The Alberta Teachers’ Association

Question:  With schools returning to in-person instruction after being online for two weeks and with the prospect of an end to pandemic restrictions as we move toward the summer, what have we learned about in-school transmission of COVID-19?

Answer:  To answer that I turned to Dr. Lynora Saxinger, infectious diseases physician and associate professor at the University of Alberta. Dr. Saxinger is co-chair of the Scientific Advisory Group for the Alberta COVID-19 Emergency Coordination Centre and she has been generously advising the Association on matters related to managing the pandemic in schools.

She responded that this is a really complex question. Saxinger then pointed us in the direction of recent publications that shed some light on what has been learned about the pandemic in schools, while indicating that we need to be cautious about drawing firm policy conclusions based on a superficial reading of these reports — much is dependent on specific detail and methodologies reflected in each. Understanding that, I think we can draw some conclusions:

• The cessation of in-person instruction and extra-curricular activities has had negative effects on the social, emotional and educational well-being of students. Preventing transmission of SARS-CoV-2, the virus that causes COVID-19, in schools is imperative for safe in-person learning.
• Preventive measures such as masking, physical distancing, hand hygiene and improved ventilation reduce transmission of SARS-CoV-2, together with vaccination, are important elements of a comprehensive approach to promoting school safety.
• As indicated in a recent study out of Utah, for high school students at least, there is evidence that school-based COVID-19 testing should be considered part of a comprehensive prevention strategy to identify SARS-CoV-2 infections in schools and sustain in-person instruction and extracurricular activities.
• Young children are significantly less affected by COVID-19 than adults. There are both fewer cases in children, and fewer children who are severely unwell. The exact reason why there are so few children with confirmed COVID-19 is unknown. Recent evidence from Iceland, Japan and Korea shows that children may also be less likely to become infected with SARS-CoV-2 following exposure.
• It appears that children under the age of 10 may not play a significant role in spreading SARS-CoV-2. A German study concluded that students this age are three times less likely than the general population to test positive for the virus and their parents are also considerably less likely to be infected than others in the community, indicating that their children are not a source of infection. Generally, young children have not been found to have a significant role in household transmission.

If all this sounds familiar, it is because it aligns with advice that the Association has offered, based on Dr. Saxinger’s advice, throughout the pandemic. As vaccination rates increase, it is tempting to conclude that we can quickly remove restrictions and that the lessons reported above will shortly be moot. That would be a mistake.

As Saxinger points out, while there is good news on the vaccines front, with a growing portion of the population having some degree of protection from at least one dose of a vaccine or having been previously infected and recovered, the vaccination rate is hardly uniform across the province and some communities have very low rates of vaccination compliance.

Furthermore, the emergence of variants of concern (VOCs) that may be communicated at a higher rate, even among those who have been previously infected or who completed only the first round of their vaccination, is a significant problem that will have to be addressed through enhanced testing and rapid response as well as by the promotion of vaccinations to underserved, vulnerable or reticent populations.

As the school year comes to a conclusion, the summer time provides an opportunity to assess our readiness to return to mass in-person school and the time necessary to look at taking steps to make schools safer now and into the future.

COVID-19 was a tragedy for many Albertans. Let’s not make it meaningless by failing to learn its lessons. ❚

COVID-19 and children: what do you need to know? (dontforgetthebubbles.com)

COVID-19 Testing to Sustain In-Person Instruction and Extracurricular Activities in High Schools — Utah, November 2020–March 2021 (cdc.gov)

Mask Use and Ventilation Improvements to Reduce COVID-19 Incidence in Elementary Schools — Georgia, November 16–December 11, 2020 | MMWR (cdc.gov)

https://jamanetwork.com/journals/jamapediatrics/fullarticle/2775656

https://www.nccmt.ca/covid-19/covid-19-rapid-evidence-service/19