Manitoba has no clue how many classrooms fail to meet ventilation standards, and it does not intend to mandate schools to monitor indoor air quality during the fourth wave of COVID-19.
A group of concerned doctors pressed provincial officials on the status of ventilation in K-12 schools during a virtual meeting on Nov. 9.
"It was quite illuminating and profoundly disappointing that there is no plan," said Dr. Eric Jacobsohn, an intensive care specialist and professor of internal medicine at the University of Manitoba.
"Here we are heading into the fourth wave, and ICUs are increasingly under strain. It's remarkable we're putting kids in classrooms, probably hundreds of classrooms in hundreds of schools, that are failing standards."
Jacobsohn said he and his colleagues were taken aback when officials — among them, Dr. Jazz Atwal, deputy chief provincial public health officer, and deputy education minister Dana Rudy — could not say how many of the approximately 800 schools in Manitoba meet modern ventilation criteria.
Back-to-school guidelines recommend systems be adjusted to increase the frequency of fresh air exchange, encourage outdoor education, and keep windows open to improve air quality.
In September, the province also called on schools who had not recently had their ventilation inspected to get a professional assessment. It asked them to repurpose classrooms without operable windows or other access to a fresh air supply, if possible.
Ideally, mechanical ventilation systems with high performance filters (MERV-13 or better) can be adjusted to allow for complete air replacement with no recirculation as often as possible, there are frequent hourly air exchanges, and systems operate around the clock to achieve "complete flushing," as per national standards.
Canadian guidelines indicate portable high-efficiency particulate air (HEPA) filters can reduce the concentration of some viruses from the air, but caution their effectiveness in reducing transmission of COVID-19 has yet to be demonstrated.
Dr. Dan Roberts, who was on last week’s call, said he was "disappointed" Manitoba remains uninterested in mandating ventilation assessments and related reporting, in addition to using rapid testing in schools.
"Good intentions and guidelines are not enough. They don’t ensure anything in the middle of a disaster," said Roberts, an intensive care physician, who noted he provided officials with a new study on the effectiveness of HEPA filters last week.
He takes issue with Manitoba’s position that divisions oversee ventilation when the province has mandated masks.
“Good intentions and guidelines are not enough. They don’t ensure anything in the middle of a disaster." – Dr. Dan Roberts, intensive care physician
"The facilities themselves are under the purview of the local school board, that's their jurisdiction. We certainly remind them of the guidelines and criteria that are there, and we will provide any expertise that we can to help in that discussion," said Education Minister Cliff Cullen.
Should ventilation improvements be required, as a result of inspections, divisions are expected to use their sum of safe schools funding — a total of $40 million was distributed to divisions on a per pupil basis — to cover costs, said a provincial spokesperson.
The spokesperson indicated just under half of divisions have reported spending part of their allocation on ventilation-related expenses.
Jacobsohn said schools should be required to collect CO2 data from classrooms using inexpensive monitors so the public has a better understanding of the quality of ventilation.
A doctor colleague who attended the Nov. 9 meeting sent their child to school with a monitor both at the start of the year and late last month to gauge how CO2 levels changed when dropping temperatures meant windows had to be closed. The September results showed levels mirrored outdoor levels, but Jacobsohn and Roberts said follow-up measurements indicated carbon dioxide spiked significantly.
CO2 concentrations in outdoor air typically range from 300 to 500 parts per million.
Mechanical engineer Matt Froese said it's important to contextualize readings so they tell an accurate story about occupants' breathing in a space and how well air circulates indoors. For instance, Bunsen burners in science labs emit CO2, said Froese, adding 800 ppm is typically a good range.
With COVID-19 cases climbing, Jacobsohn said schools could use readings to decide whether it’s necessary to temporarily use community facilities or switch to remote learning to limit the potential of transmission and keep Manitobans healthy and out of hospitals.
"Our concern comes from the fact that we know that the hospital system is really under siege," added Roberts. "It never recovered from the last two waves."
— with files from Alan Small
Maggie Macintosh reports on education for the Winnipeg Free Press. Funding for the Free Press education reporter comes from the Government of Canada through the Local Journalism Initiative.