Surge in COVID-19 tests for kids may lead to revised symptom list, Russell says

Now that cold season has started, it may be time to take some symptoms off the COVID-19 checklist, says New Brunswick's chief medical officer of health.

Dr. Jennifer Russell said her colleagues from across the country have talked about "streamlining" testing requirements to avoid a logjam of tests for people who end up simply having a cold.

Several of the symptoms for COVID-19 overlap those of the common cold, including runny nose, sore throat, and headache. Those are three of the 10 symptoms British Columbia removed last week.

"I know there's a level of confusion and again, we are working on it," said Russell.

She said the system can handle the current situation, but if there's a spike in COVID-19 cases in New Brunswick, then the checklist may have to be scaled back.

"So we're happy with where we are, but I think as we move into a time frame where the risks are going to be higher in terms of case numbers possibly increasing as we are seeing around the country, then I think it merits having that discussion," Russell said Tuesday afternoon.

She said there's been "a surge in demand" for COVID-19 testing since children returned to the classroom.

There were 837 more tests done for those under 20 during the first two full weeks of school than there were for the entire month before that, according to figures supplied by the department. The age group went from representing 27 per cent of all tests done in the month before to 43 per cent in the first two full weeks of classes.

Schools are required to send students home when they display two or more symptoms of COVID-19. Those children are then required to self-isolate at home until a negative test is received.

Days off sick up 132% in Anglophone South

While a spokesperson for the Department of Education did not provide numbers when asked about school absences on Tuesday, the superintendent of the Anglophone South School District did.

Zoë Watson explained that absences are coded based on a variety of reasons, including illness or medical appointment. She said the code for illness at K-8 was used 132 per cent more this month than in September 2019.

Russell said Public Health has responded to the increase in demand by adding staff, increasing hours and making other changes, such as prioritizing call-backs for children.

Russell said New Brunswick's testing capacity "is where we want it to be," but the length of time to notify people of their test results got bogged down by the increased demand.

The goal had been 72 hours, but Russell said it was taking longer than that.

Without mandatory masks, Infection control epidemiologist Colin Furness predicts that New Brunswick will see a lot more respiratory viruses.

"I'm expecting more cold and flu in New Brunswick than I am in ... Toronto," he said.

Since masks are mandatory in the Toronto area, he said, it's unlikely that the area will see many colds and flus, so any respiratory symptoms would have to be taken very seriously.

"So in Ontario, I would say anything that looks like a respiratory illness is scary. In New Brunswick, I would say that 'Well, a cold is probably just a cold.'"

Given the low case counts, Furness said masks are likely a hard sell in New Brunswick, but it's the best way to avoid students having to get a COVID-19 test every time they catch a cold.

"Your best way forward as a parent is to try and make sure that no one catches any cold at all. That's harder to do when people aren't wearing masks," he said.

"If I were a parent in New Brunswick, I would be doubling down on hand sanitizer and physical distancing and all the things that we know work to keep us from getting sick — and flu shots for sure."

Furness said the stress that parents feel when their child gets sick in New Brunswick would be different from what parents in Ontario may feel.

Here, it's not a genuine fear of COVID-19, it's the hassle of having to prove that it's not.

"It becomes a headache rather than this fear," he said.

Whether it stays on the COVID-19 checklist or not, Furness said one of the most common symptoms at this time of the year isn't a great indicator of COVID-19 anyway.

"COVID in kids tends to present asymptomatically — a runny nose is not associated with COVID," he said.

"That's not to say that it's impossible for someone with a runny nose to have COVID. You can also have more than one virus at a time. But kids are typically asymptomatic. And so the whole concept of screening is a little bit misplaced."

Yukon offers guide

Yukon health officials have recently come up with a colour-coded system to help parents.

Green means go to school. That's when a child has no symptoms, or only symptoms of a previously-diagnosed condition.

Yellow means a child has some symptoms and should stay home for 24 hours to see whether the symptoms resolve. They include a runny nose, fever, fatigue, sore throat, vomiting or diarrhea.

A runny nose or congestion that persists, but is relatively mild and not worsening, means a child can go back to school after 24 hours — so long as they have no other symptoms.

Vomiting or diarrhea, however, warrant keeping students home until those symptoms are gone.

Red means a child has symptoms that warrant a COVID-19 test — or they could stay in self-isolation for at least 10 days before returning to school.

"Red" symptoms include coughing, a fever, shortness of breath or difficulty breathing, and loss of taste or smell.

British Columbia shortens list

The list of symptoms in British Columbia was shortened last week to remove many that overlap with the common cold, including sore throat, runny nose, headache, and fatigue.

"This was a recommendation from public health to remove some of the symptoms, given the very low probability of these symptoms by themselves indicating COVID," B.C.'s Ministry of Health said in an emailed statement to CBC.

"They are also very common in children, so there are concerns that it would unnecessarily exclude children," said the ministry.

The following symptoms have been removed from the daily checklist:

• Sore throat

• Runny/stuffy nose

• Headache

• Fatigue

• Loss of appetite

• Muscle aches

• Conjunctivitis (pink eye)

• Dizziness, confusion

• Abdominal pain

• Skin rash or discolouration of fingers and toes

Parents are now asked to screen children for the following symptoms:

• Fever

• Chills

• Cough or worsening of chronic cough

• Shortness of breath

• Loss of sense of smell or taste

• Diarrhea

• Nausea and vomiting