Ontario schools in low-risk communities should scrap COVID-19 restrictions like distancing and cohorting, experts say

Schools in communities with a low number of COVID-19 hospitalizations should be able to forgo physical distancing and cohorting in the fall while adopting a more relaxed approach when it comes to masking and screening students for symptoms, according to a new paper being released by Ontario’s science table.

The paper, which was prepared by a Sick Kids led group of experts, argues that schools should remain open for in-person learning “barring catastrophic circumstances” and that extracurricular activities should be prioritized as “an important component of return-to-school plans.”

The 41-page report does say that temporary school-based measures to prevent the spread of COVID-19 should continue for the time being but it suggests that they should be imposed differently depending on the level of “community COVID-19 burden” rather than transmission.

The expert recommendations are based on three different scenarios – one in which there is only “limited and sporadic cases” of severe disease, another in which there is “early evidence” of an upward trajectory in severe disease and a third with a high prevalence of severe disease and a continued upward trajectory in hospitalizations.

In the best-case scenario, they say that contact tracing and low-barrier testing would serve “as an early warning system for emerging variants and increased transmission,” allowing for schools to return to something more closely approaching the pre-pandemic normal.

That means there would be no requirement for distancing or cohorting, though the experts say that class sizes “should still be kept as small as possible” and that classroom mixing should only occur outdoors.

In moderate and high-risk scenarios, the experts are recommending a return to physical distancing in the classroom but only for older students. For younger students, they say that “cohorting and masking” should be emphasized instead “to allow for close interactions.”

The experts do not take a position on making vaccines mandatory for eligible students and staff at schools but do say that schools and school boards should be given access to “anonymized and aggregated information” on vaccine uptake to support targeted education and improved accessibility.

“I think the take home message really is that we have thought about a framework and guidance under the assumption that number one children have to be in school starting in September and have to stay in school, which is really the essential workplace for children,” Dr. Ronald Cohn, the president and CEO at The Hospital for Sick Children, told CP24 on Monday afternoon. “We need to ensure that children can stay in school and only under catastrophic circumstances should we use school closures as a measure to control the pandemic.”

SCHOOL ACTIVITIES SHOULD MOSTLY RESUME WITH PRECAUTIONS

The paper released on Monday goes into significant detail about the harm caused to students by prolonged school closures, citing research which suggests that only 15 to 60 per cent of learning loss could be mitigated through remote learning.

The paper says that there is also “significant evidence” that the closures have had an impact on the physical and mental wellbeing of children with high rates of anxiety and depression being observed.

The experts say that students should be greeted by a more normal school environment in the fall with the resumption of many activities that were put on hold this year.

That means that assemblies can resume in “low risk communities” while remaining online only in “high risk communities.” Intramural sports and competitive sports, meanwhile, can be held both outdoors and indoors in low-risk communities but in high-risk communities they should be outdoors-only.

Cafeteria closures are not recommended for any of the scenarios but the experts say that in high risk communities additional measures such as staggered lunch breaks and shorter lunch times could be put into place to reduce the risk of transmission.

“The past was dominated by using schools or school closure as a blunt tool for pandemic control. That should not happen anymore. We should make that history,” Dr. Peter Juni, the scientific director of Ontario's science advisory table, told CP24. “I think we had real consensus on the harms done to our kids (from school closures). Ontario actually had the longest deviation from in-person learning in Canada and we were probably also relatively world leaning on that one and that is not a good place to be. Next time we are in situations where new need to fine tune our response it shouldn’t be schools that have to stay closed or become closed.”

The Ford government has not yet released its plan for the resumption of classes but Education Minister Stephen Lecce has previously suggested that one will be made public sometime this month.

In a statement issued on Monday afternoon, Lecce said that his government is “following the advice of Sick Kids and paediatric experts” when it comes to the return to class and has already invested $1.6 billion in keeping students safe.

He said that the back-to-school plan will “will work to ensure a more normal in-class learning experience” in September, including the resumption o extracurricular activities. He did not, however, specifically address the dozens of recommendations made by the Sick Kids-led panel.

OTHER HIGHLIGHTS FROM THE PAPER:

• Symptoms screening as students arrive for school should only be considered in high-risk communities

• The symptom list should be narrowed in low-risk communities to focus on ones more commonly associated with COVID-19

• Fully vaccinated students who develop symptoms should also be exempted from a previous policy requiring that they isolate for 14 days or test negative for COVID-19.

• Asymptomatic testing of students is not recommended in low or moderate risk communities and should be further studied for high-risk communities due to “substantial logistical and equity concerns.”

• The definition of high-risk contacts should be reconsidered to minimize disruption to in-person learning

• Masking should be optional in low-risk communities but is recommended in moderate and high-risk communities