Open Letter: Keeping schools open during the pandemic

B.C.’s public health physicians and child health specialists reflect at end of school year

 

ONE year ago in British Columbia, schools were preparing for limited re-entry of students who had been learning online since the end of spring break amid the province’s first wave of COVID-19. Survey data from this period gave an early indication of the detrimental impacts of school closures we’ve now observed around the world: impaired learning for many students, decreased social connection, and stress for families.

The return to classes in September came with both benefits for students, and accompanying fears that schools could be drivers of community transmission. But thanks to the hard work of schools, staff, parents and caregivers, and students, B.C. was able to achieve a collective goal: schools remained safely open in the second and third waves to fulfill their essential function in the intellectual and social growth of students.

Over the past year we have learned a great deal about COVID-19 and the risk in our schools. We now know that, although students and staff do test positive for COVID-19, they most often acquire the virus from the community at rates that mirror community transmission. The vast majority of the time these are isolated events with no onward transmission in the school. Contact tracing studies conducted in Ireland, Singapore, Wisconsin, England, North Carolina, and Utah, among others, have consistently demonstrated low rates of in-school transmission. In B.C., Vancouver Coastal Health and Fraser Health have reported similar results. Asymptomatic viral testing and seroprevalence studies addressing the potential for “silent” asymptomatic spread in Italy, Norway, Australia, and B.C. have similarly suggested that widespread COVID-19 transmission is rare in the school setting.

The percentage of exposures in school leading to transmission events has remained low even as we’ve seen a shift in the circulating variants of COVID-19 in B.C. This means that the safety measures in schools – including accessible testing for those who need it, keeping kids home when sick, practicing good hand hygiene, and restricting entry – continue to be effective even against variants of concern. In B.C.’s third wave, while close contacts of COVID-19 cases were isolated, broad school closures were not implemented, and maintaining consistent in-school education did not prevent public health measures from effectively decreasing community transmission. Perhaps most importantly, B.C. has been able to keep schools safely open for in-person learning, while still maintaining one of the lowest COVID-19 mortality rates of any larger jurisdiction in North America.

We’ve also learned more this year about how closing schools hurts children and families, especially those who are the most vulnerable. For many students, schools are important for learning and social development. For vulnerable children, schools can be a lifeline – the site of access to healthy and consistent meals, a place of connection to trusted adults, and, for some, a source of stability in chaotic lives. School closures also place disproportionate burdens on women and lone parents who shoulder the responsibility of supporting childcare and online learning.

Finally, in recent months we’ve seen how effective vaccination against COVID-19 is at cutting community transmission and protecting those at risk of severe disease. In Prince Rupert in Northern British Columbia, where >60% of adults were vaccinated in March as part of a whole-of-community campaign, rates of new COVID-19 cases have dropped more than 90% since their peak. Cases in other communities prioritized for vaccination in B.C., such as the town of Whistler, have also seen substantial reductions in cases. With many staff, parents and caregivers, and children now eligible for vaccination, we will collectively be able to build on our ability to protect the vital role schools play in a healthy, equitable society. By the fall, we can also look forward to a return to many of the extracurricular activities that keep students engaged at school and connected to their peers.

We have shown that, even during a pandemic, students’ education can be safely prioritized; vaccination will help us cement that success and support the school experience that children, youth, and families deserve.

 

Find out how to get vaccinated in your province by visiting www.canada.ca/covid-vaccine. If you’ve already been vaccinated, you can help by reaching out to others in your community who might need help to register. Covidquestions.ca has answers to common questions you might hear from family and friends who have yet to be vaccinated.

 

 

Alex Choi MD MHSc CCFP FRCPC

Medical Health Officer

Vancouver Coastal Health

 

Ariella Zbar MD CCFP MPH MBA FRCPC

Medical Health Officer

Fraser Health Authority

 

Ashley Roberts, MD, M.Ed., FRCPC

Division Head, Pediatric Infectious Diseases

Department of Pediatrics, UBC

 

David Goldfarb, MD, FRCPC

Clinical Associate Professor

Department of Pathology and Laboratory Medicine, UBC

 

Manish Sadarangani, BM BCh FRCPC DPhil

Associate Professor, Department of Pediatrics, UBC

Director, Vaccine Evaluation Center, BC Children’s Hospital Research Institute

 

Christine A. Loock, MD, FRCPC, DABP

Medical Director and Specialist Lead, RICHER Program,

Department of Pediatrics, UBC

 

Susan Wakeham, MD, FRCPC

Pediatric Infectious Disease Fellow

University of British Columbia

 

Esther Lee, MD, FRCPC

Clinical Instructor, Division of General Pediatrics and Division of Pediatric Palliative Medicine

Department of Pediatrics, UBC

 

Matt Carwana, MD, MPH, FRCPC

Clinical Instructor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Alison Lopez, MD, FRCPC

Pediatric Infectious Diseases physician

 

Raina Fumerton, MD, MPH, FRCP

Public Health and Preventive Medicine Specialist

 

Rakel Kling, MD, MSC, MPH, FRCPC

Public Health and Preventive Medicine Specialist

 

Mel Krajden, MD, FRCPC

Medical Director, BCCDC Public Health Laboratory

Professor, Dept. of Pathology and Laboratory Medicine, UBC

 

Jocelyn Srigley, MD, MSc, FRCPC

Clinical Assistant Professor, Department of Pathology and Laboratory Medicine, UBC

 

Sandra Allison, MD, MPH, CCFP, FCFP, FRCPC

Medical Health Officer and Public Health and Preventive Medicine Specialist

Vancouver Island Health Authority

 

Julie Bettinger, PhD, MPH

Professor, Pediatrics, UBC

Vaccine Evaluation Center, BC Children’s Hospital Research Institute

 

Allison A. Eddy, MD, FRCPC, CAHS

Professor and Head, UBC Department of Pediatrics

 

Geoff McKee, MD, MPH, FRCPC

Medical Director, Population and Public Health

BC Centre for Disease Control

 

Trevor Corneil, MD, MHSc, FCFP, FRCPC

Clinical Professor, School of Population and Public Health

University of British Columbia

 

 

Laura Sauve, MD MPH FRCPC

Clinical assistant Professor, Division of Pediatric Infectious Diseases

UBC Department of Pediatrics

 

Ghada Al-Rawahi, MD, FRCPC

Clinical Associate Professor, Department of Pathology and Laboratory Medicine, UBC

 

Silvina Mema MD, MSc, FRCPC

Medical Health Officer, Interior Health

 

Erin Peebles, MD, FRCPC

Clinical Assistant Professor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Alison Lee, MD, FRCPC

Pediatric Emergency Medicine Physician

Clinical Instructor, Department of Pediatrics, UBC

 

Matthew Chow, MD, FRCPC

Child and Adolescent Psychiatrist

Clinical Instructor, Department of Psychiatry

University of British Columbia

 

Tommy Gerschman, MD, MSc, FRCPC

Pediatric Rheumatologist and Pediatric Sports Medicine

Clinical Instructor, Department of Pediatrics, UBC

 

Sarah Freedman, MD, MES, FRCPC

Clinical Instructor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Erik Swartz, MD, MSc, FRCPC, CCPE

Clinical Associate Professor

Department of Pediatrics, UBC

 

Samara Laskin, MD, FRCPC

Clinical Instructor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Tom McLaughlin, MD, MPP, FRCPC, FAAP

Clinical Assistant Professor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Catherine Biggs, MD, MSc, FRCPC

Clinical Assistant Professor, Division of Allergy & Immunology

Department of Pediatrics, UBC

 

Jennifer Retallack, MD, FRCPC

Clinical Instructor, Division General Pediatrics

Department of Pediatrics, UBC

 

Dianna Louie, MD, FRCPC, FAAP

Clinical Assistant Professor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Robert Lehman,  MD, CCFP, MClSc, FCFP

Clinical Assistant Instructor, Division of Family Medicine, UBC

Division of Family Practice, Sunshine Coast

 

Hana Mitchell, MD, MSc, FRCPC

Clinical Assistant Professor

Pediatric Infectious Diseases | Pediatrics

The University of British Columbia | BC Children’s Hospital

 

Michaela Remington, MD, FRCPC

Clinical Assistant Professor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Aven Poynter, MD, FRCPC

Community Paediatrician, Langley

Clinical Assistant Professor, Department of Paediatrics, UBC

 

David Smith, MD, FRCPC

Child and Adolescent Psychiatrist, Vernon

Medical Director C&A Psychiatry, IHA

 

Kirsten Miller, MD, FRCPC

Community Paediatrician, Prince George

Clinical Assistant Professor, Paediatrics, UBC

 

Alexis Crabtree, MD, MPH, PhD

Resident Physician in Public Health and Preventive Medicine

School of Population and Public Health, UBC

 

Wilma Arruda, BSc, BEd, MD, FRCPC

Community Pediatrician, Nanaimo

Clinical Assistant Professor, Pediatrics, UBC

 

Mark Bigham, MD, FRCPC

Medical Health Officer

Fraser Health Authority

 

 

Gwyneth McIntosh, BScN, MN, NP(F)

Family Nurse Practitioner

RICHER Social Pediatrics Program

BC Children’s Hospital

 

Claire Seaton BM, BCh, MRCPCH, FRCPC

Clinical Assistant Professor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Dominique Eustace, MD, FRCPC

Locum, Division of General Pediatrics

Locum, Division of Child Development and Rehabilitation

BC Children’s Hospital

 

Nita Jain, MD FRCPC

Clinical Assistant Professor, Division of General Pediatrics

Department of Pediatrics, UBC

 

Denise Hanson, MN

Pediatric Nurse Practitioner

RICHER Social Pediatrics Program

BC Children’s Hospital

 

Albert de Villiers, MBChB, MMed

Chief Medical Health Officer

Interior Health

 

Shobhit Maruti, MD MPH (OEM) PRCPC DABPM

Medical Health Officer

Interior Health

 

Sue Pollock, MD MSc FRCPC

Medical Health Officer

Interior Health

 

Karin Goodison, MD MPH FRCPC

Medical Health Officer

Interior Health

 

Carol Fenton, BHSc MD MSc FRCPC

Medical Health Officer

Interior Health

 

Réka Gustafson, MD MHSc, FRCPC

VP Public Health and Wellness and Deputy Provincial Health Officer

Provincial Health Services Authority

 

Sim Grewal, MD FRCPC

Medical Director, Pediatric Emergency Medicine

Clinical Associate Professor, Department of Pediatrics, UBC

 

Jane Buxton MBBS MHSc FRCPC

Professor UBC School of Population and Public Health

Physician Epidemiologist, BC Centre for Disease Control

 

Meghan Gilley, MD FRCPC

Pediatric Emergency Medicine

Clinical Instructor, Department of Pediatrics, UBC

 

Althea Hayden, MDCM MPH FRCPC

Medical Health Officer

Vancouver Coastal Health

 

Harold (Hal) Siden, MD, MHSc, FRCPC

Clinical Professor and  Division Head, Pediatric Palliative Medicine

Department of Pediatrics, UBC

 

Naomi Dove MD MPH FRCPC

Public Health & Preventive Medicine Consultant Physician, Office of Provincial Health Officer

Clinical Assistant Professor, UBC School of Population & Public Health

 

Veronic Clair, MD, MSc in Health Administration, CCFP, FRCPC, PhD

Public Health and Preventive Medicine Specialist and Addiction Medicine Consultant

Physician Epidemiologist, Communicable Diseases and Immunization Service, BC Centre for Disease Control

 

Mary Bennett, MD FRCPC

Clinical Professor and Associate Head, Education

Department of Pediatrics, UBC

 

Jasmine Allaire, MDCM FRCPC

Pediatric Emergency Medicine

Clinical Instructor, Department of Pediatrics, UBC

 

Marie-Claude Grégoire, MD MSc FRCPC

Clinical Instructor, Division of General Pediatrics and Division of Pediatric Palliative Medicine

Department of Pediatrics, UBC

 

Mark Lysyshyn MD MPH FRCPC

Deputy Chief Medical Health Officer, Vancouver Coastal Health

Clinical Assistant Professor, University of British Columbia

 

Patricia Daly MD, FRCPC

Chief Medical Health Officer, Vancouver Coastal Health

Clinical Professor, School of Population and Public Health, UBC

 

Tessa Diaczun, MN NP(Pediatrics)

Pediatric Nurse Practitioner

BC Children’s Hospital

 

Carmen Tait, MD FRCPC

Pediatric Emergency Medicine

Clinical Instructor, Department of Pediatrics, UBC

 

Karen Black, MD FRCPC

Community Pediatrician, Vancouver

Pediatric Emergency Medicine

Clinical Associate Professor, Dept of Pediatrics UBC

 

Simi Khangura, MD FRCPC

Pediatric Emergency Medicine

Clinical Associate Professor, Department of Pediatrics, UBC

 

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