1/ @SickKidsNews released guidance today about school reopening. Colleagues, mentors +caregiver advocates among co-authors. I was not involved in its development, and can appreciate concerns raised re: content and comprehensiveness. A few thoughts as peds + ID/IPAC physician:
2/ This was a summary of current published evidence + #IPAC principles to consider w/school reopening, and would've benefited from ON-specific data - BUT we couldn't routinely test sx'ic kids for MONTHS unless they were admitted. Huge gap in knowledge of provincial epi.
3/ Clinicians are trusted sources of knowledge + community partnership; we have a role in knowledge translation. Need scientists at table to dissect real-time data + model impact of strategies (screening/cohorting/shielding) to inform dynamic approach ie responsive to local epi.
4/ We have limited knowledge of #SARSCoV2 transmission in kids d/t early school closures and lockdowns except in specific settings outside of Canada.
@DrZoeHyde has written a nice summary of what we know in kids: https://twitter.com/DrZoeHyde/status/1272134717039509506?s=20
5/I read this document as framework of 12 principles to anchor stakeholder convos - ALL need to be addressed + contextualized locally for safe return to school. This is a starting point to what has to be MANY conversations + decisions that continue through the Fall
6/agree with premise that kids SHOULD return to school - NOT for economy OR caregivers to return to work, but to optimize kids' health+welfare. @CHEO sig increase in mental health consults; vulnerable kids bearing the brunt of prolonged shutdown physically, emotionally, mentally.
7/Some considerations for the next iteration:
1) consider local epi+age grps (elementary vs middle-HS) in a phased approach to reopening ~ what we're developing in hospitals for service delivery. If 2nd wave is to peak in August, should expect tighter IPAC strategies in schools
8/
2) #faceshield instead of #mask for teachers - kids need to see facial expressions + benefit from being able to read lips
(kids w mask touch their faces ++ vs shield =no nose-picking/nail-biting - anecdotal but #Faceshieldsforall should be explored further by #PHAC as option)
9/
3) bus services - how to keep kids and driver safe? Lessons to be learned from @OCTranspoLive + other public transit services

4) education resources for families on how to minimize infection transmission risk at home when kids back in school esp if at-risk household member
10/
5) How to manage outbreaks, failed screens, or sx'ic kids in culturally sensitive manner (can be psychosocial nightmare - kids should not be made to feel "dirty"...)

6) model class sizes + evaluate impact of cycling/cohorting (2wks on, 1wk off) @AmyGreerKalisz
11/ In setting out zero tolerance policy for new infectious symptoms, need to invest in #virtuallearning. No excuses @ONeducation: take lessons learned NOW to improve platform + delivery for kids at home d/t isolation, immunocompromised, sick, parent choice #equity
12/ Good ventilation is not fans (please, no!). Outdoor education does not mean taking desks outside. Schools w/outdoor-based programming can share insights into how to teach science, math, geography, phys-ed in all seasons. Need to bring teachers to the table #InThisTogether
13/Families w/medically complex children have unique needs+ already face barriers to accessing education services. Hard to understand the 24/7 attn from families + need for skilled professionals to support tech-dependent kids at home + classrooms. Bring caregivers to the table.
14/Kids in #complexcare need direct focus from educators, public health, clinicians + community services to dvp individualized care + learning plans. All 3 ministries must work together to give overdue attention to these kids' needs in and out of classroom #equity #respite
15/Must ensure @ONThealth @ONeducation
@ONSocialService hold one another accountable. In supporting an #LTC outbreak response, I was struck by the vacuum of responsibility btw MOH+MLTC. Let's NOT make the same mistake, and ensure plan contextualized to local epi, community needs
END/ This framework is a useful start. Next step = broad consultation w/groups mentioned +local stakeholders; tailor guidance to younger/older grades, higher/lower prevalence areas, rural/urban areas; dvp thresholds for restrictions/IPAC controls as informed by local data
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