Dr. Rachel Pearl: Keeping Kids Safe at School

Sept. 29, 2020 – By SUSAN MINUK

It has been just a few weeks since most students have returned to the classroom under the looming threat of COVID. Teachers and kids alike are navigating new rules, from cohort education, social distancing, hand sanitizing, and the use of masks.

Dr. Rachel Pearl
Dr. Rachel Pearl

Dr. Rachel Pearl works as a pediatric nephrologist at Toronto’s Hospital for Sick Children, and as a general pediatrician and nephrologist in the William Osler Health System at Brampton Civic Hospital. Dr. Pearl spoke with the CJR about kids physically attending school and how best to keep them safe.

Is it safe for a child to be in school?

It’s perfectly safe. A lot of kids during the last six months in quarantine have become very depressed, anxious and restless. There are also some kids who are not going to learn well online because they’re not motivated, or they have a learning disability or an attention problem. 

Yet, for some families, learning online is a really good option. But if I had to choose, I would send my child to school.

The burden of disease in children from COVID has been extremely low in terms of what we see at SickKids.

Should kids get a flu vaccine?

I strongly recommend it. Even though we know that it might be safe and effective [only] for 60 or 70 percent of children, we still recommend it.

Are children less likely to be sick with COVID?

So far, since school has started, I have not seen one admitted school age patient with COVID. 

How do we minimize or prevent its transmission in schools?

Students need to wash their hands before they eat and after, and periodically throughout the day. We have to teach this to them and I think that is something the school can make part of its day. 

Anyone who can wear a mask should be asked to wear one, whether the school is mandating it or not. For the younger children, if they can tolerate a mask, let them wear a mask. 

We should be limiting our bubble when the kids are outside of school to protect elderly parents and grandparents. Those are the ones who need to be protected.

Is there a way to ensure children wear their mask properly?

If the mask looks like it’s comfortable for the child and it seems to cover their mouth and nose, then it’s being worn properly. We have to teach them that when they take the mask off, to touch it by the loops as opposed to in the middle.

How do we encourage smart behaviour?

We recommend layers of protection: hand washing, mask wearing, flu vaccination, and common sense. I think Canadians in general are very compliant and are appropriately concerned, far more than our neighbours to the south. And that’s why we have done a better job at containing this.

Are classrooms of more than 20 students too large to protect children?

Not if they have the space to spread the kids out. We are always looking at the risks of kids not being in school versus the kids being in school. If we had an ideal world, we would have smaller class sizes, bigger schools and better ventilation. If I were the parent of a kid in a class of 25, I would send them to school. I think the risk to them is extremely low.

How can parents protect children if they must take a school bus?

The children are hopefully staying seated and belted and spread out as much as possible. And they should be sitting with kids in their cohort. Students should wear a mask and open their window. 

This is a confusing time for many students. How do we validate kids’ feelings?

They need to know that there is a bad virus out there right now. Kids understand about people getting sick. What they should know is that this is only temporary, and we have to manage this now. But it’s not forever.

Students should be encouraged to express their feelings. If they are anxious or worried, that should be acknowledged, not dismissed. Some kids have become overly worried, especially kids who have the tendency to be anxious or have anxious thoughts. It’s really hard for those kids to switch their thinking, and they have to find ways of distracting their thinking when they feel overwhelmed and sad. I recommend parents make a playlist of songs on their iPad or a watch a video that makes them laugh or smile.

Some children have underlying health problems. Should they stay home?

SickKids has really good guidelines online about going back to school. It is pretty rare there is a kid who really should not go to school. It’s usually someone who is very immune- suppressed or has had a recent transplant or is undergoing therapy for cancer. 

Children with asthma should be going to school. We haven’t seen evidence that children with asthma are worse off if they get COVID. We didn’t see it with the first wave and we still haven’t seen it. There is usually an asthma surge in the middle of September because kids go back to school and share viruses. We haven’t seen the surge yet, maybe because everyone is wearing a mask or maybe because half the people are not back. I don’t know what this winter will bring.

What should a parent do if their child becomes ill at school?

A lot of schools will have public health nurses assigned to them and they will be able to provide advice. No parent will be forced to get their kid tested for COVID, but if your child is sick and you don’t test them, you will be required to stay home for two weeks and self-quarantine.

Has the impact of COVID damaged kids’ mental health?

Families have struggled. People have lost their jobs or the way they work has changed. Some parents’ field of work has become obsolete. There is a big trickle-down effect to the kids who are dealing with parents who are very stressed out and not always in a good place. 

I think it does affect the children. I don’t think there is any way to protect them from that. I am seeing more anxiety and more psychosomatic symptoms, like kids with headaches and abdominal pain that come out when people are not feeling good in their mental health. It overflows into their body, for sure.

The lack of physical activity has also contributed to their mental wellbeing. Some kids have been inside because parents are scared, and they haven’t been allowed to do sports or play outside or even ride a bike. Exercise is so vital for kids’ mental health.

By being back at school, we are giving kids structure and hope that things will go back to normal. This is the way forward. 

Israeli Experts on Back to School in the COVID Era

Sept. 9, 2020 – By SHARON GELBACH

As schools slowly open on different dates and in different forms, the CJR consulted a panel of experts from the Sheba Medical Center’s Safra Children’s Hospital in Tel HaShomer, near Tel Aviv, on commonly asked questions: Dr. Itai Pessach, director of the Safra Children’s Hospital at Sheba Medical Center; Dr. Galia Barkai, director of the department of Infectious Diseases in Children at Sheba Medical Center; and Prof. Doron Gothelf, director of the Department of Child and Teen Psychiatry.

Now that the children are going back to school, how can we prevent them from bringing home the coronavirus?

Dr. Galia Barkai

Dr. Barkai: The good news is that children, especially those under 10, have a significantly less chance of catching the virus and of becoming ill with it. Overall, the number of cases of children with COVID worldwide has been very low. At Sheba, the majority of the children were hospitalized for a different reason entirely and a routine test showed that they were COVID-positive.

Nevertheless, they certainly can be carriers as we’ve seen numerous times. What we need is collective responsibility, which implies, among other things, following the safety rules: Wearing masks, maintaining distancing (I don’t like to say “social distancing” because school is a social experience; but rather, physical distancing), and hand hygiene, which I think is the most important thing. Habituate children to hand-washing with soap or sanitizing with gel. Once we do this, we greatly reduce the chance of infection.

Dr. Itai Pessach

Dr. Pessach: Another important regulation that applies to older children is keeping them in capsules, and we’ve seen that this can significantly reduce the rate of infection.

In the coming few weeks, as summer turns to fall and we enter the flu and cold season, we have to be much more vigilant. It’s never a good idea to send a child with a runny nose, cough or fever to school. I know of many parents who would give a mildly ill child a Tylenol and send him to school; this is not an option these days. If a child exhibits any symptom that could be COVID, he must be kept at home as long as those symptoms persist.

Prof. Doron Gothelf

Dr. Barkai: The school bus can also be a source of infection. Try to make sure that the bus is not crowded. Children should have their masks on in the bus and sit as far away as possible from one another. If possible, the windows should be kept open.

What do you recommend for a child with asthma or a child with a weakened or suppressed immune system?

Dr. Pessach: Children with chronic illnesses or who have weakened immune systems due to special medications or chemotherapy are at higher risk of developing a severe case of coronavirus, but overall, the chances are still slight. That said, parents must consult with their health provider to receive specific advice and guidelines related to their individual issues.

How do you recommend that teachers keep themselves safe?

Dr. Barkai: First of all, teachers should know that if they wear a mask and the children also wear a mask, they are very well protected. We found that in the hospital, whenever infections did occur, they could be traced not to the clinical areas, but to the common rooms, where the staff took breaks. So, it’s the same thing at school. Teachers should adhere to safety rules in the classroom, but also in the teacher’s room. Teachers of children who are not of the age required to wear a mask can gain additional protection with a plastic shield. Nothing is 100 percent but I really think that is sufficient.

Dr. Pessach: I want to stress that masks do work. In the Safra children’s hospital, the medical staff was extremely strict about wearing masks and not one clinician caught COVID or even had to go into quarantine. If you wear a mask and a plastic shield, know that you are protected. This is how we protect high-risk patients.

How often should we change masks?

Dr. Pessach: The recommendation for disposable surgical masks is to change them twice or three times a day. At the hospital, we are required to switch every shift, which is every eight hours.

How can I keep my child safe while taking part in sports?

Dr. Barkai: It’s impossible to do sports with a mask because of the increased output of carbon dioxide. For this reason, sports are best done outside to reduce the chance of infection. Alternately, they can be done inside a large auditorium, where it is possible to keep a distance between students. If the only place for physical activity is inside the classroom, it’s better to forgo it.

How can I help my child who has to be in quarantine?

Prof. Gothelf: Quarantine is not a normal situation and it is never pleasant. The following are a few important steps to take:

1. First, explain to the child, in an age-appropriate manner, the reason for quarantine and its importance. When we grasp the significance of what we do, it gives us the strength to do it. Lacking a full explanation, the child is liable to imagine all kinds of scenarios. It’s also important to clarify to the child that he did nothing wrong, so that he shouldn’t feel guilty.

2. Try to keep up a regular routine that is as close to the child’s regular routine, including normal sleep/wake times.

3. Limit the child’s exposure to media. Children who read the news may become unduly anxious; it’s better for them to hear the news through the filter of their parents.

4. In the event there the school offers Zoom classes, try to encourage the child to participate so that he will continue to feel involved in the class and won’t fall behind with his schoolwork.

How can I prepare my child for the transition from preschool to first grade?

Prof. Gothelf: Children become anxious mainly when they don’t know what to expect. It’s Important to prepare a child for any transition, especially one in which there are COVID regulations added to the mix. Hang the school schedule on the fridge, tell him about the new rules at school and explain their importance. Personal example here is of utmost importance. You can’t expect your child to adhere to the rules if you don’t. 

Small children often have trouble managing with their masks. Make sure they fit well, that the elastic isn’t too loose or too tight, that the material doesn’t irritate the child’s skin. Allowing the child to choose a fabric mask in the color or design of their choice can help.

Preschoolers should have at least one visit to school before the start of the year to help them make the transition from kindergarten to school — to meet the teacher, learn where the washrooms are, etc. In the COVID era, schools have skipped this stage. Remember that and try to fill in those gaps by taking the child to school in the first days.

How can I help my child get the most out of distance learning?

Prof. Gothelf: Let me begin by saying that distance learning is challenging for both parents and children. Relax. Now is not the time to insist on children getting straight A’s. Let’s lower our expectations; our children will have plenty of time to catch up.

Unlike in a classroom situation, teachers cannot see when the children are experiencing difficulty. You as the parent must try to keep in touch with the teacher to keep her in the loop. Often, children need more help with distance learning, and this can be challenging for working parents. Try to get the help of an older sibling, or a neighbor. And again, keep in touch with the teacher. 


Sharon Gelback
Sharon Gelback

Sharon Gelbach grew up in Toronto, studied journalism at Carleton University, and moved to Israel in 1982. She lives in the Jerusalem area with her family. A writer, editor and translator, among her many projects are writing PR content for the Sheba Medical Center.

Editorial: Let’s Continue to Save Lives

Aug. 27, 2020

In the Jewish tradition, we are taught that“whosoever saves a life, it is as though he had saved the entire world” – surely a beautiful sentiment embraced by other faith traditions.

And yet, we see very much the opposite today, especially in the reaction of a significant minority both here and in the United States to dangerous fiction that “trumps” truth when it comes to Covid-19.

Alarmingly, more than a few people are either ignorant or think they are invincible,or worse, believe religiously-tinged fairy tales from numbskulls in leadership positions.

Take Ohio state representative Nino Vitale, for example. The Republican has urged his fellow Ohioans to refuse to wear face masks. As he rambled to Newsweekrecently, “When we think about the image and likeness of God, that we’re created in the image and likeness of God, when we think of image, do we think of a chest or our legs or our arms? We think of their face. I don’t want to cover people’s faces. That’s the image of God right there. I want to see it in my brothers and sisters.”

Ordinary Americans have also invoked God, claiming masks interfere with His divinely-designed human breathing apparatus. A study released in late June suggested that White American evangelicals’ attitudes toward the coronavirus pandemic are considerably more relaxed than those of other religious groups.

This might go some way to explaining the fact that the United States has the highest number (per 100,000 people) of Covid cases and deaths in the world.

To date, nearly 180,000 Americans have died in the pandemic, a number that scientists and epidemiologists tell us wasavoidable had people followed the simple hygienic rules by now burned into our brains: keep your distance, wash your hands, and wear a mask – simple rules that Donald Trump was reluctant to mandate.

Worse, Trump seems to treat unnecessary deaths with a shrugging normalcy. Asked a couple of weeks ago about the staggering death rate in his country, he responded, “it is what it is.”

One might assume that members of his own party would be horrified at such a reply. Not so much. A recent CBS poll found 57percent of Republicans felt that a death toll of 176,000 Americans (at the time) was “acceptable.” The same survey found that 73 percent of Republicans believe Trump is handling the Coronavirus pandemic well.

Thankfully, saner heads prevail when the same question is asked across the United States, where 62 percent of voters believe the response is “going badly.” Incredibly,however, that means close to 40 percent of Americans (almost 150 million people) are just fine with Trump’s handling of the pandemic.

In Canada, we are faring much better, even though we have our own “Covoidiots.” Take the recent example of 600 patrons packedshoulder-to-shoulder into a downtown Toronto strip club. Naturally, an employee tested positive for the virus. Now all attendees and employees have to isolate and monitor. Consider also pandemic house parties held across the country, just begging for infection?

The good news, however, is that for the most part, our political leaders, no matter where they stand on the spectrum andunlike their American counterparts, have saved lives by listening to science and taking the best possible advice from those in public health charged with looking after our welfare.

This is not to say problems don’t exist. Finding the right balance between opening our schools and preventing huge spikes in the virus remains a real challenge.

So far, with the customary Canadian sense of following established rules (and a little luck), our pandemic numbers have been trending downward. We need to continue down this path with care and thoughtfulness. We need to continue saving entire generations.

Montreal Jewish Schools Say They’re Ready

Aug. 27, 2020 – By JANICE ARNOLD

MONTREAL—Jewish day school officials here say they have put in place all of the measures required under Quebec’s COVID back-to-school plan, and even exceeded them – but only within the limits of the law.

In an online discussion Aug. 25 organized by the Communaute Sepharade Unifiee du Quebec as part of the annual Festival Sefarad de Montreal, officials offered assurances that their schools are ready to provide a safe environment for students and staff when they open after being closed since mid-March.

The schools are members of the Association of Jewish Day Schools (AJDS), an independent body funded by member schools.

A key point of divergence between some of the Jewish schools and the government’s plan, unveiled on Aug. 10, was the wearing of masks. The plan stipulates that masks must be worn by students in grade 5 and up at all times in the school’s common areas, such as corridors. Wearing them in the classroom, however, is optional.

Some schools had wanted to make masks obligatory in the classroom or for younger children as well, as a few non-Jewish private schools in Montreal said they would. In reaction, the government was firm: That neither private nor public schools have the legal authority to impose measures beyond the public health directives.

The AJDS-affiliated schools, which open as early as Aug. 27, are now “strongly recommending” that students cover their faces while in class.

The discussion, moderated by journalist Elias Levy and conducted in French, heard that some schools have also implemented such extra precautions as Plexiglas shields between desks and air purifiers in classrooms. At least one school will be doing temperature checks.

The Quebec plan does not require social distancing in the classroom. Students in each class are expected to be a “bubble”’ that stays together, with teachers moving between classrooms.

Connecting to the Zoom conference were: AJDS executive director Sidney Benudiz; Lucienne Azoulay, director of Academie Yechiva Yavne; Laura Segall, Hebrew Academy’s head of school; Jennifer Benoualid, principal of Solomon Schechter Academy; Alexandra Obadia, president of Talmud Torah/Herzliah High School; and Esther Krauze, president of Ecole Maimonide.

Another AJDS affiliate, Jewish People’s and Peretz Schools/Bialik High School, which did not take part in the panel, had to retract a message it sent to parents that all students from kindergarten and up would be required to wear masks in class after the government made clear that no school could make such a decision.

Under the province’s plan, all students must go to school fulltime this fall, at least up to grade 9. For the two senior years, schools may opt for a combination of in-school and distance learning, as long as students are in class at least 50 per cent of the time.

The sole exemption is for medical reasons, either the child’s or a member of their household, and that must be certified by a doctor according to strict criteria the government has defined. A group of Quebec parents who want the choice of online learning extended to all students has launched a legal challenge to the government, led by constitutional lawyer Julius Grey.

About 150 doctors and scientists with school-aged kids have also issued an open letter to Premier Francois Legault criticizing the plan as inadequate to protect against the spread of the coronavirus, and urging masks and social distancing in class.

The government has not yielded to this criticism, insisting its plan meets the current advice of health and educational experts, but is open to modification if the situation changes. On Aug. 25, Health Minister Christian Dube described COVID as under control in the province, which now has an average of 80 new cases confirmed daily.

The panelists acknowledged considerable concern exists among their schools’ parents, but the number that have secured exemptions for their children is relatively small.

Benoualid said Solomon Schechter, which is has elementary grades only, has 10 out of an enrolment of 450, while Obadia said Talmud Torah/Herzliah, which has 650 students, has 20 that are exempted.

All of the officials affirmed that their schools are well prepared to provide a full education online to these students, as well as any others who may have to stay home for an extended period, citing the experience they gained this spring.

Benudiz noted that the member schools, under AJDS’s guidance, rallied when they were ordered to close in March to develop distance learning platforms, and quickly put them in place. This combination of real-time instruction by teachers and online materials available proved to be successful, said Benudiz, who applauded the co-operation that continues among the schools.

The schools have now installed cameras in classrooms that will enable students at home to follow along with their peers and even interact.

The schools have closed their cafeterias, and lunches will be eaten in the classroom. The Orthodox schools are using the cafeterias and other repurposed spaces for socially-distanced prayers.

The panelists were definite that their schools would be able to cope well should they have to shut down again due to a second wave of COVID, saying they could pivot within 24 hours to remote instruction.

The other AJDS members are: Akiva School and Hebrew Foundation School, both elementary; and Beth Jacob School, which has elementary and secondary levels.

* A previous version of this story stated that the Association of Jewish Day Schools (AJDS) is a Federation CJA agency. In fact, it is an independent body funded by member schools. The CJR regrets the error.