Risk mitigation tool for child and youth settings operating during the COVID-19 pandemic

Objective: This tool will assist school boards and operators of child and youth settings in considering risks to children/youth, staff and volunteers during the coronavirus disease (COVID-19) pandemic, and provide examples of strategies that may be implemented to mitigate potential risks.

Audience: Those responsible for child and youth settings and programs (e.g. federal/provincial/territorial and local/municipal authorities, school boards, summer camps, daycare providers, community organizations and programs).

In response to the COVID-19 pandemic, many provinces and territories required child/youth settings to close, except for those providing childcare for essential workers. As provinces and territories adjust public health measures, child/youth settings need to implement risk mitigation measures as they re-open and operating during the COVID-19 pandemic. This tool is designed as a resource intended to be used alongside and in support of guidance from provincial/territorial health authorities, ministries of education and Indigenous community governance structures. Guidance from provincial/territorial health authorities will consider local epidemiology, which varies widely across the country. Therefore, implementation of guidance is not expected to be uniform throughout Canada.

For the purposes of this document, child and youth settings includes early learning and daycare centres, schools (K-12), day programs, summer camps, and other settings where children and youth represent the majority of the population accessing the setting. It is acknowledged that some early learning programs are inclusive of children and their parents/caregivers. While they are not explicitly addressed in this guidance, when parents/caregivers are present, they should be made aware of, and comply with risk mitigation measures in place.

Public health measures implemented by child/youth settings are part of Canada's collective approach to mitigate the transmission of COVID-19. This tool is based on concepts outlined in the guidance developed for community-based measures titled: Community-Based Measures to Mitigate the Spread of Coronavirus Disease (COVID-19) in Canada. It reflects the currently available scientific evidence and expert opinion, and is subject to change as new information on transmissibility, epidemiology, and effectiveness of public health and risk mitigation measures becomes available. It also provides advice for congregate living settings in the context of overnight camps and student residences/housing for children and youth.

In interpreting and applying this guidance, it is important to recognize that the health, age, ability status, or other socio-economic and demographic circumstances faced by some individuals and groups may limit their ability to follow the recommended measures. This may necessitate adapted responses and recommendations in some situations.

Indigenous communities may choose to implement child and youth programs specific to the needs of their communities, including remaining closed or limiting attendance as a risk mitigation measure. Respect and support for these decisions is needed, as well as recognition of the disproportionate burden of communicable diseases on some Indigenous communities, and the legacy of past pandemics.

It will be important to promote and provide mental health support services as children/youth, as well as staff and volunteers may experience increased stress associated with COVID-19. Mental health and wellness support may contribute to the resiliency of children/youth and the staff responsible for them in these settings. Mental health and wellness support need to be made accessible for diverse groups (e.g. considerations based on factors such as age, gender, ethnicity/culture, and other socio-economic and demographic factors). Additional information is available for parents, children and youth on taking care of physical and mental health during COVID-19, along with relevant resources.

What are the COVID-19 risks in children and/or youth setting?

The following facts about COVID-19 and associated questions can help you consider the risks of COVID-19 in the children/youth settings under your responsibility.

The risk level is affected by whether there is COVID-19 transmission in the local community. If there is known COVID-19 activity in the community, the likelihood that it could be introduced into the settings is higher. The risk of COVID-19 introduction and spread is also presumed to be greater if a higher proportion of individuals visit the setting from outside of the community. Measures put in place to mitigate risk should be proportionate with the risk in the community. PHAs can be consulted for information about local COVID-19 transmission.

COVID-19 spreads from person to person, most commonly through respiratory droplets (e.g. generated by coughing, sneezing, laughing, singing or talking) during close (i.e. within 2 metres) or prolonged (i.e. lasting more than 15 minutes and may be cumulative) interactions. People who have COVID-19 may have few to no symptoms, or symptoms may be mild. COVID-19 can be spread by infected individuals who have mild symptoms, or who have not yet or who may never develop symptoms.

COVID-19 can also be spread through touching something with the virus on it, then touching your mouth, nose or eyes before washing your hands.

COVID-19 can cause more severe disease or outcomes among older adults (increasing risk with each decade, especially over 60 years); people of any age with chronic medical conditions (e.g., lung disease, heart disease, high blood pressure, kidney disease, liver disease, stroke or, dementia); people of any age who are immunocompromised, including those with an underlying medical condition (e.g., cancer) or taking medications which lower the immune system (e.g., chemotherapy); and people living with obesity (BMI of 40 or higher).

COVID-19 spread can be reduced by consistently practicing personal preventive practices.

How can child/youth settings mitigate COVID-19 risks?

To prevent or limit the spread of COVID-19 in community-based settings, such as those focused on children/youth, consider the following risk mitigation principles and measures. Risk mitigation measures that are more protective involve separating people from each other or shared surfaces through physical distancing and physical barriers. However, these most protective measures are not always the most practical in settings such as these. Measures that are less protective rely on individuals to consistently follow personal preventive practices (e.g., environmental cleaning and disinfection, conducting frequent hand hygiene, wearing of non-medical masks or cloth face coverings). In some settings, physical distancing or separation may not be possible. To maximize safety, use a "layered" approach with multiple measures to reduce the risk of COVID-19 spread, including decreasing the number of interactions with others and increasing the safety of interactions. Layering of multiple mitigation measures strengthens the risk mitigation potential overall. The following examples of risk mitigation measures are provided for consideration. They are not exhaustive -those responsible for these settings are encouraged to find creative and adaptive ways to mitigate risk that align with public health advice and are respectful of children/youth, staff and volunteers.

For mitigation measures specific to employees (e.g. staff and volunteers in child/youth settings), such as the use of personal protective equipment and non-medical masks, the Risk mitigation tool for workplaces/businesses operating during the COVID-19 pandemic is available.

Prohibit individuals who have symptoms of/or have had exposure to COVID-19 from entering the child/youth setting.

Promote and facilitate personal preventive practices. Everyone plays a part in making child/youth settings safer, including children/youth, staff and volunteers and families.

Examples of protective public health measures mitigation strategies tailored for age categories

Younger children

Older children and youth

Promote physical distancing as much as possible. Keeping a 2 metre distance from others helps to reduce the spread of illness; however, it is not always practical in child and youth settings. Layering of multiple mitigation measures in these circumstances strengthens the risk mitigation potential overall.

Examples of physical distancing mitigation measures tailored for age categories

Younger children

Older children and youth

Create physical barriers between children/youth, staff and volunteers when physical distancing is not possible.

Examples of physical barrier mitigation measures tailored for age categories

Younger children

Older children and youth

Increase ventilation.

Mitigate risks from exposure to high-touch surfaces (i.e., surfaces frequently touched by others).

Examples of mitigation measures for high-touch items, tailored for age categories

Younger children

Older children and youth

Mitigate risk for people at risk of more severe disease or outcomes.

Modify practices to reduce how long children are in contact with each other and how many children come into contact with each other.

Examples of mitigation measures for changing practices, tailored for age categories

Younger children

Older children and youth

Should children/youth wear non-medical cloth masks or face coverings in community settings?

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