Front Burner - With schools reopening, how do you keep kids safe?

Episode Date: February 11, 2021

As COVID-19 cases go down, pandemic restrictions are loosening across the country, including in Ontario, but concerns about variants remain. Today on Front Burner, what that means for the safety of kids at school.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Jamie Poisson. COVID cases have started to go down nationally, but there remains arguably two big challenges in the second wave of the pandemic. The threat of multiple coronavirus variants of concern and access to vaccines.

But despite that, provinces, even the ones that have been hardest hit by the pandemic, are reopening again. In Quebec, you can go for a haircut or a manicure, and curfews in certain parts of the province are shorter now. Non-essential businesses can reopen with limited capacity in parts of Ontario with the lowest COVID-19 rates. And in Alberta, you can dine in and go to the pub. Manitobans can do that too, starting on Friday. And one key piece of reopening is that many schools are back. In Ontario, for example, kids in cities like Hamilton and Windsor are back, while kids in Toronto, Peel and York are set to start next week. But given all these ongoing concerns about variants, about the access

to vaccines, are we opening up too fast? Today I'm talking to Amy Greer. She's an infectious disease epidemiologist at the University of Guelph, and she's written a lot about this. Hi Amy, thanks so much for joining me today. Thanks for having me. As an infectious disease epidemiologist, but also just as a person living in Ontario where there were 1,072 recorded cases on Wednesday, how comfortable are you with the general trend of reopening right now? My short answer would be I think we need to hold the line for a little bit longer. And there are a couple of reasons for that. I think that, you know, I had this conversation in May of 2020, you know, as we kind of headed into spring about reopening at that point in time. It's been weeks since we had to do the unthinkable.

Thanks to our collective efforts, today we're prepared to announce the details of the next stage of reopening the economy. And in May, when we were having this conversation, the province of Ontario was reporting, you know, 300 and some odd cases on average over a week per day. Right now, we are reporting, you know, a thousand more cases per day than we were in May when we were talking about reopening. For the second day in a row, we are below 1,100 new cases with 1,072. And it's based on more than 52,500 tests. reduced transmission over the last four to six weeks, we still have very high rates of community transmission such that, you know, we have to really think about how low we are willing to push this so that when we do reopen, we have a little bit more wiggle room. I wonder what you would say to people who might argue, look, like, we do have some vaccines now, although the majority of people

aren't vaccinated, but we are making progress in long term care homes where 80% of our deaths have been around 80%, something like 70% of long term care staff has had been vaccinated and a lot of frontline workers as well. And so we're in a different situation than we were back in May. as well. And so we're in a different situation than we were back in May. Yeah, I mean, certainly vaccine as vaccine comes on the scene, the situation will change. Transmission in the community is also still an important consideration, right? And we need to think about all of the other things that go into the control of infectious diseases. And so, you know, we have to think about whether or not we have enough capacity to be able to really do good testing, tracing and isolating of cases to, you know, break those chains of transmission. Do we have access

to supports like paid sick days and support for individuals to isolate and quarantine if they're required to. You know, what about healthcare capacity? We still have a lot of patients in hospital. And so, you know, we need to think about, do we have healthcare capacity for the inevitable increase as we reopen in cases? And not just for coronavirus patients, right? But healthcare capacity for all of the other reasons people need to be able to access healthcare. And so it sounds like what you're saying is that you don't think that we. If you think about increasing case counts, you have to have, you know, people who call every single one of those individuals. And we heard earlier when cases started to really surge, that, you know, contact tracing becomes very difficult.

And in the hardest hit health units, many of those health units had to prioritize contact tracing for only some of the cases based on their definition of high risk individuals. There have been so many cases in Toronto, contact tracing is now only being done for outbreaks. With numbers skyrocketing above 500 cases a day, cases have been slipping through the cracks for months. And so, you know, I think that it is really challenging. Do you think that there's been a failure of governance there? You know, for me, I feel as though we continue to ask individuals to do more and more.

And no matter what the federal government, no matter what the provincial government does, municipal governments, if we don't have the cooperation of the people, this is going to get out of hand. I just can't stress it enough. Please, please just follow the protocols. And at the same time that we're really putting a lot of pressure on individual responsibility and individual actions, it does feel a lot like some of the things that government could do to help, really significantly likely help with disease control, like paid sick days, has just not been on the table, which seems really hard to kind of accept. kind of, accept. I want to ask you about the variants for a minute.

I'm thinking about that press conference with Eileen de Villa the other day, the head of Toronto Public Health, where she talked about the possibility that the B.1.1.7 variant, the one that first was found in the UK, could now become the dominant strain. We are in a transition from one pandemic to another. I understand the value of preparing for the time we can lift restrictions. From a public health perspective in Toronto, that time is not now. And I wonder if you could talk to me a little bit about that and what if anything concerns you about that? Do you share Dr. Davila's concerns? Yeah, I most certainly do. And I think that, you know, work that's been done here in Canada across a number of different groups is highly suggestive of the fact that

that variant, given that it is being already transmitted in the community more widely, will likely, you know, overtake the original variant, if you will, and start to be responsible for many more of the infections that we see. And so, you know, that, again, presents us with a new challenge. It means that we are, at the same time as we are allowing our contacts to start to creep up, we then have, you know, spread of a virus that is now more easily transmitted from person to person. And so, certainly, you know, having those two things happen at the same time is worrisome. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem.

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50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. I want to move on to schools here. We're talking about the spread of these variants as schools reopen in Ontario. While kids stay at home to learn remotely, and with the introduction of tough measures and the stay-at-home orders for all Ontarians, we have seen a consistent decline in community

transmission. Ontario is ready to reopen our schools because it is safe. And since January, schools have been opening in Quebec and Alberta. And so I want to talk about the implications of that with you. I know you have kids at home and And I wonder if I could ask you how old they are? Have they gone back to school? Will they go back to school? Yeah, so I have two kids, they're five and nine. And for a variety of reasons, we actually opted for non in person school in September. But within the province of Ontario, that was an option that we were given. We are learning at home, day in and day out, which has its own challenges, but is the choice that we made for our own situation. And it's been working fine for us.

I know that you've been part of a growing chorus of epidemiologists and doctors who are concerned that there hasn't been a clear enough plan to make schools safe to open. And what are your key concerns here? We have much more transmission of this virus happening in the community than we had in September. So, you know, when we opened in September, one of the most important things that was said over and over again, and certainly, you know, the WHO has gone on the record and said the same thing, the best way to protect the safety of schools so that kids can go back to in-person school, the best line of defense is to keep

community transmission low. We are moving to stage two of BC's education restart plan. We know that schools can safely reopen if community transmission is low. And even though we've had an uptick in the last few weeks, we know that we have flattened the curve here in BC and we know we have what it takes to continue. The reason why that's so important is because when community transmission is low, the risk of, you know, importing a case into a school setting is also low. Right. And I just, I just want to be clear here, you know, and I think this goes back to the conversation we were having sort of back and forth at the beginning, you think, you know, a thousand cases is still too high because it is still a lot lower than we were

in December, right? When Ontario was clocking like 3,000 cases a day. Yeah, for sure. And so now we have kind of moderate to high rates of community transmission, depending on where you are in the province. And that doesn't mean that schools have to be closed, right? I want to be clear that that is not what it means. But what it means is when we have high rates of community transmission, we need to have a plan to escalate our in-school measures to provide extra protections. I wonder if I could ask you briefly, you know, we hear a lot about schools and school transmission or a lack of transmission in schools. You know, you hear people say that kids don't really get sick very often, but they are also not really transmitting the virus. And what do we actually know about the transmission of COVID-19 in schools?

It's a really good question because there are people who have very clearly stated, you know, transmission does not happen in schools. As chief medical advisor, Dr. Anthony Fauci has said for months. Close the bars and keep the schools open. Shows very little risk of transmission at brick and mortar schools. For me, I find that a challenging statement to be able to support with evidence. And the reason for that is because, as you say, kids, especially young kids, often don't show any symptoms. So, you know, up to a third of young kids, if they have an infection, will not have symptoms. And so if our testing is only focused on children with actual respiratory symptoms, then there is the potential that we are missing individuals who are asymptomatic,

because we have not done asymptomatic testing in kind of a comprehensive and strategic way. So for me, what I would have liked to be able to see, because there's so much debate about it, and I just feel like we could have had an answer to this question in the fall. And what we would have wanted to do would be every time we identified an introduction into a class where that class was then dismissed to go home to quarantine for 14 days, what would have been really great would have been in each of those exposed cohorts conducting, you know, targeted asymptomatic testing to exposed individuals. So kids who had a known exposure test them at day six or seven to identify if any of them actually get flagged as being positive,

because then we could know whether or not our in-school measures are working really well to prevent in-school spread. And so it's really hard to understand whether that was not done because we did not sufficiently have capacity in the system, or is it that it was a cost issue? You know, it's very unclear to me why we would not have just collected the data. I also wonder if, in terms of like the data being readily available, if it's also about even the kids with symptoms, how it's being recorded. So, you know, I was reading about this one family in Thornhill where the five-year-old appears to have gotten COVID from school and then infected the entire family of five. But it's unclear whether a case

like that even gets registered as community spread or as school related. I think it is also a very challenging thing, as you've said, to attribute, you know, the source of infection, especially when, you know, kids have lots of different contacts. So it becomes very difficult to ascertain, you know, with certainty where those infections would have been acquired. to ascertain, you know, with certainty where those infections would have been acquired. And I do worry that, you know, it is possible that we have been under-attributing cases to school and saying, well, you know, this was likely acquired in the community when we can't really rule out that it could have been acquired in the school. You know, you mentioned that you think with these sort of moderate to high levels of community transmission, it is still possible to open schools. And there is a plan that the Ontario

government has put forward, which includes new measures to protect staff, students. Those include province-wide access to targeted voluntary asymptomatic testing that will be deployed by the local public health units for students and for staff. Which is what you mentioned before, increasing their mandatory mask policies, efforts to stabilize staffing levels. And when you hear that, what do you think? It sounds like a plan. For me, the problem is, is that it doesn't feel as though there is any sort of operational part of the plan. So while we've said we're going to do targeted asymptomatic testing, you know, I have not heard of detailed information about what this would actually look like. information about what this would actually look like. You know, in theory, certainly some of these statements sound like, you know, more robust or kind of escalated measures from what we had in

September. But it's not really clear, you know, how they're actually going to be deployed. And to me, that's very problematic, because we already have an awful lot of students and staff who are already back in school. And that doesn't seem to have been worked out yet. So look, if I'm a parent, I mean, I am a parent, but my child is quite young, so not of school age yet. But if I'm a parent with school age children, and I'm listening to you right now, I think maybe I would feel quite concerned about sending my kids back to school or having just sent my kids back to school. But I also imagine that I would be grappling with some other questions. And, you know, maybe I'm coming from a family where, you know, I don't have the luxury of working from home and it's very difficult for me to keep my kids at home. And so I wonder what you might say

to these parents who might be finding themselves in very difficult positions right now. Yeah, so I think, you know, I don't want people to be scared. So let me say that off the bat. So I do think that there are a lot of things that we can do to help minimize risk. And certainly, you know, focusing on the basics is really important. We also know that schools have, and this is something we didn't talk about, but that has been changed, is that especially in public health units where there are significant rates of community transmission still, community transmission still, many of those health units have moved to a higher testing threshold.

So now if your child has any single symptom, that child is not able to attend school. It is also recommended that their siblings also stay home until they have a negative test result. That's really incredibly helpful and protective, especially in settings where we have increased community transmission. We know that's happening if you look at the school screening guidelines in some of those higher risk public health units. So that's, you know, that's something that has been changed that helps to provide additional safety. You know, I think the other thing about keeping schools as safe as possible so that kids, you know, the essential work of children is to be in school. And we want to, you know, everybody has said schools should be the last to close and the first to open. And I agree with that statement.

I think that we need to, as adults, have to continue to keep our contacts very low, as low as possible, to keep schools open as long as possible. Because if the contacts start to creep up, it will become harder and harder to do that. All right, Amy Greer, thank you so much for this conversation. Thanks for having me. All right, so before we go today, some news on a story that we've been following. After 1,001 days, Saudi women's rights activist Loujain al-Hathoul has been released from prison.

The UBC graduate is best known for calling for the right to drive before it was granted in 2018 and for the removal of male guardianship laws that had long restricted the ability to travel for Saudi women. Her imprisonment, based on a vague law aimed at combating terrorism, drew international criticism from rights groups, the Canadian government, and American lawmakers. We did an episode about Lou Jane's story over the summer. You can find it in our feed. I'm Jamie Poisson. Thanks so much for listening to FrontBurner and talk to you tomorrow.