Alanna Golden is a primary-care physician and a former social worker. Martha Fulford is an associate professor of infectious diseases at McMaster University.
When this started and we didn’t know what we didn’t know, we feared that children might be at serious risk of COVID-19. We now know that the risk of COVID-19 in children remains low, even with the variants of concern. We have discovered that in-person learning does not pose a significant risk to the physical health of children.
Next, we worried that schools might be dangerous to teachers and school communities. In Ontario, school-aged children accounted for 10 per cent of confirmed cases from Aug. 30, 2020, to March 31, 2021. Only 0.9 per cent of confirmed cases in Ontario were linked to school outbreaks. We have since learned that teachers and their household members are at no greater risk of serious outcomes than other adult workers of the same age. Moreover, school closures have not shown an appreciable effect on COVID-19 transmission. Studies that suggest otherwise fail to consider the impact of greater societal closures occurring alongside school closures, in addition to viral seasonality and aggressive vaccination efforts that result in positive change.
In contrast, the negative impact of school closures on children has become increasingly apparent. Learning loss, reduced social interaction, isolation, reduced physical activity, more mental health problems and the potential for increased abuse, exploitation and neglect to name a few. We are now learning of families that are off the radar and children who have disengaged from school. Attendance is an important predictor of academic achievement and affects the likelihood of high-school graduation and admission to postsecondary schools. These known harms are the real risks of school closures and should prompt us to consider where the benefit of such measures lies.
Prior to the most recent school closures, an asymptomatic testing campaign was under way in Ontario schools to determine rates of COVID-19 positivity. The Ministry of Education reported that, as of April 30, 2021, there was a positivity rate of only 0.7 per cent in Ontario schools. In the high-risk regions of Toronto and Peel, the positivity rate was under 1 per cent in schools when community rates were about 10 per cent. These numbers demonstrate low rates in school-aged children and are consistent with earlier public-health messaging that schools are safe.
According to public-health officials, schools needed to close this time around because of high levels of community transmission. As rates of community transmission decrease, when can we expect a return to in-person learning? We have seen new daily case counts in Ontario peak at 4,812 on April 15; as of Tuesday, the number was 2,073. The count began to drop before any possible impact from school closures would have been apparent. This is consistent with what we have seen in British Columbia, where schools have not closed and their epidemic curves mirror Ontario’s. Knowing the incredible harms associated with school closures and the lack of meaningful benefit, how can we continue to justify them?
In a recent letter to Premier Doug Ford titled “A Path Forward: Switching Gears in Our Pandemic Response,” a group of physicians outlined practical measures to improve outcomes in hot spot schools and industries. These measures include the vaccination of teachers and adult households in high-risk communities with the simultaneous vaccination of workers in hot spot industries, as well as the implementation of rapid asymptomatic testing in schools and workplaces where transmission has been documented, with accompanying financial support for parents who need to stay home with their children in quarantine and workers who need to self-isolate. These measures can and should be implemented alongside school reopenings and should not be seen as barriers to return.
It’s time to demand answers from our governing bodies about why schools remain closed. We have seen strong advocacy efforts on the part of the Canadian Paediatric Society, which on May 7 called on the government to demonstrate a plan for a return to classrooms before June. Given what we now know, we need an immediate return to in-person learning if we’re to act in the best interests of children. We need to invest in measures to support schools in communities of high transmission in order to allow these schools to safely remain open. All children deserve the right to in-person learning.
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