All Toronto schools to get faster, easier take-home COVID testing kits within weeks of starting class

yorkregion.com
Aug. 27, 2021
Megan Ogilvie

Faster, easier COVID tests are coming to Toronto schools as part of a program to avoid last year’s hours-long testing lineups and encourage more kids to get swabbed -- an especially urgent goal this September as unvaccinated students head back to the classroom amid a surging Delta wave.

As COVID-19 testing is scaled back across Ontario, the new program aims to provide every school and school-based daycare in Toronto with take-home testing kits by the end of September, with test results available within 24 to 48 hours. For pandemic-weary families, this means no more scrambling to book online appointments, long waits at testing sites, or tiny kids subjected to traumatic “brain tickler” swabs.

Experts hope the program will improve testing uptake and enable faster contact tracing when kids test positive -- especially critical given Delta’s increased transmissibility, shorter incubation period, and fears the variant could be more severe for children than previous strains. Catching the virus before it spreads will also help reduce the risk of school outbreaks and closures, keeping more kids in classrooms and limiting learning losses for students who have already suffered the longest school closures in Canada.

“Without question, testing is especially important this year with Delta,” said Dr. Vinita Dubey, associate medical officer of health with Toronto Public Health. “We know Delta can be more severe, we know it can spread more easily, and we know that the symptoms can come on quicker. So all the more reason why (kids should) quickly get tested, quickly get the result, and be able to act on them.”

The program will be a spot of relief for stressed-out parents still recovering from last year’s nightmarish school year, when the ever-present fear of infection was compounded by endless disruptions triggered by a cough or stubbornly leaky nose.

“Last year was a challenge for us,” said Ricardo Ribeiro, whose two young children -- a toddler in daycare and daughter in junior kindergarten in Toronto’s Weston neighbourhood -- were swabbed a combined five times through the spring and early summer, the result of repeated runny noses.

“I’m glad to hear something like this (take-home testing) is on the horizon; it’s going to be more convenient for everybody.”

Earlier this month, Ontario’s chief medical officer of health said school testing requirements will have “less impact on families” this school year, with a pared-down symptom list and alternative testing options for kids. “We’ve ... heard loud and clear from parents that (they) want multimodal methods of testing,” Dr. Kieran Moore said in a press conference.

The province recently launched an eight-week pilot in 13 health units to supply testing kits to vaccinated staff and students at select secondary schools who are asymptomatic following a COVID exposure. But the pilot does not include daycare or elementary kids -- who remain ineligible for vaccination -- nor does it cover Ottawa or Toronto, where school testing efforts have largely been headed by local hospitals.

Toronto’s new citywide testing program is an expansion of pilot projects led by three Toronto hospitals and Toronto Public Health during the previous school year. The Ministry of Health is funding the tests, with hospital staff and volunteers powering the program.

For September, the Hospital for Sick Children, Michael Garron Hospital and Women’s College Hospital have divided Toronto’s more than 1,200 schools between them, each taking on those in their catchment areas, with Sick Kids partnering with schools in Scarborough and the city’s northwest corner. The program will cover elementary and high schools in all four Toronto boards, along with private and independent schools, youth shelters and school-based daycares.

The hospitals are also expanding a pilot program to provide testing kits to daycares located outside of schools, though the timeline for completing that rollout is less certain.

The hospitals will supply the take-home test kits and education materials, and co-ordinate and pay for daily couriers to bring completed specimens back to their labs. Students, staff and their families can use the simple tests -- either a saliva test or a self-administered oral-nasal swab -- which can be completed at school or at home. The tests are PCR (polymerase chain reaction), not rapid-antigen tests, meaning a second, confirmatory test is not needed for a positive result.

The goal is to remove as many barriers to testing as possible and make it easy for families, said Dr. Julia Orkin, physician lead for Sick Kids’ COVID-19 outreach program and the hospital’s medical officer of integrated community partnerships.

Some families cannot easily travel to testing centres, others lack internet access to book COVID tests, and many with young children want to avoid the nose-burning swabs, Orkin said. Sick Kids’ spring pilot project found more families were willing to undergo COVID testing with the take-home kits, key to finding and stamping out the virus in classrooms, she said.

And because the kits are available for the families of students and staff, schools become a “community hub” for testing, hopefully increasing uptake even more, Orkin said.

At Michael Garron Hospital, which piloted the program at more than 100 east Toronto schools last year, many families with positive cases said they would have never tested their children if not for the take-home kits, said Dr. Janine McCready, an infectious disease physician at the hospital.

This year, the need to identify positive cases as quickly as possible is even more urgent with Delta, she said. Previous strains had an average incubation period of five to seven days, she said -- but with Delta, the average is more like four, with some people developing symptoms after just two days.

“It certainly seems to be faster in terms of spread,” McCready said. “You really don’t want people to be waiting three or four days before they do their test.”

McCready said an example scenario from last year might see a student getting sent home sick on a Monday, and waiting a day or two before booking a COVID test. That means they might not receive their positive result until the weekend -- and by that time, their exposed classmates have already spent a week at school, potentially incubating the virus and spreading it further.

With the new testing kits, the sick student can now get tested on the same day their symptoms emerge, with results available as early as the following day, McCready said.

Last fall, a surge in respiratory viruses in school-aged children overwhelmed testing centres, leading to lengthy lineups and days-long waits for results. Experts worry the start of the school year -- combined with the increase in mobility and social contact -- will lead to an even larger spike in common viral illnesses this fall, on top of the expected spread of COVID fuelled by Delta.

But Dr. Marc Dagher, medical director of COVID-19 pandemic programs at Women’s College, said the three downtown Toronto hospitals are well prepared for the potential surge in testing demand.

“We’ve run the numbers to predict capacity, based on the busiest times last year, to make sure we can meet the demand for our catchment area,” he said. Women’s College is the testing partner for about 120 schools in Toronto; about half of those schools will have take-home kits by the start of school, with the others included “within weeks,” Dagher said.

Though the start of the school year is just days away, it is not yet known what symptoms -- and whether just a single one, like a runny nose -- will trigger the need for a COVID test. In response to repeated questions from the Star, a spokesperson for the Ministry of Health would only say “the revised screening tools for all sectors will be available in the coming days.”

Dagher said the updated screening tool will impact the number of students rushing for tests, and that he hopes the threshold for testing will take into account vaccination rates of children over age 12, and reflect emerging data on those symptoms more predictive of COVID.

In Michael Garron’s catchment area, 112 public schools will have testing kits on site before school starts, McCready said. Nearly 70 independent schools and daycares have also received kits, with more rolling out each day, she added.

With the largest number of schools in the testing program -- about 900 -- Sick Kids volunteers are racing to package take-home kits, already stockpiling more than 100,000 for the school year. Orkin said they aren’t yet sure how many schools will have kits the first day of class, but that the hospital is “working as fast as possible” and aims to add 20 schools a day.

Schools considered high-risk for COVID transmission have been prioritized for the kits, a determination made with input from Toronto Public Health, she said. But any school that has an outbreak, or a cohort that has been exposed, will receive take-home kits, no matter its location, she said, noting students and staff can go to an assessment centre, for COVID testing, if more convenient.

Along with the kits, the hospitals offer an education component to the school community to ensure staff and students understand the need for rapid testing, isolation and contact tracing, said Orkin, adding that mobile vaccination clinics may also be sent to schools following an outbreak.

In the east end, pop-up testing centres are also being converted into “COVID outreach sites,” which will not only serve as drop-off points for take home tests but also one-stop shops for everything from vaccinations to basic medical assessments, according to McCready.