Health
As Ontario Schools Reopen, Parents, Experts Say COVID Test Plan Details Missing

As Ontario Schools Reopen, Parents, Experts Say COVID Test Plan Details Missing

With Ontario students returning to face-to-face classes, the Ministry of Education recently announced it could provide up to 50,000 rapid antigen and PCR tests per week as a key part of its plan to curb the spread of COVID-19 and reopen schools safely.

Testing for COVID-19 is overseen by Ontario Health, a provincial body responsible for coordinating health care. But much of the decision-making on how the tests will be used has been left to the discretion of individual public health units. The Department of Education and the Department of Health both said it was because factors such as community transmission vary from region to region.

But the province’s lack of specific direction is causing parents to fear there is no cohesive plan, said Jessica Lyons, member of the Ontario Parent Action Network and a mother of three in Toronto.

“Testing is how we know where we are… It’s how we know where we are in terms of the effectiveness of school safety measures,” said Lyons, who is also a community nurse.

The emergence of worrisome new coronavirus variants – believed to originate from the UK, Brazil and South Africa and which appear to be more easily transmitted – makes a ‘robust’ testing plan even more vital as it unfolds. prepare to send him two elementary items. school-aged girls are going back to school next week.

“I am terrified of the variations,” Lyons said. “I’m really, really nervous.”

Mollye, 7, and Ruby, 9, work on their reading while going to school from their home in Toronto. Their mother, Jessica Lyons, is concerned that Ontario does not have a solid plan in place – including a “ robust ” COVID testing strategy – for a safe school reopening. (Jessica Lyons)

In a joint email response to CBC News asking for more details on how COVID testing works, the Ontario ministries of education and health said they were working with “mobile test providers to support the provision of targeted testing in schools and daycares.[s] across the province when local public health units have identified a need. “

The email also stated that if a student or teacher tested positive for COVID-19 with a rapid antigen test, they would be referred for a laboratory-confirmed PCR test – the test performed at COVID assessment centers. – to confirm the result.

The Ministry of Education too refers to an announcement from Premier Doug Ford’s office since Jan. 29, announcing that the province had increased its laboratory capacity so that it could screen all positive PCR tests to identify variants of concern.

However, the response did not specify whether or how the results of those tests would link to schools to determine whether cases of COVID-19 – including the worrisome variants – were spreading there.

It is also unclear what support the province offers in terms of people to administer the tests.

More clarity on how tests in schools will work is key to resuming in-person classes, said Ashleigh Tuite, infectious disease epidemiologist at the University of Toronto’s Dalla Lana School of Public Health.

“Details matter,” Tuite said. “What you really want to see is a real plan.”

Epidemiologist Ashleigh Tuite says that while local public health units may vary their approaches to COVID testing in schools, the Ontario government should still lead the way with a detailed plan. (Ashleigh Tuite)

“Obviously, every health unit or every [school] the board, you know, can have different circumstances, “she said.” But, you know, you expect the province to provide some kind of direction.

“You can change it to suit your needs based on your personal situation.”

No test details from Toronto, Durham Public Health

Based on the email CBC News received from the departments of Education and Health, it appears the province is suggesting the tests be used when public health units identify a school with a COVID-19 outbreak or in a community with a high rate of virus transmission.

CBC News has contacted three public health units in the Greater Toronto Area to learn more about their school-based COVID testing plans.

Peel’s medical officer of health, Dr Lawrence Loh, said he understands that Ontario Health will provide mobile unit staff who will perform asymptomatic tests and that Peel Public Health will direct them to where they are most needed. . However, Loh said he is still awaiting confirmation of this, along with more details from the province on what resources they will have.

The Toronto Public Health Department said it could not provide any information until later this week.

Schools in the Peel region and Toronto will reopen on February 16.

Schools in Durham Region reopened on Monday. In an email response on Friday, the Durham Region Health Department said it was “determined to work with local school boards to ensure the safe reopening of schools, which will include testing on staff and asymptomatic students, as indicated by the province ”.

A spokesperson for Durham Region Health said the ministry will provide “additional details to the community as more information becomes available.”

Peel Region chief medical officer Dr Lawrence Loh said a previous pilot study in the region showed the value of asymptomatic testing for COVID-19 in schools. (CBC)

Loh said a pilot project in Peel, where asymptomatic testing was conducted in schools late last year, showed how important testing is in identifying COVID-19 infections that would otherwise have may not be detected.

The key, he said, is not just rapid testing, but a rapid response when a student tests positive.

“When a case is detected in a school, we have to be very strict about quick and automatic dismissals,” Loh said.

The student, along with their cohort, should be sent home immediately to minimize the risk of spread to other students, teachers and staff. They will also receive laboratory PCR tests, which are the gold standard in COVID diagnostics.

Rapid tests can then be used on any other contacts in the school who are not in the cohort, Loh said.

Loh also said he understands lab capacity across the province has increased after a backlog earlier this winter and that labs will review positive test results for the variants of concern.

School data required

But in addition to rapid diagnosis, a provincial COVID screening plan for schools should also have a surveillance component, Tuite said – especially during this window when the rest of society is largely on lockdown and schools are down. the main gathering place for people.

If the COVID test isn’t in place when schools open, she said, it’s a missed opportunity to collect valuable baseline data to help answer a question that is being investigated. ongoing debate: whether or not schools are driving COVID-19 transmission, or are they simply reflecting the ongoing transmission in the surrounding community.

“The way to answer that question is to be really systematic about it – to, you know, come up with a testing approach that will allow us to answer these questions in terms of, you know, what’s going on in our communities. [and] what’s going on in our schools, ”Tuite said.

“I think we’re going to be in a similar situation to where we were in the fall where we’re just not going to collect this data.”

Several research studies from other countries suggest that schools do not appear to amplify transmission – but using school-based testing to generate Canadian data would go a long way in determining a more definitive answer, said Dr Jeffrey Pernica , pediatric infectious disease specialist at McMaster University.

“It would be very helpful to do more coordinated and targeted testing to be able to verify that schools are as safe as we think they are,” he said.

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