Flu Season and Coronavirus: Were Schools Fully Prepared for the Latest Twist?*

Students are now coming down with seasonal colds and the flu.  What was predicted to be a normal flu season in schools turned ou out to be highly unpredictable with the arrival of a ghost menace – the fear of coronavirus, now labelled COVID-19.  Public anxieties were fed by a popular media inundated with frightening stories about the spectre of coronavirus, rivaling that associated with the outbreak of SARS in 2002-2003. The latest scare also sparked a disturbing undercurrent of suspicion, with racist undertones, directed at Canadians of Chinese ancestry.

The common flu remains a bigger threat than coronavirus but you would never know it from the media coverage.  Some 25,854 confirmed cases of the regular flu have been reported since late August 2019, and, so far, the coronavirus, has only infected a dozen Canadians. Some 12,200 Canadians are hospitalized for influenza each year and about 1,000 die across Canada. In 2002-2003, for comparison purposes, 44 people died of SARS in Canada.

Normally calm Public Health authorities are now forecasting an uptick in cases throughout February into March. Teachers and principals will be on the front lines because schools are well-known breeding grounds for germs and infections.

This flu season it is going to be worse because, according to the Public Health Agency of Canada (PHAC), the country is seeing an unusually high number of Influenza B cases, which tend to cause more severe illness in children. Of the 33,615 reported Canadian influenza cases (up until February 8, 2020), 11,905 were classified as Type B, with 57 per cent of those patients under 20 years-of-age. Reported Influenza B cases were also more common in the Maritime provinces of Nova Scotia and New Brunswick.

Face masks are disappearing from pharmacy shelves as people are either wearing them outside or hoarding them in the event of a global pandemic. Nova Scotia’s Chief Medical Officer of Health Robert Strang claims that the masks are not guaranteed to offer protection and may encourage people to touch their faces, actually spreading the germs.

The global outbreak is Chinese in origin and that most regrettably still carries insidious connotations. It may have originated in Wuhan in China’s Hubei Province, where some 57 million citizens were placed in a state of lockdown and isolation, but exaggerated fears and anxieties have spread worldwide. The two-week ordeal of international tourists trapped on the quarantined and virus-ravaged Diamond Princess cruise ship anchored in Yokohama, Japan, further fed public anxieties.

Combating and surviving the flu season in school used to be so much easier. Counselling students and teachers to stay home, drink fluids, and get rest used to suffice in weathering the seasonal onslaught. Most of us fooled ourselves into thinking that miracle cures for the cold and flu like Cold-FX were actually working and toughed it out with Tylenol, Hall’s cough drops, and, on a bad day, toilet tissue kleenex.

Today’s principals, teachers, and students come to school prepared with new weapons in the ongoing war against contagion. Wiping down desks with disinfectants and packing little bottles of Purex in pockets and purses is now standard practice. A few even don surgical masks to keep colds in, or ward them off, walking to and from school.

Fear and panic are running high in Ontario and British Columbia school districts where many of the students are Chinese Canadians or recent arrivals of Chinese descent. Vocal and active parents are clamouring for schools to increase screening of Chinese students suspected of being carriers and sending home children whose families have recently returned from China.

Coronavirus-induced tensions are most acute in York Region, north of Toronto, particularly in Richmond Hill and Markham, where 40 per cent of the population is of Chinese origin. A coronavirus-inspired petition targeting Chinese families launched in late January in York Region, north of Toronto, was quickly endorsed by parents in 145 local schools and generated some 10,000 signatures. In the York Region District Board of Education, Board Chair Juanita Nathan and Education Director Louise Sirisko, were compelled to send out a memorandum to all schools in direct response to the level of concern and anxiety being felt by families of Chinese heritage.

While the province of Nova Scotia is home to some 3,500 Chinese-born students, the only public display of concern was by Max Chen, a second-year Chinese student at Cape Breton University. After searching in vain for surgical masks to send home, he voiced his concern that the province’s public health officials were unprepared to deal with a potential outbreak at the university.

Public health officials, educators and academics are fearful of schools and universities becoming swept-up in an us-versus-them cycle of racism directed at those who look different. Spreading of misinformation and ignoring facts from public health agencies is symptomatic of deeper, sublimated problems.

A leading SARS impact researcher, York University’s Harris Ali, who studied the stigmatization of the Chinese population in Canada, put it best. Gaslighting the Chinese as carriers of the contagion, he claims “feeds into already pre-existing underlying biases or prejudices.”

Global pandemics turn flu season into a mass psychological experience that can overshadow the actual health risks of transmission. Calming and dispelling exaggerated fears as well as sanitizing desks have now become the essential skills in a 21st-century educator’s repertoire. That may be a clear indicator of the high anxiety temper of our times.

Why was the current flu season so unpredictable in our schools?  Were Canadian public health authorities ready for the surge in Influenza B, the strain most commonly infecting young people of school age?  Are principals and teachers fully prepare to deal with students showing signs of coronavirus?  What are the challenges posed by containing the spread of viruses while ensuring that students and families of Chinese ancestry are not unfairly targeted in the broader community? 

*An earlier version of this commentary was published in The Chronicle Herald, February 15, 2020.

Read Full Post »

Childhood Disease Outbreaks: What’s the School System’s Responsibility in Child Immunization?

Measles outbreaks in the spring of 2019 in the American Pacific Northwest and British Columbia were part of a global revival of an infectious disease that had already affected thousands in Asia, Africa and Eastern Europe. In the wake of that outbreak, the BC Ministry of Health under Adrian Dix acted to require all parents to provide local public health units with their child’s immunization record before beginning school in September 2019. Twelve measles cases in Saint John, New Brunswick, in June 2019, prompted the Chief Medical Officer of Health Dr. Jennifer Russell to intervene to protect as many as 2,000 people exposed to the disease, ordering up 20,000 more doses of MMR vaccine, protection against measles, mumps and rubella.

Lagging childhood immunization rates are emerging as a major public health concern.  Periodic outbreaks of measles and mumps have alerted the public to the fact that childhood diseases, once virtually eradicated by vaccines, are reappearing in and around schools.

Vaccines remain one of the safest and most effective tools we have to protect ourselves, our families and our communities from infectious diseases. Those are not my words, but those of the Public Health Agency of Canada. The current reality is that we are not meeting our national immunization goals and too many children as well as adults remain unprotected and liable to experience illnesses from vaccine-preventable diseases that can cause serious health complications, some of which carry a risk of death.

Each year in April Health Canada raises the alarm during National Immunization Awareness Week and education programs are announced in an attempt to raise vaccination rates. Our Chief Medical Officer of Health, Dr. Robert Strang, makes regular appeals, most recently in August of 2019, to encourage parents to keep their children’s immunization records up-to- date.

The current strategy is not working in Nova Scotia where only 71 per cent of 7- year-olds are immunized for measles and mumps, some 15 per cent lower than the national provincial average and ranking last among the provinces. In New Brunswick, where it’s considered a “crisis,” the measles and mumps coverage rate at age 7 is 92.3 per cent.

While provincial health and school authorities in New Brunswick, British Columbia and Ontario are tackling it head on, Alberta and Nova Scotia are still vacillating on how to improve its abysmal childhood immunization rates. While Health Minister Randy Delorey dithered, PC Leader Tim Houston introduced a private member’s bill to try to force the government’s hand.

Sparked by the spring 2019 measles scare in the Saint John region, New Brunswick Education Minister Dominic Cardy has championed legislation that would make vaccinations mandatory for children without medical exemptions in provincial schools and day cares.

Taking a proactive approach to combating the resurgence of childhood diseases is becoming common right across Canada. Three years ago, Ontario introduced stricter childhood vaccination regulations and in British Columbia legislation requires the reporting of immunization records. Ontario has far higher rates of reported childhood immunization at age 7 than Nova Scotia. Yet, since 2016, that province has required student vaccinations be up to date unless a parent or guardian can provide medical, religious or philosophical reasons why their child has not received a vaccine. Even when exemptions are granted, families are required to watch a 30-minute video on the importance of vaccines and then sign a document saying they viewed the presentation.

Public health authorities hold sway in Nova Scotia, unlike in New Brunswick, where a proactive Education Minister is leading the charge to meet childhood immunization targets so schools do not become sources of contagion.

Nova Scotia Health Minister Delorey may be deterred by fears of stirring-up the radical anti-vaxxers and setting back the cause. He should be taking his cue from New Brunswick’s courageous Education Minister. Confronting a posse of opponents, Cardy called out the group as conspiracy theorists who “influence, mislead and deceive” parents into thinking their children are at risk if they are vaccinated.

Prominent among the N.B. protesters were former Halifax chiropractor Dena Churchill who recently lost her licence to practice because of her anti-vax campaigning, and California pediatrician Dr. Bob Sears, a well-known anti-vax advocate funded by Vaccine Choice Canada.

Vaccine adverse reactions do happen, but, on balance, immunizing children prevents far worse harms caused by the unchecked spread of childhood infectious diseases. School attendance is compulsory and, in that context, so should immunization aimed at safeguarding children’s health.

Minister Cardy stood his ground defending his legislative changes aimed at achieving the goal of 95 per cent coverage. Growing anti-vaccination sentiment, he claimed, was being fed by social media, and threatened to discourage parents from vaccinating their children, reducing immunization rates below a critical threshold that allows a community to resist an outbreak.

Playing nice does not seem to be working at raising childhood immunization rates. Scare stories spread by anti-vaxxers should not go unchallenged. Claims that vaccines are harmful, in Cardy’s words, are “not supported in fact.” “If you believe in evidence-based decision-making, you have to look at the evidence and the evidence is incontrovertible.”

Childhood diseases such as measles, mumps, diphtheria, pertussis, and rubella can do great harm if left unchecked by regular vaccination. With childhood infectious diseases making a comeback, is now the time to be vacillating on child immunization? Does the school system have some responsibility to ensure that immunization rates are high enough to prevent mass outbreaks in the community?  Should it all fall on provincial and local health authorities? 

• An earlier version of this research commentary appeared in The Chronicle Herald, October 31, 2019.

Read Full Post »