Opening schools a balance in benefits and risks
Niagara, Windsor-Essex have higher likelihood of community spread
The medical officers of health in two regions among the highest risk categories for school transmission of COVID-19, as per thresholds set by the Centers for Disease Control and Prevention, say they are cautiously monitoring the return to in-person learning for thousands of Ontario students.
According to a transmission risk framework created by the CDC, the United States’ national health protection agency, Niagara and Windsor-Essex would fall under the “higher” risk category, with more than 100 cases per 100,000 people within the last 14 days in the local community.
“I’ve been worried all along about the potential for transmission in schools, even back in September when things were pretty low … but on its own it’s obviously not a reason you don’t necessarily open schools. It’s a risk-benefit balance,” said Dr. Mustafa Hirji, Niagara Region’s acting medical officer of health, noting that he has confidence reopening can be done safely given the relatively low number of reported cases in schools last term.
“Despite this second wave being really intense everywhere in Canada, other provinces have managed to keep schools open and they’ve managed to do that successfully. So I think that’s another piece that can be reassuring.”
Niagara and Windsor-Essex are two of the 13 public health units that returned to in-person school Monday, joining the 18 that have already returned in recent weeks.
Only schools in Toronto, Peel and York remain closed. They will return to in-person learning Feb. 16.
According to a Star analysis of COVID-19 infection rates in all of Ontario’s 34 public health regions, adjusted for population, all regions returning to inperson school this week fall into the CDC’s higher category of risk transmission in schools.
The CDC’s risk framework is broken down into five categories: lower or lowest risk for 20 new cases per 100,000 people in the last 14 days; moderate risk for 20 to 50 cases; higher risk for 50 to 200 cases; and highest risk for more than 200 cases. The agency recommends using these categories in conjunction with another indicator, such as an individual school’s ability to take measures to reduce the spread, before local authorities decide to reopen schools.
As of Monday, the following regions would fall under the CDC’s higher category of risk of COVID-19 transmission in schools: Chatham-Kent (191), Niagara (189), Wellington-Dufferin-Guelph (158), Waterloo (139) and Windsor-Essex (139).
Last Wednesday, when Education Minister Stephen Lecce announced return dates for the remaining public health regions, Niagara and WindsorEssex were the only two regions headed back to school on Feb. 8 that were in the highest risk category.
“We felt that when you’re trying to balance the risk, continuing to keep (children) at home may not necessarily be the only option,” said Dr. Wajid Ahmed, medical officer of health for Windsor-Essex. “Our communication to the community has been very clear that there’s no risk-free solution. It doesn’t matter what you do. So there is some level of risk that individual families have to make based on their own child.”
Ahmed noted that the region’s case counts have dropped significantly on a per 100,000 people basis per week since January. But he did say that parents’ concerns about their kids getting sick are valid “because we are still living in the middle of a pandemic and things change.”
“It’s an ongoing assessment of the risk and that’s why the surveillance piece is important,” he said.
Dr. David Williams, Ontario’s chief medical officer of health, said last week that the decision to open or close schools is not based on an exact number, but rather investigations of individual public health units.
“The bottom line is that no one knows what’s going to happen. Nobody knows,” said Colin Furness, an infection control epidemiologist at the University of Toronto, noting that the province has done “zero systematic measurement” to get a true sense of the spread of COVID-19 in schools.
“From a front-line public health standpoint, they’re saying they’re not seeing transmission in schools, but then again that’s based on really limited measurement and the fact that kids are asymptomatic,” he said. “We might have measured schools that have forced air versus schools that don’t, classrooms that have windows open and classrooms that don’t. We could have collected all this beautiful data and we’d be able to define what a safe classroom is and what a risky classroom is and what a safe level of community prevalence is,” Furness added.
“We spent four months in school not doing those measurements and that is absolutely tragic.”