Doctors and Health Specialists Question Safety of Back-to-School PlanOn August 26, Quebec media published a letter by Dr. George Thanassoulis, Director of Genomic and Preventive Cardiology at the McGill University Health Centre (MUHC) and Assistant Professor of Medicine at McGill University, and Sonia Tremblay, a family physician. The letter was co-signed by more than 150 health specialists and is addressed to the Premier, the Minister and Assistant Deputy Minister of Health, the National Director of Public Health, and the Regional Director of Public Health in Montreal. Dear Premier Legault, Ministre Dubé, Ministre Roberge, Dr. Arruda and Dr. Drouin,
We believe the majority of Quebeckers want their children to return to schools come September. However, this must be done safely. Therefore, the objective should be to optimize the school environment to ensure that the risk of SARS-CoV2 transmission is as low as possible. To do so, the government should carefully review its back to school plan with the view of implementing the following: 1. Social distancing: Social distancing must be prioritized for all children (i.e. separation of at least one metre between students), in all areas of the school and for all grade levels. The government's plan to not encourage social distancing within classes (some having more than 30 children) is contrary to current recommendations by many expert groups. The number of students per class should also be reduced as much as possible and the appropriate resources should be provided to make this possible. Denmark and Norway succeeded with their back to school plan with reduced classes of 12-15 children. Childcare programs should also be modified to limit interaction between children of different classes. 2. Mask wearing in all indoor school areas: Several studies demonstrate that masks effectively reduce the transmission of SARS-CoV2. However, the Quebec return to school recommendation to wear masks does not include time in classrooms, where students spend most of their day in close proximity to their peers. In fact, the American Academy of Pediatrics recently recommended masks in primary and secondary schools to reduce the spread of SARS-CoV2. 3. Mandatory daily symptom screening: The best way to prevent outbreaks in our schools is to ensure that the virus is kept out of schools. To do so, parents, teachers and students must remain vigilant to any potential symptoms that suggest SARS-CoV2 infection, and if present must stay home. Daily mandatory symptom screening should be undertaken by parents before sending their children to school. Given the expected high rates of absenteeism due to possible symptoms, schools must have measures in place to ensure students can continue their learning from home. Quebec should also encourage new active screening strategies such as use of saliva-based tests and rapid point-of-care tests. 4. On-line learning option: The government should consider expanding the online option to allow parents the choice for online learning, given the current situation. Each family should have the right to determine whether their child should attend school in person this fall based on their own specific set of circumstances. This option would also have the effect of reducing class sizes and improving social distancing, as a sizeable minority of parents would likely select this option. 5. Air quality/ventilation: Many schools in Quebec are in older buildings and are overpopulated. Therefore, every effort should be made to optimize air quality and ventilation. School ventilation systems should be evaluated and updated as required within the shortest possible timeframe. In the meantime, simple solutions to improve ventilation should be recommended (e.g. opening windows, use of outdoor spaces and addition of temporary air filtration devices). Based on the experience of many countries around the world (e.g. the Netherlands, Germany, south Korea), we know that students can return to school safely with the appropriate plans in place. However, in other countries (e.g. Israel), the reopening of schools led to major outbreaks and triggered a massive wave of infections in the community, demonstrating how precarious the schools can be. Since it is impossible to accurately predict the impact of the reopening of schools in Quebec, a careful and prudent approach is strongly recommended. The current back-to-school plan in Quebec needs to better consider all the available scientific evidence to prevent outbreaks in schools, to avoid jeopardizing the safety of our children, teachers and parents, as well as, to prevent a resurgence of SARS-CoV2 in our community. It needs to be promptly reviewed and revised to ensure a safer return to school for all. To see the list of signatories, click here. (Translated from original French by Workers' Forum)
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As physicians, scientists, and parents of school age children, we
were largely disappointed with the government's return to school plan
that was disclosed to the public on August 10. We believe the current
plan is inadequate and needs to be improved. As described, the return
to school plan may put children and teachers at risk of contracting
COVID-19. Furthermore, the plan could lead to outbreaks within their
families and their communities. This could, ultimately, undo much of
our efforts to control this epidemic that have been made collectively
in the last six months.