For parents in eastern Ontario struggling to work from home while overseeing their grade-school children's at-home learning — or battling for bandwidth with their teenagers — Wednesday may be D-day.
That's when Ontario's chief medical officer of health is expected to submit his recommendations on which regions should be allowed to resume in-class learning as of Jan. 25. Education Minister Stephen Lecce will make the announcement publicly — after cabinet approves the decision — either Wednesday or Thursday.
Under the provincewide shutdown that began Dec. 26, elementary students were to return to class on Jan. 11, while secondary-school teens had to wait until Jan. 25. But with COVID-19 numbers on the rise over the holiday period, the government extended online learning for elementary schools until at least Jan. 25 — longer for hotspot zones in and around Toronto, as well as Windsor, Ont.
'Trickier' to reopen Ottawa schools
Neither provincial nor local health officials would comment on the likelihood of local schools reopening later this month. But experts say the province will be looking at COVID-19 transmission numbers as a key indicator for whether students should go back to school.
So while in-person learning could be returning for regions with relatively low ratios of spread — think Kingston, Prince Edward County, or Lanark — Ottawa's numbers mean it will be a "little bit trickier" to open schools in the capital, says one expert.
Dr. Gerald Evans, chair of the division of infectious diseases at Queen's University and medical director of infection prevention and control at Kingston Health Sciences Centre, said the province will likely be looking at how many new cases are being reported a week per 100,000 people in each region, to assess the prevalence of COVID-19 in a community.
We are still seeing a significant increase in the number of children and youth testing positive for COVID-19. - Dr. Vera Etches, Ottawa's medical officer of health
"That's the classic metric that's being used," Evans told CBC. "Certainly where I am here in Kingston is going to look very good because that number is actually less than seven."
In Ottawa, it's almost 82.
Positivity up among children
Another key statistic the province will study, according to Evans, is the proportion of children testing positive, which has risen in recent weeks.
In a letter sent to parents of students in the Ottawa-Carleton District School Board on Tuesday evening, Dr. Vera Etches warned that "we are still seeing a significant increase in the number of children and youth testing positive for COVID-19," even though there's been a significant decline the number of young people getting tested.
Ottawa's medical officer of health wrote that the city is currently seeing a positivity rate of 21 per cent among children aged five to 12 who are tested for COVID-19.
"We know there are likely many more undiagnosed infections in our community and unless we test more, we will not be able to identify them," she wrote.
Etches pleaded for children with even minor symptoms to get swabbed because "refraining from testing is adding to the growing risk of community spread." She said that could lead to pressures on the health-care system, and "ultimately lead to an extension of the lockdown and other restrictions."
Weighing numbers vs. social importance
It's important to note that the recent rise in COVID-19 cases in children is likely not due to spread in schools, as they've been closed since Dec. 17.
According to Dr. Doug Manuel, a scientist with The Ottawa Hospital and a member of the province's COVID-19 Science Advisory Table, the province needs to consider whether school closures are necessary to reduce the spread of COVID-19 faster.
There have been 72 COVID-19 outbreaks in Ottawa schools since September — 45 of them in elementary schools. An outbreak is declared when it's reasonable for public health officials to conclude that two positive cases in a school are related. The vast majority of the outbreaks consisted of just a few people; 11 outbreaks involved five or more students or staff.
While school outbreaks are certainly an area of focus for officials, Manuel points out that the transmission there isn't "as high as we expected going into the fall."
"I think we can all agree that the teachers and the students and the custodial staff exceeded our expectations."
Manuel, who says he'd feel comfortable sending his own grade-school aged children back to class in Ottawa, points to a number of promising signs that Ottawa is beginning to flatten the curve, including the receding daily count of new cases. Each person who tests positive is reporting an average of 1.3 close contacts, instead of seven just before the holidays.
Also on Tuesday, Ottawa Public Health reported an effective reproduction rate — the average number of people infected by a single COVID-19 case — of 0.96. A rate below one suggests the spread is coming under control.
"People often describe schools as the last place you want to shut down," said Manuel. "And I think that's a reflection of the importance for schools for kids."
He suggested it can be possible for society to reduce COVID-19 levels while keeping schools open — like Ottawa did in October.