Hamilton students are back in schools. How risky are classrooms?

After weeks of remote learning, Hamilton schools reopened to students on Monday with enhanced measures and the promise of asymptomatic testing.

With relatively high case counts in the city, some parents are wondering whether or not schools are safe.

Some experts say the benefits of in-school learning - social and academic - outweigh the risks.

Nobody's ever saying there will be zero risk, but even higher risk in the context of schools is low risk," said Dr. Martha Fulford, infectious disease specialist at McMaster Children's Hospital.

Kids and their mental health and their physical health and their future is a critical thing that we need to be supporting."

Hamilton public health says there were 39 outbreak-related cases of COVID-19 among students and staff at public and Catholic schools in the first half of the school year.

We've seen evidence with all four types of transmission - student to student, student to staff, staff to student, staff to staff," spokesperson James Berry said in an email to The Spectator.

The public health unit could not provide a breakdown of how transmission among students and staff was occurring.

The Hamilton-Wentworth District School Board, which has a student population of approximately 50,000, reported 218 cases of COVID-19 - 175 students, 42 staff and one individual not identified" - between September and December.

Hamilton public health says 22 of those - 13 students and 9 staff - were related to an outbreak, which is defined by the province as two or more lab-confirmed COVID-19 cases ... with an epidemiological link, within a 14-day period, where at least one case could have reasonably acquired their infection in the school."

The public board had a total of 10 outbreaks before the winter break.

As of Feb. 10, there have been 154 cases - 124 students and 30 staff - at the Hamilton-Wentworth Catholic District School Board since the beginning of the school year. According to Hamilton public health, seven outbreaks were declared between September and December, with 17 related staff and student cases.

Fulford said that while there may be higher risk in schools in places with high case counts like Hamilton, the baseline risk is low."

The overwhelming data from Ontario, from the rest of Canada to the world, is that schools have been shown to be safe and not amplifiers of the pandemic, but more reflectors of what's going on in the community," she said.

In data compiled by the Toronto Star on new cases per 100,000 people in the last 14 days for each public health unit in the province, Hamilton was assigned a higher" risk category for transmission in schools, based on U.S. Centers for Disease Control and Prevention (CDC) thresholds.

Fulford said the challenge is the nuance behind these numbers."

Population numbers give you sort of give you some general trends," she said, adding high case counts in the community might" make schools riskier.

Children need to be considered as a population in and of themselves."

Medical experts have said kids are less likely to catch and spread the virus.

Fulford said the problem" with the narrative that schools are high risk is that some people are really only looking at COVID as if there's nothing else to consider."

But it's easier to talk about that, it's easier to talk about COVID numbers because they're easy to count," she said, adding that the harms of remote learning and the benefits of in-person learning are much harder to quantify.

In Halton, 1,015 cases of the virus - 881 students and 134 staff - and 15 outbreaks were reported in school settings since the beginning of the school year. Forty-eight cases were related to outbreaks.

At the Grand Erie District School Board, which encompasses Brantford, as well as Brant, Norfolk and Haldimand counties, 78 cases - 56 students and 22 staff - have been reported since September among its more than 25,000 students and about 2,500 staff.

While many families are happy about the return to school, some have chosen not to send their kids back, citing fears around virus transmission.

Dr. Zain Chagla, an infectious disease physician and associate professor at McMaster University, said studies from around the world looking at transmission from schools to the community have derived different data."

Some of them (are) really suggesting no real transmission if good infection control practices in schools, whereas others have really said, OK, there is some transmission in schools that might get out into the community," he said. It's a function of our ability to contact trace cases and really determine what's happening outside of schools."

Low case numbers in schools and a lack of local data make it challenging to draw definitive conclusions.

Hamilton's COVID trends, he said, are going in the right direction." As of Feb. 9, there have been 9,630 cases of COVID-19 in Hamilton - 91 per cent of them resolved. Fourteen per cent of cases - approximately 1,350 - are among children and youth ages 0 to 19.

There's been a gradual decline in cases week to week," Chagla said. Every day is looking better and better and better."

He said the decline has been in basically all the parameters," including per cent positivity, total cases and number of outbreaks, and that Hamilton is at a similar level as it was in late November or early December.

Since then, new variants of the virus, which are more transmissible, have been found in Ontario, and are not accounted for in existing modelling.

Schools are probably the canary in the coal mine," he said. There can be localized transmission within the school, but it's not necessarily that they're fuelling transmission in the community."

Asymptomatic testing, which the province announced would be expanded to schools across the province, could help detect the virus in children, preventing further transmission. But they can produce false negatives and false positives, Dr. Elizabeth Richardson, Hamilton's medical officer of health, said at a media briefing on Tuesday.

It is unclear how asymptomatic testing will be implemented in Hamilton.

Dr. Jeff Pernica, head of the division of infectious disease in the department of pediatrics at McMaster University, said the challenge with COVID is that people like numbers."

I would welcome getting more data, you know, having testing of schoolchildren so that we can actually prove that schools in Ontario are as safe as we think that they are," he said. But we need to do it in a co-ordinated way that doesn't involve testing every kid every day because that is impossible."

Kate McCullough is a Hamilton-based reporter covering education at The Spectator. Her work is funded by the Canadian government through its Local Journalism Initiative. Reach her via email: kmccullough@thespec.com