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SickKids Release Guidelines for School Re-Openings

June 17, 2020

SickKids releases recommendations for school reopening

An advisory group led by The Hospital for Sick Children (SickKids) has been working closely with the Ministry of Education of the Government of Ontario to provide guidance on the safe reopening of schools in September.

The document, COVID-19: Recommendations for School Reopening, released today, addresses how schools can reopen in a way that maximizes the safety and well-being of students, staff and their families. Representing a variety of specialty areas including paediatrics, infectious diseases and child and youth psychiatry, the authors offer their insights into the impact of COVID-19 on the health and well-being of children and youth.

“We have to accept that COVID-19 will stay with us for a long time. We must move on with certain activities in our lives, such as schooling, while keeping in mind that there are a lot of ways to mitigate risk,” says Dr. Ronald Cohn, President and CEO of SickKids and one of the authors of the document.

“Not opening schools in September would continue to have a negative impact on the mental, behavioural and developmental health of children. We hope these recommendations help provide a framework to keep everyone safe when school doors reopen.”

Developed by experts from SickKids and Unity Health Toronto, with input from scientists at the University of Toronto and SickKids’ Family Advisory Network, the recommendations include important topics such as screening, hand hygiene, physical distancing, use of non-medical masks, and more.

At a media webinar held today, experts from SickKids discussed the impact of COVID-19 on the health and well-being of children and youth, and presented their guidelines for the reopening of schools.

Watch the COVID-19 and Kids media webinar.

Read COVID-19: Recommendations for School Reopening [pdf].

Handwashing, desks spaced far apart? Yes. Masks, or physical distancing at recess? No.

https://www.thestar.com/politics/provincial/2020/06/17/handwashing-desks-spaced-far-apart-yes-masks-or-physical-distancing-at-recess-no.html

“Ontario students should return to class this fall with safety precautions such as “hand hygiene breaks” at least five times a day — but not masks, experts at Sick Kids hospital say in their recommendations to the province.

And while desks should be spaced apart, with students grouped into “cohorts” and a ban on school assemblies, the team of doctors did not recommend physical distancing when kids are outdoors at recess because it’s not enforceable — and because playing together is “really central to child development and should not be discouraged,” said Dr. Michelle Science.

Kids should attend classes daily, and as many clubs and activities as possible should continue, the doctors said, though they warned some close-contact sports such as football, rugby and wrestling may have to be put on hold because of the ongoing threat of COVID-19.

“We have to accept that COVID-19 will stay with us for a long time. … Not opening schools in September would continue to have a negative impact on the mental, behavioural and developmental health of children,” Sick Kids CEO Dr. Ronald Cohn said during a webinar held Wednesday. He noted that kids are not believed to be “superspreaders” of the novel coronavirus and risks can be mitigated, if not avoided.

“We hope these recommendations help provide a framework to keep everyone safe when school doors reopen” and that for children, “not being exposed to in-person teaching and not being with their friends and peers is something that myself and many of my colleagues in pediatrics are literally losing sleep over.”

Education Minister Stephen Lecce said the government “will take a cautious approach that underscores our complete commitment to safety. We also appreciate the advice from the Hospital For Sick Children related to the importance of robust mental health supports to ensure this transition is positive.

“We will ensure those supports are in place. We will continue to seek the guidance of these medical and scientific leaders to reduce risk and maximize safe learning for all children.”

The Sick Kids team recommended:

  • Frequent handwashing — including several “hand hygiene breaks” daily — and hand sanitizer be available at the door of every classroom. Disinfecting wipes should also be readily available;
  • Holding classes outdoors when possible;
  • No temperature checking or other screening before kids can enter school. Parents can screen at home and not send sick children to school;
  • Children with underlying health conditions who are more vulnerable should be able to learn from home online if the family feels that is safest;
  • Sports and phys. ed classes “should be encouraged and continue according to available protocols” but high-contact sports “postponed or modified.”

The Sick Kids report did surprise some, including epidemiologist Dr. David Fisman who took to social media to say “why is there absolutely no consideration of the role of large gatherings in broader epidemic dynamics? Why does the document dismiss transmission in kids at a time when per-test positivity in those under 20 is now the highest in the province? Etc. So many questions.”

The Sick Kids team said while students and staff should remain in their grouping and not intermingle with other classes to minimize exposure in case someone falls ill, “cohorting should not be done in a manner that compromises daily school attendance or alters the curriculum options available to children.”

It says smaller classes are desirable, but “the daily school routine should not be disrupted to accommodate smaller classes for physical distancing.”

Cathy Abraham, president of the Ontario Public School Boards’ Association, said she hopes strong mental health supports will be in place given students will not have stepped foot in a classroom for about six months when school restarts.

The association is asking for local flexibility because the situation in a city like Kingston, with relatively few cases, is different than Toronto or Peel Region.”