As schools reopen in Ontario's hardest-hit regions, experts urge province not to lift COVID restrictions
Public health doctors say cautious approach needed with more transmissible variants
Weeks of online learning are coming to an end for thousands of students and parents as schools in Toronto and neighbouring Peel and York regions reopen — the last in Ontario to do so after the Christmas break.
Many medical experts — including a committee led by Toronto's SickKids Hospital — have called for schools to be the priority as the Ontario government decides when and how to bring the hardest-hit regions out of COVID-19 lockdown.
As they watch the alarming rise of more contagious variants of the novel coronavirus, some public health officials and epidemiologists are warning that in areas with high community transmission, schools should be the only places to reopen in the immediate future.
The return to school means students, parents, teachers and staff are leaving their homes and moving about in the community more than they were before, said Dr. Lawrence Loh, Peel Region's medical officer of health.
"When you make a change like that in the community, you usually want to wait at least one or two [virus] incubation periods to see what impact it has on case numbers."
Although strong COVID-19 precautions — including physical distancing and mask wearing — have proven to be quite effective in limiting transmission in schools, the emergence of more transmissible variants of the virus is a new factor that needs close monitoring, Loh said.
He's asking the provincial government to hold off on lifting other COVID-19 restrictions in the region, including reopening non-essential businesses, for two to four weeks.
Concerns about a 'third wave' of virus
So far, the Ontario government hasn't announced its plans for lifting restrictions in Toronto, Peel or York, except to say that the current stay-at-home order will remain in effect for all three hard-hit areas until "at least" Feb. 22.
However, if the province allows any degree of reopening at that time, it will be less than a week after the return to school — not long enough to get any increased variant spread under control and try to prevent a dreaded "third wave" of the virus, Loh said.
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"I feel for our small businesses," Loh said. "[But] if we just hold on for another couple of weeks, another few weeks, we may be able to avoid a third wave altogether with the vaccines coming in.
"If we do see a third wave in our community ... another shutdown to save lives and protect the health-care system is not going to be weathered well by our small business colleagues."
If case numbers rise after schools open, Loh and other experts said, it will be much easier to track the source of infection and identify variants of concern if other potential community sources aren't thrown into the mix at the same time.
"We have this tendency to try and move too many levers at once ... and then we struggle to know what it is that's causing an increase in cases — if and when we see an increase in cases," said Ashleigh Tuite, an infectious disease epidemiologist at the University of Toronto's Dalla Lana School of Public Health.
"Everybody wants schools to open and stay open," she said. "And so the way to do that is to open the schools and give that a bit of time ... see what happens with the case counts, make sure that things are headed in the right direction. And then you can start reopening other aspects of our economy."
Toronto's medical officer of health, Dr. Eileen de Villa, also expressed concern about easing restrictions too quickly, particularly as students return to in-class learning.
"We are in a position of great uncertainty with respect to variants, but what we know is alarming," de Villa said in a public statement on Feb. 8.
"I understand the value of preparing for the time we can lift restrictions. From a public health perspective in Toronto, that time is not now."
Unlike Loh, de Villa has not specified a minimum time frame between opening schools and easing other restrictions.
Economy can reopen 'with a lot of care'
Dr. Karim Kurji, medical officer of health for York Region, agrees that the more transmissible coronavirus variants are "the big wild card just now."
But now that long-term care residents — the most vulnerable people in this pandemic — have been vaccinated and strict COVID-19 safety protocols have been put in place in schools, Kurji told CBC News, he thinks it would be possible to safely open parts of the region's economy as early as Feb. 22.
"Many of our residents have really been suffering ... [including] those that are the owners of small businesses," he said.
"We really have to assess the whole community as being our patient," Kurji said. "I think in this instance, you know, we are finding the appropriate path forward so that we reopen the economy, but with a lot of care and with a lot of vigilance."
In addition, even if businesses were allowed to open on a limited basis, he said, the public health message to York Region's residents would still be to "stay at home unless it's really essential for you to go out."
That's something the Ontario government, including Premier Doug Ford, have also repeatedly said while talking about easing restrictions.
But telling people to stay home while opening more places for them to go creates a confusing, mixed message, Tuite said.
"It's sort of say one thing and do another thing," she said. "It's a communication disaster."