With multiple provinces choosing to delay in-person schooling this month amid the pandemic's current Omicron-fulled wave, remote learning is once again the reality for scores of Canadian students.
Meanwhile, a major conversation taking place among parents, educators and physicians revolves around what measures can be enacted in the short term to help students from kindergarten to Grade 12 get back to — and remain in — safer classrooms.
We asked some educators and medical experts the ways they think schools could be made safer over the next few weeks.
Everyone 'as vaccinated as they can be'
Jason Bradshaw, a high school science teacher in Brampton, Ont., hopes officials will "make the most of the time" students are once again learning remotely and prioritize vaccination of everyone in classrooms in the next few weeks. That means boosters for teachers, school staffers and older students, as well as a renewed drive for first and second doses to the younger students who became eligible just before the holidays.
Bradshaw says many of his educator colleagues haven't been able to secure appointments until later January or February.
"We can't just sit back," he said. "We need to be proactive about it."
Some cities, public health regions and individual hospitals have already moved ahead with this idea, either by holding dedicated new immunization clinics for school and childcare staffers or adding these groups as well as students to the priority list of existing ones. Ontario on Thursday announced plans to follow suit, beginning with the Toronto and Hamilton areas.
Bradshaw added that teachers getting sick or needing to isolate amid this latest spike in cases remains a real concern. School leaders must clearly communicate updated screening protocols and realistically plan for how to cover staff absences without throwing established safety measures — such as class cohorts — to the wind, he said.
Upgrade masks for students and staff
Improved masking — namely respirators such as N95 or KN95 masks — is another straightforward way to make in-person learning safer, according to Dr. Anna Wolak, a family physician in Vancouver. However, she highlighted that equitable access to respirators for all families is an issue — in terms of availability, as well as cost.
B.C. schools previously distributed cloth masks to students and staff. Given Omicron's greater transmissibility, "I don't see why we cannot do the same for N95 masks," she said.
Wolak has noted some parents are asking whether these higher-grade masks can comfortably be worn by students. She put the question to those already wearing new, kid-sized versions, including her own three school-aged children.
They told her these were more comfortable than cloth masks, "which can get wet and soggy by the end of the day" and that wearing them is easier than doubling up with cloth and surgical masks.
"Short of upgrading the HVAC system in [just a few days] and in the middle of a snowstorm, the best thing that we can do is get N95s now to every school child and every teacher, and replenish it on a regular basis," said Wolak, who is also a clinical assistant professor of family medicine at UBC.
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Beyond that, Wolak would also like to see school officials take a renewed look at lunchtime, when "we have an entire congregation of children who are unmasked and talking and spreading aerosolized droplets all over the place."
Put rapid tests to use
Last fall, schools in different provinces began employing rapid antigen tests, from testing Quebec students showing symptoms at school to sending kits home in Nova Scotia students' backpacks for families to use.
They became the hottest item on many people's holiday wish lists over the winter break. On Wednesday, the federal government said it will distribute 140 million more testing kits this month — four times the amount it sent out to provinces and territories in December.
That same day, Quebec said it will send more than seven million rapid tests to preschools and elementary schools ahead of the latter's in-person return on Jan. 17. Newfoundland and Labrador says it's also working to get tests out to schools.
Dr. Dalia Hasan says it's a measure that's long overdue. "Rapid tests have been and continue to be an underutilized tool," said the Kitchener, Ont., physician and founder of COVID Test Finders, an initiative on Twitter flagging where people can pick up rapid tests and advocating for increased accessibility.
She said the unavailability of rapid tests thus far is due to what provincial authorities previously requested from the federal government, along with their decisions about whom tests should go to.
"Businesses seem to have become a priority for the distribution of rapid tests," said Hasan. "However, if we believe that schools should be the first to open and last to close, then we need to be prioritizing schoolchildren."
Rapid antigen tests offer "a snapshot, in real time, of a person who is infectious and can spread the disease to others," she said, so an ideal world of unlimited availability would mean "testing children and school staff at least twice a week, every week," she said.
However, given more scarcity, Hasan said education officials could implement a "test-to-stay" strategy where close contacts to positive COVID-19 cases could continue in-person learning if they regularly test negative for seven to 14 days following exposure.
She likened polymerase chain reaction (PCR) tests, the established "gold standard" for detecting COVID-19, to espresso coffee ("expensive and they require a machine to churn out the results") whereas rapid antigen tests can be thought of "like instant coffee," she said. "Fast, simple to use and cheaper."
Hasan believes them a valuable tool to keep in-class learning safer when used in tandem with measures such as masking, ventilation improvements and vaccination.
"There's no one measure that's going to be a silver bullet," she said. "We need to be using all our knowledge and all the technology that we have access to."
'A safer indoor space'
That sentiment is echoed by Dr. Isaac Bogoch in Toronto.
"It's no secret how to create a safer indoor environment. We know how to do this at this point of the pandemic, right? You have to have good quality masks, good air ventilation, high uptake of vaccination, crowd control," said Bogoch, an infectious diseases specialist at Toronto General Hospital.
"If you have tests at your disposal, certainly integrating rapid testing can be very helpful from a rule-in and sometimes maybe even a rule-out basis."
That said, even if all these tools are used, Bogoch emphasized that some outbreaks will inevitably happen.
"This is not a safe indoor space, it's a safer indoor space," he said.
"There will be outbreaks regardless of what measures are taken. It doesn't mean you throw your hands up in the air and say 'Forget about it.' It means you still have to push to create safer indoor environments."