Transcript: Prescribing Best Practices For Ontario Schools | Sep 03, 2020

Nam sits in the studio. She's in her early forties, with shoulder length curly brown hair. She's wearing glasses, a black blazer over a striped green and white shirt, and a golden pendant necklace.

A caption on screen reads "Prescribing best practices for Ontario Schools. Nam Kiwanuka, @namshine, @theagenda."

Nam says IN JULY, EXPERTS FROM THE HOSPITAL FOR SICK CHILDREN AND OTHER LEADING CHILDREN'S HEALTH CENTRES IN ONTARIO, ISSUED A REPORT. IT LAID OUT SEVERAL RECOMMENDATIONS FOR HOW SCHOOLS COULD BE SAFELY REOPENED IN THIS PROVINCE. WITH THE FIRST DAY OF SCHOOL JUST AROUND THE CORNER, LET'S CHECK IN ON WHAT EXPERTS ARE SAYING NOW. JOINING US FROM MONTREAL, QUEBEC: PRACHI SRIVASTAVA, ASSOCIATE PROFESSOR SPECIALIZING IN EDUCATION AND INTERNATIONAL DEVELOPMENT AT WESTERN UNIVERSITY...

Prachi is in her thirties, with long straight brown hair and bangs. She's wearing a white shirt.

Nam continues IN THE NATION'S CAPITAL: DR. LINDY SAMSON, A PEDIATRIC INFECTIOUS DISEASES PHYSICIAN AND CHIEF OF STAFF AND CHIEF MEDICAL OFFICER AT CHEO, A PEDIATRIC HEALTH AND RESEARCH CENTRE IN OTTAWA...

Lindy is in her fifties, with short feathery brown hair. She's wearing a purple sweater and a polka-dotted blouse.

Nam continues AND HERE IN THE PROVINCIAL CAPITAL: DR. RONALD COHN, PRESIDENT AND CEO, THE HOSPITAL FOR SICK CHILDREN, KNOWN AS SICKKIDS, AND A PROFESSOR IN PAEDIATRICS AND MOLECULAR GENETICS AT THE UNIVERSITY OF TORONTO...

Ronald is in his sixties, clean-shaven, with short white hair. He's wearing glasses, a gray suit and a white shirt.

Nam continues WELCOME TO YOU ALL.

Ronald says THANK YOU.

Nam says I'M REALLY LOOKING FORWARD TO THIS CONVERSATION. BEFORE WE TALK ABOUT SOME OF THE ISSUES THAT HAVE COME OUT OF THE REPORT, I WANTED TO FOCUS ON THE GUIDELINES IN THE REPORT. DR. COHN, THE FIRST QUESTION IS TO YOU: HOW DID THIS REPORT COME TOGETHER?

The caption changes to "Ronald Cohn. The Hospital for Sick Children. SickKids."

Ronald says THANK YOU SO MUCH FOR HAVING ALL OF US, AND I THINK IT'S IMPORTANT TO SET THE CONTEXT OF HOW THE REPORT CAME TOGETHER. SO AT THE BEGINNING OF MAY WHEN MANY OF US BEGAN TO REALIZE THAT THIS VIRUS WAS GOING TO STAY WITH US FOR A PROLONGED PERIOD OF TIME, WE ALSO BEGAN TO SEE THE IMPACT THIS VIRUS HAS ON THE MENTAL AND PHYSICAL HEALTH OF CHILDREN. WE ALSO REALIZED THAT CHILDREN WEREN'T REALLY DISCUSSED AT ALL GIVEN WHAT WAS UNDERSTANDABLY SO THE CRISIS OF THE LONG-TERM CARE FACILITIES WE HAD TO DEAL WITH AT THAT TIME. AND THEN WHEN WE STARTED TO HAVE DISCUSSIONS AMONG MY COLLEAGUES, THEY FOUND IT EASY TO WRITE AN ADVOCACY PIECE ON THE ISSUES THAT CHILDREN ARE FACING IN THIS PANDEMIC. WE ALSO RECOGNIZED THAT SCHOOL WOULD HAVE TO LOOK VERY DIFFERENT. WE COULDN'T THINK ABOUT SENDING KIDS BACK TO SCHOOL UNDER THE SAME CONDITIONS BEFORE THE PANDEMIC, AND AS WE WERE IN OUR OWN HOSPITAL ACTIVELY LIVING WHAT IT MEANS TO PUT IN ALL THE SAFETY MEASURES THAT ARE NECESSARY TO KEEP PATIENTS, PARENTS, AND FAMILIES SAFE, WE REALLY TOOK ON THE RESPONSIBILITY TO PUT TOGETHER THESE GUIDELINES, WHICH IS REALLY KIND OF A HOW-TO DOCUMENT THAT IS SUPPOSED TO HELP THE EDUCATION SECTOR WITH GOVERNMENT, TEACHERS, AND SCHOOL BOARDS TO THINK ABOUT HOW WE CAN CREATE A HEALTHY AND SAFE ENVIRONMENT FOR OUR CHILDREN AND WE HAVE DONE THIS IN COLLABORATION WITH ALL OF THE ACADEMIC CHILDREN'S HOSPITALS, WE CONSULTED WITH ADULT INFECTIOUS DISEASE EXPERTS, WITH PUBLIC HEALTH OFFICIALS, TEACHERS AND PARENTS WHO ALL HAVE PROVIDED INPUT INTO THIS DOCUMENT, AND IT WAS REALLY A GRASS ROOTS TYPE OF EFFORT WHERE ALL THESE PEOPLE WHO OBVIOUSLY HAVE A LOT OF OTHER THINGS TO DO TOOK ON THE RESPONSIBILITY TO TRY TO PROVIDE A DOCUMENT THAT WILL HELP SCHOOLS, AND I WOULD ALSO LIKE TO TAKE THE OPPORTUNITY BRIEFLY TO SAY THAT THIS REPORT WAS NOT COMMISSIONED BY THE GOVERNMENT OR BY ANYBODY ELSE, AS SOME INDIVIDUALS AND MEDIA HAVE SUGGESTED, AND IT IS A LIVING DOCUMENT. WE ARE CONSTANTLY IN CONTACT AMONGST EACH OTHER TO COLLECT NEW EVIDENCE AND WE WILL CONTINUE TO UPDATE THIS DOCUMENT AS THE EVIDENCE BECOMES AVAILABLE.

Nam says SOME OF THE POINTS YOU BROUGHT UP WE WILL BRING THEM UP, AND I DID READ THE REPORT, AND JUST TO REITERATE SOMETHING, THE FOLLOWING IS NOT INTENDED AS AN EXHAUSTIVE SCHOOL DOCUMENT. THE SAFE RETURN TO SCHOOL IS THE PRIMARY RESPONSIBILITY OF THE MINISTRY OF EDUCATION. SO SOME OF THE GUIDELINES THAT YOU HAVE IN THE REPORT INCLUDE SCREENING TO PREVENT SYMPTOMATIC INDIVIDUALS FROM ENTERING THE SCHOOL; CONSISTENT HAND HYGIENE, PHYSICAL DISTANCING TO REDUCE LIKELIHOOD OF TRANSMISSION, MASKS WHERE POSSIBLE; REGULAR ENVIRONMENTAL CLEANING; ENSURING VENTILATION THROUGH OPEN DOORS AND WINDOWS; MITIGATION OF RISK FOR STUDENTS WITH UNDERLYING HEALTH ISSUES; MENTAL HEALTH AWARENESS AND SUPPORT FOR ALL CHILDREN; A STRATEGY FOR MANAGING SUSPECTED AND CONFIRMED COVID-19 CASES. DR. COHN, IS THERE ANY ONE OF THESE MEASURES THAT ARE MORE IMPORTANT THAN ANOTHER?

The caption changes to "Ronald Cohn, @ronald_cohn."

Ronald says IN FACT, THE KEY IS THAT WE LOOK AT THIS AS A BUNDLED APPROACH. THE MOST SUCCESS WE WILL GET OUT OF THIS IS BY IMPLEMENTING AS MUCH AS POSSIBLE ALL OF THESE MEASURES BECAUSE THE BUNDLED APPROACH IS WHERE THE SUCCESS IS GOING TO BE MORE LIKELY. I THINK WE HAVE TO KEEP IN MIND, THOUGH, LIKE WITH EVERYTHING ELSE WE DO CURRENTLY IN OUR OWN PERSONAL LIVES, WE WON'T BE ABLE TO ELIMINATE THIS. OUR STRATEGIES ARE REALLY ABOUT BALANCING AND MITIGATING RISKS AS MUCH AS POSSIBLE IN ORDER TO KEEP OUR SCHOOLS, OUR STUDENTS, THE PARENTS, THE TEACHERS, AND SCHOOL STAFF SAFE.

Nam says DR. SAMSON, WHY WAS IT IMPORTANT FOR CHEO TO TAKE PART IN THIS?

The caption changes to "Lindy Samson. CHEO."

Lindy says FIRST AND FOREMOST THE RESPONSE TO COVID ON THE HEALTH AND WELL-BEING OF CHILDREN AND YOUTH IN OUR COMMUNITIES HAS BEEN SIGNIFICANT AND WE NEED TO HELP THEM TO GET BACK TO STRUCTURED LEARNING AND THEIR SCHOOLS WHERE THEY ALSO GET A LOT OF SUPPORTS TO HELP THEM STAY WELL AND THRIVE. SO AT CHEO, WE LISTEN TO AND ACT ON WHAT FAMILIES WERE TELLING US AND WE WERE HEARING LOTS OF QUESTIONS AND A NEED FOR INFORMATION FROM OUR FAMILIES AND OUR LOCAL EDUCATORS WHO WANTED GUIDANCE AND GOOD INFORMATION ABOUT HOW TO SAFELY RETURN TO SCHOOL. AND SO WE'RE VERY HAPPY TO HAVE CONTRIBUTED OUR EXPERTISE IN COLLABORATION WITH OUR COLLEAGUES AND PARTNERS ACROSS ONTARIO TO DEVELOP, AS DR. COHN SAID, A SET OF GUIDING PRINCIPLES BASED ON THE EVIDENCE TO DATE AND A KEY MESSAGE IS THE EVIDENCE... WE'RE STILL LEARNING. IT'S A NEW VIRUS, AND SO WE NEED TO CONTINUE AND WE WILL CONTINUE TO LOOK AT THE EVIDENCE AND LEARN FROM WHAT'S HAPPENING AND THEN ENSURE THAT EVERYBODY HAS THE INFORMATION TO IMPLEMENT THE RIGHT SOLUTIONS IN THEIR CONTEXT, AND THAT'S ALSO VERY IMPORTANT, THAT WHAT THE RIGHT NUMBER OF BUNDLES AND THE RIGHT HIERARCHY OF BUNDLES IS IN ONE SCHOOL, IN ONE COMMUNITY, WILL BE DIFFERENT THAN WHAT THE RIGHT BUNDLE IS IN ANOTHER COMMUNITY AND ANOTHER SCHOOL, AND THAT'S BECAUSE THE ACTIVITY OF COVID IN THAT COMMUNITY IS DIFFERENT, THE POPULATION IS DIFFERENT, AND THE SCHOOL ENVIRONMENTS ARE DIFFERENT. SO WE'RE HAPPY TO CONTINUE TO CONTRIBUTE IN THAT WAY.

Nam says AND I NOTICED WHEN I READ THE REPORT, THERE WERE DIFFERENT GUIDELINES DEPENDING ON THE AGE GROUP. AND DR. SAMSON, SINCE THE PANDEMIC LOCKDOWN, WHAT HAVE YOU BEEN SEEING IN TERMS OF CHILDREN'S MENTAL HEALTH?

Lindy says SO, THE OVERALL IMPACT OF OUR STRATEGIES IN THE COMMUNITY, WHICH HAS BEEN SELF-ISOLATION AND KEEPING PEOPLE TO BUBBLES AND PRIMARILY CLOSED THE SCHOOLS, REALLY HAS HAD A SIGNIFICANT IMPACT ON THE OVERALL WELL-BEING AND VERY SPECIFICALLY INCLUDING THE MENTAL HEALTH OF CHILDREN AND YOUTHS. WE'VE HEARD FROM SURVEYS OF FAMILIES ACROSS THE PROVINCE THAT MORE THAN one third OF PARENTS ARE OBSERVING SOME SORT OF MENTAL HEALTH OR BEHAVIOURAL CHANGE IN THEIR CHILDREN. THAT'S BEEN GREATEST IN CHILDREN WHO ARE ALREADY LIVING WITH MENTAL HEALTH CHALLENGES AND IT'S NOT ONLY ABOUT MENTAL HEALTH, IT'S ALSO ABOUT THE OVERALL WELL-BEING OF CHILDREN.

Nam says PRACHI, I WANT TO BRING YOU INTO THIS CONVERSATION BECAUSE YOU'RE PART OF ONTARIO SAFE. A TWO-PART QUESTION: WHAT IS ONTARIO SAFE, AND HOW DID THAT GROUP COME TOGETHER?

The caption changes to "Prachi Srivastava. Western University."

Prachi says WELL, I'M LENDING MY VOICE TO ONTARIO SAFE. I, AS AN EXPERT, AS A GLOBAL EDUCATION EXPERT, AS SOMEONE WHO HAS BEEN WORKING ON THE PANDEMIC AND THE GLOBAL EDUCATION EMERGENCY SINCE MARCH. AND I THINK I WOULD LIKE TO START OFF BY SAYING THAT MOST OF US WHO ARE WORKING ON THIS ISSUE READ THE SICKKIDS REPORT WITH GREAT INTEREST, AND WE WERE, YOU KNOW, VERY HAPPY TO SEE THAT THERE WAS A MEDICAL RESPONSE TO THE SITUATION FACING CHILDREN IN SCHOOLS. WE DID FEEL THAT THERE WERE SOME ISSUES THAT COULD HAVE BEEN ADDRESSED IN A MORE HOLISTIC MANNER. IF EXPERTS IN EDUCATION AND FROM AN EDUCATION BACKGROUND WERE MORE PERHAPS INVOLVED IN THE DRAFTING OF THIS REPORT AND... YES?

Nam says SORRY. I JUST WANTED TO FOLLOW UP ON WHAT YOU JUST SAID. YOU SAID SOME ISSUES, YOU WISH THEY WOULD HAVE BEEN ADDRESSED IN A MORE HOLISTIC MANNER. WHAT ISSUES ARE THOSE?

The caption changes to "Prachi Srivastava, @prachisrivas."

Prachi says SO I THINK THE FIRST ISSUE IS ONE AROUND CURRICULAR ADAPTATION, TO ADDRESS EXACTLY SOME OF THE CONCERNS AROUND MENTAL HEALTH AND WELL-BEING THAT THE DOCTORS ARE MENTIONING HERE. SO WE NEED TO UNDERSTAND A FEW THINGS. THE FIRST IS THAT THE HARMS CAUSED BY SCHOOL CLOSURES ARE NOT GOING TO BE FELT EQUITABLY ACROSS DIFFERENT GROUPS. WE KNOW THAT FAMILIES AND CHILDREN ENTERING THIS PANDEMIC IN PRECARIOUS CIRCUMSTANCES, THEY ARE GOING TO BE FURTHER AFFECTED, AND IN A STATE OF EMERGENCY, THIS IS... WE HAVE TO MAKE NO MISTAKE ABOUT IT. THIS IS THE LARGEST EMERGENCY TO FACE EDUCATION IN OUR LIFETIME. I AM NOT BEING... I AM NOT BEING A FEARMONGER. WE HAVE SEEN, THERE IS A REPORT THAT HAS JUST COME OUT BY UNESCO A COUPLE OF DAYS AGO THAT SAID THAT TWO-THIRDS OF CHILDREN ON OUR PLANET, TWO-THIRDS OF CHILDREN ON YOUR PLANET, THAT'S ROUGHLY 900 MILLION CHILDREN, THEY ARE NOT GOING TO BE RETURNING TO SCHOOL IN A CONTINUOUS MANNER OR ARE GOING TO BE RETURNING IN GRAVE UNCERTAINTY. WHEN WE LOOK AT EDUCATION IN EMERGENCIES, WE NEED TO THINK ABOUT WHAT ARE THE CURRICULAR ADAPTATIONS THAT WE CAN MAKE, HOW SHOULD WE BE PLANNING FOR PERHAPS TWO YEARS, AND HOW SHOULD WE BE PLANNING IN A WAY THAT TAKES INTO CONSIDERATION THE HEALTH EXIGENCIES, THE BUNDLE OF MEASURES THAT HAVE BEEN MENTIONED IN THE SICKKIDS REPORT AND BEYOND, AND HOW DO WE ACTUALLY MARRY THAT WITH THAT NEEDS TO BE HAPPENING WITH OUR CHILDREN IN THE CLASSROOM FOR THEM TO SUCCEED.

Lindy says THANK YOU FOR RAISING SUCH AN IMPORTANT ISSUE. I THINK WE COMPLETELY AGREE AND THE FOCUS ON... YOU KNOW, THIS HAS TO BE AN INTERSECTORAL COLLABORATIVE PIECE OF WORK, SO THE PIECE THAT HEALTH CAN OFFER IS FROM THE HEALTH... ABSOLUTELY THE IMPLEMENTATION AND THE GUIDANCE MOVING FORWARD HAS TO BE DONE IN A COLLABORATIVE INTERSECTORAL WAY. EDUCATORS HAVE THE EXPERTISE AND KNOWLEDGE OF HOW TO GET KIDS IN THE CLASSROOM USING THE GUIDING PRINCIPLES AND OF COURSE THE EQUITY ISSUE IS SO IMPORTANT, AND THAT'S THE ABSOLUTE REASON WHY WE NEED TO DO COLLECTIVELY WORK TOGETHER, POOL OUR EXPERTISE TO GET KIDS SAFELY BACK TO SCHOOL WITH THE SAFETY OF CHILDREN, YOUTH, TEACHERS, AND ALL THE STAFF AT SCHOOLS AS THE NUMBER ONE PRIORITY. SO THANK YOU SO MUCH FOR RAISING THAT.

Nam says WELL, I WANTED TO POSE... SORRY. I JUST WANTED TO INTERJECT FOR A SECOND, BECAUSE I THINK ONE OF THE POINTS ABOUT KIDS GOING INTO SCHOOL IS THAT IF THEY DON'T GO BACK TO SCHOOL, THERE ARE SOME RISKS. SO WHAT'S AT RISK IF CHILDREN DON'T GO BACK TO SCHOOL IN THE USUAL WAY? DR. COHN?

Ronald says YES, SO I THINK DR. SAMSON ALREADY MENTIONED SOME OF THE SURVEY RESULTS THAT WE HAVE SEEN IN TERMS OF THE IMPACT ON THE MENTAL HEALTH. I WOULD LIKE TO ADD, THOUGH, THAT WE ALSO HAVE SEEN AND CONTINUE TO SEE THE IMPACT ON THE PHYSICAL HEALTH OF CHILDREN. SO, FOR EXAMPLE, OUR EMERGENCY ROOM VISITS HAVE, IN NUMBERS, DROPPED BUT THE ACCUITY BY WHICH CHILDREN ARE COMING TO OUR EMERGENCY HAS SIGNIFICANTLY CHANGED COMPARED TO PREVIOUS YEARS. WE ALSO SEE A SIGNIFICANT HIGHER NUMBER OF INJURIES, LIKE SCALDING OR BURNING INJURIES THAT OFTEN RESULT FROM STAYING AT HOME WITH LESS SUPERVISION, AND LAST BUT NOT LEAST WHILE WE ARE JUST ABOUT TO SUMMARIZE OUR CANADIAN DATA, WE KNOW FROM THE UNITED STATES THAT JUST SOME VERY BASIC HEALTH MEASURES OF CHILDREN RELATED TO IMMUNIZATIONS, FOR EXAMPLE, HAVE DROPPED WITHIN A MONTH BY 50 percent. SO I THINK THERE ARE COLLECTIVE IMPACTS ON CHILDREN, BUT I ALSO WOULD LIKE TO EMPHASIZE, AS DR. SAMSON SAID, IT HAS TO BE A COLLABORATIVE EFFORT AND REALLY THAT THE REASON AND THE MAIN GUIDANCE THAT OUR DOCUMENT WAS TRYING TO DO IS TO HELP SCHOOLS AND SCHOOL BOARDS TO UNDERSTAND HOW YOU CAN CREATE A HEALTHY, SAFE ENVIRONMENT. THERE ARE MULTIPLE OTHER ASPECTS THAT NEED TO BE TAKEN INTO CONSIDERATION, AND IT'S NOT GOING TO BE A ONE SIZE FITS ALL SOLUTION. THERE WILL BE REGIONS WITH LOWER COMMUNITY TRANSMISSION THAT MAY HAVE VERY DIFFERENT CIRCUMSTANCES IN REGARD TO BRINGING CHILDREN TO SCHOOL THAN OTHERS, AND IT IS REALLY THE VULNERABLE CHILDREN WHO ARE COMING FROM DENSE POPULATION AREAS THAT WE ARE MOST WORRIED ABOUT.

Nam says PRACHI, I WANT TO FOLLOW UP WITH WHAT DR. COHN JUST SAID. WITHIN THE PAST FEW DAYS WE'RE HEARING FROM THE TDSB, AFTER THEY'VE DONE THE SURVEY WITH THE PARENTS, BETWEEN 70 AND 80 PERCENT OF KIDS ARE GOING BACK TO IN-CLASS LEARNING, DEPENDING WHETHER YOU'RE IN ELEMENTARY OR WHETHER YOU'RE IN HIGH SCHOOL. IN YOUR VIEW, PRACHI, HOW MUCH HELP HAS THIS REPORT BEEN?

Prachi says WELL, I THINK... I THINK WE NEED TO ADDRESS A COUPLE OF ISSUES AND I THINK THERE ARE A COUPLE OF ELEPHANTS IN THE ROOM THAT I NEED TO ADDRESS BECAUSE THESE ARE THE ISSUES THAT I'VE BEEN WORKING ON COLLECTIVELY WITH... GLOBALLY AND HERE IN ONTARIO. THE FIRST ISSUE IS THE ONE OF SMALLER CLASS SIZES, AND I THINK, YOU KNOW, YOU ASKED ME ABOUT ONTARIO SAFE. ONE OF THE MAIN MESSAGES OF ONTARIO SAFE IS TO INSTITUTE SMALLER CLASS SIZES TO MINIMIZE CONTACT. I THINK ALL THE EPIDEMIOLOGICAL LITERATURE WE'VE SEEN SO FAR HAS SHOWN THAT MINIMIZING CONTACT IS PROBABLY ONE OF THE MOST EFFECTIVE WAYS OF HELPING TO KEEP RISK DOWN. SO HOW DO WE DO THAT IN SCHOOLS? SCHOOLS ARE NATURALLY COHORTED BY CLASS, AND IN ELEMENTARY SCHOOL, THEY'RE VERY TIGHTLY COHORTED AS THEY ARE BECAUSE THE CHILDREN ARE PRETTY MUCH WITH THEIR TEACHER MOST OF THE DAY OTHER THAN ONE OR TWO SUBJECTS LIKE PHYS. ED. OR PERHAPS THEY HAVE A FRENCH OR A SECOND LANGUAGE COMPONENT. BUT THE COHORTS ARE ALREADY TIGHT. WHAT YOU WANT TO DO IS MINIMIZE THOSE NUMBERS OF INTERACTIONS. HOW DO YOU DO THAT? YOU DO THAT BY MINIMIZING THE NUMBER OF CHILDREN THAT THEY ARE GOING TO BE INTERACTING WITH, WHICH MEANS SMALLER CLASS SIZES. OF COURSE, THIS HAS IMPLEMENTATIONS ON WHAT THIS MEANS FOR MANAGING A SYSTEM, AND THERE ARE CERTAIN COUNTRIES... I MEAN, DENMARK GLOBALLY WAS ONE OF THE FIRST THAT HAD REOPENED ITS SCHOOLS IN APRIL. IT DID THAT IN APRIL WITH A REDUCTION IN CLASS SIZES AS A TEMPORARY MEASURE. BUT THE SITUATION IN DENMARK WAS VERY DIFFERENT THAN IT IS HERE IN ONTARIO. THE SITUATION IN TERMS OF THE COMMUNITY TRANSMISSION WAS VERY DIFFERENT IN ONTARIO AT THE TIME. AND EVEN THOUGH IT WAS MUCH LESS IN TERMS OF THE COMMUNITY TRANSMISSION, THE CLASS SIZES WERE REDUCED UNTIL SUCH A TIME AS THEY THOUGHT THAT THEY COULD SUSTAIN THE CLASS SIZES OF AROUND 20, 25, THAT WE ARE MORE ACCUSTOMED TO HERE. SO THAT IS ONE, I THINK, NUMBER ONE MEASURE THAT WE ARE TRYING TO SEE, PARTICULARLY AS DR. COHN HAS ALSO MENTIONED, WE WANT TO LOOK AT THIS AS A LOCALIZED RESPONSE, BROADLY LOCALIZED. AND WHAT THAT MEANS IS YOU WANT TO HAVE A BROAD BUNDLE OF MEASURES IN PLACE, THAT INCLUDES SANITIZATION MEASURES, IT INCLUDES INCREASED VENTILATION, IT INCLUDES REALLY LOOKING AT WHAT THE VENTILATION SYSTEMS ARE, IT INCLUDES LOOKING AT BROAD-BASED TESTING FOR OUR EDUCATION STAFF AND FOR OUR TEACHERS. AND THAT ALSO INCLUDES MASK-WEARING, WHICH I KNOW THERE WAS CERTAIN BIT OF DISCUSSION WITHIN THE REPORT ITSELF IN TERMS OF SOME DISCUSSION, WHETHER ON EFFICACY, BUT IT DOES INCLUDE ALL OF THESE MEASURES BROADLY. AND THEN YOU WANT TO LOOK AT THE HIGH-RISK COMMUNITY AND YOU WANT TO LOOK TO SEE WHERE WE NEED TO PRIORITIZE SMALLER CLASS SIZES. IF IT WERE UP TO ME, WE WOULD BE LOOKING AT MINIMIZING CONTACT ACROSS THE BOARD, AS THEY DID IN DENMARK, AS THEY ARE DOING CURRENTLY IN OTHER COUNTRIES, WHERE THEY ARE ABLE TO OPEN AND KEEP SCHOOLS OPEN. THE POINT HERE IS: WE ARE NOT LOOKING TO HAVE OUR SCHOOLS OPEN IN A TEMPORARY MEASURE. WHAT WE WANT IS TO INCREASE THE SUSTAINABILITY OF THAT REOPENING AS MUCH AS WE POSSIBLY CAN. AND THE WAY TO DO THAT IS TO MINIMIZE OUR CONTACT.

Nam says TO FOLLOW UP ON WHAT PRACHI WAS SAYING, THE GOVERNMENT HAS CITED YOUR REPORT IN HOW IT'S MADE REGARDING SCHOOL OPENINGS. YET THEY HAVEN'T FOLLOWED THE GUIDELINES AROUND SMALLER CLASSROOMS AND VENTILATION. HOW THEN CAN PARENTS AND TEACHERS FEEL COMFORTABLE ABOUT HOW SAFE THE REOPENING WILL BE, DR. COHN?

Ronald says I AGREE WITH YOU THAT MOST OF OUR RECOMMENDATIONS HAVE BEEN IMPLEMENTED. WE ALSO STATED VERY CLEARLY AND CONTINUE TO EMPHASIZE THAT SMALLER CLASS SIZES HAVE TO BE A PRIORITY, AND PARTICULARLY AS MY COLLEAGUE JUST MENTIONED IN THE VULNERABLE COMMUNITIES. AND WE ARE CONTINUING TO HEAR FROM SCHOOLS WHO ARE TRYING TO BE AS CREATIVE AS POSSIBLE TO MINIMIZE CLASS SIZE AS MUCH AS POSSIBLE. IT IS A CRITICAL PIECE OF OUR BUNDLED APPROACH THAT NEEDS TO GET AS MUCH ATTENTION AS POSSIBLE. I'D LIKE TO ADD ONE MORE COMMENT, THOUGH, TO THIS DISCUSSION, BECAUSE, YES, WE HAD DISCUSSIONS, FOR EXAMPLE, AROUND MASKING AND THE NUMBER OF DIFFERENT IMPLEMENTATION STRATEGIES. ONE THING THAT WE ALL NEED TO REALIZE IS THAT WE HAVE TO REMAIN FLEXIBLE. AND REMAINING FLEXIBLE NEEDS TO BE SEEN BY EVERYBODY AS A STRENGTH AND NOT A WEAKNESS. WE KNOW WITHIN THE HEALTH CARE SECTOR, AT THE BEGINNING OF THE PANDEMIC, CERTAIN IMPLEMENTATION RULES WE PUT INTO PLACE WERE BASED ON NEW SCIENTIFIC EVIDENCE, ARE SOMETIMES BASED ON SIMPLE PRACTICALITIES

[INDISCERNIBLE] AND I THINK IT'S IMPORTANT AS A SOCIETY WE REALIZE WHATEVER WE PUT INTO PLACE NOW, IF WE SEE THAT IT MIGHT NOT BE WORKING OR WE NEED TO CHANGE IT, IT'S A STRENGTH AND NOT A WEAKNESS AND IT SHOULD NOT MAKE US MORE NERVOUS THAN ALL OF US ARE CURRENTLY.

Nam says I WANT TO PUSH BACK ON SOMETHING THAT YOU JUST SAID BEFORE, AND YOU SAID THAT YOU HAVE BEEN MAKING... SMALLER CLASSES HAVE BEEN A PRIORITY. WHEN WE... WHEN THE PREMIER HAS DAILY NEWS UPDATES FOR US AND THIS REPORT HAS BEEN MENTIONED MANY TIMES OVER, AND I DON'T KNOW IF IT'S THE FAULT OF THE MEDIA, AND I WILL CALL MYSELF OUT AS A MEMBER OF THE MEDIA, MAYBE WE HAVEN'T BEEN COMMUNICATING IT WELL, BUT IF SMALLER CLASSES ARE A PRIORITY FROM YOUR VIEWPOINT, THEN WHY NOT SAY THAT LOUDER AND SAY, IF THIS ISN'T A PRIORITY OR IF THIS DOESN'T HAPPEN, WE CAN'T SIGN ON TO SCHOOLS OPENING IN THE SAFEST WAY POSSIBLE?

Ronald says I THINK THAT ALL OF US HAVE BEEN TRYING TO MAKE THIS STATEMENT VERY CLEAR AND I PERSONALLY AM ON THE RECORD WITH TWO ARTICLES IN THE GLOBE AND MAIL AND THE TORONTO STAR A COUPLE OF WEEKS AGO, WE CONTINUE TO ADVOCATE ON ALL DIFFERENT LEVELS AND PUSH THAT CLASS SIZES BE AS SMALL AS POSSIBLE, BECAUSE LIKE DR. SRIVASTAVA SAID, IT IS KEY IN KEEPING COHORTS SMALL, KEEPING CONTACTS SMALL, BECAUSE IT IS INEVITABLE THAT WE WILL SEE CASES, AND IT SHOULD NOT NECESSARILY BE ALSO SEEN AS A FAILURE HERE. BUT THE CLOSER THE CONTACT AND THE SMALLER THE CLASS SIZE ARE, THE EASIER IT WILL BE TO DO TESTING, ISOLATION, AND CONTACT TRACING, AND THEN IN COLLABORATION WITH PUBLIC HEALTH AND SCHOOL BOARDS AND SCHOOLS, IT WILL HOPEFULLY ALLOW US TO KEEP SCHOOLS OPEN. WE DON'T WANT TO OPEN SCHOOLS AND CLOSE THEM IN A COUPLE OF WEEKS OR A MONTH. SO I THINK THAT'S ANOTHER KEY.

Lindy says I WANT TO ADD A NUANCE THAT I THINK THE REAL GUIDING PRINCIPLE, THE FUNDAMENTAL KEY, IS MINIMIZING THE NUMBER OF CONTACTS THAT EACH CHILD OR EACH TEACHER HAS IN THEIR SCHOOL DAY. AND CERTAINLY CLASS SIZES ARE A GO-TO WAY OF DOING THAT AND VERY IMPORTANT AND SHOULDN'T BE NEGATED. IT'S NOT THE ONLY THING, AND IN AND OF ITSELF, IT WON'T BE GOOD ENOUGH. SO WE NEED TO CONSIDER LOTS OF OTHER STRATEGIES, INCLUDING COHORTING WITHIN COHORTING. SO THAT'S WHY THE LOCAL RESPONSE IS SO IMPORTANT, BECAUSE OUR SCHOOL ENVIRONMENTS LOOK SO DIFFERENT ACROSS THE PROVINCE. THERE ARE SOME SCHOOLS THAT ARE REALLY CROWDED WITH SMALL CLASSROOMS, AND THERE ARE OTHERS THAT HAVE LARGER PHYSICAL SPACES WITH LESS CHILDREN IN A CLASSROOM. SO LET'S NOT LOSE SIGHT OF THE CONCEPT, WHICH IS MINIMIZING CONTACT. AND SO COHORTS WITHIN COHORTS OF CLASSES MAY BE THE RIGHT THING TO DO IN ONE SETTING, AND THE RIGHT THING TO DO IN ANOTHER IS REALLY REDUCING CLASS SIZE. BUT THINGS LIKE STAGGERING RECESS, THINGS LIKE MINIMIZING TRAVEL FROM ONE CLASS TO ANOTHER... ALL THOSE SORTS OF THINGS ARE VERY, VERY IMPORTANT. AND I JUST CAN'T TAKE AWAY ENOUGH... YOU ASKED AT THE BEGINNING ABOUT, YOU KNOW, IS ANY ONE STRATEGY TAKING A PRIORITY. THE NUMBER ONE THING I THINK WE ALL NEED TO DO IS KEEP THE COVID ACTIVITY IN EACH OF OUR COMMUNITIES AS LOW AS POSSIBLE, AND WE ALL HAVE A ROLE IN THAT, AND THAT IS GOING TO BE WHAT KEEPS... MAKES IT LEAST LIKELY FOR COVID OUTBREAKS IN SCHOOLS. HOWEVER, WHAT DR. COHN SAID IS VERY IMPORTANT, THAT IT'S NOT, YOU KNOW, WE ARE GOING TO SEE SOME COVID ACTIVITY IN SCHOOLS, AND A VERY IMPORTANT STRATEGY IS RAPID IDENTIFICATION, MINIMIZING THE CONTACTS, AND SO THAT WE CAN TRACE THEM VERY QUICKLY AND ISOLATING AND MINIMIZING IT SO THAT AS MY COLLEAGUE JUST SAID, A SUSTAINABLE APPROACH TO KEEPING SCHOOLS OPEN IS WHAT WE CAN MANAGE AND WHAT OUR GOAL IS.

Nam says AND PRACHI?

Prachi says SO THIS IS WHERE THE QUESTION OF RESOURCING COMES INTO PLACE, AND THIS IS WHERE THE QUESTION OF MAKING THOSE RESOURCES AVAILABLE TO INDIVIDUAL SCHOOLS, TO THE SCHOOL BOARDS IN ORDER TO ACTUALLY IMPLEMENT THOSE STRATEGIES IN A LOCALIZED WAY. WE HAVE SEEN IN THE MEDIA... THIS HAS PLAYED OUT IN THE MEDIA PROBABLY MORE THAN ANY OTHER EDUCATION STORY THAT I HAVE SEEN, THAT BOARDS HAVE DEVELOPED PLANS AND REDEVELOPED PLANS ONLY FOR THE MINISTRY TO TURN AROUND AND SAY, ACTUALLY, YOU KNOW WHAT? EVEN THOUGH THE TDSB HAD A PLAN TO BE ABLE TO REDUCE CLASS SIZES WITHIN THEIR BOARD AND THEY WERE TOLD THEY HAD THE FLEXIBILITY TO DO SO. AND WHEN THE PLAN WAS PRESENTED TO THE MINISTRY, IT WAS REJECTED. I THINK THAT GOES AGAINST THE ADVICE THAT WE'RE HEARING TODAY FROM DR. COHN AND DR. SAMSON AND FROM THE SICKKIDS REPORT. IT CERTAINLY GOES AGAINST THE ADVICE THAT I MYSELF HAVE RECOMMENDED TO THE MINISTRY IN A SERIES OF RECOMMENDATIONS BASED ON BROADER GLOBAL RECOMMENDATIONS THAT I'M DELIVERING TO THE G-20. THESE ARE THE KINDS OF FLEXIBILITY AND FLEXIBLE APPROACHES THAT WE NEED. BUT WE NEED TO SEE THE RESOURCING. WE NEED TO SEE THE MONEY BEHIND THAT. AND WE ARE JUST NOT BEING ABLE TO IMPLEMENT... SOME OF THE BOARDS ARE NOT BEING ABLE TO IMPLEMENT THE STRATEGIES THAT THEY THOUGHT WERE VIABLE IN ORDER TO DO THAT. WE HAVE TO REMEMBER ONE VERY CLEAR THING, WE TALK ABOUT MINIMIZING CONTACTS WHICH IS ABSOLUTELY KEY IN OUR PERSONAL LIVES, IT'S ABSOLUTELY KEY IN EVERY PROFESSIONAL AND INSTITUTIONAL ROLE THAT WE PLAY WHETHER IN SCHOOL OR IN BUSINESS, WHEREVER IT IS, BUT WE ARE STILL IN ONTARIO IN A SITUATION WHERE WE ARE SEEING NUMBERS OF CASES GO UP WHERE THE R-VALUE THAT IS USED IN OTHER CONTEXTS IN TERMS OF HOW MANY PEOPLE CAN ONE PERSON INFECT ON AVERAGE... IT'S NOT JUST NUMBER OF CASES, IT'S HOW MANY PEOPLE CAN ONE PERSON INFECT ON AVERAGE... IS HOVERING AT A LEVEL IN MANY OF OUR REGIONS ACCORDING TO THE HOWSMYFLATTENING.COM WEBSITE, ACCORDING TO THE PUBLIC HEALTH UNIT INFORMATION, IN MANY OF OUR REGIONS IN ONTARIO, HAS NOT GONE DOWN TO A LEVEL THAT IS SIMILAR, TO SAY, DENMARK OR NEW ZEALAND OR VIETNAM OR SOUTH KOREA AND I MENTION THESE BECAUSE THESE ARE COUNTRIES THAT SIGNIFICANTLY REDUCED COMMUNITY TRANSMISSION BEFORE THEY RE-OPENED SCHOOLS WITH ROBUST MEASURES. WE NEED TO BE DOING THIS ON ALL ANGLES. AND WE ALSO NEED GOVERNMENT, WE NEED OUR PROVINCIAL DEPARTMENTS OF EDUCATION, WE NEED OUR PROVINCIAL DEPARTMENTS OF LABOUR, OF HEALTH TO BE WORKING TOGETHER IN ORDER TO MAKE THIS HAPPEN SO THAT IT IS SUSTAINABLE REOPENING.

Nam says WE HAVE 30 SECONDS LEFT. I JUST WANTED TO GIVE DR. COHN AN OPPORTUNITY TO RESPOND.

Ronald says SO I AGREE WITH EVERYTHING YOU HAVE SAID AND I THINK DR. SAMSON ALREADY MENTIONED THAT IT'S REALLY NOW UP TO ALL OF US TO BE AS SMART AND VIGILANT AS POSSIBLE IN OUR OWN COMMUNITY TO KEEP THE COMMUNITY TRANSMISSION LOW, AND WE HAVE TO SEE THE FLEXIBILITY OF THE AREAS WHERE THE COMMUNITY TRANSMISSION IS HIGHER, THAT NEEDS TO TRANSLATE INTO SLIGHTLY DIFFERENT SCENARIOS IN THESE SCHOOLS IN ORDER TO ENSURE THAT CHILDREN CAN GO BACK TO SCHOOL IN A SAFE WAY. I DO WANT TO SAY... DR. SRIVASTAVA SPOKE ABOUT ALL THE OTHER INTERSECTORAL PEOPLE WORKING TOGETHER, AND I AM THE FIRST TO ADMIT THAT WE ARE DEALING WITH A NUMBER OF UNCERTAINTIES RIGHT NOW, BUT THERE'S ONE THING I DO KNOW, AND I FEEL VERY STRONGLY ABOUT, THE ONLY WAY AND REALLY THE ONLY WAY WE WILL BE ABLE TO GET THROUGH THIS IF WE REALLY GENUINELY COLLECTIVELY WORK TOGETHER, LISTEN TO ONE ANOTHER IN A CIVIL AND RESPECTFUL MANNER, BECAUSE THAT'S THE KEY HOW WE ARE GOING TO GET THROUGH THIS, AND I THINK IF WE COULD CHOOSE A BIT MORE CONVERSATION OVER CONTROVERSY AT ALL LEVELS, AT ALL LEVELS, I THINK THIS IS WHAT OUR CHILDREN, OUR PARENTS AND OUR TEACHERS DESERVE. LET'S NOT FORGET, OUR CHILDREN ARE OUR FUTURE...

The caption changes to "Producer: Carla Lucchetta, @carrletta."

Nam says THANK YOU SO MUCH... I DON'T WANT TO CUT YOU OFF BUT WE'VE RUN OUT OF TIME. I REALLY DO APPRECIATE YOUR INSIGHTS AND WE WILL BE FOLLOWING THIS STORY IN THE NEXT COMING FEW WEEKS AND HOPEFULLY THIS CONVERSATION WAS ABLE TO ANSWER SOME OF THE QUESTIONS THAT PEOPLE HAVE ACROSS ONTARIO. THANK YOU SO MUCH FOR YOUR INSIGHTS, ALL OF YOU.

Ronald says THANK YOU FOR HAVING US.

Prachi says THANK YOU VERY MUCH FOR YOUR WORK.

Watch: Prescribing Best Practices For Ontario Schools