Of the many things that are forefront in our minds, especially the minds of parents, at the very top of the list is the concept of back-to-school, the ever shifting shadow that is COVID19, and the possible efficacy of any future vaccines.
We live in a unique time – a time that requires the best minds that we can find. And, as a lay person listening to all the reports with an ear glued to the Canadian media, one voice that stands out is the voice of Dr. Iris Gorfinkel.
We spoke with Dr. Iris Gorfinkel from our sunny patio in Saanich this afternoon. One thing became clear immediately: The good doctor has an inexhaustible focus for the crisis at hand but also a delightful self-deprecating humour on the subject of her long time love affair with music and the piano. We spoke of the mindful life savers in our personal realm and, as it turned out, music itself was one of those meditative exercises that keep us on course. But for now, the challenges at hand remain front and center in the doctor’s world.
This is her essay on the subject of Rethinking the social bubble before schools re-open:
When kids return to school in just a few weeks it will greatly impact social bubbles that contain both children and seniors. Children and adolescents will be exposed to other students in groups in which physical distancing may not be possible. This carries serious potential risk to those older than 60 years and those with chronic conditions who have school-aged children in their social circle.
Just last week the Toronto District School Board released an impressive 50+ page document describing well thought-out plans to bring children back to school. Bringing kids back isn’t just about the didactic teaching of core subjects. It’s critically important for children’s social skills, lends stability to at-risk children’s lives, provides reduced-priced daily meals and supports both physical and mental health. It also allows parents and guardians to re-enter the work force. The document describes the stringent control measures that are to be put in place including not only masks and hand sanitizer use, but also recommendations on restricting class sizes to 15 students with physical distancing in place along with some at-home learning.
These measures are critical but like all proposals intended to control the pandemic, it is far from perfect with plenty of unknowns. There is the question of adherence on the part of students, teachers, custodians and bus drivers with the suggested measures. Will everyone wear a mask? Wash their hands? Practice physical distancing? What will happen with the oncoming colder weather? What about aggressive contact tracing? Will kids or staff come to school when they have the sniffles?
When we look at the experience of other countries, school re-openings have been sobering. Israel was one of the first countries to re-open its schools and serves as an illustration of caution when moving too precipitously. Within days of reopening in May, COVID-19 infections mushroomed in Jerusalem forcing a widespread shutdown of schools.
We continue our grapple with the unpredictable in Canada. Schools have complex social structures with variable physical layouts, unique student and staff bodies, and a myriad of social dynamics. These factors make accurately predicting the impact that school reopening will have on the number of cases of COVID-19.
It is for this reason that returning students should be considered high risk to vulnerable populations. It follows that, when possible, kids should avoid contact with those over 60 and those with chronic conditions when schools reopen. Instead they should communicate by phone or electronically. When possible, this precautionary measure should be left in place for a minimum of one month following schools’ re-openings. After this, we will have a much better idea of the impact that returning to school has had on the number of cases, hospitalizations and deaths from COVID-19.
Should the number remain low, easing back on complete physical distancing can then be reconsidered. At that point, it still would be prudent for students to continue to wear masks, adhere to hand washing and maintain physical distancing.
Canada has recently exceeded 9,000 deaths from COVID-19. We’ve seen close to 3,000 deaths in Ontario alone. Ontario also boasts the dubious distinction of having one of the lowest hospital bed ratios in the western world during a pandemic for which there remains no known cure and for which no safe and effective vaccine is yet available. It is sobering to contemplate that these numbers may well represent only the beginning of what’s to come.
Rethinking the social circle of vulnerable populations when schools reopen is a consideration that for many may not be an option. But not rethinking seniors’ social bubble in advance may cost far more in terms of human suffering, hospitalization and death. A bit of advanced planning may well help to mitigate infections in our most vulnerable populations.
Dr. Gorfinkel graduated from McGill University and completed her post graduate training at the University of Toronto where she was named Intern of the Year. Following this she became a Clinical Instructor in Family Medicine at the University of British Columbia, maintained a family practice, and served assessing women in the emergency room on the Sexual Assault Service at Shaughnessy Hospital (now the BC Women’s Hospital).
She moved to Toronto where she maintains a full time general practice and participates in clinical research.
Care to read some more on the good doctor’s latest initiatives? A National Vaccine Registry Blueprint Check over here
Colin Newell is a Victoria resident and author of the coffeecrew website… his meandering on the subject of specialty coffee goes back decades…