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Opinion: Quebec’s January back-to-school plan gets a failing grade

MONTREAL — Quebec’s January school re-opening plan seems like déjà-vu all over again. With COVID case counts at an all time high, Ontario chose to delay the reopening date to Jan. 25. The Quebec government, however, chose to re-open elementary schools on Jan. 11 and secondary schools Jan. 18, despite the fact that the number of active cases in Quebec in individuals up to 19-years-old was 2.3 times higher than in Ontario in the 14 day period between Dec. 20 to Jan. 2.

Despite all the extra measures taken in Ontario schools and a much lower school infection rate, Ontario’s Premier Doug Ford chose the path of prudence. By contrast, Quebec’s decision to reopen schools earlier is clouded by obfuscation and misleading statements.

Unlike Ontario, which invested a lot in school ventilation, Quebec continues to ignore and downplay the ventilation issue. In a press conference last Friday, Quebec Director of Public Health Richard Masse left scientists aghast when he stated that air purifiers have not been demonstrated to clearly limit COVID-19 transmission, brazenly sweeping aside an abundance of scientific knowledge and international expert opinion, even misquoting and contradicting his own Quebec Public Health Institute’s (INSPQ) report.

It is now well established that aerosols can transmit COVID-19 and travel at distances far greater than two meters, which is why air purifiers are so important when school ventilation is inadequate in reducing infected aerosols by 99.7 per cent. Properly installed air purifiers, along with masking and social distancing, will provide added protection against the SARS-CoV-2 virus.

When questioned about at what level would the government decide to impose stricter school measures, Masse failed to give a clear answer.

In fact, a tipping point threshold level has been established and we have already passed it by a wide margin. The Harvard Global Health Initiative (HGHI), an elite organization at the forefront of pandemic studies, recommends a complete lockdown, including schools, if the numbers exceed a threshold level of 25 cases per 100,000.

On Jan. 9, Montreal recorded 77 cases per 100,000, over 3 times the HGHI threshold level. In a recent revision, the HGHI recommended that schools could exceptionally remain open at high levels of community spread, but only if mandatory rules are put in place with extraordinary diligence.

This guideline is conditional on the presumption that educators and staff must feel safe at work for any in-person learning to resume. While the HGHI report is much too detailed to fully describe in this article, it calls upon mandatory infection control measures which must include:

  • Universal masking for all students and staff at all times

  • Achieving six air changes per hour of ‘clean’ air through any combination of ventilation and filtration, although some sources suggest up to 12 air changes per hour when the presence of airborne virus is suspected

  • Enforcing social distancing rules at all times and in all shared places

  • Lowering occupant density in the room

  • Instituting widespread surveillance/screening testing, preferably by using rapid testing

It is also essential to develop a community culture of shared responsibility and universal precautions outside of school as well.

It is quite clear that the recently announced Quebec measures currently fall far short of those issued by the Harvard Global Health Initiative to prevent transmission in schools.

But there’s more unsettling news. Following the massive surge in school cases which occurred in the weeks preceding the closure of schools for the holiday season, the daily number of cases in people under 19 years old have not gone down as was hoped. With levels as high as they are, we should anticipate that the re-opening of schools will be followed by a surge in school cases and outbreaks surpassing the very high numbers of last month.

Despite the dire situation, the Quebec government offered very little in new measures to curb the spread of COVID-19 in schools aside from providing procedural masks for high school students. Universal masking was not addressed nor was the lack of social distancing in elementary classrooms. Air filtration issues were casually dismissed. Online tutoring is a step in the right direction but does not replace the option of distance learning for those who choose it. As a sedative, government officials proposed to give priority for vaccinating teachers sometime in the spring while ordering them to continue to work in an unsafe school environment. Meanwhile, vulnerable populations will have to wait even longer for their turn to get vaccinated, resulting in more sickness and deaths.

The many hardships of a prolonged lockdown on families cannot be disputed, but keeping the schools open while being reasonably safe at this critical time would require considerably more effort, critical thinking and flexibility than what the government has been willing to offer. Without more stringent measures and greater access to distance learning, the sacrifices we have made to date, and during the lockdown and curfew may be compromised.

Unfortunately, by sticking stubbornly to a failed approach and ignoring the science, the government’s latest handling of the school situation merits a failing grade.

Michael Levy holds a Master’s in Public Health and is an Environmental Health Specialist and Epidemiologist.

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