QUEBEC -- Below is a letter signed by over 130 health-care professionals demanding the government revise their back-to-school plan.

Dear Premier Legault, Ministre Dube, Ministre Roberge, Dr. Arruda and Dr. Drouin,

As physicians, scientists, and parents of school age children, we were largely disappointed with the government’s return to school plan that was disclosed to the public on August 10th. We believe the current plan is inadequate and needs to be improved. As described, the return to school plan may put children and teachers at risk of contracting COVID19. Furthermore, the plan could lead to outbreaks within their families and their communities. This could, ultimately, undo much of our efforts to control this epidemic that have been made collectively in the last six months.

We believe the majority of Quebecers want their children to return to schools come September. However, this must be done safely. Therefore, the objective should be to optimize the school environment to ensure that the risk of SARS-CoV2 transmission is as low as possible. To do so, the government should carefully review their back to school plan with the view of implementing the following:

1. Social distancing: Social distancing must be prioritized for all children (i.e. separation of at least 1 meter between students), in all areas of the school and for all levels. The government’s plan to not encourage social distancing within classes (some having more than 30 children) is contrary to current recommendations by many expert groups. The number of students per class should also be reduced as much as possible and the appropriate resources should be provided to make this possible. Denmark and Norway succeeded with their back to school plan with reduced classes of 12-15 children. “Service de garde” programs should also be modified to limit interaction between children of different classes.

2. Mask wearing in all indoor school areas: Several studies demonstrate that masks effectively reduce the transmission of SARS-CoV2. However, the Quebec return to school recommendation to wear masks does not include time in classrooms, where students spend most of their day in close proximity to their peers. In fact, the American Academy of Pediatrics recently recommended masks in primary and secondary schools to reduce the spread of SARS-CoV2.

3. Mandatory daily symptom screening: The best way to prevent outbreaks in our schools is to ensure that the virus is kept out of schools. To do so, parents, teachers and students must remain vigilant to any potential symptoms that suggest SARS-CoV2 infection, and if present must stay home. Daily mandatory symptom screening should be undertaken by parents before sending their children to school. Given the expected high rates of absenteeism due to possible symptoms, schools must have measures in place to ensure students can continue their learning from home. Quebec should also encourage new active screening strategies such as use of saliva-based tests and rapid point-of-care tests.

4. On-line learning option: The government should consider expanding the on-line option to allow parents the choice for online learning, given the current situation. Each family should have the right to determine based on their own specific set of circumstances whether their child should attend school in person this fall. This option would also have the effect of reducing class sizes and improving social distancing, as a sizeable minority of parents would likely select this option.

5. Air quality/ventilation: Many schools in Quebec are in older buildings and are overpopulated. Therefore, every effort should be made to optimize air quality and ventilation. School ventilation systems should be evaluated and updated, as required, within the shortest possible timeframe. In the meantime, simple solutions to improve ventilation should be recommended (e.g. open windows, use of outdoor space and addition of temporary air filtration devices).

Based on the experience of many countries around the world (e.g. Netherlands, Germany, South Korea), we know that students can return to school safely with the appropriate plans in place. However, in other countries (e.g. Israel), the reopening of schools led to major outbreaks and triggered a massive wave of infections in the community demonstrating how precarious the reopening of schools can be. Since it is impossible to accurately predict the impact of school reopening in Quebec, a careful and prudent approach to school reopening is strongly recommended.

The current back-to-school plan in Quebec needs to better consider all the available scientific evidence to prevent outbreaks in schools, to avoid jeopardizing the safety of our children, teachers and parents, as well as, to prevent a resurgence of SARS-CoV2 in our community. It needs to be promptly reviewed and revised to ensure a safer return to school for all.

SIGNATURES

  • Aalamian, Armand, MDCM, CCFP, FFCP, Vice Doyen formation postdoctorale, Université McGill, parent de deux enfants (12 et 13 ans).
  • Sabrina Ahmed MD CCFP, Family doctor, mother of 3 kids (9, 11 and 14).
  • Mohammed Al Mahroos, MD FRCSC. General Surgeon, St Mary’s Hospital. Assistant Professor, McGill University. Father of 1.
  • Sara Ahronheim, MDCM, FRCPC. Emergency Physician, Jewish General Hospital, Assistant Professor, McGill University. Mother to two elementary school aged children.
  • Ali O. Abualsaud MD, Assistant Professor, Cardiology, Jewish General hospital, McGill University, father of 2.
  • Najma Ahmed MD, Associate Professor, Pediatrics, Montreal Children’s Hospital, McGill University of 3 children (14, 16, 20).
  • Waqqas Afif MD , Associate Professor, Gastroenterology, MUHC.
  • Mylene Arsenault, Assistant Professor, Family Medicine, McGill University (2 children ; 10-14).
  • Aviva Aspler MDCM, Family Doctor,GMF Santé Kildare, mother of 4.
  • Andrea Alter, BSc Microbiology & Immunology (McGill), PhD Experimental Medicine (McGill), Primary Care Paramedic (Urgences-Santé). Mother of two (ages 7 and 12).
  • Simon Bacon, PhD, FCCS, FABMR, Professor and Canadian Institutes of Health Research SPOR Chair in Innovative Behavioural Clinical Trials, Concordia University; Co-Director, Montreal Behavioural Medicine Center, CIUSSS-NIM, Hopital du Sacre-Coeur de Montreal; Lead, International Behavioural Trials Network. (2 children age 9 and 12).
  • Sahir Rai Bhatnagar, PhD, Assistant Professor of Biostatistics, McGill University.
  • Stephanee Bakare MD CM, OB/GYN, Lakeshore General Hospital. Mother of two children- 9 and 13 years old.
  • Marie Beauregard MD, FCMFC, CLSC Côte des Neiges. Mère d’un garçon de 17 ans.
  • Arie Benchetrit, MD. Chirurgien plasticien, clinical lecturer à l’université McGill, père de quatre enfants âgés de 6, 8, 11, et 13 ans.
  • Andrea Benedetti, PhD, Associate professor, McGill University, mother of three kids aged 9, 14 and 16.
  • Axel Bergman, Directeur Adjoint Institut TransMedTech, Polytechnique de Montréal, papa de trois enfants (5, 10 et 11 ans).
  • Donia Zeineddine, professeure, PH.D . en éducation, mère de deux enfants 11 et 16 ans.
  • Sonia Bignami, Professeure Agrégée, Département de démographie, Université de Montréal, maman de deux enfants (7 et 13 ans).
  • Jason Boman, urologue Centre Hospitalier du Suroit, 2 enfants 13 ans.
  • Natalie Bottega MD CM, Professeur Agrégé, Département de Médecine, Université McGill, mère de deux enfants (8 et 11 ans).
  • Leslie Breitner, DBA, Academic Director and Senior Faculty Lecturer, International Masters for Health Leadership, Desautels Faculty of Management, McGill University.
  • Dr. Benjamin Burko MD CM, Professeur Agrégé, McGill University-Staff Montreal Children's Hospital, Former Medical Director, Tiny Tots Medical Centre. Father of a 13 year old and a 15 year old.
  • Anne-Marie Canakis, MDCM, Assistant Professor, Pediatric respiratory Medicine, McGill University Health Center. Mother of 3 (13, 17, 19).
  • Sandra Carriero, PhD. Bio-Organic & Medicinal Chemistry. Director of Operations. Seaway Family Dental. Mother of 2 girls - age 12 and 10.
  • Juan Carlos Castro, PhD. Curriculum Studies & Art Education; Concordia University, Department of Art Education. Father of 2 (7 & 9).
  • Theoharisti Constantatos, general dentist, DMD, Mother of 2 school aged children 7 and 10.
  • Jasmin Chahal, PhD, professeure au département de microbiologie et immunologie, Université McGill.
  • Jeffrey Chankowsky MD, Associate Professor McGIll University (Diagnostic Radiology), Director, Medical Imaging, McGill University Health Center. Father of 2 high school aged children, 14 and 16.
  • Arès, Chantal, MD. Oculoplastic surgeon, McGill University, maman de 3 enfants (11, 9, 8).
  • Cheema, Dev MD CM, Assistant Professor Department of Ophthalmology McGill University (3 children ages 13, 15, 17).
  • J.Cohen. Family MD and mother of 2.
  • Cracower, Jill, MDCM, family physician, Santé Kildare and Jewish General Hospital, mother of 4 kids (12, 10, 7 and 3).
  • Natalie Dayan MD, M.Sc., General Internal Medicine, McGill University Health Centre, Chercheur Boursier Clinicien - Junior 1. Mother of three children age 11, 8, 5.
  • Deshaies, Doris, MD, M.Sc., médecin à la retraite, grand-maman de 2 adolescents, un petit-fils de presque 3 ans, et d'un petit-fils de 4 mois.
  • Sabrina Di Martino registered nurse 1 child age 14.
  • Sarah Dorner, Professeure, Département des génies civil, géologique et des mines, Polytechnique Montréal, maman de deux enfants (10 et 12 ans).
  • Line Dufresne, Analyste de données à l’institut de recherche du centre hospitalier l'Université de McGill, mère d’un enfant de 12 ans.
  • Elyssa Elman, MD CCFP ABOM, Family Physician, Mother of 2 children (8 and 5).
  • Marc Fabian, PhD, Professeur Agrégé, Département d'oncologie, Université McGill, père de deux enfants (8 et 11 ans).
  • Susan Finkelberg, MD, mother to three children- 7, 7,10.
  • Daniel Friedmann, MD, Omnipraticien, Professeur Adjoint, Département de Médecine, Université McGill, père de 3 enfants (8 ans, 5 ans, 20 mois).
  • Jorg Fritz, PhD, professeure au département de microbiologie et immunologie, Université McGill, père d’un enfant (7 ans).
  • Rebecca Fuhrer, PhD Professor, Epidemiology and Public Health, McGill university, et Grand-mère de 5 petits enfants.
  • Soren Gantt, MD PhD MPH, professeur titulaire, Départments de pédiatrie et de microbiologie, infectiologie et immunologie, Université de Montréal et CHU Ste-Justine, père de 2 enfants (10 et 11 ans).
  • Nathalie Garcin, PhD Clin Psych, Principal, Clinique Spectrum, Montreal. Mère de deux adolescents de 15 et 17 ans.
  • Paul Giacomini, MD, FRCP(C), Médecin traitant, Institut Neurologique de Montréal et Centre Universitaire de Santé McGill, Professeur agrégé, Département de neurosciences, Université McGill, Père de deux enfants (6 et 15 ans).
  • Annick Gauthier, MDCM, PhD, Médecin de Famille, Professeur Adjoint Université McGill, maman de deux enfants (11 et 15 ans).
  • Ayleen Gelbart, RN, very concerned mother of 3 daughters ages 16, 13, and 11.
  • Andreas Giannakis, MD, Département de Médecine de Famille, grand-père et tuteur de 3 enfants de 3 ans et demi, 10 et 11 ans.
  • Ning Gu, MD, PhD, Research associate, Department of Physiology, Faculty of Medicine, Mcgill University, Father of one 14-year-old daughter.
  • Mehmet Gumus, PhD., Professor of Operations Management at McGill University Academic Director of Master of Management in Analytics. Father of 15 year old and 9 year old.
  • Namta Gupta, Assistant Dean Student Affairs, Faculty of Medicine, McGill University (Mere de trois enfants, 12, 14 et 17).
  • Terry Hébert, PhD, professeur titulaire, Département de Pharmacologie et Thérapeutiques, Université McGill, père d’une fille 16 ans.
  • Lisa Iannattone, MD, FRCPC, Professeur Adjoint, Université de Montreal, Department de Médecine.
  • Natalia Ioffe, B.Eng., McGill University; 2 children (7 and 2 years old).
  • Michael Kalin MD FCFP, Family Medicine, GMF Santé Kildare, father of 6 children aged 11, 14, 14, 16, 18 and 19.
  • Sherif Karama, MD, PhD, professeur adjoint, Département de Psychiatrie, Université McGill, père d’un garçon de 10 ans.
  • Steven Kembel, PhD, professeur agrégé, Département des sciences biologiques, Université du Québec à Montréal, père de deux enfants (11 et 15 ans).
  • Afsheen Qayyum Khan, MD, Clinical Research Coordinator, MUHC, mother of 2 children (5 and 9 years old).
  • Emmanuelle Khoury, PhD, professeure, école de travail social, université de Montréal, parent de 3 enfants (14,12 et 8 ans).
  • Barbel Knauper, PhD, Professor, Psychology, McGill University (2 children, 14 and 16).
  • Marina Klein, MD, MSc, FRCP(C), Professor of Medicine, McGill University Health Centre, Research Director, Division of Infectious Diseases and Chronic Viral Illness Service, National Co-Director, CIHR Canadian HIV Trials Network, mother of two children, 16 and 18 years old.
  • Lianne Kopel, MD, Assistant Professor, Pediatrics, Pediatric Respirologist, The Montreal Children’s Hospital, McGill University, mother of 2 children ages 5 and 7.
  • Krackovitch, Stephanie - MD, OB-GYN at Lakeshore General Hospital, mother of 5 children 8, 12, 14, 17.
  • Caroline Lambert, PhD, associée de recherche clinique en oncologie, hôpital général juif, maman de deux enfants de (2 et 6 ans).
  • Kim L. Lavoie, PhD, FCPA, FABMR, Tier 1 Canada Research Chair in Behavioural Medicine, Professor, Dept of Psychology, UQAM; Adjunct Professor, Faculty of Medicine, University of Montreal; Co-Director, Montreal Behavioural Medicine Center, CIUSSS-NIM, Hopital du Sacre-Coeur de Montreal; Chair, Canadian Network for Health Behaviour Change and Promotion (CAN-Change); Member, College of the Royal Society of Canada. Mother of two children: Age 9 and 12.
  • Maya Leitner, MDCM, Pediatrician, Adolescent Medicine specialist; Medical Director Club Tiny Tots, Associate Lecturer MUHC, 3 children (ages 5, 2.5, 6 weeks).
  • Valerie Leroyer, MD, M.Sc., DCBC, médecine générale Clinique Médicale Diamant à Montréal. Maman d’un ado de 17 ans, adopté d’Haïti.
  • Leonard A. Levin, MD, PhD, Chair of Ophthalmology and Visual Sciences, Professor of Neurology and Neurosurgery, McGill University (13, 15, 17 years).
  • Jamie Libman MDCM, RCPSC Urology MUHC - no kids, but uncle of 8.
  • Deborah Loyer, pediatrician, Children’s Care Pediatricians- mother of 2 adult children.
  • Jennifer Luu, B.Sc.N, RN, CIUSS Ouest-de-l'ile-de-mtl, maman de 3 enfants; 1an, 6 ans et 9 ans.
  • Chandra Magill, MD, Pédopsychiatre en cabinet privé, mère de deux ados (13 et 16 ans).
  • Don Melville, MBA, chargé d’enseignement, Faculté de gestion de l'Université McGill, consultant, milieu de la santé, père de deux enfants.
  • Christine Meyers, MDCM, FRCP. Emergency physician at McGill University Health Centre. Mother of two, aged 8 and 9.
  • Susan Mintzberg, MSW, PhD Candidate, School of Social Work, McGill University, (trois enfants âgés de 8, 13, et 15 ans).
  • Soledad Miranda-Rottmann, Associée de recherche, Centre de Recherche, CHU Ste-Justine, Université de Montréal, Mère de Roberto, 10 ans.
  • Erica EM Moodie, Professor of Biostatistics, McGill University. Mother of two children aged 9 & 11.
  • Jessica Morrison, MDCM, pédiatre, Club Tiny Tots, Mère de quatre enfants, 6,8,11 et 13 ans.
  • Diane Munz, developmental pediatrician, CRDP Mackay & Philip Layton School.
  • Marc Bernard Mydlarski, MD, PhD, McGill University, Assistant Professor, Chirurgien Ophtalmique (age d'enfants: 11, 11, 20 ans).
  • Serge Naoum, MD FRCSC, chirurgien général, Père de 2 enfants de 8 et 10 ans.
  • Caroline Ng Cheong, MD, médecine familiale, mère de deux enfants,13 et 16 ans.
  • Viviane Nguyen, MD, cardiologue, mère de 4 enfants (12, 9, 5 et 1 an).
  • Nina Nouraeyan MD FRCPC, Neonatologist, mother to 2 children (Ages: 2 and 6).
  • Matthew Oughton, MD, FRCPC, Infectious Diseases & Médical Microbiology, father of three children ages 6, 10, and 13.
  • Scott Owen, MDCM, FRCPC, Assistant Professor, Medical Oncology, father of 2 boys (7 and 4 years old).
  • Callie Padan, MD, CCFP, Médecin de Famille, GMF Vaudreuil-Dorion et Tiny Tots, mère de deux enfants de 4 et 5 ans.
  • Reshma Patel, BM CCFP Family Doctor Mother of 2 elementary school children.
  • Shauna Reinblatt, MDCM, obstetricienne-gyneoclogue, CUSM, 2 enfants 13 ans.
  • Nitika Pant Pai, MD., PhD Associate Professor. Clinical Epidemiology/ Mother of 1 secondary school child age 12.
  • Caroline Petit-Turcotte, PhD Molecular neurobiology, Évaluatrice scientifique, Santé Canada, deux garçons de 11 et 10 ans.
  • Nathalie Poirier, EMBA, Master Computer Sciences, maman d’un garçon de 5 ans (maternelle), Montréal.
  • Timothée Poisot, PhD, professeur agrégé, Département de Sciences Biologiques, Université de Montréal, père de 3 enfants (2 ans, 2 ans, 6 ans).
  • Vicky Pololos, MA Sociologie, Intervenante Psychosociale, mère de deux enfants (3 ans, 1 mois).
  • Kostas Pantopoulos, PhD, Professeur, Département de Médecine, Université McGill, père de deux enfants (8 et 10 ans).
  • Masha Prager-Khoutorsky, PhD, Assistant Professor, Department of Physiology, McGill, mother of 2 (13 and 18 yr old).
  • Svetlana Puzhko, MSc, PhD( c), McGill University, Department of Family Medicine.
  • Maria Natasha Rajah, PhD, Professor, Departments of Psychiatry & Psychology, McGill University, mother of a 7yr old.
  • Mark Rabinovitch, MD FRCPc, Professeur Adjoint, Université McGill, père de deux enfants (9 et 12 ans).
  • Mitchell Rodier, MD, MSc, FRCPC, Faculty Lecturer, McGill University, Psychiatrist, father of a 1yr old.
  • Sarah Racine, PhD, Professeure Agrégé, Département de Psychologie, Université McGill, mère d’un enfant (1.5 ans).
  • John D. Rioux, PhD; Chaire de recherche du Canada en génétique et médecine génomique; Professeur de médecine, Université de Montréal; père de deux garçons (jumeaux de 9 ans).
  • Marie-France Roux-Groleau, DMD, dentiste généraliste, pratique privée, mère de 3 enfants (11 ans, 8 et 7 ans).
  • Oliva Rossella, MD, Family Doctor. Mother of 3 children (Ages : 11, 8).
  • Renata Sava , MDCM, CCFP, family doctor, mother of 3 kids.
  • Teresa Rudkin, MSc, MD, CCFP, Family Medicine, Assistant Professor, McGill University, mother of 2 children (ages 7 and 10 years).
  • Paula Ruttle, Ph.D., Developmental Psychophysiology, mother of one kindergarten student and one K4 student.
  • Selena M. Sagan, Ph.D. Associate Professor, Virology, département de microbiologie et immunologie, Université McGill, tante de 2 enfants (14 et 16 ans).
  • Laura Schleifer, PhD, psychologue clinicienne; mère d’un enfant (16 ans).
  • Alexandra M. Schmidt, PhD., Professor of Biostatistics, Department of Epidemiology, Biostatistics and Occupational Health, McGill University.
  • Ketra Schmitt, PhD, Associate Professor, Centre for Engineering in Society, Concordia University, mother of 3 children (ages 5, 8 and 10).
  • Dr. Deborah Schwarcz, MDCM, CCFP-EM, Emergency and Family Medicine, McGill University Health Center, mother of 3 children (ages 7,5,3).
  • Dr. Hannah Schwartz, MDCM, Psychiatry Department, St. Mary's Hospital Cente.
  • Assistant Professor (Clinical), McGill University (4, 6, 12, 14).
  • Rosie Scuccimarri, MD, Associate Professor, Department of Pediatrics, McGill University, mother of 2 children (15 yo, 19 yo).
  • Giada Sebastiani, MD, Professeur Agrégé, Département de Médecine, Université McGill, mère de deux enfants (8 et 10 ans).
  • Amélie Seidah, Ph.D., psychologue clinicienne; mère de deux enfants âgés respectivement de 10 et 13ans.
  • Jesse Shapiro PhD, professeur agrégé au département de microbiologie et immunologie, Université McGill, et professeur associé au département de sciences biologiques, Université de Montréal; père d’un enfant (4 ans).
  • Don Sheppard M.D. FRCPC, Director, McGill Interdisciplinary Initiative in Infection and Immunity; Chair, McGill University Department of Microbiology & Immunology.
  • Allan Sniderman MD FRCPC FRSC , Edwards Professor of Cardiology, McGill University.
  • Leslie Solomon, MDCM, omnipracticienne, Club Tiny Tots, Mère de trois enfants, 9,12,et 15 ans.
  • Paul Stamboulis B.Sc., DMD, dentiste généraliste, pratique privée, père de 3 enfants, 11, 8 et 7 ans.
  • Lara Stern, MDCM, FRCPC, psychiatrist, mother of 2 children.
  • Meira Stern, MDCM, CCFP, family doctor, mother of 4.
  • Marty Teltscher, MDCM, FRCPC, infectious diseases specialist and medical microbiologist at CIUSSS-CO-Montreal Jewish General Hospital. McGill University, assistant professor of medicine. Father of 3 children, 14, 12 and 10 years old.
  • Yves Terrat, PhD, associé de recherche en Microbiologie, Université de Montréal, père d’un enfant de 2 ans.
  • Marc Tewfik, Associate Professor, Otolaryngologist, McGill University, ( 2 children ; 10-14 yo).
  • Debra Titone, Ph.D., Professor, Department of Psychology, McGill, mother of two children - 10 & 14 years old.
  • Rebecca Tittler, Ph.D, chargé de cours, Départements de biologie de géographie, planification et environnement et Collège Loyola pour la diversité et la durabilité, Université Concordia, mère de trois enfants (8, 12, et 16 ans).
  • George Thanassoulis MD MSc, Professeur Agrégé, Département de Médecine, Université McGill, père de deux enfants (9 et 11 ans).
  • Sonia Tremblay MD, Médecin de Famille, Maman de deux enfants (9 et 11 ans).
  • Claire Trottier, PhD, professeure au département de microbiologie et immunologie, Université McGill, maman de deux enfants (6 et 9 ans).
  • Robert D. Vincent, Ph.D., professeur d'informatique, Collège Marianopolis, père de deux enfants (10 et 14 ans).
  • Melissa A. Vollrath, PhD, professeure adjointe au département de physiologie, Université McGill, maman de deux enfants (10 et 12 ans).
  • Monica Walczak, BSc, MATL. Maman de trois enfants (17, 15, 12).
  • Francine Wein, MDCM, assistant professor of Ophthalmology and Visual Sciences, McGill University, mother of 3.
  • Machelle Wilchesky, PhD, Assistant Professor, Department of Family Medicine, McGill University, Scientist, Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital.
  • Christina Wolfson, PhD. Professor, Medicine and Epidemiology and Biostatistics and Occupational Health, McGill University.
  • Jessica Yeates, BSc, MD, FRCPC. Pediatrician, mother of 4 and 1 year old boys.
  • Yoon Kow Young, BSc, Gr. Dip., responsable de plateforme scientifique, Institut Lady Davis, père de 2 enfants (2 et 6 ans).
  • Mark Zoccolillo, MD. Psychiatrist (Retired from McGill). Father of 15-year-old girl.
  • Grace Lalonde, MD CM, Clinique Agoo pediatrique, Professeure Ajointe, Département de Médecine, Université McGill, mère de quatres enfants.
  • Vafa Keser, Ph.D. Human Genetics, mother of 3 children 7, 3 and 2 years old.
  • Andie Zeliger, MSc, Rehabilitation Administration, Manager, Academic Staff Concordia University, mother of 14 year old (entering Sec 3) and 20 year old - University.
  • Caroline Zerey, BSc, MD, Médecin de famille , maman de deux enfants 8 ans et 10 ans.