Layers of safety needed to reopen schools

Funding for smaller class sizes will be crucial,

As the start of the school year approaches, families continue to struggle with the decision of whether to send their children to school. The core of this dilemma lies in Albertans’ lack of confidence in the safety of the current school re-entry plan. Health professionals, families, and educators in Alberta have all called on the government repeatedly in the past several weeks to fund a robust and comprehensive school re-entry plan.

Physical distancing is one of the main tenets of preventing COVID -19 transmission and is impossible to achieve without smaller class sizes or larger spaces. Classrooms were overcrowded and understaffed prior to the pandemic. These conditions, which previously resulted in teaching challenges, will now create an environment of close contact optimal for the transmission of viruses, including COVID -19, potentially leading to outbreaks and resulting in school and work absenteeism.

Mandating masks in older children at school is a step forward in preventing the transmission of COVID -19. However, it is insufficient alone. A layered approach to prevention is required, in which physical distancing is one of the most important measures. Masks may be useful as an adjunct to physical distancing, hand and environmental hygiene, and effective building ventilation. Masks are not recommended as a sole measure of prevention due to the inherent difficulties in masking correctly, even for adults. Furthermore, most non-medical/cloth masks have low filtration efficiencies, meaning many viral particles get through.

Countries across Europe and Asia that have opened schools successfully had two things in common:

First, they had low rates of COVID -19 transmission in the community and second, they resourced physical distancing, hand hygiene and/or enhanced sanitization measures — at least in the initial stages. Alberta does not have low rates of COVID-19 transmission in the community. In fact, Edmonton has the highest number of active COVID -19 cases to date. The safe reopening of schools requires prioritizing public health measures, such as the closure of non-essential services (bars, movie theatres) to decrease community transmission.

Guidelines from leading medical journals, the Hospital for Sick Children (Toronto) and the Alberta Health Services Scientific Advisory Group all recommend cohorts or smaller class sizes, enhanced sanitization, and optimizing building ventilation as measures to prevent outbreaks in schools. These public-health interventions required adequate funding. Although some countries were able to relax school safety measures with time without increased outbreaks, this is likely due to low COVID -19 rates in the community as well as variables such as outdoor learning, ability to keep windows open, and baseline small class sizes. In Sweden, where schools remained open throughout the spring, there were very few outbreak investigations in schools due to limited contact tracing capacity, making it problematic to use the country as a model for COVID -19 transmission in schools.

Although the majority of children do not get severely ill if they catch COVID -19, children live in family units, many of which include high-risk individuals. This is especially true in vulnerable populations. Minorities or low-income families are more likely to live in multi-generational households and do not have the option of not seeing their elderly relatives. Furthermore, children spend the day in classrooms with teachers who may be at high risk or live with vulnerable family members.

Studies showing teachers were not at higher risk of acquiring COVID -19 than other professionals were limited to elementary students, suggesting children of younger age do not transmit COVID-19 as well. However, junior high and high school outbreaks involving transmission between students and teachers have been reported in multiple countries which is consistent with recent evidence that children over the age of nine spread COVID-19 as efficiently as adults.

Implementing and funding comprehensive safety measures in schools is also beneficial because it will decrease the transmission of other viruses, including influenza. Every time a child or teacher has a cold-like symptom, they will have to be tested and isolate, which will overwhelm our already underfunded public health department, leading to delays in test results and contact tracing. It will also lead to missed school days, and pull parents out of the workforce. Resourcing schools to enable distancing and sanitization will decrease the frequency of other viral illnesses, thus improving both school and work attendance.

Access to education is a human right. Our children rely on it for their social development, intellectual progress, and mental health. The economy relies on it to ensure parents can participate in the workforce. The onus should not be on families and educators to determine how to ensure safety in schools. Parents shouldn’t be forced to decide between their family’s health and their child’s education, and teachers shouldn’t be forced to decide between their safety and their profession.

A safe school environment is a non-partisan issue — one that requires collaboration of key stakeholders to ensure a positive outcome.

Children over the age of nine spread COVID-19 as efficiently as adults.