As children across Canada get ready for the start of the new school year with most COVID-19 restrictions lifted, experts are warning of a potential wave of infections this fall.
Starting next month, full-time in-person classes will resume across provinces where public health mandates have been largely scrapped amid a decline in cases.
“The bottom line is that with schools reopening, with people gathering indoors, we expect that there will be another fall wave,” said Dr. Jesse Papenburg, a pediatric infectious disease specialist and medical microbiologist at the Montreal Children’s Hospital of the McGill University Health Centre.
The dominant Omicron subvariant, BA.5, coupled with children gathering in enclosed settings for extended periods of time, will likely drive the transmission rate up, said Dr. Anna Banerji, a pediatric infectious diseases specialist at the University of Toronto.
In line with public health guidelines, masks are no longer mandatory in schools, but will be made available for those who wish to wear them.
In Ontario, schools will provide optional three-ply cloth masks for students and non-fit-tested N95 masks for all staff, the provincial government said on its website.
Students or staff may still be required to wear a mask in school if they are a close contact of a positive case or have recently travelled internationally, Toronto Public Health’s COVID-19 guidelines state.
“Schools and school boards should be prepared that there may be a need to resume a requirement for mask wearing if a new variant of concern emerges,” TPH said.
In British Columbia, the decision to wear a mask or face covering in schools is “a personal choice” for everyone, the province says, that “will be supported and treated with respect.”
However, Banerji says masks should be required in classrooms as there is still “a lot of COVID out there.”
“My fear is that there may be a lot of peer pressure in schools and kids that are wearing masks, if they’re the minority, they may be teased,” she said.
Despite the lifting of provincial and territorial mask requirements, some Canadian universities have decided to keep them for the safety of staff and students this upcoming fall semester.
At this time, Papenburg believes mask mandates are not needed in schools, given other available tools, including vaccines, and immunity from recent Omicron infection among children.
“We wouldn’t want to have mandatory masks in schools unless the epidemiologic situation really requires it – and that could happen at some point during this school season,” he said.
In the absence of school mandates, Banerji stressed that positive messaging will be important – likening the face covering to a “superhero cape.”
“I think we need to bring it up and tell people you’re wearing masks because you’re being a hero and you’re supporting other kids in school, the teachers, your family and vulnerable people,” she said.
COVID-19 vaccination uptake
In Canada, COVID-19 vaccines have been approved for all school-aged children.
Two vaccine doses at least eight weeks apart are recommended for children aged five to 11 years and a booster dose should be offered to those with underlying medical conditions, including immunocompromised kids, according to the National Advisory Committee on Immunization (NACI).
While vaccinations are not required in schools, they are being encouraged amid a relatively slow uptake among the younger population.
As of Aug. 14, roughly 42 per cent of Canadian children in the five to 11 age group had received two COVID-19 vaccine doses, government data showed.
For older youth in the 12 to 17 age bracket, 83 per cent were fully vaccinated and 19 per cent boosted with a third dose.
In Toronto, schools are encouraged to develop a vaccination policy for staff and students to boost the uptake.
“If you’re a parent and you want to protect your child, then I think the best thing to do is to get them vaccinated,” said Banerji.
In Quebec, rapid COVID-19 screening tests will be made available in all pre-schools and elementary schools.
But it cannot be administered to children under 14 years without parental consent.
If a child develops symptoms and the parent has not consented to testing, “the child is kept in isolation and a parent is called to come pick them up at the school,” the province’s guidelines state.
In Nova Scotia, where students will be able to participate in the full range of activities, including, band, clubs, sports and field trips, high-touch surfaces will continue to be cleaned regularly.
The Ontario COVID-19 Science Advisory Table (SAT) released new recommendations Thursday on how to limit the spread of the coronavirus in schools.
It said a number of “permanent measures” should be implemented.
These permanent measures include achieving and maintaining adequate indoor air quality, proper hand hygiene, environmental cleaning and disinfection and ensuring students and staff stay home when they are sick.
The advisory table said temporary infection-related measures such as masking, physical distancing, cohorting, active screening and testing “can help reduce the transmission of communicable illnesses in schools.”
While cohorting, which involves dividing students into groups, and physical distancing are effective methods to control COVID-19 transmission, Papenburg said the ease with which they can implemented in a school setting needs to be considered.
Banerji said opening windows as long as the weather allows can also make a difference, as well as installing high-efficiency particulate air (HEPA) filters.
She is hopeful the experience of the last two years when schools were forced to shut down does not repeat this time around.
“Parents and children have suffered in the past two and a half years,” she said.
“There’s been a lot of impact on the school year. Let’s try to do everything possible to make it safe so that you can have a normal school year.”
— with files from Global News’ Hannah Jackson