The Covid-19 variants are spreading throughout Quebec, including the South African variant (B1.351) which is more widespread in this province than anywhere else in Canada. In spite of this, high schools have been told to fully reopen with hardly any time to prepare. The vaccination program is going well but will it be enough to prevent a third wave which we are already seeing across the Atlantic in Italy and France as well as on our own shores in Ontario, British Columbia and Alberta?

Why has the government rushed to fully reopen the high schools even in regions where the spread of the virus is not in control? Waiting until after the Easter and Passover holidays would have given the schools a chance to prepare as well as an opportunity to see if the special vaccination program targeting school outbreaks is working.

A study recently released, but not yet peer reviewed, helps to explain this concern. It compared the effect that school opening had on the spread of COVID-19 in Montreal to Toronto and Calgary. The study revealed that the increase in the cases of COVID-19 that we saw in the fall of 2020 in Montreal was driven by school outbreaks. Children got infected at schools in Montreal, which they were forced to attend and where mask wearing and proper ventilation was not encouraged, as opposed to Toronto and Calgary.

The disease then spread to their parents and then to the rest of the community. The message is very clear. With the return of high school students to their classrooms full time in the midst of outbreaks of the variant in their schools, we run a very real risk of increasing the spread of the virus, creating a third wave here.

This had been a tough year for students and their parents. Academic performance has suffered and families have been battling significant psychological issues. What can we do to keep this return to school from fuelling a third wave? Distancing and ventilation will need to be rigorously followed. Mask wearing at all times must be compulsory. But the key may be to prioritize for vaccination the teachers, the staff as well as the parents at all these schools.

Why should these groups jump to the head of the line? Classically the best way to stop the spread of a virus like COVID-19 is to do what we have done in the past when there were outbreaks of measles, a virus which is also spread by airborne droplets. The person infected is identified and isolated and the immunization status of everyone who has been in contact with them is verified and if necessary those contacts are vaccinated.

That very effective process is currently being checked out in the project that is underway in a limited number of schools in Montreal. The assumption is that the virus is in the school and so the parents and the staff are being vaccinated to see if what holds true for measles and other viral outbreaks holds true for COVID-19. Given the present situation I would argue that we could either have waited for the results of that project before bringing the high school students back full time or that we vaccinate the staff and the parents pre-emptively.

We are so close to putting this virus in its place. To increase the risk doesn’t make any sense. Protect yourself and your loved ones. Wear your mask, wash your hands, keep your distance and do whatever you can to help the schools keep our children safe. They need our support.

Dr. Mitch Shulman is an Associate Professor in the Department of Emergency Medicine at McGill Medical School as well as an Attending Physician in the Emergency Department of the McGill University Health Centre. He’s also the CJAD AM 800 Medical Consultant.

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