Back to School and Daycare Recommendations

The Vaughan Pediatric Clinic

We are receiving many questions about school and daycare openings.

In order to answer your questions effectively and in a timely manner, we are directing our patients to our website and facebook site.  Hopefully this will provide a framework for all of your questions.  All of our pediatricians have reviewed these recommendations and we are all in agreement.

Be aware that clearly this is a changing situation depending on the current status of COVID-19 in our community.  Higher prevalence of the infection may change our back-to-school and day care recommendations.

First, we would direct you to Sick Kids Updated COVID-19 Guidance for School Reopening.   This guidance is thorough and will continue to be updated:

Highlights of this report include:

⎯ It is critical to balance the risk of direct infection and transmission of COVID-19 in children and youth, school staff and the community, with the harms of school closure on children’s physical health, developmental health, mental health and learning.

⎯ Based on the evidence available at the present time and the current epidemiology, it is our view and SickKids’ view that the adverse impacts of school closure on children and youth significantly outweigh the current benefit of keeping schools closed in order to reduce the risk of COVID-19 in children, youth, school staff and the community at large.

⎯ Keeping schools open safely will be helped by low numbers of COVID-19 cases and lower community transmission of COVID-19 and, therefore, it is important we should all do what we can to reduce disease prevalence and community transmission such as by social distancing and by wearing masks

⎯ Families should advocate that their schools have adequate funding, resources and staff to provide for social distancing, screening of children, appropriate cleaning, soap, sanitizing and handwashing facilities.   Discussion with your school about their own strategies regarding physical separation, utilization of outdoor education and their own back to work and back to school policies when someone is sick will be essential

⎯ Screening to prevent symptomatic individuals from entering the school: parents and caregivers should take an active role in daily screening of their children and youth prior to them leaving for school.  Parents/caregivers should be educated around the importance of providing truthful information both for their child and others’ safety.

⎯ Virtual learning or other forms of structured learning should be put in place for children and youth who are required to stay home because they are sick or in isolation due to COVID-19 infection or exposure, or for those who cannot attend in person for specific health reasons.

⎯ Hand hygiene: Children and youth should be taught how to clean their hands properly (with developmentally and age-appropriate material) and taught to try and avoid touching their face, eyes, nose and mouth as much as possible.

School should stress and teach regular and frequent hand washing/sanitizing: ​​

▪ When entering and exiting the building or classroom

▪ After using the washroom

▪ Before and after eating

▪ Before and after sharing toys, equipment or other commonly used items

▪ Before putting on or taking off a mask

Schools need to provide and maintain hand sanitizing and washing stations with adequate supplies, drying equipment and hand towel disposal receptacles

⎯ Respiratory etiquette: Children and youth who have symptoms of a respiratory tract infection (i.e. cough, congestion, runny nose, sneezing, sore throat, fever or difficulty breathing) must stay home and should be reminded to sneeze or cough into a tissue followed by hand hygiene, or their elbow/sleeve if no tissue is available.

⎯ Physical Distancing: Plans for physical distancing must be age appropriate and conducive for child learning.  Recommendations are likely to change as we gain more knowledge and experience and will likely be affected by the current community transmission numbers

Families should discuss with their schools plans on how to maintain social distancing:

▪ Smaller class sizes when possible

▪ Arrangement of furniture to provide physical separation of 1-2 meters

▪ Utilization of “non traditional “ classroom space such as outdoor education when possible, gymnasiums or assembly rooms

▪ Avoid large gatherings such as assemblies .

▪ Avoid choir, wind instruments

▪ Stagger lunch and recess to minimize interactions with other class cohorts with utilization of effective hand hygiene,  outdoor areas when appropriate and consideration of shorter breaks for lunch and recess

⎯ Masks:  Families should cooperate with and adhere to local government and school board related policies developed toward wearing of face masks.  These policies will take into account factors such as local disease transmission, ability to provide physical distancing within the classroom, age and developmental levels of the children as well as  individual health factors of the child.

⎯ Environmental Cleaning:  Families should advocate for adequate staff and resources to provide for increased ability to keep surfaces clean including

▪ Regular cleaning schedules using appropriate disinfecting products​

▪ Strategies to increase “No-touch” situations such as automatic doors and faucets, keeping doors open when appropriate

▪ No sharing of food water and cutlery

▪ Reminders and availability of hand hygiene when surfaces have been shared or touched

▪ Cleaning and disinfection of shared toys and other equipment used in the classroom

⎯ Ventilation:  Parents and caregivers should advocate for adequate and modern ventilation within their children’s school and classrooms.  

⎯ High Risk/Special Needs Students:  Children who are at high risk due to chronic medical conditions or have other special needs should be encouraged to attend school as best as possible but may be at risk of becoming ill related to COVID-19.  It is advisable that children in these circumstances make “return to school” appointments with their own health care providers to assess their current status and own individual risks related to school attendance.

⎯ Mental Health related issues:  We understand that return to school will result in considerable challenges related to stress and mental health.  Families should be prepared to discuss and work with their schools, primary health providers and mental health professionals about adapting to this most challenging situation.

Other issues discussed in this report include:

⎯ Issues related to the health and safety of teachers, including distancing, masks, physical environment

⎯ Issues related to the health and safety of family members, other caregivers, and others living in the home of children attending school

⎯ Issues related to managing children who may be exhibiting signs of COVID-19

⎯ Communicating with your child about COVID-19

Other recommendations we can give:

⎯ Families should communicate with their school, politicians and public health workers about particular concerns that you may see within your child’s classroom, school and environment

⎯ Parents and caregivers should develop policies with the other families within their child’s classroom cohort.  We suggest an online meeting between parents to discuss issues such as sick-days, home screening as well as raising any particular health issues of your child with the other parents.  This may help parents to get to know each other, as well as each child’s and family’s own needs, and may help to develop a sense of trust and honesty between families

⎯ Be responsible and honest: It is no longer acceptable to send your child to school when he or she is sick – even a little bit

⎯ If concerned, get a test!  COVID-19 screening centers provide timely and accurate results for your child, and results are typically available online within 48-72 hours

⎯ If your child is quarantined, so is the whole family!  Stay home from work if your child is sick and keep your other children home.  Negative testing for COVID-19 will help families get back to work and school sooner and will help prevent community spread

⎯ If you aren’t sure if your child is or is not sick, keep your child home for 24 hours to be sure

We will not be providing notes that state that your child is “okay to return to school or daycare”.  Instead, we have created a form for all patients and advise that families check off that their child has been isolated for an appropriate period of time and has been well, or has had a negative COVID-19 test.

⎯ Be a responsible role model to your family and to your community.  Wear masks in social situations, and practise good hand hygiene yourselves

⎯ Get a flu shot this fall – The combination of FLU and COVID-19 may be quite serious!  When you or your child gets the flu, they will miss school and you will miss work!