OTTAWA -- Ottawa's top doctor is telling parents an uncomfortable truth: there will be cases of COVID-19 in schools in the fall; however, she says there are ways to keep schools as safe as possible.

Speaking to reporters in a virtual media availability on Tuesday, Medical Officer of Health Dr. Vera Etches said there are many layers in the plans to keep school students and staff safe. First among them is keeping cases out of the classroom in the first place.

"Every one of us doing our part today will support a safer return to school in September," Dr. Etches said. "It starts with what we're doing today in the community."

The onus on keeping children safe falls squarely on the shoulders of adults. It involves keeping transmission low within social circles, workplaces, and the broader community.

Still, Dr. Etches says cases of COVID-19 in schools are not a hypothetical.

"There will be children with symptoms where we need to do the assessment and keep people out of school and determine if it's COVID, and there will be COVID cases. We know we can anticipate that," Dr. Etches said. "I am sure we will see a case of COVID in school. Most likely it will be the result of an introduction from outside the school. What we are working hard to do is making sure there isn't transmission within the school after that case is identified."

She does believe, however, that there will be more students with symptoms of COVID-19 than confirmed cases of COVID-19.

Dr. Etches said OPH is working to expand its testing capacity in the coming weeks to prepare for the increased demand from families, teachers, and other school staff in September.

"We know, given the size of the school student and staff population in Ottawa, which is nearly 200,000 people, there will be people with symptoms similar to COVID-19 that will need assessments every day," Dr. Etches. "Ottawa Public Health is working with our health care partners to make sure we can maximize our testing capacity to rule out or detect COVID-19 in the population on a daily basis."

Testing demand has already been high, with long wait times reported at testing centres. OPH has previously said that people who feel they might have been exposed should wait at least five days from a potential exposure before seeking a test, as earlier tests will not be as reliable. That messaging is expected to be repeated in the fall, as school populations become a priority.

Another method of keeping COVID-19 out of schools is through daily screening. Boards have said parents will be responsible for screening their child every day for symptoms and keeping them home when sick. Dr. Etches said that OPH will work with parents who have questions about what that means.

"What does it mean to screen your child every day?" Dr. Etches said. "What if it's just a headache or a stomach ache? We want to be very cautious as we go forward. Any mild symptom that previously may not have been a concern, we want to think twice about that."

Dr. Etches said OPH is hiring about 36 additional public health nurses to work with school boards.

OPH will also be more active in following up with families in cases where students are absent, to ask about symptoms and testing.

"What if one child is staying home or three children stay home? Reaching out to families to see if they have pursued testing or to recommend testing," Dr. Etches said. "In a regular year, we'd be working with schools around absenteeism. This is taking it to another level where we would be doing some of that active investigation and follow up if there's absenteeism due to illness."

Over the next several weeks, OPH will be practicing possible scenarios in order to have staff trained on the best response to a positive case or an outbreak.

In cases where a child or staff member does test positive, Dr. Etches says the focus will shift to preventing further spread within the school.

"It really is case by case," she said. "Public Health will be assessing where the likely source of exposure was. Most children's infections come from adults in their family."

OPH would then work through to communicate with the school and monitor for possible spread. Should additional spread occur, an outbreak is declared.

"The scenario where it looks like we're meeting the definition of an outbreak—which is when there are two cases in a school with a link between them—that is a time when we would be practicing what communications, what steps need to be taken in order to investigate more broadly where that transmission came from."

Dr. Etches stressed that the actions adults take in their everyday lives—mask use, handwashing, physical distancing, and isolating when sick—can help reduce the overall transmission of COVID-19 in the city and make schools a safer place for children.

She is asking employers to be flexible with their employees with children, in cases where people need to stay home. OPH is also looking at support structures for families that may face hardship in cases where they need to isolate themselves or a child.