Is a little certainty too much to ask?
They say kids crave structure, and certainty. Parents, too, these days. On Monday, Ontario’s minister of education held a press conference to explain that federal money would now be spent in schools to fund safety measures that have largely been implemented, and which should probably have been installed back in September.
Stephen Lecce didn’t mention the federal money part, or the already implemented part, or the September part. But the safety part was welcome. Schools in hot spots across the province were scheduled to reopen to in-person learning Feb. 10, and later in the day, Lecce announced that announcement would come Wednesday. It all felt seat-oftheir-pants, but why stop now?
“We hope we can provide that in the coming days based on risk assessment,” said Lecce. “And more importantly, based on the new protocols, the stronger, stricter protocols put in place, to make sure that when we reopen, all kids can be safe in this province.”
Were there concrete thresholds for reopening schools? There were not. It explained a lot about the dangers as Ontario lurches toward a vaccinated future. What are the thresholds for reopening schools in this province? How does decision-making work? Yes, it’s a complex matrix, but what would the basic number be? Sadly, this question went to Dr. David Williams, the province’s chief medical officer of health.
“Not an exact number per se,” said Dr. Williams. “We would like them all down, ideally, quite low but we know one, that from our feedback from the our public health measures table, and from our council of medical officers of health, and talking with medical officers of health, that if the rates are still showing community transmission up in the levels of, let’s say under 200 (cases per 100,000 per week), they’re now 100 to 150 in that range there. Can they still open? I say yes. With proper checks and balances.”
One hundred to 150? One hundred and fifty per 100,000 per week would be a convenient threshold if you wanted to reopen schools: As of Ed Tubb’s Sunday night tally, only five regions are currently above 100 cases per 100,000 per week: Toronto, Peel, Niagara, Wellington-Dufferin-Guelph and York Region.
But the Harvard Global Health Initiative pegged 25 cases per 100,000 per week as a safe school reopening threshold; the first seven Ontario regions to reopen after Christmas were all under 40, which was also the difference between Public Health Ontario recommendations and the province’s numbers during the framework fiasco. Cases aren’t the only measure, but they are a baseline indication of COVID-19 in the community.
“It is high,” says Dr. Ashleigh Tuite, an epidemiologist at the University of Toronto, and a member of the province’s volunteer modelling table. “It points to the problem of never having had a clear framework for when to stop or start inperson learning. We seem to keep moving the goalposts.”
Tuite added that Williams’s threshold was high before you include the more transmissible variant first identified in U.K. is not just in Ontario, but loose in the community.
The province’s partial lockdowns and stay-at-home orders from Dec. 26 and Jan. 14, respectively, are driving cases down. Not as fast as they could — paid sick leave is still the most significant missing piece, and sending kids back to school without paid sick leave is almost cruel in the time of COVID. Still, Ontario is headed, finally, in the right direction.
But that’s not fated, either.
The B.1.1.7 variant was found at a Toronto-area meat processing plant, which could present a GTA-wide problem. The first case of the more daunting variant discovered in South African was identified in Peel, too, with no known link to international travel, which means it’s pretty far from the first case. Both are circulating in the community; we’ll find out more about how much this week, when Public Health Ontario releases more point prevalence testing data.
So what to do about schools, whose safe reopening should remain one of the most important parts of a pandemic? Asymptomatic school testing in November and December found 2.5 per cent positivity, with 1.8 per cent being children; that’s not precisely analogous to the 2.26 per cent positivity in asymptomatic testing at Pearson airport in January, but it gives you an idea about which one the government describes as safe.
The real new safety measure announced Monday is finally deploying rapid tests, and Lecce promised every school board would be able to do asymptomatic testing when open, up to a total of 50,000 tests per week, and maybe that’s true. Positives will be screened for the variant first found in the U.K., whenever possible.
But how do you confidently reopen schools with a high level of COVID in the community, and limited ability to detect variants? On one of the numerous please-clarify-forGod’s-sake follow-up questions, Williams said any decisions would take place in concert with local medical officers of health, which was another example of the province handing off the ball when it suits it; during that framework fiasco the province didn’t provide a specific threshold for something close to real lockdowns. Like much of Williams’s briefings, this is another grey area.
And it reinforces a fundamental problem with this province’s response all the way through the second wave. This government has tolerated a higher baseline level of infection than it needed to, and with it, sickness and death and everything that comes with that. The result was therefore a blend of economic strain and human tragedy, and truly serious and still-incomplete intervention only when the hospitals were close to being overwhelmed.
So, have they learned at all? Can we trust this government to hold the line on restrictions, and to safely handle schools, as the variant spreads? Hotspot schools might not be the tipping point. But when the variant found Denmark, primary schools closed.
And all along Ontario has been perpetually late in building testing, contact tracing, isolation and, above all, protections for the working class. What are the odds Ontario is ready for what could be a wildfire? It would be nice to have some certainty. The comforting kind, anyway.
How do you confidently reopen schools with a high level of COVID in the community, and limited ability to detect variants?