Ottawa’s top doctor supports keeping schools open amid Omicron spread

Ottawa's medical officer of health says she supports keeping schools open, despite calls from teachers' unions and others to shut them down amid the rampant spread of the Omicron variant of COVID-19.

Representatives from several teachers' unions in Ottawa penned an open letter to Dr. Vera Etches on Friday, urging her to use her authority as medical officer of health to order a temporary closure of schools until additional safety measures are put in place, including access to N95 masks for staff and students, better air filtration in classrooms, and priority for boosters for education workers and older students.

However, in a statement on Sunday, Dr. Etches said she does not support closing schools.

"While I am expecting further guidance from the province about school reopening and measures to limit transmission in the community, I am currently in support of schools returning," she wrote. "I have evaluated the evidence and recommendations from my healthcare colleagues that being in school is what is best for children, youth, families and the health of our community overall."

The province delayed the resumption of school this week by two days. School boards that were set to resume classes on Monday will now start back up on Wednesday.

Etches says evidence suggests schools are not a driver of COVID-19 in the community.

"The information we have from throughout the pandemic is that schools being open is not a key reason for making the pandemic spread worse. In Ottawa, in December, with the Omicron variant circulating, the data showed that the COVID-19 rates grew in the community much faster than in the school population. Many of the introductions of COVID-19 into schools were related to transmission from social and sports activities outside of school," she said.

Data from Ottawa's four school boards shows there have been more than 1,300 COVID-19 cases in students and staff so far this school year, though that figure is most assuredly higher because the Ottawa Catholic School Board only lists active cases, meaning any resolved cases from past months are not on their public dashboard. Most boards have also not updated their case counts since the start of the Christmas break.

The province also says it plans to stop collecting data from school boards, though it remains unclear whether the boards will cease reporting new cases as they become known.

Ottawa Public Health has reported more than 15,000 cases of COVID-19 in the city since the start of the school year. It should be noted that 43 per cent of all reported cases in the city thus far either have no known epidemiological link or do not have enough information to determine where the virus was contracted. Thirty-nine per cent of cases are linked to close contact with another infected individual. 

OPH is recommending keeping contacts to a minimum, including a pause on indoor contact and team sports while Omicron is spreading.

Etches has long been an advocate of keeping schools open for reasons that include the mental health of both students and parents.

"If schools do not re-open, there is the potential that this could result in more indoor gatherings of children and more community transmission as parents and caregivers may need to rely on others to watch their children for work or for their own mental health, which we saw with previous COVID-19 waves," she said.

"While overall schools are not likely to be riskier for children than the contacts they have in the community, we know there would be harms from closing schools. Children and youth have fallen behind in social and educational development. They have more mental health challenges – depression, anxiety, eating disorders, hospitalizations included. Parents and guardians also report high levels of stress when schools are closed and their ability to work is affected. Keeping schools open consistently remains a key pandemic goal for the health of children and youth. School is an essential service."

Despite the reassurances, some students, like Grade 11 student Madison Page, say the current situation is frightening.

"I’m definitely concerned, I’d even go so far as to say I’m scared," Page told CTV News Ottawa. "With the extreme contagion of Omicron, it’s really dangerous to not know if you’re a close contact, especially for students like me who have work outside of school or who are engaged in other communities where they could be spreading the virus."

Page says there should be a greater effort on making schools safer for students and educators.

"I think the way I would feel safe at school is if teenagers were given boosters, as they are in the U.S., if we had N95 or KN95 masks for everyone - that’s students and teachers and also any other school staff - and also HEPA filters in classrooms and the hallways because that’s where students are often eating without masks." 

Etches stressed that keeping COVID-19 out of schools depends on proactive screening and keeping children home when they experience symptoms.

Etches responded to some of the requests in the open letter from unions, asking for N95s and vaccination priority. She recommends three-layer masks that fit well and can be worn throughout the day for both children and educators, and she says the city is working on expanding vaccine access.

"Some have suggested keeping schools closed until all children and youth are fully immunized. Unfortunately, with an 8-week interval between doses and 61% of children 5-11 immunized with one dose at this time, that timeline would mean too much missed school that causes known harms," she said. "That said, I am working with the City of Ottawa’s Emergency Operations Centre to ensure there is ongoing access for children and youth to receive first and second doses. As well, the team is working to create a way to focus on immunizing childcare and education staff with booster doses while continuing to focus on increasing rates of vaccine coverage with booster doses in older adults."\

Etches working with province on measures to limit transmission

Etches says Ottawa Public Health's goals during the Omicron surge are to keep a focus on minimizing severe outcomes and strain on the healthcare system, and on maintaining essential services.

"I will continue to listen to the questions and concerns that people raise and work to see us through this wave. Concerns for the whole population’s health, and all dimensions of health – related to infection and to mental health, continue to be our priority."

In an interview with CTV News Ottawa, she said she was speaking with her provincial counterparts about stricter measures that would help keep community transmission levels down.

"I am talking to the province about really strong measures to limit all indoor sports activities that could lead to transmission to prioritize keeping schools open. I am hopeful that we will see some movement on this this week," she said. "We know this is temporary, we’re going to make it through this Omicron wave, but right now it is important because it spreads so quickly, it will reach more vulnerable populations, we need to do more to limit that spread in the community."

Etches added that the wastewater monitoring signal is on the rise and has been for much of December. So far, it has not reached the heights of the Delta wave in April 2021, but with it going up, it shows that COVID-19 is still spreading in the city.

"That wastewater signal is going up. When it starts to turn, that will be when we know that we’re starting to have less COVID in the community and we can start to look at bringing back some of these extra curricular activities and looking at indoor gatherings again."

She also urged older adults who have yet to receive their COVID-19 vaccine to book appointments as soon as they can. 

"I am concerned that with the amount of COVID in our community right now, it will reach more vulnerable populations. The older adults who aren’t immunized is really a top concern of mine and I would ask people to recognize that they are at greater risk than vaccinated people for severe illness."

Infectious disease specialist Dr. Isaac Bogoch told CTV News Ottawa that there are steps to take that could further reduce the risk of COVID-19 transmission in schools. 

"This does seem to be an area that we can improve on and there are steps to keep schools safe. Having said that, some of those steps take a little bit of time to implement," he said. "Even in a perfect world where you’ve got all the resources at your disposal and you’ve implemented tools to maintain a safer indoor space, it’s a sad reality you’re still going to see cases and outbreaks in the schools, you are." 

He also said he thinks school boards should continue reporting COVID-19 data, which can be helpful in giving parents the information they need to make decisions about their children.

"It would be helpful even if it is poor, incomplete data to let parents know if there’s COVID in the school, or how much, or if people are out; this is all helpful and might inform some decisions of parents," he said. "It would be helpful to have that data available; it might change some people's mind whether they want to send their kid to school or not, but in general it’s usually more helpful to have more data rather than less."