Ontario government releases guidelines for dealing with COVID-19 outbreaks in schools

The Ontario government has released guidelines on how to monitor and deal with COVID-19 positive cases or outbreaks that may occur in schools as students and staff prepare to head back to the classroom this fall.

Numerous scenarios are laid out in a 21-page document released Wednesday on what schools, boards, principals, teachers, staff, students, and local public health units should do if a student becomes ill during school hours, if a person is exposed to the virus outside of school or if there is a positive case.

“We have robust plans for schools and school boards so that when a case or an outbreak occurs, everyone knows what to do,” Premier Doug Ford said at a news conference. “So we can quickly find, isolate and contain the virus.”

According to the documents, an outbreak in a school is defined as “two or more lab-confirmed COVID-19 cases in students and/or staff in a school with an epidemiological link, within a 14-day period, where at least one case could have reasonably acquired their infection in the school (including transportation and before or after school care).”

The government said the school’s local public health unit (PHU) will work with the school to determine the epidemiological link and will advise on which cohorts are high risk contacts that will require isolation.

Local PHUs are responsible for determining if an outbreak in a school exists, managing the outbreak with the school and other relevant partners and determining when the outbreak can be declared over.

An outbreak will be declared over by the local public health unit based on:

• At least 14 days from the last outbreak associated case (including if a student, staff, essential visitor, or anyone else in the school during the outbreak).
• No further symptomatic individuals with tests pending.

The province also noted the outbreak does not necessarily need to be over for the affected school to reopen.

“Cohorts without evidence of transmission can be gradually brought back to school as additional information and test results become available. Consideration should be given to implementing additional preventive measures and active surveillance as part of reopening,” the document said.

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Role of school administrators and school boards:

• Implement prevention measures found in guidance from the Ministry of Education, Ministry of Health, and their local public health unit.
• Cooperate with the local PHU, and others as required.
• Communicate with early years partners about COVID-19 in schools and boards.
• Maintain accurate records of staff, students and visitors. Schools should be able to produce information regarding students and staff members in any and all class cohorts (i.e. classroom, bus, before and after school programs, extracurricular activities).
• Up-to-date records must be provided to the local public health unit within 24-hours of the request to ensure timely follow-up.

However, the province did say that in general, “schools should not report all instances of ill individuals in the school setting to the PHU as these are frequent occurrences and typically students have non-specific symptoms.”

The exception being, under Section 28 of the Health and Protection and Promotion Act, “school principals are required to report to the medical officer of health if they are of the opinion that a pupil has or may have a communicable disease.”

Principals are also advised to contact public health if they are concerned about a student’s absence or attendance concerns.

Communication with parents, students and staff:

• All school boards will be asked to create a COVID-19 advisory section on their website (if they have websites).
• School boards and schools will be asked to post information if there is a confirmed case of COVID-19 that involves a student or a staff member in a school setting.
• Students or staff members may withdraw from school if a family or household member has a confirmed case of COVID-19 but information will not be posted in these instances.
• In the interests of privacy, information provided to school communities will not identify the student or staff member that has received a positive COVID-19 test.
• If public health advises that a class, cohort or a school should be closed for a period of time, parents, students and staff will be notified immediately.
• Notice of any closures of classes, cohorts or schools will be posted on school and school board COVID-19 advisory sections.

If a student, teacher or staff member becomes sick during school, some recommendations include maintaining as much physical distance as possible, wearing PPE such as masks, hand hygiene, disinfecting rooms or areas, advising parents/guardians, and inform the local public health unit.

Schools are required to have a PPE kit that is specifically used for anyone who may fall ill. These are also recommended for before and after school care.

Dr. David Williams, Ontario’s chief medical officer of health, said there can be many reasons why children get sick and the symptoms of COVID-19 are very similar to symptoms of other illnesses, viruses, or possibly an ear infection, among others.

Children who fall ill will be sent home and parents will be asked to monitor them and seek medical attention if necessary, Williams said.

However, Williams said it will ultimately be up to the child’s parents to determine if the child needs to be tested for coronavirus and can be advised by medical professions to do so or not.

“Each case is different, each case needs to be approached separately,” he said. “We’ll do it the proper method of clinical assessment and diagnosis to give us the best advice… and to give direction to the parent on what to do with the child accordingly.”

If a student, teacher or staff member tests positive for the virus, he or she will be required to self-isolate for 14 days and no negative test results will alter the isolation requirement.

Classroom cohorts in contact with the infected person are considered at high risk of exposure and will be asked to self-isolate and be recommended to go get tested.

“Negative test results do not change the requirement for isolation nor do they shorten the isolation period for close contacts,” the document stated.

Anyone waiting for test results must be in isolation and cannot go to school in-person.

If a parent tests positive for coronavirus, they do not have to inform the school, although it is recommended any children in the household should stay home and self-isolate for 14 days.

Depending on the circumstances surrounding the case, the local PHU would provide direction to the school principal.

Local public health units will advise schools about a positive COVID-19 in the community and identify cohorts who are at high risk of exposure or at low risk of exposure.