Vancouver – It was mid-May, an intense and unusual heatwave was on in Jerusalem, Israel.
Students in a reopened school were complaining it was too hot to wear a mask.
The ministry of education relented and allowed students to remove their masks for just 3 days.
That’s all it took to create a “perfect storm” – a Covid-19 outbreak that infected 153 students and 25 teachers, says Professor Ora Paltiel in an interview from Jerusalem.
She’s an expert epidemiologist who has advised government and is a professor at the Braun School of Public Health, Hadassah-Hebrew University in Jerusalem.
Prof. Paltiel, a Canadian born and educated hematologist and epidemiologist, says the outbreak at Gymnasia Rehavia high school/middle school in Jerusalem occurred in May during an intense heatwave
“There was an uprecedented heat wave lasting 10 days in May. The health minister said that masks could be removed because kids were complaining that it was difficult to breathe and very warm,” she said.
“Over 60% of students were asymptomatic. Some of the teachers got sick – no deaths.”
“This was a perfect storm in a very crowded school – 34 to 40 kids per class, small classrooms, closed windows, masks removed, extreme heat.”
She says it’s difficult to determine how much school openings contributed to a second wave being experienced in Israel currently because other social events were also occurring simultaneously during reopening of the economy.
“In other schools infections were more sporadic and some of them occurred in households and were brought into the schools and not the opposite.”
Lessons learned in Israel could help other jurisdictions open safely.
So what would she tell us to do?
“School opening should take place during rates of low community transmission but that is not enough to keep schools safe,” she said.
“There needs to be learning in small groups, physical distancing , especially for children above the age of ten years, good hand hygiene and masks wherever possible and open windows.
“We also recommend monitoring and screening the teachers for infection and of course making sure that no-one comes to school sick,” Prof. Paltiel said.
Children should be monitored for “gastrointestinal symptoms which may be a more common SARS-Cov 2 presentation in kids.”
“There needs to be a clear policy in place about teachers in risk groups as wells a students.
“There needs to be a clear policy when to close schools ( one case – probably not, two cases in two separate classrooms – probably yes).
“Teachers need to practice social distancing in and out of school teachers’ lounges – these can be a place to spread the virus since there is talking, eating usually in close quarters, and interaction with staff from other ‘capsules’
“We believe masks are important as is spreading out (distancing between students) in the classroom.
“The exact distance is not known. Children should not share a desk. Learning should take place outdoors as much as possible and especially activities that require singing or yelling; and should use all available space in and outside the school.
“Groups in schools should be limited, we think, to 15-20 kids with little or no mixing between classrooms.”
“This is important for minimizing transmission but also for minimizing disruption – the bigger the group, the more people have to be quarantined after a single case.”
“I would space them out as much as possible – either different morning and afternoon sessions or different days of the week or for the older kids staggered weeks with online learning on the “off” week.”
“In Israel, the infection rate of children 1-9 years old is half of their proportion in the population. youth aged 10-19 have rates similar to adult groups.
“The main “drivers” of infection are in the age group 20-29 in Israel – probably because of social behaviours and a wide range of social contacts at work and at leisure.
“Mask wearing and social distancing in this age group is crucial for keeping infection rates down, since many of them are asymptomatic.”