Andrew Morris

Children are vulnerable members of society and protecting them from infectious diseases should be one of our highest priorities.

Short-term consequences of COVID appear relatively minimal, but COVID is not always benign for kids. And when there’s lots of COVID, lots of kids will get infected. 

• The CDC looked at kids in 10 states from January to March of this year. Looking at over 200 adolescents, they found that nearly a third required ICU admission. Five per cent required being on a ventilator.
• Long-term consequences of COVID infection in children are unknown.
• So how do we protect people vulnerable to infection? We use the hierarchy of infection prevention and control, a slew of measures to prevent these diseases.
• The risk for spread may be less for kids and almost certainly is, and we can attenuate that risk even further, but we can’t eliminate it. School is safe for kids when there’s no COVID in the classrooms, which logically means also no COVID in the communities.
• Kids are vulnerable because they need their parents, their grandparents, their guardians and teachers. In Canada, up to 25,000 parents, grandparents, guardians and teachers have died. Yes, kids need school, but they also need their adults healthy.
• Studies showing kids in schools are not a driver of the pandemic are heavily biased and massively flawed. Apart from Dr. Tony Fauci himself just yesterday saying that kids transmit COVID, I will point out one basic fact, of the 138 variants of concern incidents identified and managed by Public Health England last week, half were in an educational setting.

Cross-examination:

Moderator Meera Dalal-Burns: One of the downsides to the precautionary approach that you were talking about, or the wait-and-watch approach, is public confusion. With every change in policy, and with these changes happening in real time, there is an eroding of public trust. In addition, this places a lot of the burden on family members and the caregivers to try and find last-minute schooling strategies. And it’s very, very skewed towards the people who have resources and extended family in the area, and less skewed towards those with less social support. So how would you consider addressing this, and communicating with parents and mothers, who are disproportionately impacted by school closures? And how can we maintain trust with the community when we’re making decisions in real time, and then going back on things we’ve said earlier?

Andrew Morris: Let’s not confuse poor strategy and poor communication that have occurred throughout the pandemic with whether or not kids can safely be in schools. I’m somebody who all along has felt that the best way to keep kids in school – and I think we should try everything possible to keep kids in school – is we focus our strategy on keeping cases in the community as low as possible. In fact, most times you can keep kids at school for as long as possible, if not throughout, but unfortunately, what we haven’t done is really clearly prioritized what’s important to keep open and what is, I think, more modifiable. If we were to do that, then we would have pretty clear communication. I think in Ontario, for sure, one of our failures was articulating a strategy. We actually never had a strategy articulated. And if we had one, then we’d be able to communicate with parents much more clearly. So they would know what to expect over time, but they didn’t know that. Absolutely, parents, especially moms, have been disproportionately affected through this pandemic. And I think it is one of what will be the everlasting tragedies of this whole pandemic and our response.

Meera Dalal-Burns: Let’s talk about acceptable risk profiles. We take risks, and we have acceptable risk profiles, in medicine all the time. There are potential harms we tolerate in order to reap the benefits: anesthesia for surgeries, bleeding risk with medications, schools opening during the influenza season Dr. Bitnun talked about. He also talked about transmission being rare. So let’s say for argument’s sake, because everyone is often quoting different studies, that the transmission is there, but it’s a relatively low rate of transmission compared to the significant economic, psychological and social harms. What is different about this risk profile compared to the risk profile we take in medicine every day?

Andrew Morris: I think there are a few aspects to that that are important to note. One is that you can keep kids in school for quite a long period of time, but as we saw with our last wave, we were teetering on the precipice of total collapse of our health-care system. And we were at a point where we didn’t have many other choices, other than to, as much as possible, reduce transmission. Because I don’t think kids are as important to transmission as some other workplaces, you can certainly try and mitigate and delay having kids be kept from school. But at a certain point, you just can’t do that. And also, you know, in the pre-vaccine era, it was very different because we also had to protect teachers and other health-care workers. It wasn’t only the kids. And as somebody who took care of more than one teacher infected with COVID, I can tell you it did occur.