Two Toronto pediatricians are warning parents that if their kids display symptoms that could be related to COVID-19, they should keep them at home even if they test negative for the novel coronavirus — because tests can produce inaccurate results in children.
They say with flu season just weeks away, children with a runny nose, cough or sore throat could have COVID-19, influenza or just the common cold, and it won't always be possible for health experts to tell.
Dr. Dina Kulik, a pediatrician and emergency room physician, told CBC's Here and Now Thursday that if kids have a fever, runny nose, rash or nausea, parents should simply proceed as if their children have the novel coronavirus.
"I think all of that should be considered to be COVID because the testing is inaccurate and unreliable, particularly in children," she said. "I can say that with 100 per cent certainty."
Kulik said even though the province will allow children to return to school 24 hours after their symptoms subside if they test negative for the virus, parents should keep those kids isolated at home for two weeks.
Dr. Anna Banerji, a pediatric infectious disease specialist, said since children often experience milder symptoms, or none at all, they should stay home from school for at least a week if they are experiencing any new symptoms.
"We know that kids are going to get sick," she said. "There's going to be so many competing viruses around that we won't know what's caused it."
Kulik, who is also the founder and director of the Toronto medical clinic Kidcrew, said parents should keep kids at home and isolated for 14 days if they feel unwell, and extends that to other family members.
As a mother of four school-aged children, she said she understands how stressful that could be.
"I get it, totally," she said. "But, if we send our kids that are even a little bit sick, we're going to be increasing the risk that other people get sick."
Kulik said given the fact that an asymptomatic student could spread the virus in a classroom, it's especially important to practise physical distancing, hand hygiene and to wear masks.
Parents put in impossible situation, says mother of 3
Romana Siddiqui, a mother of three who lives in Mississauga, says she had high hopes for the government's back-to-school plan because additional federal funding was announced, but says she was left disappointed.
"I feel that it's still not a safe plan," she said.
Siddiqui, who is part of a parent group advocating against the government's previous cuts to education, was hoping for more protocols to be put in place and is mainly concerned about class sizes being too large.
She says she's fortunate that her work schedule is flexible and her children are old enough to stay home by themselves, but says many parents will be left in an impossible situation.
"I don't want to send my kids to school sick, I don't want other parents to send their kids to school sick," she said. "But I know based on my experiences [working in a daycare] parents do that sometimes out of necessity."
She would like to see the province provide more paid sick days for parents who have to keep their kids at home.
A spokesperson for the Ministry of Labour, Training and Skills Development says the government passed job-protected leave for workers, which allows them to stay home for reasons due to COVID-19.
"This includes if you are caring for a child who becomes ill, needs to self-isolate, whose school is closed, or if you are following the advice of a medical professional," Janet Deline said in a statement.
She also pointed to the federal government's $19-billion 'safe restart' funding, which will include $1.1 billion to create a temporary national sick leave program that will provide 10 days of paid sick time to those who don't already have it through their employer.
Banerji said those who keep kids home if they're unwell shouldn't be penalized, but supported, especially by employers.
"We have to find solutions to support parents to keep that child at home if they're sick," she said.
False negative test results a major concern
Both Banerji and Kulik said Ontario's COVID-19 school outbreak plan relies too heavily on testing that can often result in false negatives, which could lead to a student bringing the virus to school.
Under the province's plan, a child who has symptoms but receives a negative COVID-19 test can return to school 24 hours after their symptoms have resolved, but some experts say that could still put others at risk.
The guide says if there's a single positive test in a class cohort, all members must be sent home to self-isolate. It says those people should be tested "as soon as possible," but doesn't mandate it.
Kulik said there's a lot health experts don't know about testing and that it's "unwise to put all our stock" into tests when determining if a child should go back to school.
"I think we are putting ourselves in a dangerous position until we know exactly the statistics on how reliable and accurate these tests are," she said.
Banerji pointed to scenarios in which members of a family test positive for COVID-19, but a child with the same symptoms does not.
"There's this ongoing narrative that if your test is negative, you don't have COVID, despite your symptoms and we know … there's a high rate of false negatives depending on when the test is done," she said.
Province's plan open to change, ministry says
A spokesperson for Minister of Education Stephen Lecce said the government's plan to reopen school has been informed by the best medical and scientific minds in the country.
In an emailed statement to CBC Toronto, Caitlin Clark said Ontario is spending more money on reopening schools than any other province, has implemented an "aggressive" mask policy, has hired more than 1,300 custodians and is spending $75 million in additional cleaning and on the hiring of more than 600 public-health nurses.
Clark said the province's plan will adapt to the best advice as new evidence emerges.
"We will never hesitate from taking further action to protect the health and safety of Ontario's students and education staff," she said.