Sarah Downey, president and CEO of Michael Garron Hospital asks Dr. Janine McCready, Infectious Diseases Physician, five questions on every parent’s mind as schools plan to reopen this fall.
Is it safe to send my child back to school? What will happen if there is a case or outbreak in my child’s class?
In this edition of “5 Questions”, Sarah Downey, president and CEO of Michael Garron Hospital (MGH) interviews Dr. Janine McCready, Infectious Diseases Physician, to get her take on back-to-school planning.
Dr. McCready highlights infection prevention and control (IPAC) measures she’d like to see implemented in local schools, how MGH is preparing to support community schools in East Toronto, and how she is personally preparing her own children for a safe return to school this fall.
- Is it safe to send my child back to school? (1:02)
“This is definitely the question I’m getting about 150 times per day!” Dr. McCready says, “It’s a very good question.”
What we know about COVID-19 so far is that in the vast majority of cases where children do get infected, they have very mild illness so it’s rare for children to get very sick. Dr. McCready explains that this helps to frame the risk assessment around kids going back to school.
When Dr. McCready considers whether or not she will send her own children back to school, she highlights the following key questions that influence her decision-making process:
- What are the rates of community transmission? She will closely monitor case counts as the school year progresses.
- As an individual and parent, it’s important to look at your own household, the people you live with and ask yourself who your kids will be interacting with regularly – are they at higher risk for severe disease? If so, you might have a higher threshold as to whether or not you are comfortable sending your kids to school.
- What is my individual school doing and what precautions are being put in place to keep my child safe? For example, physical distancing, mask wearing, improved ventilation and hand washing.
- The individual needs of the child: How are they doing in an environment where they are going to school versus virtual learning and your ability to support them?
Dr. McCready adds that her son is in grade two and will be attending school this fall.
“I’ve been watching case numbers closely and I’m hopeful and confident that he can remain safe at school” she says, “we’re doing a lot of practicing wearing masks so that he’ll be ready.”
- What will happen if there is an outbreak or case in my child’s class? (3:52)
The Ministry of Education recently released operational guidance for COVID-19 management in schools.
The local public health unit is responsible for determining if an outbreak exists, declaring an outbreak, and providing direction on outbreak control measures to be implemented.
According to the operational guidance, “an outbreak in a school is defined as two or more lab-confirmed COVID-19 cases in students and/or staff in a school with an epidemiological link, within a 14-day period, where at least one case could have reasonably acquired their infection in the school (including transportation and before or after school care).”
If there is one case within a classroom, the guidance indicates that other children potentially exposed within that class would be sent home to isolate for 14 days.
The idea is to keep classes and cohorts separate as much as possible to prevent widespread transmission throughout the school if a case is introduced.
- What is the hospital doing to support community schools in East Toronto? (6:15)
“Here in the East we are really passionate about our community,” says Dr. McCready. “We want to help our local schools to make sure parents, teachers, principals and everyone feels supported as they prepare to return.”
There are several guidance documents to follow but it’s very helpful to digest and translate this information for the local setting. Therefore, Dr. McCready sees MGH’s role as providing a helpful resource to local schools and administrators.
In an effort to prevent and limit the spread of COVID-19 in East Toronto, physicians from MGH’s infection prevention control (IPAC) team and East Toronto Family Practice Network (EasT-FPN) are conducting virtual town halls with principals and teachers of more than 60 schools in the hospital’s catchment area.
During these ongoing meetings, school faculty have the rare opportunity to pose questions directly to MGH’s and EasT-FPN’s IPAC specialists and receive answers in real time. This allows teachers, principals and school support staff to leverage medical knowledge and expertise so they can address challenges related to understanding and applying the back-to-school guidelines put forth by various levels of government and school boards.
- What happens if my kid has a cold or runny nose? (8:55)
“They can’t go to school,” says Dr. McCready. “We want to keep all of the colds, viruses, coughs and everything else out of schools.”
The schools will be very strict and ask parents to be responsible about keeping children at home if they show any signs of sickness – even minor symptoms.
It is recommended that children showing signs or symptoms associated with COVID-19 get tested for the virus. If the symptoms are very mild, parents or guardians should keep their child at home until symptoms resolve for 24 hours.
“I would recommend a COVID-19 test because it is useful to know if there is transmission. If the COVID-19 test is negative, the child can return to school once their symptoms have resolved for 24 hours,” says Dr. McCready. “Even if the COVID-19 test is negative, we still want children to be healthy when they return to school.”
Dr. McCready explains that the spread of other viruses in schools will create more confusion, anxiety and absenteeism. “We’re relying on everyone to do their part,” she says.
- Where can my child/family get tested? When should we get tested? (12:00)
Where: The COVID-19 Assessment Centre at Michael Garron Hospital provides screening, assessment and testing for individuals in East Toronto. In addition, when schools reopen, the hospital’s plan is to open pop-up COVID-19 testing sites in late September in local neighbourhoods where a need is demonstrated. There are also COVID-19 assessment and testing centres across the city of Toronto.
When: Ideally, if you are symptomatic, it is best to get tested as soon as possible. Therefore in the event that you test positive for COVID-19, this will facilitate contact tracing, notification of other people you’ve been in contact with and ensuring everyone in your household self isolates.
COVID-19 testing scenarios for consideration:
- If your child has symptoms of COVID-19, but you do not, it is recommended that the child gets tested, but you do not necessarily require a test at that point. However, if your child or someone in your household tests positive for COVID-19, you should also get tested.
- If your child has been in contact with someone who tested positive for COVID-19, they should get tested.
- If you come into contact with someone who just tested positive for COVID-19 yesterday and you are asymptomatic, you may want to wait 5-7 days before getting tested. Otherwise, if you are tested too early, it may not pick up any transmission of the virus.
- If you are exposed to a confirmed case of COVID-19 (by Toronto Public Health or notification via the COVID alert app), it is recommended you get tested 5-7 days following the exposure but you will still need to self-isolate for the full 14 days.
Dr. McCready has downloaded the COVID Alert App and recommends that others do the same.
“It’s another tool in our tool box for the fall,” she says. “Anyone with a smartphone can download it.”