Ontario students with the sniffles no longer need a COVID test. Some experts warn this might be a big mistake

A significant overhaul of COVID in Ontario schools, which will allow kids who recover quickly from a runny nose, headache or upset stomach to return to class without a test, has stunned several infectious disease experts in Toronto, despite a similar move in B.C.

These experts say the province has not provided the evidence to justify loosening guidelines as cases surge.

Dr. Janine McCready, an infectious diseases physician at Michael Garron Hospital, who has been reaching out to families of students who test positive at her hospital since schools reopened, said the decision is not in line with what she is seeing on the ground.

In the past few weeks, McCready said she has seen several cases of COVID in students with no known contact to another COVID case, whose only symptom is a runny nose that resolves “quite quickly.” The new screening tool, she said, “wouldn’t have caught the cases.”

“It worries me that we’re making this step now, and we’re making it easier for potential cases of COVID to get into schools,” she said. “Maybe there’s data that I don’t have available, but certainly, from the cases I’ve (seen), this makes me nervous.”

Ontario’s decision to revise the COVID screening guidelines in schools and child-care centres follows the easing of return-to-school protocols in British Columbia, where nasal congestion was recently removed as a symptom forcing kids to stay away from school. The policy will no doubt be greeted with relief by many parents who have lost days of work — and much of their sanity — trying to get their sniffly kid tested.

In a press release Thursday, Ontario Education Minister Stephen Lecce said the revision to the guidelines reflects “the best available medical advice.” Dr. Barbara Yaffe, Ontario’s associate medical officer of health, said the new screening tool is the result of consultations with health officials in B.C, who recently revised the screening protocol, as well as pediatric infectious disease specialists.

But Dr. Anna Banerji, a pediatric infectious diseases specialist at University of Toronto, who said she was consulted by the Ontario government, does not support the recent revision, calling it “bad policy.”

She said runny noses are “a pretty typical presentation of COVID among kids and that the government appears to be “more concerned about having kids in schools than keeping schools open long-term.”

The move comes amid long lines at COVID assessment centres in Ontario and even longer turnaround times for results in Ontario, where the testing backlog surpassed 82,000 on Thursday.

Yaffe told the Star in an interview that here, as in B.C., “we were aware that a lot of kids were being sent home with a runny nose, and parents were going to the assessment centres, waiting in line, getting everyone tested and then waiting at home for the results … and it was just a runny nose.”

But Dr. Andrew Morris, an infectious diseases specialist at U of T, warned against applying the B.C. context to Ontario, because the policy change has only been in effect there for a few weeks and caseloads are higher here.

“To use that rationale to say that it’s safe to do, that’s jumping to a very large conclusion,” said Morris, who is also calling on Ontario to provide more data to support the move. “It might be the right thing to do, but what is the scientific basis for this decision?”

When B.C.’s medical officer of health, Dr. Bonnie Henry, discussed changes to the school screening checklist late last month, there were 2,000 active cases in the province. On Thursday, Henry said there have been no outbreaks in B.C. schools since they reopened in September. The province’s average daily cases are now sloping downwards, with 1,284 cases currently active.

“We’ve done over 35,000 tests in people under the age of 19 and very few of them are positive,” she said in an online press conference. “And a runny nose by itself — which, (as) anybody who has children knows, is a very common symptom during the winter months — is not associated with COVID by itself very frequently.”

In Ontario, Yaffe said, “we were asked why even include a runny nose — a runny nose is so common,” she said. “There are so many reasons for a runny nose that are not COVID-19” such as allergies, coming inside from the cold outdoors or other viral infections.

But Ontario chose to keep it on its list of less serious symptoms — along with nausea/diarrhea and headache or fatigue — because about 17 per cent of COVID cases present with a runny nose, she said.

The province did not provide the Star with data on the number COVID tests that have been performed on children with runny noses or the positivity rate of these tests.

In a statement, a health ministry spokesperson said: “As this outbreak evolves, the province will continue to review the scientific evidence to understand the most appropriate guidance for the health system and the people of Ontario and make updates as needed.”

Yaffe said any child with just one of the less serious symptoms who also had COVID would experience worsening symptoms within 24 hours. “What we are trying to do is balance,” Yaffe added. “Obviously we want to minimize the transmission of COVID-19, but we also want to ensure that kids can go to school or child care if it’s safe.”

Yaffe said no test or doctor’s note should be required when they have one of the less serious symptoms, she said. However, students whose condition worsens, or those who have the “more significant” symptoms of a fever, cough, shortness of breath or loss of smell or taste, do need to isolate and seek medical help, she also said.

Families in B.C. were initially told to keep their children home if they showed any symptoms, but B.C. changed its guidelines mid-September, saying a runny nose, sore throat or headache shouldn’t stop kids from attending class.

Yaffe said Ontario has spoken to numerous pediatric experts here and in B.C., and made its changes to help balance public safety while recognizing children’s need to be at school.

Liz Stuart, president of the Ontario English Catholic Teachers’ Association, said “we are reviewing the revised screening protocols, and continue to encourage everyone to be cautious and diligent in following public health advice.”

However, she added, “if we really want students to continue enjoying the benefits of the in-class experience, the bottom line is that the government must finally step up and implement all reasonable precautions to make our schools as safe as possible. This is becoming increasingly urgent as we see cases of COVID-19 surging in our communities.”

MPP Marit Stiles, the NDP’s education critic, said the changes are causing confusion.

“Parents who spent hours and hours in line this week with their little ones waiting for a test …have a right to be frustrated at the horrible lack of clarity on when kids need a test, and when they should return to school or daycare,” Stiles said.

With files from Jennifer Yang

Kristin Rushowy is a Toronto-based reporter covering Ontario politics for the Star. Follow her on Twitter:

Rachel Mendleson is a Toronto-based investigative reporter for the Star. Follow her on Twitter:

Nicholas Keung is a Toronto-based reporter covering immigration for the Star. Follow him on Twitter: