To BC Premier Dave Eby, Health Minister Adrian Dix, Education Minister Rachna Singh, and to all BC parents:

Unbelievably, we are approaching the fourth unsafe return to school during the ongoing COVID-19 pandemic. In September, BC parents will be sending their children back to school just as newer recombinant SARS-CoV-2 variants will be circulating. As well, just like last year, RSV and influenza are expected to hit children hard.  

Recall that in August of 2022, Protect our Province BC warned the BC government that if it didn’t act fast, BC children would be hit with a potentially lethal “tripledemic” of Covid and other diseases particularly RSV and flu. Our warning proved well-founded. Six BC children died, paediatric hospital ERs crashed and wait times skyrocketed, and schools saw a record number of student and educator absences. 

Currently in BC, we have no mask protections in schools, no proof of indoor air quality in schools including monitoring of CO2 levels during full class occupancy, no HEPA filtration units available in most classrooms, almost non-existent PCR testing, and only the occasional provincial public health report (and those reports we do see are of limited value).

With the elimination of isolation policies, parents may now knowingly send COVID-infected children to school. “It’s just a cold” is what BC Public Health officials have (mis)led them to believe. Yet no one has explained to parents why their children are constantly sick with one infection or another. Make no mistake, this is the result of Covid-induced “immune dysfunction” and has nothing to do with the unscientific myth of “immunity debt” that children were falsely claimed to suffer as a result of having been masked or not in school.

Given the tone of BC public health authority messaging, it’s no surprise that most British Columbians believe the pandemic to be over. Little do they know that a new summer wave of Covid cases is starting up in the United States. Japan is being devastated by the new EG.5.1 variant, which is now also starting to impact the UK. This variant is already in BC as per GISAID data. We are now hearing about LTC outbreaks (called clusters so that BC Health Authorities don’t have to report them) starting up again. 

The southern hemisphere always gives us a useful glimpse of our coming fall and winter. Children in Australia are now once again being hit hard by influenza which, just like last year, started early. Many South American countries have also seen a rise in RSV, influenza and Covid with some countries reintroducing masking in schools and others closing schools early for the winter break. As Uruguay Health Minister Karina Rando explains, “to help reduce viral circulation by reducing the children's school attendance,” because at school, contact is ”much more intense.” 

In short, we are on track for a rinse-and-repeat of last year. 

You as leaders have a choice: either do nothing or decide to protect BC children, their educators and their families. Schools are not islands. Viruses walk in and then viruses walk out to infect families and communities. Studies show that  schools are still the major source for COVID-19 transmission with 70% of COVID-19 infections transmitted to households from children. 

Here is what you can and must do for a safe return to school this September.

1) Ventilate and clean the air in schools so it is as clean, fresh and virus-free as possible. 

In a historic move, on May 12, 2023, the US CDC updated its guidance for ventilation in buildings, setting a health-based ventilation target for occupied spaces. Never before has the CDC set “a ventilation target to address respiratory infectious diseases.” 

 The new American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 241 should be urgently reviewed and adopted. 

Parents have a right to know the status of the air quality in their child’s classroom and school. The BC government must provide transparent public reporting on indoor air quality (IAQ) in schools, including realtime public display of CO2 in all shared spaces as Boston Public Schools has already been doing for two years. 

As an added benefit, cleaner air means better cognitive function as well as prevention of other airborne diseases like RSV and flu. The Lancet Commission found that improved school ventilation led to decreased school absences and improved math and reading scores. 

2) Bring back mask protections with high quality masks, such as KN95 or better, to control COVID-19 and other airborne viruses at the source. High quality masks must be provided for free by the government to ensure equity of access and protection.

Mask mandates in school work. At the start of the 2021 school year, Alberta schools with mask mandates saw a third of the outbreak numbers seen in schools without mask mandates. This translated into a reduction in Covid cases and hospitalization rates for ages 5-11 and for the 30-59 year olds in those same communities. 

A greater Boston area study showed similar finding, “Around 30 per cent of COVID-19 cases among students and staff in schools around Boston could possibly have been prevented if they hadn’t lifted their masking mandates.”

3) Name It: Covid is Airborne. SARS-CoV-2 spreads like cigarette smoke and can hang in the air for hours. Infections occur by breathing in aerosols, both near the source and far from it.

Early on in the pandemic, in the summer of 2020, the BC Public Services Agency asked whether SARS-CoV-2 could be transmitted through the airborne route. Dr. Sarah Henderson (PhD, BC CDC Scientific Director Environmental Health Services, Scientific Director National Collaborating Centre for Environmental Health and Associate Professor School of Population and Public Health) answered the question. Listen to her answer here. (12:34-16:13 mark). In short, it’s airborne.

4) The federal government has a stock of 39 million rapid antigen tests. Provide these rapid tests to students and staff along with up to date, accurate public education on how and when to test and how often.

Encourage and support parents with adequate numbers of sick days to keep kids home when sick, and direct schools and teachers to notify parents of positive cases in the class.

5) Vaccinate families and children early against COVID-19 and influenza.

There cannot be a repeat of last year’s youth vaccination clinic shambles. In 2022, BC walk-in family vaccination clinics were finally opened on December 9. This was past BC’s flu epidemic peak and too late for the 6 families whose children had already died. 

BC’s current child and youth COVID vaccination rate is too low. Only 16% of children ages 6 months to 4 years, and 19% of 5 to 11 years old are up to date on their vaccine doses, with the rate being 38% in the non high risk 12 to 17 year old youths.

Support parents and guardians by clearly addressing their vaccination concerns  and making it easier for them to get their children vaccinated and boosted. This will lower the risk of transmission, infection and long-term illness such as Long Covid in children. Recent studies show that with Omicron variants, Long Covid in kids is just as likely whether it’s a first infection or a reinfection. “1 in 6 children and adolescents have been found to have persistent symptoms for 3 months after infection”, and some of them will not recover.

“Long” takes on another dimension altogether when you are a child or youth.  Preventing repeated COVID infections in children should be BC leaders’, educators’ and parents’ top priority.  

The BC government must not make the same lethal mistakes it made in 2022. There is still time to turn this around. Act now.

Signed

Protect Our Province BC, including:

• Elisabeth Crisci, MD CCFP, Medical Director, Pacifica MD
• Lyne Filiatrault, MD, FRCPC (EM) retired
• Brenda Hardie MD, CCFP, FCFP Family Physician
• Susan Kuo MD, CCFP, FCFP Family Physician, Clinical Associate Professor, UBC Faculty of Medicine 
• Karina Zeidler, MD, CCFP, Family Physician 

Safe Schools Coalition BC, including:

• Victoria Chung, parent
• Dr. Lauralee Dukeshire, Family Physician and Parent
• Jennifer Heighton, BSc, Teacher, Co-Founder Protect our Province BC
• Tom Jackman, parent and disability rights advocate
• Ian Robertson, M.Arch, parent
• Karen Tsang, parent

BC School Covid Tracker

• Kathy Marliss, parent
• Andrea Roszmann, parent

Do No Harm BC

• Elaine Carol
• Luc Latulippe, Caregiver/Artist 

Ontario School Safety (link)

Vancouver District Parent Advisory Council (VanDPAC) Health & Safety Working Group

• Roger Haskett, Parent, VanDPAC Health & Safety Working Group Coordinator
• Oana Hyatt, parent
• Nathalie Kos, DMD, parent
• Luc Latulippe, Caregiver
• Michael Livan, parent

Canadian Aerosol Transmission Coalition, including:

• Stéphane Bilodeau, ing., Ph.D., FIC. Adjunct Professor, Bioengineering Department, McGill University. Independent International Contractor, United Nations Office of Project Services. Chief Technology Officer, Smart Phases Inc. (Novacab). Editor and Coordinator of the Indoor Air Quality Task Force,  World Health Network. Chair, Public Affairs Advisory Committee, Engineers Canada
• Nancy Delagrave, B.Sc. in Mathematical-Physics, Chief Executive and Scientific Coordinator of Covid-Stop, Québec
• Alec Farquhar, retired Occupational Health and Safety Regulator, Canadian Aerosol Transmission Coalition
• Ziad Fazel, BASc, DipAdmin, P.Eng.
• Kathleen Gadd, MLIS
• Kevin Hedges Ph.D., CIH, COH, Occupational Hygienist
• M.B. Oliver, CD, P.Eng.
• Simon Smith PhD ARCS CChem FRSC(UK)
• Mark Ungrin, Interdisciplinary Biomedical Researcher, Associate Professor University of Calgary
• Dorothy Wigmore, MS, Occupational hygienist

Individual signatories:

• Christopher Applewhaite, MD, CCFP, Family Physician
• Ric Arseneau, MD FRCPC MA(Ed) MBA FACP CGP. Clinical Professor, Division of General Internal Medicine, St. Paul's Hospital, University of British Columbia
• Yaneer Bar-Yam, Professor and President, New England Complex Systems Institute, Co-Founder World Health Network
• Dr. David Berger, BSC(Hons), MBBS(Hons), MRCP(UK), MRCGP, FRACGP
• Astrid Brousselle, Professor, School of Public Administration, University of Victoria
• Tracy Casavant, BASc (Chml), MES
• Arijit Chakravarty, Ph.D., CEO, Fractal Therapeutics
• Dr. Damien Contandriopoulos, PhD (Public Health) Professor, University of Victoria School of Nursing & former CIHR Applied Public Health Chair
• Irene Corman, M.A. educator, Associate Superintendent of Schools (Retired)
• Mauricio Drelichman, Professor, University of British Columbia
• David Elfstrom, P.Eng.
• Dr. David Fisman, Infectious Disease Epidemiologist and Physician. Professor of epidemiology at the Dalla Lana School of Public Health at the University of Toronto. Co-Lead, Readiness Stream, University of Toronto Institute for Pandemics
• Malgorzata Gasperowicz, PhD, Developmental Biologist
• Professor Trisha Greenhalgh, University of Oxford
• Dr. James Heilman, MD, BC Emergency Physician
• Amanda Hu, BA BFA NCT, Clean Air Advocate
• José-Luis Jimenez; Distinguished Prof., Dept. of Chemistry & Biochemistry, CIRES Fellow, University  of Colorado
• Andrew Longhurst, MA. Research associate, Canadian Centre for Policy Alternatives, BC Office. PhD candidate and health policy researcher, SFU
• Steve Morgan, PhD. Professor, School of Population and Public Health, University of British Columbia
• Kimberly A. Prather, Ph.D. Director, NSF Center for Aerosol Impacts on Chemistry of the Environment, Distinguished Professor, Distinguished Chair in Atmospheric Chemistry, Scripps Institution of Oceanography, University of California, San Diego, La Jolla
• Dr. Sarah (Sally) Otto, FRSC, Director, Liber Ero Fellowship Program, University Killam Professor, Department of Zoology, University of British Columbia
• James Andrew Smith, PhD, P.Eng, Associate Professor, York University
• Peter Stein, School Counsellor, (Retired)
• Nicola Waters PhD MSc RN. Health Research Consultant, Adjunct Professor University of British Columbia, Okanagan. 

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Protect Our Province BC is a grassroots group of physicians, nurses, health scientists, health policy specialists and community advocates. We are working together to help people in BC stay safe by sharing accurate information about the COVID-19 pandemic in BC, and advocating for policies based on the best available science. Our ultimate goal is to end this pandemic through a vaccine-plus strategy that includes addressing how this virus spreads through aerosols.