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Will Back-to-School COVID Crush Families?

BC’s status quo approach is not good enough, says a grassroots organization of doctors and teachers.

Michelle Gamage and Katie Hyslop 29 Aug 2023The Tyee

Michelle Gamage is The Tyee’s health reporter. This reporting beat is made possible by the Local Journalism Initiative. Katie Hyslop is a reporter for The Tyee. Reach them by email.

A week before the start of school, British Columbia doesn’t have an updated back-to-school plan for reducing respiratory infections in schools, including COVID, flu, cold and RSV, says a grassroots organization of doctors, teachers, nurses, scientists, academics and parents.

Despite the release of her own study last year showing 80 per cent of kids and youth in the province have contracted COVID at least once, provincial health officer Dr. Bonnie Henry has maintained schools are not a meaningful site of transmission.

Protect Our Province BC challenges this by citing an American-Taiwanese study that found 70 per cent of in-household virus transmission began with children, especially when school was in session.

Earlier this month The Tyee asked the Health Ministry for their strategy for reducing respiratory illness transmission in schools this fall.

They responded with an email statement that outlined their strategy. This includes an updated vaccination campaign starting sometime this fall that is expected to target the XBB15 variant, also known as the Omicron subvariant “Kraken," following the latest advice from the National Advisory Committee on Immunization. The Kraken variant first started making headlines in January 2023. The ministry said the vaccine will protect against many closely related subvariants.

According to the World Health Network, as of July 30, 2023, 7.9 per cent of COVID-19 cases in B.C. were with the XBB15 variant (an additional nine per cent were with the XBB1544 variant and 2.2 per cent were with the XBB1559 variant). The largest single variant was EG51, nicknamed the “Eris” COVID variant, which made up 18 per cent of the total cases.

“We’re into the EG51 now,” said Dr. Lynne Filiatrault, co-founder of POP BC. “Where is this [COVID strategy] posted? What has been sent to schools? What has been sent to parents and families?”

The Health Ministry says it is also following the National Advisory Committee on Immunization that recommends people get their next booster this fall when a booster that provides the “best protection” will be available.

Last week Reuters reported that Moderna and Pfizer vaccines are aimed at the Kraken XBB15 variant but also “show promise” against the Eris EG51 strain.

Masking will remain optional in schools, student and staff absenteeism will be monitored and mechanical ventilation systems or HEPA filters will be used in all classrooms in the province, including portables, the ministry told us. An updated Communicable Disease Guidance for K-12 document is underway by public health, they added.

The ministry also said it would distribute COVID-19 rapid tests to schools this fall as part of a “transition” away from PCR tests and that there would not be school-wide vaccination programs for COVID-19 because “we’ve heard clearly from families that parents want to be there when their child is vaccinated and children want their parents there too.”

This is exactly what the province said about schools last September, representatives of POP BC told The Tyee last week. But high rates of absences for teachers, school staff and students last year show the strategy wasn’t enough to keep people from getting sick, they say.

The provincial plan is also behind the times when it comes to tackling the latest COVID strain, POP BC says.

COVID-19 hospitalization rates are currently up in Canada and in the United States, where some schools have already closed because of infection rates for COVID and other communicable diseases.

The public has stopped paying attention to COVID, teacher and POP BC co-founder Jennifer Heighton said. It’s important that the government get the message out that COVID is still here and long COVID has lasting health consequences for kids and adults, she added, beyond the 30 days B.C. COVID mortality reporting considers people to be impacted by COVID.

“The general public has no idea it’s not like a cold or flu,” Heighton said, adding COVID infections have been linked to increased rates of heart attacks among adults under 45, while adolescents with multiple COVID infections are at an increased risk of developing post-COVID conditions, better known as long COVID, that include chronic fatigue, organ swelling and Type 1 diabetes.

“Two weeks before school starts, people think that COVID’s benign, that if you’re vaccinated you’re fine, that we’re in a different stage of the pandemic, when actually, we never left,” Heighton said.

Preparing for the next wave

Protect Our Province tracks COVID through the Centers for Disease Control and Prevention and Walgreens pharmacy COVID tracker, both in the U.S., wastewater trackers in B.C. and Canada and the Moriarity tracker for excess mortalities in Canada.

They say B.C. should pay attention to the southern hemisphere, where respiratory illness season is already well underway. In Chile, school mask mandates have returned. In Uruguay, winter break began two weeks early because of high infection rates from multiple viruses. In Australia, Filiatrault added, children are making up 80 per cent of hospitalizations from multiple respiratory illnesses this season.

POP BC’s strategy for reducing COVID, flu and RSV transmission in schools includes improving school ventilation systems to the latest standards set out by the U.S. Centers for Disease Control and Prevention and the American Society of Heating, Refrigerating and Air-Conditioning Engineers; installing CO2 monitors in every classroom and publicly reporting the results; a new mask mandate for schools, specifying KN95 style or higher protection; admitting COVID is airborne and transmitted through aerosol spray; redistributing the federal government’s stash of rapid antigen tests to schools and families; and ensuring early vaccination of all kids and families for COVID and influenza.

“If the government is saying they’re doing enough for ventilation, they’re wrong,” said Heighton, pointing to increased teacher, school staff and student absences last year.

“That tells you that the ventilation within those classrooms is not enough, because why else was there illness spreading like wildfire in these classrooms?”

According to the BC Centre for Disease Control, influenza season peaked early last year, around the same time there was a spike in RSV infections, as well as COVID, a situation POP BC refers to as a “tripledemic.”

Six children died of influenza in the province over a two-week period last fall. From 2015 to 2021 an average of 1.5 kids died from influenza in a year.

While there is no current mask mandate for B.C. schools, the ministry told The Tyee masks remain an important tool in preventing infection “and should be used in situations where it makes sense to do so,” in addition to getting vaccinated and washing your hands.

But with only 16 per cent of kids under four, 20 per cent of five- to 11-year-olds and 15 per cent of 12- to 17-year-olds fully vaccinated in B.C., masks are even more important, POP BC says. Without a mandate and public information campaign, people won’t wear them.

Kids under four need two doses to be considered fully vaccinated, five- to 11-year-olds need three doses and 12- to 17-year-olds need four doses.

“It should not be politicized the way that it is,” Heighton said, adding similar public health campaigns have already been done for using sunscreen.

POP BC questions the quality of school ventilation

Since 2020 the provincial and federal governments have spent $219.4 million helping schools upgrade air ventilation and filtration in their buildings, the Health Ministry told The Tyee in an emailed statement.

It added, “all classrooms and portables in B.C. have mechanical ventilation systems or standalone HEPA filtration units” and school districts conduct regular inspections of HVAC systems. “School districts are recommended to have the capacity to use MERV-13 filters in their HVAC systems,” the ministry added.

The ministry also said all school districts are “expected” to meet the indoor air quality standards set by the American Society of Heating, Refrigerating and Air-Conditioning Engineers, adding school districts are responsible for assessing and monitoring their own air quality.

In 2023-24 the province will allocate $41 million to upgrade HVAC systems in 101 schools in B.C. as part of a larger $261.1 million fund for school maintenance projects, the ministry added.

But POP BC questions government's claim that schools are properly ventilated. There has been no public accounting for how and where money invested in ventilation was spent or whether ventilation systems have the appropriate HEPA or MERV-13 filters to prevent COVID transmission, they said.

School districts have released their own ventilation information, but they vary in terms of detail, Filiatrault noted. For example Surrey School District 36’s site tells you exactly what kind of HVAC filters are used in each room of every school in their district. While some rooms use MERV-13 filters, which are recommended by the BC CDC for COVID prevention, many use lower rated MERV-8, MERV-9 and MERV-11 filters.

The Vancouver School District 39 information is broken down by school, but the details provided are about ventilation assessments and upgrades, not a classroom-level breakdown of filters used. This September will be the fourth time schools have reopened since the pandemic was declared in March 2020, said Filiatrault, “and yet parents still don’t know ‘what is the air quality in my kids’ school, in the shared spaces, let alone what is the air quality in my kid’s fully occupied classroom?’”

While the ministry maintains they require schools to follow the American Society of Heating, Refrigerating and Air-Conditioning Engineers ventilation standards, POP questions whether they are following the most recent version, ASHRAE 241, released earlier this year. The ministry said it is currently reviewing the update and will update its own guidance documents if required. In an emailed statement to The Tyee, the Health Ministry stated they are reviewing ASHRAE 241.

POP BC wants carbon dioxide meters in every classroom to measure classroom air quality and flow, with reporting on school air quality made publicly available, like the Boston school district does.

Heighton already uses a CO2 monitor in her classroom — in addition to a portable HEPA filter and personally masking at all times — and she noticed CO2 levels go down when her classroom windows are open.

“If you don’t have enough new air coming in, then the CO2 levels will go up and up,” she said, adding it is a good indication of how well your HVAC system works.

“Crowded, close, closed and poorly ventilated” is what the virus cares about, Filiatrault said, adding that describes B.C. schools. Especially since masks are no longer mandatory for students or staff.

Filiatrault and Heighton recommend parents send their kids to school with masks, stay up to date with vaccines, stock up on fever-reducing medicines and rapid tests, and keep their kids home when sick to prepare for the coming school year.

“Masks and cleaning the air are variant-proof,” Heighton said.  [Tyee]

Read more: Health, Education, BC Politics

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