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.

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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:

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:

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:

Promote and facilitate personal preventive practices.

For all ages:

For younger children:

For older children:

Promote physical distancing as much as possible (recognizing this is not always practical in child and youth settings).

For all ages:

For younger children:

For older children:

Create physical barriers between children/youth, staff and volunteers.

For all ages:

For younger children:

For older children:

Increase ventilation Footnote 12.

For all ages:

Reduce risks from exposure to high-touch surfaces (for instance, surfaces frequently touched by others).

For all ages:

For younger children:

For older children:

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:

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:

For younger children:

For older children:

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.

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:

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:

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:

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:

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:

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:

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.

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

References

Footnote 1

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.

Return to footnote 1 referrer

Footnote 2

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.

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Footnote 3

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].

Return to footnote 3 referrer

Footnote 4

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.

Return to footnote 4 referrer

Footnote 5

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.

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Footnote 6

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.

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Footnote 7

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.

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Footnote 8

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).

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Footnote 9

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.

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Footnote 10

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.

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Footnote 11

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.

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Footnote 12

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.

Return to footnote 12 referrer

Footnote 13

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.

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Footnote 14

O'Keeffe, J. COVID-19 Risks and Precautions for Choirs. National Collaborating Centre for Environmental Health. July 10 2020.

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Footnote 15

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.

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Footnote 16

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.

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Footnote 17

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.

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Footnote 18

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.

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Footnote 19

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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Footnote 20

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.

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Footnote 21

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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