Opinion: Public health officials must be held accountable for their decisions about reopening schools

As legendary baseball catcher Yogi Berra once said, “it’s deja vu again.”

Quebec’s decision to reopen schools on Jan. 17 has many pundits and parents shaking their heads in disbelief. This defies scientific logic as COVID-19 hospital, ICU admissions and deaths have reached record highs, while critical issues such as school ventilation and effective masking strategies are overlooked or downplayed.

This coincided incongruously with the Minister of Health Christian Dubé telling us “We are almost at the point of no return”, that stage 4 “load shedding” may no longer be enough and that we should see more critical surgeries canceled, something unthinkable in a few weeks. There are.

To make matters worse, the situation in Quebec hospitals is now the most critical of all G7 countries.

Most agree that children should go to school, but above all schools should be safe and healthy.

Children do not live in isolation. If they get sick, they can very well transmit the virus to other family members, the community and possibly to the most vulnerable.

International and Canadian studies have documented transmission from children.

What the Premier of Quebec, François Legault, is proposing falls far short of Ontario’s plan to go all out with the widespread installation of air purifiers/exchangers in every classroom, school cafeteria and gymnasium, as well as than providing N-95 masks to teachers, among other protections. measures.

The Legault government justified its inaction with inaccurate claims that “there is no ventilation problem in schools”, that “SARS-Cov-2 is only transmitted marginally via aerosols”, that ” there is no significant transmission from schools to the community”, that “the rapid tests were too unreliable”.

The real problem is that similar fallacious arguments are still being used by Quebec leaders and public health officials today as they have been since the start of the pandemic despite all the scientific evidence to the contrary.

What is particularly infuriating is the continued infantilization of the population by using simplistic and specious statements unsupported by scientific data, coupled with a paternalistic attitude towards the “inept” masses.

Left to fend for themselves, some school boards have felt compelled to purchase air purifiers as a stopgap measure. Caught off guard, Quebec public health officials falsely claimed that air purifiers “could be dangerous” if improperly installed or maintained.

Contrary to claims by Quebec Ministry of Health experts that portable HEPA air purifiers have not been shown to be effective in preventing airborne disease transmission, the Centers for Disease Control and Prevention (CDC) of United States recommends their use, especially in high-risk areas, as does the Canadian Public Health Agency.

Indeed, two recent NASA and CDC studies found that HEPA-equipped purification systems were extremely effective at capturing virus-sized particles and actually reduced the spread of COVID-19 in schools.

Quebec’s answer is that air exchangers are better than air purifiers because they remove stale air and replace it with outside air, which is true in many situations, but they are more expensive and complex to install, whereas air purifiers can be professionally installed the same day.

However, effective risk mitigation strategies, especially in times of imminent danger, require immediate action.

So why didn’t Quebec offer the air exchanger option to all school boards last year? Why have English school boards been left on their own to buy air purifiers and denied any public health guidance? How is the $432 million in federal funds allocated to improve air quality in schools being used?

Belatedly, Quebec now distributes carbon dioxide (CO2) readers to 70% of schools. Such monitors may indicate when opening windows (an unrealistic option on cold winter days) or evacuating a room is indicated to reduce the risk of airborne transmission of SARS-Cov-2, but they do not prevent the underlying cause. of viral transmission because they don’t. purify or refresh the air in a room.

The best anti-COVID strategy is to invest heavily in air exchangers and air purifiers. Currently, only 500 air exchangers are available for the entire province, a drop in the ocean of 48,000 classrooms.

After decades of neglect, inadequate ventilation systems in Quebec schools are a major health issue in the current pandemic.

We cannot wait years for much-needed repairs. To mitigate the COVID-19 pandemic, air exchangers and HEPA fans are the short-term solution required. Quebec knows that a majority of schools do not comply with American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) filtration/air exchange standards for schools to reduce SARS-Cov -2 airborne.

Recently, the media reported on the loss of confidence in Dr. Horacio Arruda, alleging that he lacked autonomy from his political leaders and merely acted as a cover for them. The arrival of Dr. Luc Boileau as the new interim director of public health meant potential hope for science-based policies.

Unfortunately, his first decision at work was to give the green light for schools to reopen on January 17.

Boileau repeated the same trope that goes against the scientific consensus, that “there is no evidence that schools amplify the transmission of COVID-19 to the community,” brushing aside international and Canadian studies that say the opposite. He dismissed Quebec’s own data, which showed a disproportionate increase in outbreaks in elementary schools from September to December 2021. It was only very recently, on January 19, that he reluctantly underestimated that the opening of schools could induce “a little” more transmission.

Dr. Boileau already gives us an unpleasant feeling of deja vu.

As Quebec’s public health leaders and officials flagrantly deviate from science and precautionary principles, an increasingly skeptical media has reached out to doctors and scientists working in the field of healthcare and academia for more reliable and trustworthy information.

We don’t have the same high expectations of politicians that we have of physicians working in public health. These health professionals have enormous responsibilities and their conduct must be exemplary.

Public health physicians must be held accountable to the same quality and ethical standards as those who work in the clinical field and who can face serious consequences if they fail in their duty to provide quality care to their patients according to the best available medical standards.

This has never been truer than now.

Michael Levy, MPH (Master of Public Health), environmental health specialist and epidemiologist

Michel Camus, Ph.D., Environmental Health Epidemiologist (retired)

Nancy Delagrave, physicist, scientific coordinator of Covid-Stop

Stéphane Bilodeau, P.Eng., Ph.D., FIC, Indoor Air Quality Task Force Coordinator, Global Health Network

Nimâ Machouf, Ph.D., epidemiologist, consultant in infectious diseases, lecturer at the School of Public Health of the University of Montreal

Pierre-Jules Tremblay, Eng.

Donald Vinh, MD, infectious disease specialist and medical microbiologist

Marie Jobin, PhD, organizational psychology

Steve Tremblay, occupational health and safety consultant