Letter to the Editor
Dear Parents, Grandparents, and Guardians of children in Grey Bruce,
As a father of one, I sympathize with everyone’s concerns about having children go back to school during the COVID-19 pandemic, and with every parent’s concern about ensuring their unwell child receives the test and care they need.
I want to let you know that we have been actively engaged with both Public and Catholic School Boards and the private and rural schools throughout Grey and Bruce. For the most up to date information, please visit our website or contact your school to see their plans.
Feeling anxious, you may want to take your child or children to get tested for COVID-19, just to be sure they do not have it. I want to explain to all parents that if there are no symptoms, and no close link to a confirmed case (as decided by local public health); then there is no practical benefit to getting your children tested. There is, however, potential harm. Let me explain.
1. Testing for COVID-19 can be a traumatic event for some children. Like any other clinical test, there is the potential for complications, including possible short-term and long-term anxiety.
2. False reassurance is another harm. Testing someone who has no symptoms only lets them know that on the day they got tested, they were not shedding the virus. It is very possible to test negative one day (while incubating the virus), and then develop symptoms and test positive in a day or so. A negative test result is not a bullet-proof way to say that you or your child is COVID-19 free; all it really says is that “the child was not shedding the virus a couple of days ago when they were tested”.
3. Testing in people that have no symptoms can result in false positives and potential harm. A false positive may cause significant and unintended anxiety in families linked to the false positive. Self-isolation, more testing, inability to attend work, and fear/anxiety are real outcomes of a false positive. Imagine getting a call from Public Health letting you know that you and your family have been exposed to COVID-19, when in fact you were not? Now imagine that this happens to a number of families as their children attend the same class or school. This is not acceptable in my mind, and could cause significant harm. To that end, as the Grey Bruce Medical Officer of Health, it is important to share that there are no practical benefits of mass testing, or anxiety-driven testing, of asymptomatic individuals and that potential harms are significant. As a key step in becoming a medical doctor, I took an Oath that governs my practice; the most crucial promise within that oath is “First, do no harm”.
4. Testing people with no symptoms puts undue pressure on provincial testing capacity and delays the results for people that actually do have symptoms. Delays in receiving results can pose significant risk to facilities that may be battling true outbreaks.
Getting a COVID-19 test would be appropriate and strongly recommended only in the following two scenarios:
1. Public Health has let you know that you are a Close Contact to someone who has COVID-19, based on a thorough risk assessment completed only by Public Health. Deciding who is a Close Contact is a decision that can only be made by Public Health. This decision as to who is a Close Contact cannot be made by your health care provider or school official(s).
2. Your health care provider has told you to get tested because you have COVID-19 related symptoms.
If neither of these situations exists, testing would NOT be suggested, and in fact, Public Health strongly recommends against it.
The increase in the provincial case count is definitely not a reason to get tested.
If there is a case in your child’s school or class, that, in and of itself is not a reason to get tested. If there is potential that you were a Close Contact to a person with COVID-19, Public Health will call you. If you do not get a call from Public Health, you DO NOT need to get tested. I fully appreciate that if you find out there was a case in your child’s school, your anxiety may be elevated. Rest assured that we will notify you if you or your child need testing, and will do everything in our power to keep the children and staff in that school safe.
We work together with school officials throughout the school year, to ensure that the safety and well-being of both your children and the staff in the schools remain paramount. We are also working with the health care providers of Grey and Bruce to support them in ensuring timely testing and care are in place for our children.
I would like to emphasize the unparalleled amount of support the provincial and local political leaders have provided during this emergency. The provincial government’s efforts based on the Chief Medical Officer of Health’s recommendations have been a vital foundation for our local public health response to maintain full control over the outbreak, and to best position our communities for safe and successful school reopening.
Despite the efforts, yesterday evening local physician leaders informed me that the assessment centres’ capacity was pushed to the limit. Based on our local data from the previous few days, over 90% of individuals seeking testing had no symptoms. Why is this important? Heartbreakingly, last night an overwhelmed mother from Grey Bruce emailed, calling on me to support the local health care system “to ensure there is easy and timely testing for our children”. The mother described her multiple attempts to have her unwell child tested at an assessment center. All attempts failed. Last night when I wrote this letter, looking at my 3 year old daughter in her bed, the only picture I had is of a parent looking at their sick child going to sleep without the test and care they needed.
As a parent and Medical Officer of Health, I would never have my child tested without proper cause. I would only consent to testing if my child had symptoms, or was considered a Close Contact and directed by Public Health to do so. I implore you to help our hospitals and health care providers to ensure no other unwell child goes to sleep without the care they need. And I remain,
Yours very truly,
Father and Medical Officer of Health, Dr. Ian Arra
Grey Bruce Health Unit
