Debbie King, RPN (left), and Dr. Janine McCready, infectious diseases physician at MGH.
Debbie King, RPN (left), and Dr. Janine McCready, infectious diseases physician at MGH.

How Dr. Janine McCready, infectious diseases physician at MGH, is spearheading broad-based COVID-19 testing at schools in East Toronto

As a mother of two young children, Dr. Janine McCready, infectious diseases physician at Michael Garron Hospital (MGH), understands how important it is for schools to remain safe and open during the pandemic.

It’s why she’s doing her part to help schools in East Toronto keep COVID-19 at bay. Since August, Dr. McCready has been working with family physicians from East Toronto Family Practice Network (EasT-FPN) to share medical expertise and guidance with principals and school staff in the area.

The physicians’ knowledge is shared through weekly virtual town halls, where principals and teachers have the chance to ask questions about how they can best keep staff and students safe during the pandemic.

Now, Dr. McCready is spearheading broad-based school testing in East Toronto, an initiative that’s part of a pilot program with the Ministry of Education in partnership with Toronto Public Health (TPH) and the Toronto District School Board (TDSB).

The program sees Dr. McCready and her core team (Tavia Caplan, infection control practitioner; Brad Lucifora, clinical nurse; and Jasmin Soobrian, project manager) conducting COVID-19 tests on-site at select schools, including Thorncliffe Park Public School, Marc Garneau Collegiate Institute and Valley Park Middle School.

The tests are available for all asymptomatic students and staff who volunteer to participate. They aim to proactively increase access to testing in Toronto neighbourhoods that are presenting high COVID-19 positivity rates; identify positive cases to minimize community transmission; and gather data to better understand how COVID-19 is spreading and how effective current prevention strategies are.

“We want to support schools in East Toronto as much as possible so we can better understand how much community transmission is happening at schools and in classrooms,” says Dr. McCready. “This allows us to help schools improve their infection prevention and control strategies so we can keep students and staff safe as the pandemic evolves.”

At Thorncliffe Park Public School, Dr. McCready and her team performed more than 600 COVID-19 tests over three days between Nov. 26 and 30. They identified 26 positive cases, resulting in a positivity rate of 4.5 per cent.

This positivity rate, which is based on asymptomatic individuals at Thorncliffe Park Public School who volunteered to be tested, is different from that of the larger Thorncliffe Park community, where symptomatic individuals are more likely to seek and receive testing.

Broad-based testing will take place at Marc Garneau Collegiate Institute and Valley Park Middle School in the coming weeks.

The pilot program builds on existing school testing initiatives in East Toronto led by Dr. McCready and MGH’s infection prevention and control (IPAC) team. Since September, the team has been identifying which positive COVID-19 cases confirmed at MGH’s COVID-19 Assessment Centre belong to students or staff at East Toronto schools.

“We want to support schools in East Toronto as much as possible so we can better understand how much community transmission is happening at schools and in classrooms,” says Dr. McCready. “This allows us to help schools improve their infection prevention and control strategies so we can keep students and staff safe as the pandemic evolves.”

Working with TPH and Toronto school boards, the team then develops a testing strategy to ensure the staff and students in these individuals’ classes have access to testing. This involves contacting each student’s parent to inform them their child may have been exposed to COVID-19, to encourage them to have their child tested and to explain the importance of getting tested.

If the parent agrees, Dr. McCready and her team schedule a time for the student to receive a COVID-19 test at one of eight nearby temporary testing sites in East Toronto. In some cases, the team has set up on-site testing at the school for the affected class.

To date, they’ve conducted this school testing initiative more than 30 times with 15 different schools across East Toronto. “We cater to individual needs of the school and what the principal thinks would be best for the community,” Dr. McCready says.

In both these early efforts and the recently launched pilot program, Dr. McCready and her team have also ensured to make mouth nose swab testing available to students.

This non-invasive COVID-19 testing method involves rubbing the inside of one’s cheek, the back of one’s tongue and the front of one’s nose with a swab. It was devised and validated by MGH’s IPAC team, led by Dr. Chris Kandel, as an effective, evidence-based alternative to the traditional nasopharyngeal (NP) swab, which some children may find painful or uncomfortable.

Dr. McCready says making the mouth nose swab available for students at schools in East Toronto helps increase the likelihood that they and their parent, guardian or family will have a positive testing experience.

This increases the likelihood that the student and their family will access COVID-19 testing in the future if needed. “Our goal is to provide convenient, low-barrier and comfortable testing experiences for these students,” Dr. McCready says. “We don’t want them to remember their testing experience in a negative light. We want them to see testing as an easy, effective way to protect themselves, their families and the community.”

This proactive testing strategy has increased testing uptake by affected staff and students at East Toronto schools to 80 to 95 per cent. Previously, staff and students were informed that they may have been exposed to COVID-19 while at school through a letter from the school board.

This letter encouraged these individuals to get tested but, without follow-up action that emphasized the importance of getting tested and made COVID-19 testing as accessible as possible, schools in East Toronto were only seeing about 10 to 15 per cent of these individuals swabbed, Dr. McCready says.

“By taking these steps, we’re ensuring that students, teaching staff and their families have all the information and tools they need to make the right decisions,” she adds.

As Dr. McCready and her team navigate the pandemic, they’ll continue to do everything they can to ensure students and school staff in East Toronto remain safe. It’s what Dr. McCready would want for her own children.

“Oftentimes, what’s happening in schools is reflective of what’s happening in the wider community,” she says. “If we can proactively identify positive cases in schools, we can prevent transmission and improve our infection control strategies to ensure our communities are protected.”

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