What happens when a COVID-19 outbreak is declared in school?

As of Monday, Toronto has 55 schools with at least one reported case of COVID-19 and outbreaks have been declared in 12 facilities.

Once a COVID-19 case is discovered or an outbreak is declared in a school, a number of procedures and protocols must be followed based on Toronto Public Health (TPH) guidelines and recommendations.

What is considered an outbreak?

The threshold for declaring an outbreak is a minimum of two cases of COVID-19.

“An outbreak is defined as having two or more people in the school setting who test positive, within 14 days, where one person could have possibly given COVID to another person,” explained Dr. Vinita Dubey, Toronto’s Associate Medical Officer of Health.

While a school in Etobicoke reported 18 cases on Monday, Dubey said since the start of the school year in September, outbreaks in schools have been an average of three cases.

She added that an outbreak in a school does not necessarily mean COVID-19 is widespread throughout the institution or that the entire school will be dismissed.

“Sometimes it’s just within the one classroom that there has been spread,” she said, adding it’s still considered an outbreak.

“Typically you will see school life continue as normal in the school despite the fact that an outbreak has been declared,” added Toronto District School Board spokesperson Ryan Bird.

What happens when a COVID-19 case or cases are detected?

When a COVID-19 case is detected in a school, the TPH child and youth schools team carries out a full investigation to determine:

• What symptoms the person has
• Who do they live with
• Where they could have gotten COVID-19
• Whether they know someone who has COVID-19
• Who could have been exposed to them during the contagious period — beginning two days before symptoms start

COVID-19 cases in students

If even a single case of COVID-19 is detected among students, the principal will dismiss the cohort even before TPH becomes involved. This includes all cohorts the student may be a part of, like their school bus and extra-curricular cohorts.

The school principal initiates communication with parents and lets the school community know of a case or outbreak and Toronto Public Health will send further instructions including when to get tested and how long to isolate.

Students in the cohorts who are unvaccinated will be required to isolate at home for 10 days and watch for symptoms. Vaccinated students can return to school the next day, as long as they do not have symptoms.

TPH recommends that all students in an identified cohort take an at-home PCR test provided by the school as soon as a case is detected and once again seven days later.

COVID-19 cases in staff

School staff often interact with more than one cohort on a given day. If a staff member tests positive for COVID-19, it is possible that every cohort they had contact with could be asked to isolate at home.

That course of action is determined by the findings of the TPH investigation and what they reveal in terms of who the staff member had contact with and when.

“We determine based on the dates, based on the symptoms, what the risk is for each of the cohorts and the interactions,” said Dubey.

Thereafter the same protocols for isolation and testing are followed as with student cases.

Protocols in school

Bird said if a case is detected or an outbreak is declared in a school, there are no additional measures the school needs to take.

Schools are already expected to enforce various public health protocols, including masking and social distancing. Good hand hygiene is encouraged and HEPA filters are used in classrooms, among other measures.

“We already have stringent health and safety measures in place … regardless if there are any COVID cases confirmed in the school,” said Bird. “I think our existing measures are enough following an outbreak declaration.”

Dubey added the safety measures and the investigations have been successful in controlling widespread infections in schools.

Learning continues

If an entire class is dismissed, that class moves to virtual or online learning.

Bird said a number of factors come into play when it comes to making the move to remote learning.

“Depending on how many students are in class or at home, can we operate a full remote class? Or is there a combination of work that can be sent home?” he explained. “It’s going to look different for each class.

“While it may not impact the rest of the school, we know for a select group of students that are either a confirmed case of COVID or considered a close contact, that’s difficult for them — they’re now at home. So we try to support them in every way we can.”