Ontario adopts stricter student screening protocols
Ontario returns to tighter screening to try to keep virus out of classrooms
Elementary and secondary students with runny noses or persistent headaches will once again be directed to stay home from school and get a COVID-19 test as the province tightens symptom-screening rules to help keep the virus out of schools.
Ottawa Public Health's online screening quiz was revised on the weekend to reflect the provincial government's direction to adopt “one-symptom” screening.
Stricter screening rules were in place when schools opened in September, but were relaxed after COVID -19 assessment centres became jammed.
The rules that take effect today in Ottawa direct students to stay home from school and get tested if they have any of the following symptoms: fever, chills, cough, shortness of breath, decrease or loss of smell or taste, sore throat, stuffy or runny nose, new, persistent headache, nausea, vomiting or diarrhea, fatigue or muscle aches.
That's a change from the rules in place since October, which had directed students with one “minor” symptom such as a runny nose, sore throat or headache to stay home for 24 hours and return to school if the symptom improved.
The change will send thousands more students to COVID-19 testing sites in Ottawa and across the province. The local public health units in the COVID-19 hot spots of Toronto and Peel had already adopted one-symptom screening in December.
Ottawa has ramped up its COVID-19 testing capacity since last September, when the stricter screening was in place and testing sites were jammed. Parents waited in line for hours at the Brewer Park assessment centre run by CHEO, or spent hours or multiple days trying to book a COVID-19 appointment online for their child and waiting for results.
After the province relaxed the screening rules on Oct. 1, the number of school-aged children tested for COVID -19 immediately plummeted.
In Ottawa currently, OPH says testing is usually available on the same day or the next day. According to data posted from last week, the median time between the onset of symptoms and getting tested is two days.
Some education-union officials had called for one-symptom screening as more contagious variants of COVID-19 spread.
The screening change is welcome, said Susan Gardner, president of the union representing Ottawa English public elementary teachers. However, she said, the provincial government must do more to ensure schools are safe. On that list are risk assessments for every classroom, higher-grade PPE, more cleaning, smaller classes and improvements to ventilation with air purifiers and carbon monoxide monitors in classrooms, she said.
In addition, if the provincial government doesn't provide more funding for educators, school boards will be in a difficult position as more staff need to self-isolate, she said.
The stricter screening is also only as effective as the ability or willingness of families to follow the guidelines.
Ottawa family doctor Dr. Nili Kaplan-Myrth said some of her patients with symptoms refuse to have a COVID -19 test and still send their kids to school.
They either can't believe they have COVID-19 or don't want to be inconvenienced by having the family self-isolate, she said.
“I literally have conversations with my patients every day where they tell me, without even seeming to feel the least bit of responsibility, they tell me, `Yeah, I had a sore throat and a cough and a fever, but you know, it's not COVID so not a problem.'”
In other cases, people without sick pay fear they won't be able to buy groceries or make rent if they miss work, said Kaplan-Myrth. She cites the difficulty faced by one of her patients, a new immigrant with five children who worked at a lowpay, part-time job and did not have a computer to book a test or a car to drive there. For her, deciding to get a test for herself or a child “is a matter of, `Can she afford to feed her kids and herself, and keep going?'”
Without adequate sick leave and widespread testing of asymptomatic students, the screening tool is
“theatre,” she said. “It's much like people wearing masks, but their noses are exposed.”
The screening quiz also allows some leeway. Symptoms related to some other condition the student has don't necessarily count. For example, if a student has a runny nose that is probably allergies, extreme fatigue that might be depression, or a cough that seems like asthma, they don't have to check off those symptoms when using the tool.
In Ottawa, if parents are asked by a school or daycare for more information about a child's symptoms that may be attributable to another condition, OPH provides a form they can fill out.
However, as Ottawa Public Health also notes, “Having an underlying condition does not necessarily mean that your child does not also have COVID-19.”
Most children and youths with COVID-19 have no symptoms or only mild ones.
There is a large variation in signs and symptoms of COVID-19 in children, note the medical experts who contributed to an Ontario school-reopening report co-ordinated by SickKids hospital in Toronto.
Predominant symptoms have included fever and cough in more than half the cases; followed by runny nose/nasal congestion, myalgia/fatigue and sore throat in 10 to 20 per cent of cases; and gastrointestinal symptoms and headache in fewer than 10 per cent of cases, says the report.
It's a balancing act. Stricter symptom-screening will catch more students with COVID-19, but will also keep more children out of school and affect their parents and siblings, who have to stay home, too.
Ontario made another major change to the self-screening rules that will affect household members of students who have symptoms or are waiting for a test result.
Household members are now advised to stay home until the student has a negative test result. (That was already the advice from Ottawa Public Health, but not in some other areas.)
The self-screening test also applies to children attending daycare centres.
Having an underlying condition does not necessarily mean that your child does not also have COVID-19.