July 28, 2021
Hon. Doug Ford, Premier
The office of the Premier
Legislative Bldg Rm 281
Dear Premier Ford,
Nurses are gravely concerned about the lack of information on Ontario’s plan to reopen schools. The beginning of a new school year is six weeks away and parents and children are anxious to hear details about a safe and timely reopening.
RNAO shares those concerns. The government is not forthcoming about details. This too little, too late approach, which was the hallmark of stages one and two of the pandemic, cannot extend to the reopening of schools this fall. Students in Ontario have been out of the classroom longer than students in any other province. We agree that they must return to class for the obvious educational benefits, as well as for their physical health and social interactions that affect their emotional wellbeing.
While we acknowledge at-home learning provided a safer environment during the first, second and third waves, it is equally true that this created inequities within and across communities around the province.
Vaccination rates across the province are promising, however, the reality is schools will house the largest group of unvaccinated people in congregate settings come the fall. Currently, children under 12 cannot be vaccinated against COVID-19 and only 35 per cent of those between 12 and 17 are fully vaccinated at this time. Protecting children, and by extension their families and our communities, must be at the top of our priority list. This is why a solid plan is urgently needed.
RNAO is calling on the government to adopt the following measures:
- improved ventilation in schools
- mandatory indoor masking
- smaller class sizes
- mandatory vaccination of teachers (unless they have a medical exemption)
- permanent employment status for the 625 public health nurse positions in Ontario schools and the additional 50 community wellness nurses to serve First Nations communities
RNAO is concerned about the lack of action on ventilation: an essential measure to keep people safe who are indoors. It has taken too long to recognize aerosol transmission of COVID-19 – a point that infectious disease expert Dr. David Fisman has systematically emphasized time and time again. The implications of COVID-19 being transmitted via aerosols are profound, but change in public health measures and government policy is slow in coming. The government’s own Science Table (ST) says COVID-19 is primarily transmitted by aerosols and respiratory droplets during close, unprotected contact, and it is recognized that aerosols play a role in longer range transmission, especially in poorly ventilated indoor areas. An ST report published July 19 contains a detailed discussion on how to achieve and maintain adequate air quality through ventilation and filtration in schools.
In a Globe and Mail article, a Winnipeg physician and mother, Dr. Jillian Horton, also weighed in on this issue. “On the aerosol front, we aren’t listening closely enough to engineers, the experts who can help us understand the scope and nuance of the ventilation challenges in new and aging schools – a complex, heterogenous problem. What percentage of those schools have windows that are fused shut? What’s a realistic timeline for making even simple modifications? What about an adjunct CO2 monitoring strategy? Where is a commitment to put free-standing HEPA filters into every classroom?”
RNAO’s concern is not related to the identification of what should be done, which the experts in various fields have clearly delineated. Our concern is the lack of political will and sense of urgency to implement investments in school infrastructure that are necessary and costly, take time, and have traditionally not been seen as a priority. We are used to flashy buildings for financial institutions, such as banks. But our schools remain in decrepit buildings. So many of our children study in physical environments that are crowded, poorly ventilated and not up to standards.
RNAO also insists that masking should be seen as an essential and necessary component of the public health measures adopted everywhere across the province in September. Dr. Kieran Moore, Ontario’s top doctor, has recognized there may not be high enough levels of immunity across the province for children and youth returning to school unmasked. “It may be that we have a very cautious start in September and then monitor the situation because I don’t know that we’ll achieve that high community immunity that we need in September,” he said. RNAO wants to avoid confusion among parents, students and teachers: Let’s be clear that masks (for all children over two years of age) and physical distancing must be part of the government’s plan for the reopening of schools. We can relax this requirement when the numbers indicate that it is safe to do so (likely in the spring).
The number of unvaccinated people in schools in September is also key. “Time is of the essence now,” Dr. Kieran Moore told reporters on July 20. Children younger than 12 cannot be vaccinated, but children 12 and older, as well as school staff and parents, can. However, we are running out of time. With a 28-day waiting period between two doses, plus two weeks to build immunity following the second dose – six weeks is the minimal requirement from a first dose to full vaccination. This week is the deadline for a first dose for those who have not received one.
Crucial investments are also required for smaller class sizes, to hire more teachers, improved ventilation and air quality, rapid testing and vaccination. We ask you: Has the funding from the federal government flowed from the province to the school boards? Have the COVID-19 closures been utilized to do the building renovations and engineering work? Was this funding sufficient to meet the proper standards? We require full disclosure and full accountability from the government and school boards on these crucial matters.
RNAO is also urging the government to grant permanent employment status to the 625 public health nurse positions in Ontario schools. This is a matter raised consistently by RNAO as a measure to protect students and teachers. An additional 50 community wellness nurses are also needed to serve First Nations communities across the province.
Premier, the government remains largely silent and has provided few specifics. Parents, teachers and nurses should not be forced to keep asking. Let’s prioritize the health and wellbeing of students and teachers this fall. Governments exist to lead during good times and especially during difficult times.
More than two million children and youth attend elementary and secondary schools across Ontario, and they deserve a fulsome and transparent plan that enables them to return to the classroom safely.
Doris Grinspun RN, MSN, PhD,
LLD(hon), Dr(hc), FAAN, FCAN, O.ONT.
Chief Executive Officer
Registered Nurses’ Association of Ontario
Morgan Hoffarth, RN, MScN
Registered Nurses’ Association of Ontario
Hon. Christine Elliott, Deputy Premier and Minister of Health
Hon. Stephen Lecce, Minister of Education
Andrea Horwath, Leader of the Official Opposition
Marit Stiles, NDP Education Critic, MPP
France Gelinas, NDP Health Critic, MPP
Steven Del Duca, Leader of the Ontario Liberal Party
John Fraser, Liberal MPP
Mike Schreiner, Leader of the Green Party
The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners, and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system, and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit RNAO.ca or follow us on Twitter, Facebook and Instagram.
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