggressively than anywhere in the country to get primary and secondary education back to normal.

With many of Montreal’s French-language public schools reopening on Thursday, parents, students, teachers and administrators are grappling with the risks and trade-offs of Quebec’s insistence on in-person learning.

Premier François Legault’s government has staked its bold policy on a belief that physical schooling is more effective and can be done safely, based in part on a partial reopening this spring when the province only saw a few dozen cases of infections in schools.

“The success of the coming school year cannot only be measured by our ability to control the pandemic and avoid outbreaks,” Education Minister Jean-François Roberge told the newspaper La Presse. “Success in a school is measured by the light … of academic success.”

Critics say this approach is too callous about the health risks of COVID-19 and tramples on the rights of parents. Prominent Montreal lawyer Julius Grey filed a legal challenge last week on behalf of parents who want the option of enrolling their kids in online learning courses without a doctor’s note.

That option is available in Ontario, the next hardest-hit province. Surveys indicate that in some Toronto-area school boards, about a third of elementary students will take part in remote learning. Mr. Grey argues that by depriving parents of this choice, Quebec’s plan violates their Charter right to make decisions related to the health and safety of their children.

“Which decisions are governments allowed to make for individuals? Is it all decisions or is there that sovereign realm of individual decision-making?” he said in an interview. “Our government appears to want to regulate everything.”

A Quebec Superior Court hearing is scheduled for next Thursday, when Mr. Grey hopes to secure a safeguard order granting the parents an e-learning option while the case makes its way through the courts.

Politimi Karounis is one of the parents involved in the lawsuit. She will be homeschooling her two school-age children in Montreal for fear of the virus, unless the courts grant a universal right to distance learning. Her immediate family has no grave health issues but she’s anxious about the health of her children and their grandparents.

“I agree that the classroom is the best place for my child under normal circumstances,” she said. “But I also think we can all agree there’s nothing normal about these circumstances.”

Quebec’s relative laxity about masks in schools has also prompted criticism and, in some cases, defiance. Masks are not required in class for students of any age, though older elementary- and high-school students must wear face coverings in common areas such as hallways. Some English-language private schools have announced that they will ignore the regulations and require masks in classrooms anyway.

Anxiety about the return to school has at times seemed to break down along linguistic lines. Earlier this month, Mr. Legault himself said the anglophone community may be more fearful because of reporting on the pandemic by English-language media outlets such as CNN and the Montreal Gazette.

But a survey in mid-August found that school-related COVID-19 fears are widespread in the province, and especially in Montreal, where the pandemic has hit hardest. In a poll by the Association for Canadian Studies, 55 per cent of Quebeckers and 64 per cent of Montrealers said they were worried about sending their kids back to school.

More than 100 doctors and scientists have also signed an open letter calling for tougher safety measures in schools, including mandatory masking and physical distancing in classrooms.

While the federal government announced $2-billion in extra funding to the provinces for safer school reopening on Wednesday, Quebec’s last-minute investments in schools have largely been directed at improving educational quality, rather than shoring up health measures.

In mid-August, the province unveiled $20-million for the hiring of about 350 professionals to help students catch up on schoolwork, particularly those with learning difficulties.

Still, Quebec teachers complain of staffing shortages that could imperil both physical health and learning this school year. Catherine Beauvais-St-Pierre, president of Alliance des professeures et professeurs de Montréal, a teachers’ union, said that Montreal schools are “overflowing” already, with as many as 40 students to a class.

“A teacher told me ... ‘If I want to keep two-metres’ distance from [my students], my back will be glued to the wall,’ ” she said.

Nancy Goyette, a professor of education at the Université du Québec à Trois-Rivières who studies teacher well-being, said that most teachers she knows are looking forward to the return of in-person classes. But with the danger of outbreaks and the constant vigilance required in the meantime, they know there are trade-offs.

“We’re taking a big risk in returning to physical school,” Prof. Goyette said. “It might go really well. We don’t know. We’re entering the unknown.”

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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