Guidance for COVID-19 following school reopening

Advisory Alert

September 21, 2020

*Cette information est seulement disponible en anglais.

To: Local health system partners

FOR IMMEDIATE ATTENTION

As school resumes in Ontario, please consider COVID-19 as a potential diagnosis for anyone presenting with symptoms of acute respiratory infection, regardless of their travel or contact history.

COVID-19 can cause a very mild, cold-like illness that is indistinguishable clinically from other respiratory tract infections. Mild and atypical presentations can occur. Evidence to date suggests that approximately 1 to 10% of COVID-19 cases are in children and occur among all age groups.¹ As such, prevalence in children may be difficult to determine and is likely to be underestimated.¹ Current estimates of COVID-19 incubation period range from 1 to 14 days with median estimates of 5 to 6 days between infection and the onset of clinical symptoms of the disease.¹

Assessing for COVID-19

Assessing for COVID-19 is a two-fold approach. Daily self assessments are to be perfomed by the individual or parent or guardian, with further assessments by a health care provider based on symptoms, as required.

Daily self assessments

Students or parents or guardians and school staff are asked to complete a daily self assessment for symptoms of COVID-19 prior to attending school. Those with symptoms, or who are identified at school with symptoms will stay home or be sent home and require further assessment. Refer to the current list of symptoms at: https://covid-19.ontario.ca/school-screening/

Further assessments

Health care providers are likely to be consulted to determine whether a symptomatic individual needs to be tested for COVID-19. This determination is based on the provider’s clinical judgment and there are no validated clinical tools available to differentiate COVID-19 from other illnesses with similar symptoms.

What can you do to support parents or guardians or students and others when they have symptoms?

Based on their specific medical history, help them make appropriate declarations when completing their daily assessment questionnaire about underlying causes of their specific symptoms
Identify when “usual” becomes “unusual” and when and how to seek care (i.e. worsening symptom, symptom that presents in a different way, no improvements with current medications).
Help them identify when the criteria for return to school after an illness or exposure has been met.
Encourage testing, as appropriate.

Testing for COVID-19

When in doubt, test.

Testing of symptomatic individuals

Public Health Sudbury & Districts strongly recommends that an individual with COVID-19-compatible symptoms and no known alternative diagnosis undergo testing during their self-isolation period and prior to returning to school, as the return of a symptomatic case of COVID-19 to a school unknowingly will place other students and school staff at high risk.

Testing of asymptomatic high-risk contacts

Public health identifies high-risk contacts and advises them on their requirement to self-isolate and recommends testing no earlier than 5 days after initial close contact with a case.

Please test or recommend testing for any high risk contacts who have been recommended for testing by public health professionals. Those who test negative must continue to self-isolate for 14 days with re-testing recommended if there are new or worsening symptoms.

Providing medical notes

Please do not provide notes or statements attesting to a clinical assessment that COVID-19 has been “ruled out” as a cause of symptoms. Medical notes or proof of negative tests are not required for staff or students to return to school following an illness or a high-risk contact.

A variety of resources are available on the Ministry of Health COVID-19 Health Sector Guidance website page that can assist you as you provide care during this unprecedented time. Please check often for updates at: https://www.phsd.ca/health-topics-programs/diseases-infections/coronavirus/guidance-for-employers-covid-19/sector-specific-guidance/

Please contact us at 705.522.9200, ext. 393 with any questions you may have.

Sincerely,

Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

Note: All Advisory Alerts are found on our website.

Source

Public Health Ontario. What We Know So Far About Infection in Children. Available at: https://www.publichealthontario.ca/-/media/documents/ncov/what-we-know-children-feb-21-2020.pdf?la=en. 05/15/20. Accessed on 09/09/20

This item was last modified on October 27, 2020