Ontario’s new school screening rules are not yet in effect in Toronto, where the medical officer of health said Friday she could oppose the changes, and a growing number of doctors are raising questions about the policy.
The province has touted its new, less stringent guidelines as a change that would clarify the rules around symptom screening and ease the burden on parents of sniffer children who have been plunged into days, if not weeks of COVID testing chaos. But in Toronto, it has so far increased anxiety and confusion among families whose daycares and schools follow Toronto Public Health guidelines.
At a press conference on Friday, Dr Eileen de Villa did not pledge to enforce the new policy, which is “effective immediately” in York and Peel, according to these health units. De Villa said she was reviewing Toronto-specific data on COVID in children before making changes to reflect the new provincial policy, which allows children with certain short-lived symptoms – like a runny nose – to return to class without testing.
“If our local data differs or tells us we need to do something different, we’ll take this course of action with the province and let them know what we’re seeing, so we can make the best decisions for residents. , and students, in particular, from Toronto, ”she said. “I have no doubt that with their desire to create safe school environments, they will come to a reasonable conclusion that makes sense for our students here in Toronto.
In an email Friday, a spokesperson for the Ontario Ministry of Health said he expected his policy to be passed. “We are asking all school boards to align the criteria” in the new guidelines “so parents and staff are provided with up-to-date and consistent information.”
However, a spokesperson for the Toronto Public Council and an administrator for the Toronto Catholic Council told The Star that until they receive the updated advice from Toronto Public Health, they are sticking to the tool. stricter screening in the city, which orders all symptomatic children to stay home for 14 days. – or test negative for COVID – before returning to school and daycare.
“We are taking our orders from Toronto Public Health,” said Norm di Pasquale, administrator of the Catholic Council. He said de Villa’s comments were a “great relief”.
“A runny nose can quickly turn into something else,” said di Pasquale. “What we really need are quick test solutions for our students… so they don’t have to be out of service for four days, five days.”
The tension around the new screening tool comes as de Villa urges the province to allow tighter lockdown restrictions in Toronto, where infection rates have reached unprecedented levels, threatening schools’ ability to remain open.
In the past two weeks, there have been 411 cases of COVID in Ontario schools and 83 cases in licensed daycares, according to the province’s online portal. Ontario’s testing capacity is under increasing strain, with the backlog reaching a record 90,000 on Friday.
The new guidelines for screening in schools are part of several changes to Ontario’s screening policy announced this week, including making testing available at assessment centers by appointment only.
De Villa said that because TPH is governed by the province, “we are in a limited capacity to act on our own”. The province replied, in an email to The Star, that local medical officers of health could, under provincial regulations, issue orders to set requirements for schools or daycares regarding COVID if the legal test is met.
Doctors also oppose the revised guidelines. Dr Hirotaka Yamashiro, a Toronto-based pediatrician and chair of the Ontario Medical Association’s pediatrics section, said the association met with the province on Friday to discuss “widespread concern” among family physicians and pediatricians in the country. about the new guidelines, which direct families to see a primary care physician before looking for tests for many symptomatic children.
“It’s a terrible perfect storm. We have a huge demand for flu shots, limited medical hours and resources, ”Yamashiro said. “People who are really sick, kids who have physical or mental problems, are going to be harder to see and may give up.”
A spokesperson for the ministry said, “We continue to work with Ontario physicians to understand their concerns and answer their questions. We expect pediatricians to continue to provide the quality of care patients expect and deserve, as they always have.
Several prominent infectious disease experts spoke out against the guidelines this week, saying the province had not provided data to justify relaxing testing rules as cases increase.
The ministry provided some of that data to The Star on Friday, when it shared a report from Public Health Ontario that helped inform the changes.
According to the report, SPO was asked to review the scientific literature on symptoms of COVID in children and analyze the epidemiology of Ontario to “support decision making related to screening children.” It was requested by the Department of Health on September 22 – a day after B.C.’s medical officer of health announced changes to the province’s screening checklist and after schools in the province reopened. ‘Ontario.
The report concluded that fever and cough were the most commonly reported symptoms in children. The following most common symptoms were “multiple” and overlapped with other illnesses or allergies, according to the report, with asymptomatic infections of up to 20% in children.
Looking at data from Ontario, the report also found that among 1,332 children who tested positive before July 13 and had information about symptoms, a runny nose was a symptom reported between 8 and 18 per year. hundred.
The report’s authors write that the symptoms of COVID chosen for school screening are influenced by “risk tolerance, epidemiology and local context, as well as screening capacity.” Decisions to remove symptoms from the screening list, or to combine them, “will depend on the level of risk tolerance,” they wrote.
“If the goal is to get the fewest symptomatic cases of COVID-19 entering the school environment (high sensitivity), then the symptoms should not be reduced in number or combined.”
The new guidelines have been greeted with glee by many parents who have been sent in long lines to COVID assessment centers through their children’s runny noses, only to wait days for results.
But within hours of the province’s announcement, many parents in Toronto were already receiving emails from their schools and daycares, informing them that the old rules remained in effect until they received further guidance from TPH.
These old rules have sent Lindsay Scott and her 18-month-old daughter to assessment centers three times in the past five weeks. The first visit was for a runny nose that “swept the daycare”; the second for a “light” cough. the the last was a fever, but this time the wait at his local assessment center was seven hours, Scott said.
She doesn’t know what to do with the revised rules, but says she wonders if the new guidelines are rooted in science.
“Any policy change (should) be based on real science and not just as a way to unclog the system which, frankly, should have been sorted out by the government months before school starts,” she said. “It wasn’t a surprise to anyone, and yet, it is as if it was.”