Archived: COVID-19 guidance for schools Kindergarten to Grade 12
Current guidance on schools for both Kindergarten to Grade 12 and post-secondary settings is now posted. For advice on public health measures, please refer to Planning for the 2021-2022 school year in the context of COVID-19 vaccination.
On this page
- Introduction
- A risk-based approach to COVID-19 decision making in schools
- Mitigation of risks of COVID-19 in schools
- Special considerations of COVID-19 in schools
- Psychosocial needs of children/youth, staff and volunteers
- Considerations for remote, isolated, and Indigenous communities
- Additional resources
- References
Introduction
The following guidance is directed to administrators of schools from kindergarten to grade 12 (K-12) and local public health authorities (PHAs) in jurisdictions where these schools exist. The guidance is not prescriptive in nature, rather, it supports administrators and PHA's to consider potential risks and mitigation strategies associated with the resumption of in-school classes during the COVID-19 pandemic. This guidance is based on the current Canadian context, the concepts outlined in the Community-based measures to mitigate the spread of coronavirus disease (COVID-19) in Canada, the current scientific evidence, and expert opinion. It builds on and should be used in conjunction with the Risk mitigation tool for child and youth settings operating during the COVID-19 pandemic guidance document.
This guidance is subject to change as new information on transmission and epidemiology becomes available. It should be read alongside and in support of guidance from provincial/territorial (PT) health authorities, ministries of education and Indigenous community governance structures. Guidance from provincial/territorial health authorities will consider local epidemiology, which may vary across the country. Therefore, it is not expected that implementation of this guidance will be uniform throughout Canada, as outlined in the Guidance for a Strategic Approach to lifting Public Health Measures in Canada.
This guidance provides information for both public and private institutions providing K-12 education programs in the classroom setting. It takes into consideration the diverse needs of population groups based on vulnerability, ethnicity/culture, disability, developmental status, and other socioeconomic and demographic factors. This guidance uses the term children/youth interchangeably with the term student(s) to align with all associated guidance and web content. Other K-12 school-based activities that may be impacted by the advice in this guidance include sports, school based nutrition programs, music classes/programs and field trips, child care provided outside of regular school hours (for example, before and after child care), professional development/activity days and school break day camps.
Schools play many important roles in communities and the development of children/youth. They provide necessary education to prepare children for adulthood, and long term online education for K-12 is not a substitute for in-person learning and socialization in a school setting. Long-term shutdowns have the potential to lead to education gaps and other consequences for many children. Particular groups may be disproportionately affectedFootnote 1, such as children living in poverty, those who receive school-based meals, those who rely on school-based services such as counselling, those who are in situations of domestic violence or abuse, children with disabilities, and those who rely on the certainty of education and social supports to maintain health and community inclusion. Despite the educational and psychosocial benefits of children/youth attending school in-person, administrators, staff, students, families, and community members may have concerns regarding a return to in-person school attendance during the COVID-19 pandemic. By encouraging a risk assessment and mitigation approach in schools, and providing specific considerations on the psychosocial wellbeing of children, youth, staff, and volunteers, this guidance aims to support schools to create an environment that is prepared, supportive, and safe.
A risk-based approach to COVID-19 decision making in schools
Public health measures implemented in schools across Canada have been adjusted over time in response to COVID-19 activity. Risk assessments should be considered when decisions need to be made about opening or closing schools and how to function as safely as possible for those that are open.
Knowing the risks associated with COVID-19 in the school setting will help administrators to consider potential mitigation strategies. An important consideration is the extent of local community COVID-19 transmission, as this influences the likelihood of COVID-19 introduction into the school setting. The proportion of individuals who visit the school from outside of the community also influences the risk of COVID-19 introduction and spread. PHAs should be consulted for information about local COVID-19 transmission.
There are a number of specific considerations when assessing risk in the school setting. For example:
- risk of transmission
- How many, how close, and how prolonged are the interactions of children/youth in the school?
- A higher number or interactions, close interactions, and prolonged interactions are associated with a higher risk of transmission
- Are interactions in a crowded or a confined indoor setting?
- High-density, confined, indoor settings are associated with a higher risk of transmission
- Are children/youth in frequent contact with high-touch surfaces?
- Frequent contact with high-touch surfaces or shared items is presumed to have a greater risk
- How many, how close, and how prolonged are the interactions of children/youth in the school?
- risk of more severe diseases or outcomes, based on their age or other medical condition
- Do children/youth, staff, or volunteers belong to (or reside with) a higher risk group?
- ability to reduce risk by consistently applying mitigation measures
- Can children/youth consistently follow advice on physical distancing, hand hygiene, respiratory etiquette and other personal preventive practices?
- If assistance is required, is there adequate supervision?
- Are the supplies and facilities necessary for frequent hand hygiene available?
- It is important to recognize that health, age, disability, developmental status, or other socio-economic and demographic circumstances faced by some individuals and groups may limit their ability to follow the recommended measures
- Can children/youth consistently follow advice on physical distancing, hand hygiene, respiratory etiquette and other personal preventive practices?
Lastly, consideration must be given to what is known about COVID-19 in children and youth. Children, especially those below 10 years of age, appear to experience less severe symptoms due to COVID-19 and form a small proportion of reported cases to date Footnote 2 Footnote 3. It is important to consider that transmission of COVID-19 in children is not fully understood and that evidence may change with time. In most household cluster investigations, children were not the index caseFootnote 4; however, emerging evidence suggests that the virus can spread efficiently in all age groupsFootnote 5. While children over 10 years may be as likely as adults to transmit the virus to others, those under 10 years may also transmit the virus, but are less likely to do so than adultsFootnote 6Footnote 7. Lastly, modeling studies suggest that outcomes of a staggered relaxation of public health measures, starting with younger individuals first, would support Canada's objectives for the lifting of restrictive public health measuresFootnote 8Footnote 9.
Risk Assessment Tools relevant to the school setting include:
- Risk mitigation tool for child and youth settings operating during the COVID-19 pandemic.
- Risk mitigation tool for gatherings and events operating during the COVID-19 pandemic can assist school administrators in evaluating risk and mitigation potential for K-12 gatherings and events
- Risk mitigation tool for outdoor recreation spaces and activities operating during the COVID-19 pandemic can assist school administrators in evaluating risk and mitigation potential for outdoor school-based activities
Mitigation of risks of COVID-19 in schools
Measures used in the school setting to mitigate risks of COVID-19 transmission can include both personal preventive practices taken by individuals to protect themselves and others, as well as community-based measures implemented by PTs, municipalities, Indigenous community leadership, school boards or individual schools to protect the school and surrounding community.
The modified hierarchy of controls provides a useful approach and helps inform the list of risk mitigation measures provided in this guidance. Risk mitigation measures that are most protective involve physically separating people from each other through physical distancing and physical barriers. Less protective measures rely on individuals consistently following personal preventive practices such as respiratory etiquette, hand hygiene, and wearing non-medical masks. Given that physical distancing is not always possible in schools, it will be important to "layer" multiple measures to reduce the risk of COVID-19 spread in schools. While some risk mitigation measures, such as the practice and promotion of personal preventive practices, should consistently take place, other measures should be proportionate with the risk in the school and community. Schools should consult with their PHAs for information about local COVID-19 transmission.
For mitigation measures specific to employees (for example, staff and volunteers in child/youth settings), such as the use of personal protective equipment, the Risk mitigation tool for workplaces/businesses operating during the COVID-19 pandemic is available and should be considered in addition to relevant guidance from Occupational Health & Safety advice. In some cases, staff or teachers (such as occasional / supply teachers) work in multiple settings. It will be important for school administrators to consult with their PHAs in advance to conduct a risk assessment and to identify potential mitigation measures/ policies based on their community needs, relevant P/T guidance, and local epidemiology. Consideration should be given to encourage teachers and staff to wear face masks and eye protection (such as face shields). The evidence is evolving and guidance will evolve.
Jurisdictions may consider and plan for different education delivery models based on where children/youth receive instruction. These models could be considered in the context of the initial return to school or in the instance of an abrupt change in local epidemiology, such as a school or community level outbreak. Possible models include in-person school attendance, virtual or at-home learning, or a hybrid of the two. Additional consideration may be given to the progressive introduction of in-person attendance based on grade level, with primary schools preceding secondary schools Footnote 10 Footnote 11. The risks, benefits, and practicalities of these options will vary greatly with the age and needs of the child/youth, individual family circumstances, local epidemiology, and the adoption of risk mitigation measures. The decision of which education delivery model to choose should take a risk-based approach and be made in consultation with PHAs in order to balance the benefits of in-person school attendance with the risk of COVID-19 transmission in the school and community at large.
Consideration of the school setting will help inform how risk mitigation measures are implemented. For example, while personal preventive practices should consistently be promoted during the COVID-19 pandemic, this may be achieved differently with younger children (for example, primary school) and older children (for example, middle and secondary schools). The remainder of this section will describe risk mitigation measures while providing age-appropriate examples based on the Risk mitigation tool for child and youth settings operating during the COVID-19 pandemic. These examples are not exhaustive, and school administrators 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. Administrators should engage early with relevant stakeholders, such as representatives of the student body, parents / guardians, and staff. The school should monitor the uptake of risk-mitigating measures and adjust as necessary, in consultation with their PHA, to address challenges in implementation. The school should also ensure accommodations are in place for those with disabilities that hinder or prevent personal preventive practices, physical distancing, and other mitigating measures listed below.
Prohibit individuals who have symptoms of/or have had exposure (in last 14 days) to COVID-19 from entering the school.For all ages:
- exclusion policies are in place for children/youth, staff and volunteers who are ill
- PHA advice regarding culturally safe active and / or passive screening for all those entering the school is followed
- children/youth, staff and volunteers stay at home if ill with symptoms of COVID-19 until criteria to discontinue isolation have been met, in consultation with the local public health authority (PHA) or healthcare provider
- communication strategies (including accessible signage) are strengthened to include messaging about staying at home when exhibiting symptoms of/or after exposure to COVID-19 to children/youth, families, staff, volunteers in languages/formats appropriate for age
- children/youth are made aware, in non-stigmatizing age and disability-appropriate language, how to identify symptoms of COVID-19 and instruct them to speak to a staff member immediately if they are experiencing symptoms
- PHAs are consulted for further guidance if there are any questions regarding a child/youth, staff, or volunteer's ability to attend school (for example, testing, screening children with chronic respiratory symptoms, self-isolation periods)
Promote and facilitate personal preventive practices.
For all ages:
- keep children/youth, staff, volunteers and families informed about current public health advice
- promote the use of personal practices (for example, frequent hand hygiene, avoid touching face, respiratory etiquette)
- post signage that is appropriate for age, ability, reading level and language preferences to remind individuals to practice good hand and respiratory hygiene
- teach children and youth about why, how and when to clean hands and cover coughs and sneezes, using age appropriate learning resources and tools (for example, "Glo Germ" hand washing demonstrations and how to use hand sanitizer)
- implement a schedule for frequent hand hygiene
- provide increased access to hand hygiene facilities (for example, by placing hand sanitizer dispensers in easy-to-see locations, for example, at entries and exits and cafeterias) and ensure accessibility or assistance for those with disabilities or other accommodation needs
- ensure adequate supplies to reinforce hand hygiene and respiratory etiquette such as soap, an alcohol-based hand sanitizer (at least 60% alcohol), paper towels, tissues, and no-touch waste receptacles
For younger children:
- reinforce and remind children not to touch others or put toys or objects in their mouths
- ensure assistance/supervision of children when performing hand hygiene
- consider increasing staffing complement to reduce the staff-to-child ratio, according to jurisdictional recommendations and budgetary limitations
- incorporate fun strategies to encourage compliance (for example, hum catchy songs while handwashing)
For older children:
- implement classroom and/or grade level projects (for example, point programs, poster contests)
- organize "spirit week" (school wide) awareness initiatives
- leverage technology and use social media (for example, post your most creative video on handwashing)
Promote physical distancing as much as possible (recognizing this is not always practical in child and youth settings).
For all ages:
- reinforce general practices to maintain physical distancing, such as replacing physical greetings like high fives, fist bumps and hugs with friendly verbal greetings or virtual high fives
- when / where possible, establish a 2 metre distance between children/youth, staff and volunteers, including when cohorted together
- in settings with young children, this may not be possible, and 2 metres between groups of cohorted children should be maintained
- restrict or manage flow of people in common areas including hallways, entrances/foyers (for example, with entry and exit procedures)
- in narrow hallways or aisles of the setting, encourage unidirectional travel where possible by painting or placing arrows on the ground
- use visual cues to encourage physical distancing (for example, accessible signage, floor markings)
- postpone assemblies, team sports, field trips, or extracurricular activities where physical distancing cannot be maintained
- where appropriate, consider offering these activities "virtually" using technology
- limit or restrict non-essential visitors/guests
- establish a process for essential visits, for example, parents/guardians picking up children outside of drop-off/pick-up hours where physical distancing can be maintained
For younger children:
- when possible, create and play games that maintain physical distancing, for example, set up play stations and limit the number of children at each station, allowing for sufficient breaks for cleaning before children change stations
- consider, if policies support, other educational activities (for example, videos) where children can maintain physical distancing as their attention spans permit
- ensure children are separated during large group activities for example, reading/circle time
- consider moving large group activities outside when space and weather permits
- increase the distance between napping mats/beds
- recommend that only one parent/guardian do drop-offs and pick-ups, and to remain in designated waiting areas (if walking) or in vehicle if driving, for example, children to be brought to waiting areas or vehicles (would not apply in circumstances where parents/guardians are in attendance as a part of the program)
For older children:
- assess whether infrastructure can be enhanced, even temporarily, to provide more space, for example, portables, repurposing existing space, outdoor classrooms
- consider the option of online/remote or correspondence learning, especially for older children or those at higher risk of severe disease
- important considerations include the accessibility of alternative approaches to those with disabilities and options for those with limited access to electronic devices and the internet
- increase desk distance between children/youth
- ensure sufficient space between individuals for smaller groups/clubs, for example, reading, cultural, environmental
- install accessible signage or floor markings to restrict or managing flow of common areas including hallways, cafeteria, dining halls, foyers, atriums
- implement locker/change room policies if applicable, which take into consideration physical distancing, personal preventive measures and environmental cleaning
Create physical barriers between children/youth, staff and volunteers.
For all ages:
- if possible or appropriate, consider installing physical separations between groups of children/youth, staff and volunteers (for example, physical barriers like a Plexiglas window or cubicle higher than head-height)
- implementing physical barriers (for instance, plexiglass) at cafeteria checkout/payment counters or behind food display counters to separate food service staff and students
For younger children:
- consider use of dividers between children during naps if safe to do so
For older children:
- install barriers in offices or on desks where appropriate or feasible
- consider barriers for staff as a reminder for students to maintain physical distancing (for example, low walled barrier at front of classroom)
Increase ventilation Footnote 12.
For all ages:
- move activities outdoors when possible (for example, lunch, classes, physical activity) and consider moving classrooms outside when space and weather permit
- ensure that the ventilation system operates properly
- increase air exchanges by adjusting the HVAC system
- open windows when possible and if weather permits
For all ages:
- increase frequency of environmental cleaning, especially washrooms, cafeterias or food service locations and high touch surfaces or equipment (for example, pencil sharpeners, knobs and push buttons, doorknobs, faucet handles, water fountains, toys, electronic devices, school bus hand rails and seats, books)
- reduce the number of common surfaces that need to be touched (for example, prop doors open, no-touch waste containers)
- when possible, remove or reduce the use of shared recreational equipment (for example, play structures, gym equipment, balls) and implement post-play hand hygiene practices
- avoid sharing communal equipment/supplies as much as possible and implement post-use hand hygiene and environmental cleaning (for example, toys, tablets, electronic devices, sleeping mats)
- ensure adequate supplies where possible to minimize sharing (for example, art supplies, toys, pencils)
- clean and disinfect essential shared equipment before and after use (for example, electronic devices)
- keep belongings separated from others (for example, in cubbies or separated areas)
- limit items carried between the school and home
- reinforce no sharing of home items
- reinforce "no sharing" food and drink policies, including potluck style meals
- have children/youth bring filled water bottles to school rather than having them drink directly from the mouthpiece of water fountains
For younger children:
- increase frequency of environmental cleaning of commonly touched objects/surfaces unique to setting for example, table tops, chairs, and toys
- remove toys that cannot be easily cleaned like plush toys, dress up clothes, water stations, indoor sand stations or playdough
- keep enough toys available to encourage individual play
For older children:
- increase frequency of environmental cleaning of commonly touched objects/surfaces unique to setting for example, desks, science lab surfaces / equipment, computers / electronic devices
- encourage youth to leave personal items (for example, cell phones, head phones) in lockers or at home. If personal items are brought to school, they should not be shared
Reduce risk for people at risk of more severe disease or outcomes. This includes older adults (increasing risk with each decade, especially over 60 years); people of any age with chronic medical conditions (for example, lung disease, heart disease, high blood pressure, diabetes, kidney disease, liver disease, stroke or dementia); people of any age who are immunocompromised, including those with an underlying medical condition (for example, cancer) or taking medications which lower the immune system (for example, chemotherapy); and people living with obesity (BMI of 40 or higher).
For all ages:
- encourage children/youth, staff or volunteers who are at risk for more severe disease or outcomes to consult their health care professional about staying at home
- provide alternative ways to provide programming (if possible) that is meaningful so that children/youth do not fall behind in their studies and maintain a sense of meaning/belonging
- accommodations for children/youth with limited access to electronic devices and the internet should be considered
- consideration should be given to the use of masks and face shields (eye protection), as the evidence is evolving on their benefits to the wearer to reduce their risk of infection
- encourage those who are at risk of more severe disease or outcomes to avoid contact with the school (for example, parents / guardians, grandparents, or volunteers who are older adults, or those with underlying medical conditions)
- those who are at risk of more severe disease or outcomes residing with a child / youth attending school should discuss their risk with their health care professional
Modify practices to reduce how long people are in contact with each other and how many people come into contact with each other.
For all ages:
- consider modifying delivery of programs (for example, reducing the number of children/youth using the same space at the same time)
- when considering numbers of individuals within a space, it will be important to take into account the size of the space, the number of individuals (including their ages/sizes), and their needs and abilities to promote physical distancing
- divide classes/groups into smaller numbers of children/youth
- if possible, cohort the same children/youth in classes/groups with the same staff or volunteers each day
- stagger meal and break times where children come together, for example, recess, lunch (in classroom or cafeteria)
- limit or cancel activities that bring children together from multiple groups or classrooms
- stagger schedules to limit the numbers of children/youth in attendance at one time
- stagger the timing of breaks during the day to limit numbers in the same location at the same time
- postpone or cancel non-essential activities, such as field trips
- postpone in person "school-wide" events for example, assemblies
- limit number of concurrent users of gyms, libraries, and other common areas
- move activities outdoors if possible
- ensure that COVID-19 measures do not introduce new occupational hazards to the setting (for example, do not prop open fire doors to reduce exposure to frequently touched door handles)
For younger children:
- encourage children to have individual bathroom breaks as needed over group bathroom breaks, maintaining required supervision
- encourage fixed seating arrangements over flexible seating arrangements where relevant
- seats should be facing in the same direction whenever possible
- encourage separation of at least 2 metres between cohorted groups of children where relevant
- consider staggering naps, or having children sleep "head to toe" during nap time
- stagger drop-off and pick-up times
For older children:
- consider staggering the school day or week to reduce the number of children/youth in the setting at same time
- stagger class rotation times
- consider having staff travel to classes, rather than children/youth travelling to classrooms
- close or limit number of concurrent users in computer laboratories
Special considerations of COVID-19 in schools
Cafeterias and food services
In addition to the risk mitigation measures described above, there are special considerations for cafeterias and food services. As there are a wide variety of food programs and cafeterias in schools across Canada, the following list is not prescriptive, and risk mitigation should be tailored to each school's particular context.
- Limiting the number of individuals permitted in cafeterias at any given time
- Ensuring at least 2-metres distance between seats in cafeterias
- Increasing accessible signage and floor markings in cafeterias to remind students/staff to practice physical distancing and have unidirectional flow of foot traffic in narrow aisles/stairways
- Increasing the number of accessible hand sanitizer stations within cafeteria
- Consider having students eat meals in classrooms or outdoors as opposed to congregating in a cafeteria
- Limiting seating areas in cafeterias (for example, cordoning off spaces, removing seating).
- Considering the use of cohorts for cafeterias during designated times
- Discontinuing self-serve models (for example, avoid buffet-style options, remove shared food/condiments/utensil stations) and increasing staff-serving options
- Reducing touching of food, by individually wrapping or packing food when on display
- Adopting touchless payment options when possible (with exceptions for those who can only pay by cash)
Specific educational activities
Some educational activities require additional considerations as they may not occur in a traditional classroom setting. Risk assessment and mitigation measures based on context-specific factors (for example, number of participants, length of session, room size and ventilation) should be considered in consultation with the school's PHA.
Music and band
Wind or brass instruments have a theoretical possibility of increasing the transmission of COVID-19 and the risk is not fully understood at this time. The evidence is evolving and will continue to be monitored and updated as more is known. Although initial reviews to date have not found evidence that the use of wind or brass instruments increase COVID-19 transmission, additional precautions should be taken, given the possibility of transmission due to production of infectious droplets while playing a wind or brass instrument or touching / blowing into an instrument recently used by an infected person Footnote 13.
Musical activities involving wind and brass instruments may increase the risk of COVID-19 transmission. A school's choice to resume music classes and / or band should be based on a thorough risk assessment and in consultation with their PHA. If resumed, schools should consider specific mitigation measures such as:
- consider outdoor music and band practices and adapt stage or orchestral pit space to maintain physical distancing
- for those who play a brass or wind instrument, the length of the instrument should be considered as an extension of the individual and included when determining the spacing between musicians as well as the potential for increased distance that droplets may be projected out of a wind instrument
- do not share instruments or accessories
- if shared, clean as per standard protocol for the instrument after each use and between users. Use a disinfectant or alcohol wipe when possible
- do not share cleaning cloths or instrument brushes
- do not share mouthpieces, reeds or harmonicas
- when cleaning of individual instruments with saliva build-up (for example, spit valves), do so physically (> 2 metres) away from others and by blowing into a disposable cloth or container that will collect the saliva, to reduce the risk of exposure of others
- do not blow the spit on to the floor
- the cloth or container should be placed in a waste receptacle or cleaned immediately. Wash hands immediately afterwards
Singing and choir
To date, there have been few studies investigating the link between singing and COVID-19 transmission, and none have been specific to children / youth. Overall, the available evidence suggests that the act of singing in indoor settings may contribute to the transmission of COVID-19 when one of the participants is infected Footnote 13 Footnote 14. Given that singing and choir may elevate COVID-19 transmission risk, schools should complete a thorough risk assessment and consult with their PHA prior to resumption of these activities. If choosing to resume choir and singing activities, schools should incorporate additional risk mitigation measures such as:
- consider outdoor singing activities, weather permitting
- keep physical distance between each singer to at least 2 metres, and add more distance if possible
- organize the choir formation so singers are not facing each other directly or standing less than 2 meters behind each other
- consider opting for performances with fewer performers if distancing cannot be maintained
- singers that are members of the same household would be at less risk and could sing together while being distanced from others
Physical education and recreational activities
Given the importance of physical activity to long-term health, the COVID-19 pandemic should not limit the amount of physical activity for children/youth. However, there are additional considerations for COVID-19 transmission during sports, recreation times (for example, recess), and physical education due to the potential for close or physical contact, the use of shared equipment, and the potential for respiratory droplet production. Schools should apply the risk mitigation principles described above, such as choosing activities where physical distancing can be maintained and considering outdoor activities whenever possible. Additional consideration should be given to ensuring children/youth do not share items such as water bottles and to limiting the use of shared equipment.
Additional guidance for outdoor activities is found in the Risk mitigation tool for outdoor recreation spaces and activities operating during the COVID-19 pandemic. Similarly, Physical and Health Education Canada has published Canadian Physical and Health Education Guidelines for the COVID-19 pandemic.
Libraries
Schools should limit the number of children/youth in a library at one time to help maintain physical distancing. There should be appropriate environmental cleaning of high touch surfaces between groups. The use of computers and other shared items should be minimized, excluded when possible, and be cleaned between uses. Schools can also consider a protocol that provides a window of time between uses of a book (for example, at least 24 hours Footnote 15 Footnote 16) to ensure potential SARS-CoV-2 contamination is reduced.
Use of non-medical cloth masks or face coverings
Non-medical cloth masks (NMM) can play a role in reducing the transmission of COVID-19. Wearing of NMMs is an additional personal practice that can help to prevent the infectious respiratory droplets of an unknowingly infected person (the wearer) from coming into contact with other people. Those wearing masks should be reminded, in age-appropriate language, not to touch their mask and to comply with other personal preventive practices such as frequent hand hygiene and physical distancing as much as possible.
NMMs should not be worn by anyone who is unable to remove the mask without assistance (for example, due to age, ability or developmental status).
Advice for staff and volunteers on the use of NMMs and personal protective equipment in the context of a workplace can be found in the Risk mitigation tool for workplaces/businesses operating during the COVID-19 pandemic. Schools should always consult with their designated Occupational Health and Safety department and local public health when considering mask-wearing policies for their staff.
Based on current understanding of COVID-19 transmission in children under 10 years, NMMs may be considered based on a risk assessment and the following considerations:
- NMMs should be sized and worn correctly
- failing to do so may present a risk rather than a benefit. Younger children or those with disabilities may not be able to use or consistently use NMMs correctly and safely during the day, including during meals and snacks (for instance comply with procedures to put on, change and remove) without assistance
- masks with exhalation valves are not recommended, as they do not protect others from COVID-19 and do not limit the spread of the virus
- children/youth in the same class/program will have recurrent interactions with one another
- the advice of the PHA should be sought for the use of NMM use for repeated interactions
- NMMs should be changed after they become wet or soiled. This could present operational challenges with respect to supply of NMMs and safe handling of soiled or damp NMMs
- parents/guardians should be reminded of appropriate use and cleaning and provide a backup clean/dry mask to store in their backpack for the child to replace the soiled or damp NMM
- a NMM could become an unintended hazard (for example, physical injury if caught on playground equipment)
- it is important that NMM or cloth face coverings be worn safely
- the ability of a child/youth to complete tasks and follow direction will be dependent on a variety of factors (for example, age, maturity, physical ability, comprehension)
- it will be important for staff, volunteers and/or parents/guardians to assess the ability of each child/youth to properly use and care for NMMs
Based on the current evidence of COVID-19 transmission, NMMs are recommended in children/youth over 10 years. When possible, schools should consider a policy that recommends NMM use according to grade level or class grouping. This measure should be based on a setting-specific risk assessment that includes the following factors: local epidemiology of COVID-19 including evidence of community transmission, the characteristics of the individual (for example, age, maturity, physical ability, comprehension), the characteristics of the setting, the nature of the activities, risk tolerance, and the potential of the setting to implement risk mitigation measures.
It will be important to establish policies regarding the use of NMMs or other personal protective equipment that align with advice from provincial/territorial/local public health authorities, as it will vary throughout Canada. Policies should reflect their PHA's advice for NMM use in particular settings or circumstances such as during all indoor activities versus only while in common areas. Furthermore, some provinces, territories or municipalities may have mandatory mask policies in the community and schools should ensure their NMM policies align with those of their jurisdiction.
It should be expected that some children/youth will wear NMMs in schools that have not adopted NMMs policies. Staff and volunteers should monitor for, and address, any discrimination or bullying associated with this practice (whether stigmatization is experienced by those who wear masks, and/or those who do not) and how this can amplify discrimination or bullying due to other factors such as differences in gender, ethnicity, or ability.
Management of illness or need for direct care
It will be important for schools to update plans in consultation with their PHAs on how to safely care for children/youth, staff or volunteers who require care while on-site during the COVID-19 pandemic. For issues that are known to be unrelated to COVID-19, such as mild injuries or emotional distress, schools should review their policies with their PHAs to ensure appropriate universal precautions are taken.
For issues which could be related to COVID-19, such as illness, schools should ensure measures are in place to recognize symptoms consistent with COVID-19 and separate sick children/youth, staff and volunteers from others if symptoms develop, while avoiding stigmatization and discrimination. Guidance for the public health management of cases and contacts associated with COVID-19 is available. For those who have symptoms consistent with COVID-19, it will be important to ensure:
- the individual is quickly given a mask to wear, if not already wearing one, with a medical mask preferred over a NMM
- schools should plan to have masks available for situations of managing respiratory-like illness in the event that the ill individual does not have their own mask
- masks should not be placed on anyone who is unconscious, incapacitated or otherwise unable to remove the mask without assistance
- the individual is isolated and remains in a designated space (for example, sick room), while avoiding stigmatization and discrimination, until they can go home safely
- additional consideration is given to individuals with disabilities, such as having someone wait with them to assist with specific needs
- plans address the potential if a private vehicle or walking is not an option. Plans must not include using public transit.
- a distance of 2 metres between the ill person and others is maintained, and staff know what to do if 2 meters cannot be maintained and/or direct care is unavoidable (for example, the use of personal protective equipment)
- the PHA should be consulted for this advice
- hand hygiene and respiratory etiquette are practiced while the ill person is waiting to be picked up/excused/transported
- tissues should be provided for the ill person to ensure their use with respiratory etiquette
- proper disposal of the tissue and hand hygiene should be performed after coughing or sneezing
- environmental cleaning of the designated space, other spaces or shared items used during the day (for example, bathroom, desk), and other medical items (for example, basin), should be conducted once the ill person has been picked up
Absences
Schools should ensure that policies are in place/developed for children/youth, staff or volunteers who are advised to stay at home due to illness, exposure history or vulnerability. Schools should work with relevant partners (for example, Human Resources) to develop policies that ensure:
- student school attendance is flexible
- teachers are able to take COVID-19 related leave as required
- the use of medical notes, perfect attendance awards, and incentives are discouragedFootnote 17
- that requirements for mandatory volunteer work be examined for practicality and safety
- interactions with families focus on dignity and privacy protection
- steps are taken to reduce the potential for stigma and discriminationFootnote 18 (for example, through outreach, information sharing and school/board level education)
- measures are in place to provide meaningful school work and support to children/youth participating virtually, particularly for those with learning disabilities, mental health concerns, or where they do not have access to online learning tools, so they do not fall behind in their studies
- measures are in place for children/youth to maintain a sense of meaning/belonging with their teacher(s) and classmates when they cannot attend in person
Reporting
It will be important for administrators to understand the usual absenteeism patterns of their school as well as the symptoms associated with COVID-19. Schools and local PHAs should have established processes in place for symptom/case reporting, case management, contact tracing (for example, attendance records), and information sharing. It is recommended that notification to the PHA occur in outbreaks or unusual situations, such as when absenteeism of children/youth, staff or volunteers is greater than would be expected (recognizing that flexible attendance may create a new baseline), or severe illness is observed. Schools should follow their jurisdiction's reporting requirement specific to COVID-19. PHAs can advise on the implementation of measures specific to COVID-19 that may be in addition to standard respiratory disease prevention, such as the separation and/or exclusion of ill children/youth, staff and volunteers from school.
Outbreak management
School administrators should develop plans, in consultation with their PHA, to help guide their actions in the event of an outbreak of COVID-19 in their schools. Plans should consider specific policies regarding case and contact management, environmental cleaning, and temporary alternative education-delivery models. Communications plans should maintain privacy while including important audiences such as students, parents / families / guardians, the school staff / volunteers, and surrounding communities. Finally, the roles and responsibilities of the school, PHA, and other stakeholders in the event of an outbreak should be identified in advance of a return to school.
Travel and international students
Special consideration needs to be given to school attendance by individuals coming from outside the community, such as international students. Local, provincial/territorial and/or national requirements for domestic and international travellers may necessitate a period of self-isolation prior to integration into school activity. As of March 25, 2020, all travellers incoming to Canada are subject to mandatory 14-day quarantine (self-isolation) enforceable through an emergency order under the Quarantine Act.
Schools must also implement policies and procedures to ensure children/youth, staff or volunteers who have travelled (internationally and/or within Canada) follow the federal/provincial/territorial/local government guidelines for quarantining.
It is important to consider that some children/youth will reside on school grounds, such as in a dormitory, while attending school ("boarding schools"). While a full discussion on risk mitigation in a dormitory setting is out of scope of this guidance, more information on living in shared spaces and dormitories can be found in the Guidance for post-secondary institutions during the coronavirus (COVID-19) pandemic.
Administrators and students should be aware of the travel restrictions, exemptions, and advice before entering Canada. Further information on the roles and responsibilities of the federal, provincial and territorial governments and designated learning institutions on international students will be available soon.
ImmunizationsFootnote 19
Existing school immunization requirements should be maintained and not deferred because of the current pandemic. In addition, the influenza vaccination should be highly encouraged for all children/youth, staff and volunteers. It is vital that all children receive recommended vaccinations on time and get caught up if they are behind as a result of the pandemic. The capacity of the health care system to support increased demand for vaccinations should be addressed through a multifaceted collaborative and coordinated approach (for example, schools, PHAs, primary care providers). When school-based immunization programs are re-started, eligibility criteria should ensure that students who missed immunizations due to COVID-19 school closures should remain eligibleFootnote 20. Students, parents, and those delivering school-based immunization programs should be aware that re-starting a series is never necessary for routine immunization programsFootnote 20.
Food insecurity
The COVID-19 pandemic has led to increased unemployment and economic insecurity for Canadian families, which in turn will likely increase even further the number of families who experience food insecurity. School re-entry planning must consider the many children/youth who experience food insecurity already and who will have limited access to routine meals through the school district if schools remain closed. The short- and long-term effects of food insecurity in children/youth are profound. Plans should be made prior to the start of the school year for how children/youth participating in meal programs will receive food in the event of a school closures/reduced programming, or if they are excluded from school because of illness, contact exposures or vulnerabilitiesFootnote 21.
Students with disabilities
There is a need to maintain equitable access to education during the COVID-19 pandemic for students with disabilities. The impact of loss of instructional time and related services, including mental health services as well as occupational, physical, and speech/language therapy during the period of school closures is significant for children/youth with disabilities. Children/youth with disabilities may also have more difficulty with the social and emotional aspects of transitioning out of and back into the school setting and may have more difficulties applying some mitigation strategies. Adjusting to new routines can be particularly challenging for children with developmental disabilities. As schools prepare for reopening, school administrators should develop a plan to ensure a review of children/youth who access services, to consider how programming can be adjusted to accommodate the lost time of instruction and other related services, while supporting children to adjust to new routines and measures in the COVID-19 context. Administrators should also take steps to ensure that accommodations are made so that children with disabilities have access to the same public health information and mitigation measures (for example, accessible hand washing stations, accessible signage, age and disability appropriate language, assistance with personal preventive measures). School administrators should also develop a plan to ensure that children/youth who are hearing impaired (and others who may rely on facial cues) have their educational needs met if NMMs are worn in their classrooms; this may include the use of transparent masks. In addition, schools can expect a backlog in new child / youth evaluations; therefore, plans to prioritize those for new referrals will be importantFootnote 21.
Guidance on COVID-19 and people with disabilities in Canada is available.
TransportationFootnote 21
Communal transportation (for example, busing) can increase the risk of COVID-19 in children/youth, staff and volunteers due to a variety of reasons:
- the range in ages of the children/youth who use it
- the need to wait in groups at stops/line up
- its enclosed quarters
- the innate challenges in maintaining physical distancing
- the lack of supervision (in some cases)
- the challenges associated with maintaining personal preventive measures (for example, hand hygiene)
Schools will need to work closely with their local transportation authority and PHAs in the implementation of transportation-related - risk mitigation measures. The examples of mitigation measures listed below are not exhaustive, and school administrators/transportation authorities are encouraged to find creative and adaptive ways to mitigate transportation risk that align with public health advice and are respectful of children/youth, staff and volunteers.
- Encourage alternative modes of transportation for children/youth who have other options (for example, walking, parent/guardian drop off)
- Prohibit individuals who have symptoms of/or have had exposure (in last 14 days) to COVID-19 from boarding the school bus
- This may involve culturally safe active and / or passive screening
- Minimize the number of people on the bus at one time
- Maintain 2 metres between children/youth (unless of the same household), when possible
- Consider the use of NMMs for all passengers on the bus
- Open windows, if feasible
- Maintain 2 metres between the driver and the children/youth, where possible
- Consider a physical barrier for the driver (for example, plexiglass) where possible
- Consider the use of NMMs for the driver
- Federal Guidance for School Bus Operations during the COVID-19 Pandemic is available
- Emphasize the importance of personal preventive practices (for example, hand hygiene upon boarding and before entering school, avoid touching face, respiratory etiquette) to all riders by posting accessible and age-appropriate signage for example
- Conduct frequent environmental cleaning of high touch surfaces with approved disinfectant products should be encouraged
- Use of NMMs or face coverings may be considered for children over the age of 2 years (see section on NMMs earlier in this document)
- Consider assigning seating, when possible, to ensure children/youth sit with the same children each day while avoiding stigmatizing or discriminatory arrangements
- Consider adding buddies or bus monitors to assist younger children with adhering to risk mitigation measures
It is important to consider how these mitigation measures may affect children/youth with disabilities who use alternate modes of transport; including the accommodations or assistance that may be required in applying the measures.
Psychosocial needs of children/youth, staff and volunteers
There are psychosocial benefits for children/youth to attend school in person. However, pandemics such as COVID-19, can cause feelings of stress or anxiety and be difficult for children/youth to understand, especially if someone in their school or family is sick, or they see or hear troubling messages on the radio, internet or television. It is normal for children/youth to feel worried or nervous and to have questions. Communication should reflect the diverse linguistic, literacy and cultural characteristics and needs of the children/youth and their families. It will be important for schools to pro-actively address, monitor for, and appropriately respond to discrimination and/or bullying surrounding COVID-19. This is particularly important for those who may have or have been exposed to COVID-19, those who must remain at home due to vulnerabilities, and those who may experience amplified discrimination or bullying due to other factors such as differences in gender, ethnicity, or disability. Schools should make all efforts to ensure that misinformation is clarified and anti-discrimination/ bullying protocols are adhered to.
Staff will need to pay attention to the feelings and reactions of children and youth. The school can consider the following:
Keeping parents/guardians informed
Parents/guardians will be a major source of comfort and reassurance to their children. It will be important for the schools to keep parents/caregivers informed of what the school is doing to protect their children and what parents can do at home to prevent the spread of respiratory infections (for example, reinforce hand hygiene and respiratory etiquette, increase environmental cleaning). In addition, parents/guardians will be the ones who will make decisions about keeping their children home. As such, open and frequent communication to parents will be important in ensuring children/youth who have symptoms of/or have had recent exposure to COVID-19 stay home from school. Communication should include references to PHAs and should be as accommodating as possible for families with disabilities or those whose first languages are not English/French.
Provide reassurance
It can be comforting to reassure children/youth about their personal safety and health and to remind them that it is okay to be concerned. Remind children/youth of the actions they can take, including personal preventive practices, to stay safe and healthy.
Listen to students
Children/youth want to be heard and can provide important contributions. They do not need detailed information about events but they do need to talk about their feelings. The school environment should ensure that children/youth can ask questions. Staff should answer questions honestly while ensuring that the information is suitable for the age level and diverse personal experience. When staff are unsure of an answer, they should be encouraged to look for resources with the child/youth that can answer their questions. Administrators and staff should be mindful of how children/youth share information in less supervised settings (for example, before and after school, lunch and snack times, recess, through social media, and on the bus). It may be in these settings where children/youth can become misinformed. It will be important for administrators and staff to correct this misinformation when they are aware of it.
Maintain routines
Routines are likely to be disrupted significantly during COVID-19. Where possible, maintain familiar activities and routines at schools as it can reinforce a sense of security for children/youth. This includes instructional time, meal times, extra-curricular activities, and unstructured time such as recess. Supporting children/youth and families as routines transition will be important through a variety of communication strategies including written communication, the school website, social media pages, announcements and on-site reminders and updates.
Pay attention to media access
Limit media exposure or ensure information being accessed on-line is reputable. Exposure to too much or misinformed resources/media coverage can give children/youth an exaggerated view of the risks associated with COVID-19. It may be easier to limit exposure in younger children but this may be more difficult with older children/youth. Where feasible, monitor for misinformation and assist students in accessing reliable sources of information. Resources to support children/youth in their media literacy are available. Explain the events as well as you can and help children/youth put information into perspective. Keep children/youth informed about what is happening and what may happen at a level that is suitable for their age.
Mental health support
It will be important to promote mental health and provide mental health support services and resources as children/youth may experience increased social, mental and emotional distress associated with COVID-19 and this support can contribute to their resiliency. Mental health and wellness support needs to be accessible for diverse groups (for example, considerations based on factors such as age, gender, ethnicity/culture, and other socio-economic and demographic factors). It will also be important for schools to recognize practices that may be contributing to social and mental distress (for example, challenges in connecting with peers and teachers, cancellation of activities) and address these factors in order to support student mental health and wellbeing. Additional information is available for parents, children and youth on taking care of physical and mental health during COVID-19, along with relevant resourcesFootnote 21.
Considerations for staff and volunteersFootnote 21
The impact of the pandemic on staff and volunteers and potential stress related to a return to work should be recognized. In the same way that children/youth may need support to return to school effectively, staff and volunteers may require mental health support to successfully provide programs to children/youth. Resources such as Employee Assistance Programs and other means to provide support and mental health services should be made accessible prior to reopening.
Considerations for remote, isolated, and Indigenous communities
The overall health of Canadians living in remote and isolated communities is differentially affected by social, environmental and economic factors, including housing, water quality or access, food security, pre-existing health conditions, education and income. These factors, in addition to limited access to health care, are important to consider in the context of schools and the resumption of in-school classes during the COVID-19 pandemic.
Local epidemiology is widely varied across the country including in remote, isolated and Indigenous communities. This will be an important consideration when identifying risks and considering mitigation strategies in schools. Local surveillance programs (where relevant) and the PHA will be important partners in determining community risk in the school. Indigenous communities may choose to implement child and youth programs specific to the needs and circumstances of their communities. Guidance for Remote and isolated and First Nations, Inuit and Métis communities is available and provides specific examples of measures that can help mitigate risk in the community context including: considerations for the availability of non-medical supplies, crowded conditions, cultural safety and shared decision-making in the implementation of public health measures, limited access to running water and transmission of COVID-19 in public gatherings. Respect and support for Indigenous community decisions is needed, as well as recognition of the disproportionate burden of communicable diseases on some Indigenous communities, and the legacy of past pandemics.
Where schools rely on staff travelling from outside communities, they should consult with their PHAs for support in conducting a risk assessment and identifying potential mitigation measures specific to their situation (for example, mandatory quarantine, self-monitoring for symptoms). Considerations for resuming in-school classes may include the availability of staff and contingency plans for staff shortages (for example, due to illness or post travel self-isolation). Schools that are outside of, but in close proximity to Indigenous communities and have a high number of students from nearby Indigenous communities should engage Indigenous leadership in the development of their re-opening plans.
Many schools in remote, isolated, and Indigenous communities are in need of additions, renovations, and maintenance projects and may not easily allow the implementation of risk mitigation measures such as consistent physical distancing between students, staff, and volunteers. As in other contexts, a layered approach to risk mitigation (described throughout this document), including both personal preventive practices as well as community-level action, will be important.
Additional resources
- Kids Help Phone
- Canadian Paediatric Society - Community-Based Supports for Parents
- Families Canada - Family Support Centres
- Kids Boost Immunity
References
- Footnote 1
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Canadian Paediatric Society. Supporting a Safe Return to School for Canada's Children and Youth. [Internet]. June 23 2020. Accessed July 17 2020. https://www.cps.ca/uploads/advocacy/Supporting_a_Safe_Return_to_School.pdf.
- Footnote 2
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Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020 e20200702. doi:10.1542/peds.2020-0702.
- Footnote 3
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Ludvigsson JF. Systematic review of COVID-19 in children show milder cases and a better prognosis than adults. Acta Paediatrica 2020. doi:10.1111/apa.15270 [doi].
- Footnote 4
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National Centre for Immunisation Research and Surveillance (NCIRS). COVID-19 in schools - the experience in NSW. 26 April 2020. Available from: http://ncirs.org.au/sites/default/files/2020-04/NCIRS%20NSW%20Schools%20COVID_Summary_FINAL%20public_26%20April%202020.pdf.
- Footnote 5
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Szablewski CM, Chang KT, Brown MM, et al. SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp - Georgia, June 2020. MMWR Morb Mortal Wkly Rep. ePub: 31 July 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6931e1.
- Footnote 6
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National Collaborating Centre for Methods and Tools. (2020). Rapid Evidence Review: What is the specific role of daycares and schools in COVID-19 transmission? https://www.nccmt.ca/knowledge-repositories/covid-19-rapid-evidence-service.
- Footnote 7
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Park YJ, Choe YJ, Park O, Park SY, Kim YM, Kim J, et al. Contact tracing during coronavirus disease outbreak, South Korea, 2020. Emerg Infect Dis. 2020 Oct [Aug 04 2020]. https://doi.org/10.3201/eid2610.201315.
- Footnote 8
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Cesar Castilho, Joao AM Gondim, Marcelo Marchesin, and Mehran Sabeti, Assessing the efficiency of different control strategies for the coronavirus (covid-19) epidemic, arXiv preprint arXiv:2004.03539 (2020).
- Footnote 9
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Zhao, H., Feng, Z., Castillo-Chavez, C., & Levin, S. A. (2020). Staggered Release Policies for COVID-19 Control: Costs and Benefits of Sequentially Relaxing Restrictions by Age [Paper]. arXiv.org. https://econpapers.repec.org/paper/arxpapers/2005.05549.htm.
- Footnote 10
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Di Domenico, L., Pullano, G., Sabbatini, C. E., Boëlle, P., & Colizza, V. (2020). Expected impact of reopening schools after lockdown on COVID-19 epidemic in île-de-france. Medrxiv, 2020.05.08.20095521. doi:10.1101/2020.05.08.20095521.
- Footnote 11
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Keeling, M. J., Tildesley, M. J., Atkins, B. D., Penman, B., Southall, E., Guyver-Fletcher, G., et al. (2020). The impact of school reopening on the spread of COVID-19 in England. Medrxiv, 2020.06.04.20121434. doi:10.1101/2020.06.04.20121434.
- Footnote 12
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Increasing ventilation may help to reduce transmission, though the exact parameters are unknown. If increasing ventilation, administrators should consider the possibility that this may introduce other airborne hazards such as pollens or other allergens, or air pollutants into the setting. Outdoor settings are associated with a lower risk of transmission.
- Footnote 13
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Public Health Ontario. COVID-19 Transmission Risks from Singing and Playing Wind Instruments - What We Know So Far [Internet]. July 09 2020. Accessed July 14 2020. Found at https://www.publichealthontario.ca/-/media/documents/ncov/covid-wwksf/2020/07/what-we-know-transmission-risks-singing-wind-instruments.pdf?la=en.
- Footnote 14
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O'Keeffe, J. COVID-19 Risks and Precautions for Choirs. National Collaborating Centre for Environmental Health. July 10 2020.
- Footnote 15
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van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med April 2020; 382: 1564-1567. Published online March 17 [Accessed July 20 2020]. DOI:10.1056/NEJMc2004973.
- Footnote 16
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Chin A.W.H., Chu J.T.S., Perera M.R.A., et al. Stability of SARS-CoV-2 in different environmental conditions. The Lancet Microbe May 2020; 1(1): e10. Published online April 2 2020 [Accessed July 20 2020]. DOI: https://doi.org/10.1016/S2666-5247(20)30003-3.
- Footnote 17
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CDC. Interim Guidance for Childcare Programs and K-12 Schools. [Accessed 18 February 2020]. https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/guidance-for-schools.html.
- Footnote 18
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CDC. Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential 2019 Novel Coronavirus (2019-nCoV) Public Health Guidance for Potential COVID-19 Exposure Associated with International Travel or Cruise Travel. [Accessed 16 February 2020]. https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html.
- Footnote 19
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https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/.
- Footnote 20
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NACI. Interim guidance on continuity of immunization programs during the COVID-19 pandemic; School-Based immunization programs. [Accessed July 10 2020]. https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/interim-guidance-immunization-programs-during-covid-19-pandemic.html#a6.
- Footnote 21
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American Academy of Pediatrics. COVID-19 Planning Considerations: Guidance for School Re-entry. [Accessed June 30 2020]. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/covid-19-planning-considerations-return-to-in-person-education-in-schools/.
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