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Coronavirus public health Q&A with Dr. Vinita Dubey (Aug 25)

Last Updated Oct 12, 2020 at 2:15 pm EDT

We know you have questions about the ongoing coronavirus pandemic and we’re working to get you the answers, straight from the most trusted sources.

Toronto’s Associate Medical Officer of Health, Dr. Vinita Dubey, answered your COVID-19 related questions in a LIVE video interview on Tuesday, August 25, at 12:30 p.m. on our Facebook page as well as here on our website.

Here are a few questions Dr. Dubey addressed:

(Questions were moderated and have been edited for grammar, punctuation and clarity)

Q: Can prolonged mask wear lead to a rise in gum disease and other potential dental issues or strep throat?
A: I am not aware of any dental issues related to mask use.

Masks have been used actually for decades and decades in medical settings and hospitals. I work in an emergency department, I wear masks when I’m at work.

There has not, as far as I know, been any association between mask usage and gum disease with healthcare workers.

I’m also not aware of mask use promoting strep throat. Strep throat is a bacterial infection that spreads through droplets. And so it’s spread often in households — if you’re sharing a spoon with someone, if you’re someone coughs or sneezes on you. So mask use might actually prevent the spread of strep throat.

There’s nothing to say that if you have a colonization of strep throat, it’s going to make you more likely to get strep throat, I’m not aware of that and scientifically, I can’t really explain that either.

Q: What is the medical evidence that is supporting the Toronto bylaw on kids as young as two to four years old wearing masks in school?
A: What we’re clear on is that masks should not be put on anyone under the age of two.

We’re in this situation right now in Toronto, where we continue to have cases of COVID every day and we’ve seen across the world that COVID continues to spread.

It’s gone down in Europe and now it’s coming back up. Just recently in Berlin, which sounds like actually a city that’s very similar Toronto, they have about 800 schools and in two weeks of school, 41 of those schools have cases associated with them.

And so if we want children to go to school, we recognize because of COVID, we need to put as many measures in place as we can to help prevent the spread. And so mask wear is required by the ministry of education for those in grade four and up and public health, strongly recommended masks for them. Further, the school boards themselves put forward motions to require it in the younger ages.

That being said, even our Toronto bylaws and the recommendations in school have room for exemptions. So if a child could not tolerate a mask for medical reasons, whether it’s developmental or whatever the reason is, the mask will not be forced upon them.

But for many children that can wear masks, the hope is that it will act as a barrier and source control so that we can prevent the spread in schools and can keep schools open for longer. That is really what the scientific principle is.

Q: Do you suggest that kids don’t visit their grandparents once schools reopen?
A: I think this is a really good question about school cohorts and then social circles.

So the social circle, if the grandparent is part of the social circle, it’s 10 people who you can have close contact with. You don’t need to physically distance and you’ve all kind of taken the same precautions.

When it comes to school, we recognize now students will be going into these cohorts. They will be with other students who they may not always be able to physical distance from, but they’re still recommended to maintain a physical distance as much as possible and to wear a mask, to wash their hands, to stay home if they’re sick. So I think we’re going to have to see as schools open in the first two weeks, are we seeing cases spread in schools?

We may have to provide more guidance on our social circles, particularly for our grandparents. It may be the recommendation that in the first few weeks or the first month of school that we keep a physical distance when we see our grandparents, just until we see how much COVID actually will spread is in Toronto schools. That may be something that, that may be coming. Keep your ears tuned that we may have to adjust or precautions when schools do open for our households and for our extended households as well.

Q: What kinds of precautions and exemptions are in place in schools for children with special needs?
A: Someone who can’t wear a mask because of medical reasons like that obviously would not be wearing a mask.

But there are personal protective measures that the teachers can wear in those situations. We want as many children who especially need extra care and support to be in school because they can’t get that care and support virtually. So the school boards have protocols in place for their staff to be protected.

It might mean that the teachers that are involved with the care of a student with special needs would be wearing a medical mask — that’s actually for all teachers in the public school system, they might wear a face shield as well as gown and gloves if they need to, depending upon the situation, so that the child could still receive the teaching that they need.

By protecting the teacher, we’re also protecting the students so that the teacher can’t give anything to the student as well.

Q: Why can we only have a social circle of 10, but classrooms can be up to 30 people?
A: I think the idea here is that in the classroom, it’s not quite a social circle.

We’re still not saying when you come into the classroom, you can hug and sit up next to someone. We’re still saying that you need to take precautions in that classroom. But we recognize that throughout the course of a school day, you might not be able to maintain those precautions at all times, but it’s still different from a social circle.

So we’re allowing the cohorts because going back to school is still really important, but even still, there are other measures — making sure that you fill out your screening before you come, making sure that you have hand washing moments, keeping the desks as far apart as possible. That’s why it’s a different from a social circle.

Going back to school, however, still will not be without its risks, that’s for sure.

Watch the full interview with web writer Dilshad Burman in conversation with Dr. Vinita Dubey in the video above.

Scroll through the questions submitted to this session below.

Note: questions were moderated before appearing in the chat window