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Students at Dawson College in Montreal return to in-class learning on Aug. 23, 2021.Graham Hughes/The Canadian Press

Sloane J. Freeman is a pediatrician at St. Michael’s Hospital (Unity Health Toronto), an assistant professor of pediatrics at the University of Toronto, medical lead of the Model Schools Pediatric Health Initiative, and a mother of four. Ripudaman Singh Minhas is a developmental pediatrician, the director of pediatric research at St. Michael’s Hospital (Unity Health Toronto), an assistant professor of pediatrics at the University of Toronto, and a father of one.

When schools reopen in September, they will need to answer difficult questions in the face of ongoing challenges from COVID-19. And in doing so, they will also need to take into account that the pandemic affected school-aged children in different ways.

The duration of school closures varied across provinces and territories – Ontario, for instance, experienced the longest shutdown at 26 weeks. How will that varied length affect children in different areas? It is anticipated that Canadian students will return to school this fall with greater mental and physical health needs, as well as significant learning gaps – but children facing socioeconomic instability have been most affected. How will schools be equipped and resourced to support returning students’ additional needs? Similarly, will schools have the capacity to meet the learning needs of students who have fallen substantially behind?

Other school disruptions, including weather- and crisis-related school closures, as well as student absenteeism, have been associated with lower academic achievement. Additionally, online learning has been shown to be inferior to in-person learning for student success at both the elementary and secondary level, with the potential to widen existing educational disparities caused by pre-pandemic strains on educational resources and supports. U.S. studies have already shown declines in academic achievement during the pandemic school year compared to previous years, especially among racialized and low-income students. Will smaller class sizes and additional teachers be available to support small-group and individualized instruction?

Pandemic-related safety measures have also led to increased isolation, mounting stressors and declining mental health. Kids’ Help Phone Canada cited huge increases in call volumes related to isolation. Pediatric mental-health providers nationwide have recorded growing wait-lists amid a rise in anxiety, substance use, eating disorders and self-harm. In our clinics, students have told us they’re worried about the impact of missed learning opportunities, and are struggling with the loss of typical rites of passage such as graduation, prom, school performances and sports tournaments.

Mental-health supports were already strained in pre-pandemic school settings, and the likely forthcoming tsunami of mental-health challenges students may face requires more in-school support and clear referral and intervention pathways. What can be done for those families – especially those that were already having difficulty accessing services prior to the pandemic due to stigma, cost and other inequities? By many criteria, these are the same groups who have been hit hardest by COVID-19 itself: racialized communities, families of front-line workers, and those experiencing poverty – who have, in many cases, also lost family members to the virus, both locally and abroad. Will we be able to provide the needed multi-faceted mental-health supports to ensure marginalized students are not left behind?

In addition, students will head to school after a summer in which there were fewer opportunities for physical activity. This compounded the effects of learning from home, where students were more able to snack or graze than in the classroom, and activities such as walking to school, team sports and informal lunchtime play were eliminated. Some U.S. studies have noted that the body mass index (BMI) scores of up to one-third of children have increased during the pandemic. Will schools embrace outdoor teaching and experiential learning, increase physical education and intramural sports, and allow for lengthened outdoor recesses so students can achieve the Canadian Paediatric Society’s recommendation of 60 minutes of moderate-to-vigorous physical activity per day?

The pandemic and its associated school closures have hurt children’s mental and physical health, as well as their learning and academic progress. That’s especially true for students facing various inequities, who will not benefit from a one-size-fits-all approach to school reopening. September, then, offers a critical opportunity to provide equitable and individualized mental-health support and increased access to better nutrition and physical activity.

And while we are indeed in this together, the big question as schools reopen remains: Will we understand that each of us – including our children – experienced the pandemic differently, and respond accordingly?

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