Even as Ontarians between the ages of 12 and 17 are getting vaccinated against in ever-increasing numbers, medical professionals expect demand for testing in younger cohorts to rise when kids return to classrooms amid growing cases of the highly transmissible Delta variant.
Provincial data shows that between Aug. 17, when children turning 12 this year were given the go-ahead to get the Pfizer vaccine, and Sept. 1, the vaccination rates for 12-17-year-olds rose from 69.8 per cent to 74.9 per cent for one shot, and from 56.5 per cent to .
While this is undoubtedly good news for worried parents and educators watching daily cases climb just a , COVID cases in school-aged children are still expected to rise to the point that assessment centres will face increased pressure to test more. , released Wednesday, shows that a rapid rise in the number of seriously ill people needing hospital care is expected among the unvaccinated, as workplaces and schools reopen in September. The fourth wave will affect all age groups, with the potential to exceed ICU capacity, according to the modelling.
At least two hospitals have opened up pediatric COVID assessment centres to brace for this , and at both, officials say they’re already seeing more kids coming with symptoms for testing.
“What’s more unusual this time is that the demand started before schools were back in session,” said Karen Riddell, chief nursing executive at Windsor Regional Hospital, where a new clinic for kids and teens opened Tuesday. “But we are expecting once schools get back in that we will see even more.”
Although older children are eligible for the Pfizer shot, those under 12 have no vaccine protection. While they are still most likely to have mild symptoms, even with the Delta variant, spikes in hospitalizations in the United States, particularly in areas with low vaccination rates, are worrying. Experts say school outbreaks are inevitable this fall and may result in entire classes being sent home, or even school closures in situations when many students are suspected to have the virus.
If that comes to pass, pediatric assessment clinics will likely experience even more demand, especially given that the province has compared to the number of facilities earlier in the year.
As of 8 a.m. Wednesday, 90 per cent of the appointment slots at Michael Garron Hospital’s pediatric clinic that day were filled. The east Toronto hospital has reopened its pediatric assessment centre, which temporarily closed in June, right next to the emergency department, in anticipation of increased COVID cases in young people throughout the fall.
“The capacity in the system for assessments and testing is critical if we are to mitigate the risk of significant spread,” said Dr. Kyle Vojdani, emergency department chief and medical director at Michael Garron Hospital.
He noted that he is particularly concerned with the small portion of children who can develop more serious illness requiring hospitalization.
“Capacity within the system for pediatric admissions and pediatric clinical care is limited. That’s what worries me.”
Vojdani added that Michael Garron’s pediatric clinic is part of a broader hospital strategy that includes in-school tests, increasing pediatric in-patient capacity and virtual assessments.
In Windsor, where there are rising cases, hospitalizations and ICU numbers in general, the number of children and teens with symptoms getting tested has doubled over the last few weeks, said Riddell. The hospital is now testing an average of 40 to 50 kids per day.
On Tuesday, 59 showed up at the new assessment centre, and another 24 at a different site. According to the most up-to-date data from , there are roughly 206 cases per 100,000 in kids and teens up to 19 years old. That’s the third-highest age group, behind people in their 20s (375) and 30s (351).
In addition to getting tested at the Windsor assessment centre if they meet the provincial criteria, children can access a pediatrician in case they need minor treatment, Riddell said. Colourful murals make the space kid-friendly. If they test positive, then contact tracing can begin to stop the spread.
“We just want to make sure that we’re able to respond quickly, and avoid some of the situations that we’re seeing in other jurisdictions, like down in the southern states, where they’re having very high rates of pediatric hospitalization and ICU stays, which is something that we have not seen in previous waves,” she added.
The Star asked the Ministry of Health for a breakdown of vaccination rates for each age between 12 and 17 but was not provided with the data. Instead, a spokesperson said in an emailed statement that the province is focusing on a “last mile” strategy to reach people who still need shots.
“This includes mobile clinics and community-based pop-ups, dedicated clinic days for families with people with disabilities, and town hall meetings in multiple languages,” said spokesperson Bill Campbell.
Colin Furness, an infection control epidemiologist at the University of Toronto, says there are a number of steps the education system could take that would cut down on spread of the Delta variant in classrooms. In addition to having all staff fully vaccinated, he says twice-weekly spit tests that teachers could administer and that labs could then test would be an excellent way to ensure high-quality surveillance.
“I would argue that (unvaccinated students) merit it. Not only are they vulnerable, not only do they depend on us for their safety, they’ve got no agency in this whatsoever.
“We know Delta is coming. This is not hypothetical. This is not a maybe. It’s coming for them. It has everywhere else.”
Other steps schools could take to improve safety include installing air exchangers that bring in fresh air from outside for classrooms that do not have HVAC systems, using carbon dioxide monitors to measure how much exhaled stale air is in the room, and introducing KN95 masks for students and teachers.
“I think if you’re really taking care of air quality I think that would be it,” Furness said. “If my kid’s school did that, I’d breathe easy so to speak.”
Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email:
May Warren is a Toronto-based breaking news reporter for the Star. Follow her on Twitter: