Keeping children out of school might be doing more harm than good, say Quebec pediatricians

Quebec's pediatricians are backing the government's plan to gradually reopen schools, saying unless that happens well before September, children and teens risk suffering further "collateral damage" from prolonged isolation and the loss of the social safety net that schools and daycares provide.

In an open letter released Thursday, the association said that for children from underprivileged families, in particular, there are enormous costs to keeping them out of school and daycare.

"Knowing that, for lots of families, their financial status is not very good now, we're worried that kids are not nourished as well as they should be," Dr. Marc Lebel, the association president, told CBC Montreal's Daybreak Friday.

About 240,000 students in Quebec depend on the breakfast programs of their schools, he said. The lunch and snacks provided by early childhood education centres (CPEs) and other daycares also ensure young children get balanced, nutritious food.

Just as serious, Lebel said, is the increased risk of abuse. The association notes there have been far fewer reports of alleged abuse to the youth protection authorities in recent weeks.

"That doesn't mean that there are no kids that are mistreated," said Lebel.

In the association's letter, he and other pediatricians say "a good number of children are sitting on a time bomb," as being in close quarters with stressed-out parents "in imposed isolation, 24 hours a day, without jobs and without income, can only multiply the risks of domestic violence." 

Because they have no contact with their teachers and resource workers, some children might be at greater risk of falling through the cracks, Lebel told Daybreak.

Premier François Legault has said the province is looking at a plan to start reopening schools later this spring, in a gradual way and on a voluntary basis. He has reiterated that all decisions will be made in collaboration with health authorities, as they continue to study the spread of the virus over the coming days.

Lebel said it is important the change be gradual, suggesting that schools might need to keep their classrooms at half-capacity, at first.

As schools do reopen, parents who are immuno-suppressed, older or have other risk factors may want to consider keeping their children home, he said. He agreed with the premier, however, that children are generally unlikely to get very sick from exposure to the virus.

"The primary goal of confinement was effectively to protect the elders, the people who are most at risk of complications from the disease," said Lebel.

"From a scientific point of view, COVID-19, in the vast majority of children and adolescents, is not at all a severe disease."

Lebel said it could take anywhere from a year to 18 months before a vaccine becomes available, making exposure to the virus, and the gradual move towards herd immunity, the only option for now.

Province needs clear strategy

Dr. David Buckeridge, an epidemiology professor at McGill University, said before any schools or businesses reopen, the province needs to ensure it has a clear testing strategy in place.

In an interview on Daybreak, Buckeridge called for a staged approach, one which would mean looking at what happens in regions where there have been smaller outbreaks first.

"No matter how you go about it, it means you're infecting people and placing them at risk," said Buckeridge. "So the real challenge is … how do we get there with the minimum amount of people being seriously ill and minimal societal disruption."

Even if the province decides to reopen region by region, Buckeridge said, public health authorities need to be cautious about how they reopen and how they go about testing people in those regions.

"You don't want to open the doors entirely, but you also don't want to do tiny little steps, you want to think it through," he said.

"To have an infrastructure in place to know if they've gone too far is the most important thing."