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  • A worrisome picture: back to school with Delta

    Stephen Hume

    Looking at the experience of other provinces and nations with school children in the past few weeks gives us some clues to what to prepare for in BC. 


    HERE WE ARE IN THE SECOND WEEK of the school year. The pandemic deepens. The numbers of as-yet-unvaccinated kids exposed to the COVID-19 virus is rising. Hospital intensive care units fill up and the insufferable and distracting culture wars over vaccination mandates get noisier.

    On the Island, the first week back saw schools in 10 communities linked to at least one case of COVID-19 says BC COVID Tracker. The independent website is run by parents and claims to monitor official notifications on a volunteer basis—valuable since the Province now only reports full-blown outbreaks. Four schools in the Greater Victoria region had reported exposures. Others extended from Mill Bay to Campbell River and Port Alberni to Nanaimo.  

    This isn’t surprising. Almost 30,000 COVID-19 infections in children have now been identified by the BC Centre for Disease Control. They appear on the agency’s surveillance dashboard. Most are aged 18 and under—but more than 10,000 cases are among children under 10. 

    Children are one of the largest remaining unvaccinated segments of the population. That makes them a prime vector for the virus as it moves into fertile ground. No wonder there’s parental concern similar to that which manifested in Sointula. There, as school opened, parents yanked 28 of 34 students out of their small school until a teacher who declined to wear a mask for what the North Island Gazette said were medical reasons could be temporarily reassigned. 

    This parental concern is not unreasonable. In Israel, which was the model for fast and extensive vaccination early in the pandemic, a new study now finds that of 13,864 children aged three to 18 who were diagnosed with COVID-19, more than 10 percent developed long term symptoms. The effects lingered up to six months after the primary episode. If the rate of incidence tracked in Israel were to emerge in BC, we’d face thousands of kids grappling with the “long haul” version of the disease, many of them infected in a school environment that is charged with keeping them safe. 

    The same survey found that 30 percent of the parents of infected children who developed COVID-19 in Israel also reported that they experienced a degrading of their “neurological, cognitive and mental health abilities.” And, yet another report by Reuters says that a British survey found that 14 percent of children who test positive for COVID-19 display symptoms associated with the coronavirus for months afterward.

    Then there are reports from the United States which has just passed a grim COVID-19 milestone. The virus has now killed one out of every 500 Americans.

    Most of the dead are in vulnerable high risk groups. But observers there now note that the US hospitalization rate per 100,000 children was 0.3 at the end of June but by mid-August, as fall school terms began, the rate suddenly spiked five-fold to 1.4 per 100,000. The percentage is still small. It’s the  trend that is worrying. The spike appeared to track the emergence of the Delta variant that’s been troubling epidemiologists because of its high rate of transmissibility.

    The American Academy of Pediatrics and the Children’s Hospital Association, a couple of gold-standard medical organizations, said that children’s cases are now increasing exponentially in the US, with 750,000 new cases added over the month of August and another 250,000 cases in the first week of September alone.  

    So, parental apprehension about the graduated—some say hasty—opening of schools just as what’s now looking a lot like an aggressive fourth wave of the pandemic gathers momentum doesn’t seem entirely misplaced.

    In Ontario, the Province has reported more than 300 known active cases in schools. Some districts report hundreds more students who are not showing symptoms but who were sent home to quarantine for two weeks because of positive tests. These followed school-environment exposures. A number of schools in eastern Ontario were already cancelling classes during the second week of school because of exposures and outbreaks.  

    In Quebec, 600 schools have reported education-based cases. 

    In Atlantic Canada, New Brunswick confirmed 11 schools with confirmed outbreaks and closed a high school. Prince Edward Island had no sooner opened schools than it began closing them again in Charlottetown, the island province’s biggest city, because of an outbreak that the chief health officer describes as “a serious situation with COVID-19 transmission…involving children.”

    In Saskatchewan, the teacher’s federation urged the provincial government to impose more stringent public health controls to grapple with rising infection rates among children. The union asked for smaller classes, broader indoor mask requirements and a vaccination mandate for everyone one eligible—children over 12, teachers and staff. The federation’s president described the situation as “dire” and called for a requirement that there be mandatory isolation for any students, teachers or staff testing positive for the virus.

    Even Alberta, where schools aren’t officially tabulated as experiencing an outbreak until 10 percent of the student body is sick and absent, some schools were already declaring that they had outbreaks. 

    Is this trend going to get worse? In Alberta they appear to think so. At a special news conference September 15 the province’s upbeat premier Jason Kenney, who not long ago was promising “The Best Summer Ever” and defeat of the virus, seemed subdued when he announced sweeping health-care restrictions to start a day later in response to what’s a developing health care crisis.

    The usually pugnacious premier didn’t just blink, he flinched.

    On the heels of his announcement, Calgary’s three largest post-secondary institutions abruptly cancelled all in-person classes for the remainder of the week. And The Calgary Herald reports that 40 Alberta schools are now being investigated for outbreaks while parents complain of a growing information void around how many positive cases are actually affecting schools and how close they may be to closing.


    ARE THESE EVENTS in school systems elsewhere a possible portent for BC? One hopes not and nobody can say for sure but COVID-19 modelling and experience with what happens to respiratory illness rates when people begin to congregate indoors during the cold winter season, hints that they might be. 

    In many of these school cases, some public health experts have said, the children were apparently infected at home, then carried the virus to school where it spread rapidly to other children, who then carried it back to their own homes to infect siblings, parents and relatives.

    At least one event involved a school bus. BC’s authorities say school buses are safe and require only regular seating for the 110,000 students who ride them twice a day, sometimes for several hours in total. One route in Northern BC, for example, requires a round trip of 230 kilometres. Meanwhile, exposures on school buses are now being reported from Oregon to Ontario.

    Not surprising, then, that in Alberta, nine post-secondary institutions have now arbitrarily ignored the province’s advisories. They simply unilaterally imposed much stricter regulations governing access to classes. Not only must faculty and staff be fully vaccinated, so must students—and students are to be required to provide verifiable proof of vaccination to attend class.

    Is it time to start thinking about mandating vaccination and proof of such for all students over 12 in all BC schools from university down? Judging from the Province’s own statistics, the majority of parents have already embraced vaccination as a safe and effective protection against the worst effects of a COVID-19 infection. 

    As of the first week of school, almost 80 percent of adults in the province were fully vaccinated, but the school-aged population between 12 and 17 lagged at 67 percent. Good, but not good enough by the government’s own targets.

    The ministry of education’s website is cheery and upbeat about all the benefits of returning to the classroom with the safety protocols it’s put in place. They include masks indoors from kindergarten to Grade 12, flexible regulations that permit the deployment of rapid response teams as necessary. And it cites studies that schools in BC were not a significant source of COVID-19 transmission. These studies found during the 2020-2021 school year that 90 percent of school-associated cases were acquired at home or in the community, not the school.

    But that was before the Delta variant, with its jaw-dropping 10-fold increase in transmissibility, came roaring onto the scene to upset models and projections. Delta variant is now the most prevalent strain circulating in BC. It is responsible for almost 100 percent of COVID-19 cases in both children and adults. About 17 percent of cases in the province and two percent of hospitalizations now involve patients under 18 years of age, says the BC Children’s Hospital in Vancouver.

    “Children get less sick from COVID-19 than adults—but rarely they can get quite sick. And we still don’t know if the Delta variant is more severe for children,” says Dr Laura Sauvé, a paediatric infectious disease specialist, on the hospital’s website. 

    What’s been occurring in other provinces suggests that BC’s optimistic approach might need a cautious re-think.

    And in the meantime, since the kids are congregating at school, maybe that’s the place to locate province-wide pop-up vaccination clinics in addition to inviting those who want to be vaccinated to travel to community drop-in clinics, public health clinics and so on.

    Maximizing vaccination coverage for the remaining 30 percent of teenagers seems like the most effective and painless way to further limit transmission, amplify school safety and reduce anxiety for parents.

    Some school districts are setting-up COVID-19 vaccination clinics—there are three scheduled for Mission over the next week; clinics were scheduled for Vernon, Armstrong and Keremeos; Cranbrook and Kimberley also planned clinics. And most of BC’s post-secondary institutions have already provided students with on-campus clinics and held vaccination drives. They seem to have been generally successful. 

    This is good news for anxious parents, but it could be better news if it were rolled out as a comprehensive provincial program rather than a piecemeal, regionally-driven program—which is what seems to have emerged.

    And perhaps it should be developed as a strategy for the next pandemic. Because there will be a next time, maybe even more stressful than this time. 

    Stephen Hume has spent half a century as a journalist writing about Western Canada, the Far North, BC and the Island.

    (Image at top from Province of BC)

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