Interview

Martha Fulford


Schools in the context of COVID did not need to close. They should have been reopened, and moving forward, schools should in fact be back to pre-pandemic scheduling come September.

  • Safety of schools:
    • We didn’t have significant transmission in our schools.
    • We’ve now dealt with COVID for long enough to know that long-term adverse effects are rare, exceedingly rare.
    • Internationally, and even if we just want to look nationally in British Columbia, the schools can absolutely be kept open and keep our community transmission under control.
    • Very good studies from Norway, Sweden, England and Scotland show that teachers are at no higher risk than the baseline community risk. 
    • In Ontario, when we closed our schools in April, school-associated positivity rates in staff were 1.6 per cent, while our community rates were around 10 per cent. With teachers now eligible for vaccination, this already low risk is going to be vastly reduced. 
  • Closures cause more harm than good: 
    • Mental health issues: A study out of SickKids has shown that in children who were previously otherwise entirely healthy, we are now seeing depression rates of 37.6 per cent, anxiety 38 per cent. Suicidality is increasing. Children’s Hospital of Colorado has recently declared a state of emergency due to the unprecedented growth in severe mental health, including suicidality, even in children as young as 10. 
    • There has been a dramatic increase in eating disorders, in the range of 100 per cent above baseline. The Children’s Hospital of Eastern Ontario, which has normally nine inpatient admissions, has 25 now. 
    • Lack of access to education disproportionately affects those who are most vulnerable and marginalized. And the longer we have school closures, the further behind that they’ll be left. 

Cross-examination:

Moderator Meera Dalal-Burns: When we talk about school closures, this conversation is very polarized: all closing versus all opening. Dr. Morris has clearly stated that schools should be the first to open and the last to close. Since we know that one-size-fits-all solutions and approaches are often flawed in medicine and epidemiology, and that when we look at transmission data being minimal in schools, it’s an aggregate of schools in hotspots and in low risk zones, is there room for a balanced approach: some school closures in hotspots, closures in high-risk age groups but not for others, maybe keeping them open for people with special needs? What are your thoughts on a more nuanced approach to school closures rather than not at all?

Martha Fulford: I think it’s important to look across all jurisdictions when we think of school closures. British Columbia is probably for me the most compelling example. They reopened their schools in June and never reclosed them. They made children and the health and wellbeing of children their priority for the province. And they had hotspots, they had equivalent increases in their curves: their Fraser region was the equivalent of our Peel. And despite very similar problems with escalating numbers, schools were kept open, children were looked after, and they didn’t see significant problems with it. And their curves have equaled Ontario’s in terms of coming down. So when we have a nuanced approach, I think if we had data now that could actually show us that schools are transmitters, it would be different conversation. But as Dr. Bitnun alluded to, one of the remarkably good news stories of COVID is, number one, children aren’t particularly susceptible, and number two, they’re not as efficient at transmission. And despite all of our fears, nowhere have schools been shown to be dangerous. And it’s a balance: it is our obligation as a society to look after the health and wellbeing of every member of our society in the way that they best deserve it. And I appreciate Dr. Morris’s comment about parents and grandparents, but we didn’t have to close schools for that. We had to control community transmission. And we should be separating these two things. We should be doing everything we can to preserve and maintain the health and wellbeing of our children while controlling community transmission. So advocating for school being open does not in any way mean that we don’t have community measures in place to control transmission. These are not mutually exclusive conversations.

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3 Comments
  • Debra Brown says:

    So refreshing to hear Dr. Fulford’s take on school closures. Why isn’t our government looking at the mental health statistics relating to children due to these closures? The physical risks are so minimal but the mental risks are so alarming. I am not an anti-vaxxer and try to follow the science, but I certainly question the efficacy of masks. As per CNN Medical Analyst Dr. Leana Wen, “Cloth masks are little more than facial decorations. There’s no place for them in light of Omicron,” We as a society need to get back to a ‘normal’ life and not live in such fear. Being cautious is one thing, but being terrified to live and facing financial ruin because of all the “protective” measures is another.

  • Janice Beveridge says:

    We need a healthy debate on the need for booster shots for healthy young adults.
    Especially after Omicron- one would think the combination of the initial vaccine series and infection would be enough to provide strong protection in the future.
    If people want a booster that’s one thing, but I don’t believe that boosters should be required.

    • Marion Day says:

      This debate took place in June, 2021. I’m seeing it reposted on social media with the date Jan 4 2022, It’s posted on YouTube as “Jan 4”, with a creation date of Dec 31 2021.

      Even if some (or even all) of the participants’ views remain unchanged in the context of Omicron, that the debate predates Omicron by 6 months provides potentially important context. It might be important for a viewer to understand the debate occurred in June 2021, not several days ago. I hope anyone with posting privileges will add this clarification. Thanks.

Authors

Martha Fulford

Contributor

Martha Fulford is an associate professor at McMaster University and chief of medicine at the McMaster University Medical Center.

Cross-examiner

Meera Dalal-Burns

Contributor

Meera is a general internist, palliative care physician at St. Michael’s Hospital, and journalist with a penchant for the unusual and a love of untold stories.

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