Cases in schools inevitable, officials say,
Public health officials say goal is to limit risk of COVID transmission
Cases of COVID-19 in reopened schools are inevitable, say Toronto public health officials, who are cautioning parents not to expect a shutdown of the entire school whenever a student or staff member tests positive.
“We expect to get cases related to schools,” said Dr. Vinita Dubey, the city’s associate medical officer of health, adding Toronto Public Health will take a “conservative” approach in how it handles cases in schools to ensure the risk of transmission is limited.
While TPH and school officials will be tasked with preventing the spread of COVID-19 when hundreds of thousands of children return to school in September, how those efforts will be communicated to the wider school community and the broader public is not yet clear.
Dubey said TPH is waiting for guidance for health units from the province on how to handle cases of COVID-19 in schools, including when to lockdown a school when the virus is believed to have been transmitted within it.
On Thursday, four teachers unions raised health and safety concerns with the reopening plan of Premier Doug Ford’s government, saying it puts students and staff in “significant and imminent danger.” While parents and other adults are encouraged to work from home, 583 Toronto District School Board locations along with 196 Toronto Catholic District School Board locations are expected to reopen at the bell on Sept. 8 — but not for school as normal.
The province has already placed guidelines on schools, including class sizes, protocols for self-screening and other measures to help prevent the spread of the virus.
TPH will be responsible for monitoring the probable and confirmed cases of COVID-19 in the school system as they already do in the broader community.
Dubey noted TPH has a longstanding relationship with schools in handling infectious diseases, such as measles.
In their guides to safely reopening based on provincial guidelines, Toronto’s public and Catholic boards spell out identical, specific processes for how they will handle cases of COVID-19.
Students and staff will be asked to assess their symptoms before attending school. Toronto Public Health is also recommending active screening take place at the school, including a paper questionnaire or other means.
If a student starts to feel sick at school they’ll be separated from others until they can be picked up by their family, with a staff member supervising them while both wear personal protective equipment. The student will be asked to get tested at an assessment centre. A staff member who becomes ill must immediately go home and get tested.
Staff and students will selfisolate while they wait for their results.
If the test is negative, they can return to school 24 hours after symptoms go away. If it’s positive, students or staff can only return 14 days after symptoms first appear — as long as symptoms are “mostly gone” and do not require a confirmatory test or clearance letter.
If there’s a confirmed positive case, the supervisor or principal have to notify a list of school board officials as well as TPH.
“The TDSB takes its lead from Toronto Public Health, which is responsible for any necessary communications with regard to
COVID-19 cases,” said spokesperson Ryan Bird said in a statement. “Should a presumed or diagnosed case of COVID-19 be present at one of our schools, we’ll work closely with Toronto Public Health to support contact tracing and inform individuals who may have been in contact with the affected person.”
Once a lab confirms a COVID-19 case, it notifies TPH directly. Public health has also told schools to contact them if they become aware of a suspected infection, in case there’s any delay from the lab so TPH’s work can begin as soon as possible.
The next step is for TPH’s case and contact team to investigate, identifying any close contacts the staff or student may have had.
Dubey said the planned school cohorts — small groups of students who will stay together throughout the day — will help, with the expectation schools will keep track of who is in which cohort and provide that information to TPH.
“The cohort is well-defined and you recognize that in the cohort while we want you to maintain physical distance as much as possible it may not always be possible throughout the course of the day,” she said. “And so, if there is a case in a cohort we might automatically say the whole cohort goes home — self-isolate that cohort until we can complete our investigation, for example.”
But parents should not expect an entire school to automatically be shutdown if there is one confirmed case, said Dubey, noting that measles are much more infectious than COVID-19, and when there have been confirmed cases of measles they have not closed the school.
But because of the risk congregate settings pose, Dubey said they will err on the side of caution and temporarily close a school if they lack immediate information to know who is at risk.
There is no clearly defined protocol for whether the entire school is notified when a suspected or positive case is identified, so how or whether all the parents of the school will be told is still unclear.
Shelley Laskin, a TDSB trustee for Ward 8 (Eglinton-Lawrence), said she shares the anxiety parents feel.
“I cannot blame them. They are worried about the health and safety of their most precious commodity, which is their child,” she said.
She said the board and TPH are providing as many details as possible to make parents feel confident in the plans that are in place.
“There has to be a level of understanding that people are working flat out to give them the answers they need,” she said.