How Canada's fourth wave may impact the return to school

As students head back to the classroom in the coming weeks, some experts and parents are expressing concern about rising Delta variant cases and how Canada's fourth wave of the pandemic may impact the return to school.

Infectious disease expert Dr. Isaac Bogoch told CTV's Your Morning that creating an indoor environment that is safe for children is key in ensuring children can return to the classroom and easing concerns for parents.

"Certainly when you put a ton of people into an indoor environment together, there's always the potential that COVID-19, especially this very contagious Delta variant, can take off," Bogoch said in an interview on Aug. 4.

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Bogoch said face masks, physical distancing, small cohort sizes and increased ventilation are all measures that can help protect children while at school. He added that most provinces' back-to-school plans do include some or all of these measures.

How well administration, teachers and students adhere to these measures will determine whether schools become a major driver of COVID-19 cases in the fall and winter, Bogoch said.

If they don't keep focus on these health measures, Bogoch said it is possible schools could turn solely to online learning again.

President-elect of the Canadian Medical Association Dr. Katharine Smart told CTV's Your Morning on Aug. 19 that vaccines will also be a factor in how well the virus is mitigated in schools, despite not all school-age children being eligible.

"We know how to keep people safe and keep schools open. We do that by driving our vaccination rates in the community up… [in] adults especially, but also kids over 12 coming forward to be vaccinated… and we also have the public health mitigation issues that we can do in schools," she said.

Smart said keeping up with health measures and increasing vaccinations for those who are eligible will "allow kids to be in school, where they need to be, and also safe."

While anyone over the age of 12 is eligible to receive a COVID-19 vaccine in Canada, the shots have not yet been approved for use in those younger.

However, a recent study that looked at more than 6,000 households in Ontario has suggested that children under 12 may be more likely to transmit the virus, raising concerns among parents.

"We certainly know that kids can get infected, we know that they can transmit this infection and if we compare kids to older adults they just tend to not get as sick they don't tend to get impacted as severely," Bogoch said. "But of course, a small but very real percentage of children can get really sick and can land in hospital."

Children generally do better than adults when they contract COVID-19, but experts say children with risk factors such as diabetes or asthma are more at risk and require more support in the hospital.

Although long-lasting COVID-19 symptoms are rare in children, there have been reports of long COVID occurring in kids. While children may be significantly less likely to die if they contract the virus, there have been reports of children plagued by lingering symptoms, some of which can be severe.

However, long-haul COVID-19 is not well understood, making it hard to know who is at risk of developing it.

Smart said she has heard from parents who are not only worried about their kids getting sick from COVID-19, but also concerned about the "broader impacts" of the virus on their children, such as schools being shutdown, further lockdowns and social isolation.

"It's really time I think for Canadians to step up, push those vaccination numbers up so that we can avoid that going into this fall and winter," she said.

Smart, who is a mother to two children – one who is fully vaccinated and one who is not yet eligible for the shot – said both of them will be returning to school in the coming weeks.

She said it is important that schools pay attention to community spread and adjust health measures accordingly, while also communicating with parents on what is being done to protect their children.

"I think all Canadian parents deserve to have answers to those questions, they deserve to see the funding being put into their schools to make sure their children are safe, and as a mom that's what I want to be seeing as well," she said.

COMPARING CHILD CASES IN THE U.S.

With fall approaching and the reopening of schools already beginning in certain states, experts are looking to pin down the cause of an increase in COVID-19 cases among children in the U.S. and whether or not Canada could see the same increase.

Dr. Marcos Mestre, chief medical officer of Nicklaus Children’s Hospital in Miami, previously told CTV News that they are seeing more pediatric patients now than they saw during the last wave in the city, with children hospitalized, some in ICU and on respirators.

"We're definitely seeing an increase in visits to our emergency departments and our urgent care centres, and we're also, secondary to that, seeing an increase in hospitalizations for children, which could be as young as two weeks of age to as old as 20 years of age," he said.

Doctors suspect the more contagious Delta variant is at work in the increase of COVID-19 cases among children.

However, Lynora Saxinger, an infectious disease specialist in Edmonton, previously told CTV News that there are key differences between the situation in Canada and the U.S.

Saxinger said our vaccination rate is much higher than that of the U.S., and doctors have not seen a huge boost in pediatric cases of COVID-19 in Canada in recent months.

"It's very important to be cautious and watch carefully, but at the moment I think that there's been a little bit of a shift in people's perception that might not really be needed at this point," Saxinger said.

"It's still unclear actually whether Delta itself is more dangerous for kids or if in fact the high transmission under certain circumstances is an issue."

According to data tracked by CTVNews.ca, more than 82.2 per cent of Canada's eligible population has received one dose of a COVID-19 vaccine and 73.2 per cent are fully vaccinated, as of Thursday.

Once children under the age of 12 are eligible for vaccination, Bogoch said it is important for them to get their shot to further mitigate the risk in schools. He added that Canada will likely see the vaccines approved for this age group "in the later fall or early winter."

"Hopefully we can get those needles in arms as quickly as possible to create much safer schools, much safer extracurricular activities, and really just lower the whole burden of infection in the country as well," Bogoch said.

With files from CTV News medical correspondent Avis Favaro, CTV News producer Elizabeth St. Philip and CTVNews.ca writer Alexandra Mae Jones