When it comes to the spread of COVID-19, vigilence works

In normal times, its the kids who get anxious about their first day of school. Today, as September approaches, parents across the country are the ones with knots in their stomachs, worried that the return to the classroom will pose a health risk to their children, but also worried that keeping them home could be harmful to their well-being in other, possibly more serious, ways.
Closing schools as part of the countrys first response to the COVID-19 pandemic was necessary and reasonable at the time. But it has come at a price. School closings have significant adverse health and welfare consequences for children and youth, according to a report from the Hospital for Sick Children in Toronto.
Those adverse effects include setbacks to childrens educational, emotional, social and physical development caused by their absence from the classroom.
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The downsides also include increased rates of depression and anxiety in children, as well as higher suicide rates, the SickKids report says. More than half the parents surveyed in a recent Ontario study cited by SickKids said they had seen drastic changes in mood, behaviour and personality in their children since schools were closed.
As well, the SickKids report said the stresses on parents caused by the economic shutdown unemployment, financial insecurity, precarious housing can trickle down and result in maltreatment. Bonnie Henry, the Provincial Health Officer for British Columbia, says schools are a safe space for some at-risk children a front line for their health care and sometimes the only place they get a decent meal.
Its for the sake of childrens welfare and health and not simply because reopening schools would make life easier for working parents that SickKids, as well as other public-health experts, support a return to the classroom this fall, as long as the necessary precautions are taken.
Parents are understandably nervous. There are no absolutes when it comes to preventing the spread of COVID-19 other than self-isolation and virtual learning, that is, and those are not the best choices.
On balance, the best choice is a cautious return to school, a decision based on three critical factors.
First, the state of COVID-19 in Canada. For now, the disease is under control. Outside of clusters that occur as the result of identifiable events, such as ill-advised house parties, there is relatively little community transmission in this country.
Second, the limited effects of the disease on young people. Children, especially teens, may be able to act as vectors to spread the disease to adults and that is an area of concern. But since the start of the pandemic, only one Canadian under the age of 20 has died from COVID-19 and only 26 have been admitted to an intensive-care unit. In 2018, car accidents killed 179 young Canadians and sent nearly 1,200 to hospital.
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And third, vigilance works. Physical distancing, regular hand-washing and wearing a mask can prevent the spread of COVID-19, if enough people do it.
Israel has been cited recently as an example of the dangers of reopening classes, when a large outbreak occurred 10 days after schools returned. But on closer inspection, the outbreak happened because students went to class with symptoms, the classes were large and overcrowded, with 35 students and up, and a heat wave meant wearing masks wasnt feasible.
In other countries, such as Finland and Sweden, schools that enforce physical distancing and other measures have reopened without major incident.
In Germany and the United States, students went back to school this week in large numbers, with different rules in different states. It remains to be seen how it plays out in each country.
But for Canadians, the bottom line is twofold: Schools need to reopen for the sake of childrens long-term well-being; theres credible evidence to believe it can be done safely, as long as the proper precautions are in place.
It will not be perfect. There will be outbreaks. But Canada has successfully reduced its rate of transmission by following the evolving science and the advice of public-health experts. This is not the time to stop. Based on everything we currently know about COVID-19 and about the effects of the lockdown on children, sending kids back to school this fall is the right thing to do.
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As long as its done properly, of course. Well write more about that later this week.
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