I am writing to you today to acknowledge the many questions and concerns about the return to school planned for many next week. While I am expecting further guidance from the province about school reopening and measures to limit transmission in the community, I am currently in support of schools returning. I have evaluated the evidence and recommendations from my healthcare colleagues that being in school is what is best for children, youth, families and the health of our community overall.
The level of the COVID-19 Omicron variant in our community is very high, so the chances that students and education staff will encounter COVID-19 outside of school is increased. The information we have from throughout the pandemic is that schools being open is not a key reason for making the pandemic spread worse. In Ottawa, in December, with the Omicron variant circulating, the data showed that the COVID-19 rates grew in the community much faster than in the school population. Many of the introductions of COVID-19 into schools were related to transmission from social and sports activities outside of school. This is why I have been recommending that residents limit their close contacts and high-risk activities and I am discussing with the province the urgent need to pause other activities to keep schools the priority. If schools do not re-open, there is the potential that this could result in more indoor gatherings of children and more community transmission as parents and caregivers may need to rely on others to watch their children for work or for their own mental health, which we saw with previous COVID-19 waves.
Keeping COVID-19 out of schools by staying home when we are sick is also very important. With so much COVID-19 in our community and reduced access to testing, we need to treat possible COVID symptoms as if they are from a COVID-19 infection. New provincial guidance is shifting us to new practices in isolation when we have COVID-19-like symptoms, regardless of access to a rapid antigen test or PCR test. I know some people need help to self-isolate, and I would encourage people to reach out for support from the city by calling 3-1-1 if needed.
When COVID-19 is present in a school, there are more layers of protection that slow transmission compared to in other settings. Many people are asking about using N95 masks in children and educators. The best masks for children and educators are well-fitted masks that they can wear comfortably throughout the day, masks that have three layers. We have learned that even children in kindergarten are adapting to keeping their masks on to block the virus, which is what I recommend.
While overall schools are not likely to be riskier for children than the contacts they have in the community, we know there would be harms from closing schools. Children and youth have fallen behind in social and educational development. They have more mental health challenges – depression, anxiety, eating disorders, hospitalizations included. Parents and guardians also report high levels of stress when schools are closed and their ability to work is affected. Keeping schools open consistently remains a key pandemic goal for the health of children and youth. School is an essential service. Additionally, at this time of more essential workers being off sick, having to stay home to look after children would also further disrupt critical services, including those who provide health care services.
Some have suggested keeping schools closed until all children and youth are fully immunized. Unfortunately, with an 8-week interval between doses and 61% of children 5-11 immunized with one dose at this time, that timeline would mean too much missed school that causes known harms. That said, I am working with the City of Ottawa’s Emergency Operations Centre to ensure there is ongoing access for children and youth to receive first and second doses. As well, the team is working to create a way to focus on immunizing childcare and education staff with booster doses while continuing to focus on increasing rates of vaccine coverage with booster doses in older adults. Older adults are most likely to suffer severe infections and potential death, compared to very low rates of hospitalization in children. The work to rapidly ramp up capacity to immunize older adults has been about saving lives and preventing hospitals from being overwhelmed.
There are many things in our control and actions we can take to protect each other during this surge, especially people at higher-risk – people not yet fully vaccinated, immunocompromised individuals, older adults – and people who work in higher-risk settings. When everyone in a household that is eligible for a vaccine is vaccinated that helps to protect the youngest children who are not. Pausing indoor gatherings and activities with people outside of your household can reduce transmission. Having everyone who lives in the house stay home when someone is sick helps too. Other tools may become more available later in the new year, such as rapid antigen tests, but taking these protective and preventive actions does not depend on the availability of tests now. We know that COVID transmission is widespread in our community. If you have symptoms, you need to act as if you have COVID. The actions (such as isolation, waiting for symptoms to resolve, and limiting gatherings) are what will slow the spread, not the testing.
I know everyone, including myself, wants the best for children, youth, parents, guardians and education staff. I am so impressed at how the school community has adapted to the challenges of the pandemic. I am thankful for their ongoing commitment to protecting each other. At the population level, my current recommendation is that children and youth deserve the health benefits of schools being open next week. Schools provide students with essential supports, for learning and social development. This is not a decision I take lightly. It is supported by our child healthcare partners across the province (see: CHEO News Release- Children’s Health Coalition agree schools must be prioritized for kids’ overall health.)
I will continue to monitor the situation and work with the province to decrease COVID-19 transmission in the community and in schools. The goals with the Omicron surge are to keep a focus on minimizing severe outcomes and strain on the healthcare system, and on maintaining essential services. I will continue to listen to the questions and concerns that people raise and work to see us through this wave. Concerns for the whole population’s health, and all dimensions of health-related to infection and to mental health, continue to be our priority.