Nisha Thampi Profile picture
Jun 2, 2021 8 tweets 4 min read Read on X
1/I have to believe this decision wasn't made lightly.

What I need to hear (and will actively support):

Resources will be committed to develop an integrated strategy for in-person instruction as a healthy, resilient workplace in Sept 2021

Why this is so important:
2/Schools offer an essential service to students

Many have benefitted from in-person instruction and stable access to clinical services as needed.

And more have benefitted when there have been additional educational supports (e.g. EAs)
We have seen investments for schools to be healthier workplaces for students

and for the education staff who are critical to their essential work.

But these measures haven't been consistently applied across communities, despite PHUs, education admin, staff, parents leaning in.
For healthier schools, there needs to be community-based measures:

- Vaccines and #CommunityImmunity for indirect benefits to younger kids

- #PaidSickLeave (to keep sick kids at home)

- intact #TestTraceIsolate systems

👆🏾 wrap-around supports for healthier schools
Measures at baseline that⬇️disruptions + ⬆️learning:

- Screening + isolation strategy for sick/exposed students/staff

- hand hygiene, cleaning

- Ventilation: outdoor ed, windows + indoor air quality, smaller class sizes

And TEMPORIZING measures to support learning when community infection rates⬆️

We have evidence-informed metrics + tools:
-cohorting students/staff
-blended learning
-masking for source control
-broader TTI
-activity restrictions...

*3rd image👇🏾 (current state) is not acceptable
While the evidence has not changed, the "fébrilité" around returning to in-person instruction is more palpable than ever.

Education vs economy.
Patio vs principles.

I appreciated @petrosoniak's take on complexities in decision-making back in January:
Debates around safe vs unsafe schools have damaged trust in education, epi and PH.

We need
- transparency on this decision, given support to MOHs
- a plan to sustain resilience to infectious hazards for schools

This values kids/staff more than as monkeys in the middle

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More from @NishaOttawa

Dec 19, 2022
It’s been an intense Fall for pediatric health systems across the Northern hemisphere.

We describe what happened at @CHEO for kids admitted with lab-confirmed resp viral infections up to Dec 10, compared to previous years.

medrxiv.org/content/10.110…

🧵 on our experiences:

/1
CHEO Context:
Catchment 500K+ kids

Sole pediatric tertiary care centre in Eastern ON
Also serving kids from western QC, northern ON, Nunavut

Adult hospitals in Ottawa don’t have peds beds but are taking critically ill teens after recent provincial directive
2/
Since October, we saw an early, rapid, two-fold increase in admissions due to respiratory viral infections compared to previous viral seasons.

This season, many admissions are patients with lab-confirmed respiratory viral illnesses

3/
Read 8 tweets
Nov 14, 2022
People talking about babies needing to get infections [to build immunity] have clearly not spent enough time around babies who've survived infections to understand this is NOT a good idea.

thread/
RSV is a great/terrible example of why infection in infancy is not a good idea

Highest admit rate if <6mos

Increased risk of sleep-disordered breathing, asthma/reactive airways with future infections

Consequences persist beyond 12m after hospitalization

And reinfection likely
Measles is a powerful example of why we seek to avoid infection in infants.

And why we seek to immunize before they are exposed to the virus - much safer than rolling the dice on infection-related consequences.

ncirs.edu.au/consumer-resou… Image
Read 7 tweets
Nov 6, 2022
The news doesn't quite capture the intensity of work at CHEO, and sense of futility as we get more kids admitted with RSV, rhino, flu, bacterial pneumonia, asthma.

I understand that the signal for public health action is when the acute care system is in crisis.
1/
What will it take for peds? We've maxed ED capacity, canceled surgeries, increased nursing and MD assignments.

Cannot redeploy more staff without a PH order, so relying on colleagues to volunteer.

Cannot create more isolation beds. Will not bring sick staff to work (good).
2/
I'm glad we haven't stopped masking at the hospital, and eye protection at point of care.

These protect staff and reduce further strain on health HR.

But we agree w many families coming in - society could be doing more to protect households during this viral surge
3/
Read 6 tweets
Mar 9, 2022
This is hard news for many families and staff, for school administration and PHUs who have tried to keep school communities safer during the pandemic.

As much as we'd all like to "return to normal", we have to acknowledge:
1. While there seems to be tolerance for COVID to spread in the community, we should continue to hold certain institutions to higher standards, including hospitals and schools.

They provide essential services as spaces for learning, child care, therapy and development.
2. Masks + testing/surveillance have helped to reduce spread and keep schools open, making for a more stable environment during an unstable period of time.

Kids have been compliant - why change now, when test positivity is not decreasing and vaccines rates variable across PHUs?
Read 8 tweets
Jul 20, 2021
Impressed at how quickly the masking recs in the ON schools guidance were taken out of context and misinterpreted. 🧵

covid19-sciencetable.ca/sciencebrief/s…

TL;DR:

1. Masking is important + effective

2. We recommend aligning school practices with PH guidance on masking indoors

1/8
cdc.gov/coronavirus/20…

We read this 👆 carefully when it came out 10d ago and compared with our guidance.

Aside - found its vent/filtration section lacking in strategies and details.

(Our stakeholders said they wanted a roadmap.
So we built that into the recs 👇)

2/
Back to CDC doc:
"Masks should be worn indoors by all individuals (age 2+) who are not fully vaccinated"

"Not fully vaccinated" i.e. guidance based on individual vaccine status?

How would this work for 12-17 now? 5-11yo later?
How to not discriminate against unvaxxed?

3/
Read 8 tweets
Jul 19, 2021
1/Our back-to-school guidance for schools in Ontario is out!
This framework reflects a year’s worth of evidence, lived experience, and tremendous stakeholder engagement.
covid19-sciencetable.ca/sciencebrief/s…
2/Here’s what the brief touches on:
3/Our group came at this with the shared perspective:

School is the “essential work” of children. Educators + school staff are critical to students’ work.

We have heard from educators, administrators, clinicians and child health advocates how turbulent this year has been.
Read 12 tweets

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