amongst books

amongst books

Thursday, November 19, 2020

Covid-19, Schools and the Need for Government Plans and Accountability

 Dr. Shushiela Appavoo MD FRCP(C) Associate Clinical Professor, University of Alberta Co-chair, Canadian Association of Radiologists Breast Imaging Guidelines Working Group and member of the Masks4Canada group spoke today with Alan Neal on CBC’s All In A Day about whether it was necessary to shut down schools. Alas there isn’t a recording of that segment on the site yet, but if it is posted, I'll add it to this piece.

She made a valid point. She said that closing schools was only one tool in the arsenal. She talked about making schools safe by ensuring they follow Covid 19 protocols. She said that class sizes of 25-30 students was too large. In the press release there are a series of demands, including the enforcement of 2-metre distance as opposed to 1-metre which is currently the case.

Masks4Canada is a volunteer grassroots group made up of physicians, media, data scientists, marketing specialists, technologists, lawyers, engineers, students, teachers, parents, and advocates. Their goal is to raise awareness about the necessity of wearing masks.

 On their site, they feature a Canada Covid 19 School Case Tracker in order to provide transparency and increase safety in schools. The map has a live tracking feature and a form for Canadians to report cases. They say that schools “violate the 3C’s of social distancing: they are crowded, closed spaces with prolonged close contact.”

 They advocate the use of masks for K-12 students, and they also advocate strengthening schools by ensuring that the schools are following the protocols.

 I have argued over and over since the schools were reopened that children can be asymptomatic carriers of Covid-19 based on information from testing where those tested positive can show no symptoms. I have said that the most recent change in the Northern Hemisphere that has coincided with a surge in case numbers has been the fall openings of schools while there has been a decline in cases in the Southern Hemisphere, where schools are closed.

 I have not denied the importance of schools. I recognize that governments need schools to be open so that they can continue to keep money moving, parents need to work and can’t do so if they have to handle childcare. I recognize that schools are often havens for children who are victims of abuse at home or dealing with issues such as housing and food insecurities. I recognize too that for many children schools are a place for society and friendship. I see that it would be better at this time if the schools could remain open.

 However I also see a myth being spun by health authorities and governments claiming that schools are following the necessary protocols. 

Teacher and support staff unions have been up in arms since news of the planned opening about the lack of preparation, overcrowded classes, poor ventilation, over crowded buses, lack of teachers, lack of proper physical distancing recommendations. These issues are, in part, due to long term and systematic budgetary constraints of governments that have placed profit over people as a priority. I’m still looking for a resource with some kind of list of Ontario Education budgets and cuts over time, but in the meantime, take a look at this opinion piece by Ricardo Tranjan, in Education Action Toronto, which shows the effects of some of the Ford government’s recent cuts in education. Here’s a link to their editorial board and mission so you can check any possible biases, but it sounded straight-forward to me.

Meanwhile businesses and individuals are being called out with claims that they are disobeying protocols. And I’m sure some might be. Small businesses and individuals who have little or no money are being fined and shamed. I don’t know how this method is expected to result in an adherence to protocols or lead to a reduction in Covid-19 cases. It reads like a bad Victorian era morality poem. "I speak severely to my child, I beat her when she sneezes, she only does it to annoy, because she knows it teases."

Anecdotally only, I have heard of businesses who have not reported a member of their staff with Covid-19 because they can’t afford to shut down their workplaces for 14 days.

The only info I can find about Ottawa businesses and Covid-19 is vague about reporting requirements on this issue, so I am not sure of the veracity of what I’ve heard; however I have heard this from several workers.

 I have heard of workers going in to work when they have symptoms because they can’t afford to take time off, even with the emergency 14-day benefit offered by the federal government for sick leave.

Once more, anecdotally only, I have heard of testing centres where the staff is simply too overworked to provide the codes necessary for the contact tracing application to be effective.

The system is broken and it’s broken because money is in short supply and governments don’t have a plan to deal with the issues, as we’re told by Dr. Joseph Gans, an economist with the Roterdam School of Management and the author of the book, The Pandemic Information Gap: The Brutal Economics of COVID-1 in a recent conversation with Rita Celli on CBC’s Ontario Today.  Governments prefer to put the onus on business and individuals.

 When a third of Covid-19 sources cannot be traced in Ottawa

and we are able to trace sources of Covid-19 from large gatherings, restaurants etc, when the only major change that has happened since the surge in Northern Hemispheres began in late summer is the opening of schools, doesn’t it make sense to at least consider the possibility?

Doesn’t it also make sense to make sure that schools are following health protocols to keep children and staff safe and to ensure that community transmission through the schools is minimized?

The science on transmission from children is not clear yet, but Ontario’s science advisory table has said it may play a bigger role than first thought.

 Anecdotally only, some of our friends with kids are talking about situations where classes are being merged due to lack of available teachers, resulting in 30+ students in one class, or windows having to be opened due to poor ventilation systems. How many teachers are in ICU? How many family members of teachers or kids in school have tested positive for Covid 19? Are they even being tested?

 A reminder: in one third of Covid 19 cases in Ottawa the source is “unknown.”

"No known source means the person with a positive case was asked about risk factors and exposures, but "no source of exposure was able to be identified." 

No information available means people who test positive "have not been asked about risk factors and exposures yet," and they haven't been identified as a close contact to another person with COVID-19." Priscilla Hwang, CBC News, October 13, 2020

Given the lack of interest or due diligence regarding tracing asymptomatic transmissions from schools, i'd say we have our smoking gun.

You can take a look at the Covid 19 Canada School Case Tracker live map here.

I would rather not see schools closed; however, I would also rather not see them remain open if there is even one possibility that transmission is occurring via the schools where educators are not able to follow protocols due to budget cuts.

 I would also rather we end the fining, blaming and shaming of individuals and businesses unless we hold institutions equally accountable.

 Governments need a plan, rapid testing, a pause on rent payments and other strategies to help businesses and individuals. This blaming and fining has got to stop. Individuals will always find a way round a broken and unjust system. This is not the best idea in the times we are in. Transparency and following protocols, a just and equitable application of the rules for everyone is.


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