Kate Dupuis sent her two kids, ages four and seven, back to public in-person schooling in Toronto in September 2022. They lasted two months before catching COVID-19.
“My son got quite sick and developed a high fever and was throwing up — it was a very scary time,” she says. They were able to confirm the infections through positive PCR tests at a hospital. “I was shocked that two separate public-health nurses told me I could send our kids back to school [while] COVID positive,” she says. Since then, her son has caught the stomach flu three times in one term.
“It has been very concerning to me to see how little has been done within the school system to help protect our kids,” she says.
But experts say there are simple, cost-effective interventions that could help keep students and staff healthy at school: improved air quality and ventilation. “The three main things you get with better indoor air quality is reduced absences, reduced respiratory symptoms, and improved test scores and attendance,” says Joey Fox, a member of the Ontario Society of Professional Engineers’ air-quality advisory group.
Since August 2020, Ontario’s Ministry of Education has invested more than $665 million in improving ventilation and filtration in schools. But experts say the government isn’t doing enough — and that there’s insufficient transparency and monitoring.
Why clean air matters
Access to clean water is considered a human right by the World Health Organization. Having clean water prevents pollutants, contaminants, and diseases from spreading throughout our communities — and it’s now recognized as an important public-health measure. Most people would hesitate to drink from the same water bottle as someone who is sick. But we don’t hesitate to share air, even when we’re breathing in other people’s germs.
Many people aren’t yet aware of the importance of clean air and the role it plays in helping us avoid illness. The World Health Organization was late to the party, too: it didn’t state COVID-19 was airborne until 2022, two years after 239 scientists signed an open letter urging “medical community and to the relevant national and international bodies to recognize the potential for airborne spread of coronavirus disease 2019 (COVID-19).” The virus has now joined a list that includes measles, tuberculosis, and the flu.
“We thought [COVID] was a disease spread by very close contact by touch and by droplets, which is very short range,” says Colin Furness, an infection-control epidemiologist at the University of Toronto. “We now know that, actually, these things move in the air, and they move in the air a lot.”
He notes that, without adequate measures like ventilation, COVID-19 can spread easily through schools. “I think we should be looking at COVID as enough of a political hot potato, enough of a threat, and enough of a motivator to actually take school safety seriously. I’ve been very disappointed that we continue to keep our heads and bury our heads in the sand.”
And COVID-19 infection can be markedly more serious than the flu.
An acute COVID-19 infection can impair the immune system’s ability to fight off future illnesses and can also lead to problems with thinking, reasoning, and memory. In kids, Furness says, acute COVID infections can lead to micro clots that cause damage to the blood vessels. Some also develop multiple inflammatory syndrome as a result of COVID infection. While vaccination with the latest XBB booster can lower the risk of these outcomes, Furness says that “we’re in single-digit vaccination rate with kids.”
In addition, it’s been estimated that 10 per cent to 15 per cent of people will develop a long COVID, a debilitating disease that can cause extreme fatigue, cognitive impairment, susceptibility to future infection, and dozens of other symptoms. There is no known cure, and few clinics offer support to such patients.
In kids, it can “present as poor sleep and fatigue, and it can present as challenges with learning, cognition, and memory,” says David Fisman, a professor of epidemiology at the University of Toronto’s Dalla Lana School of Public Health. “Even if 50 per cent of kids get COVID this winter and 2 per cent of those kids go on to develop significant health problems, that’s a huge impact on society.”
Mary Jo Nabuurs is an officer with Ontario School Safety. (Courtesy of Mary Jo Nabuurs)
Then there are the economic effects of airborne illness. Parents often need to stay home with their kids when they’re sick and may also become infected. Research indicates that 70 per cent of COVID-19 transmission in households starts with kids. Businesses lose out on productivity, while parents and families can lose out on income. Some 34 per cent of Canadians report not having paid sick leave at all.
“I don’t think there’s a parent or caregiver on the planet who hasn’t had to take days off work,” says Kate Laing, a Waterloo parent who’s also the spokesperson for Ontario School Safety, a grassroots group advocating for improved air quality in schools. “My three-year-old was home this past week because he’s had pneumonia for the fourth time in a year.”
And it’s not just about airborne illness. Carbon-dioxide levels are important in the context of the classroom, too: research has found they can affect learning performance and cause headache, fatigue, and difficulty concentrating. Smoke from forest fires is also a growing public-health threat.
“We’ve just accepted forever that our kids are going to get sick over and over in their first five to 10 years at school,” says Mary Jo Nabuurs, an officer with Ontario School Safety whose three children attend school in the York Catholic District School Board. “We have the lessons, we even have the tools to fix it. It’s just the government’s will that we’re lacking.”
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Candace McNaughton is concerned about school air quality because she’s got two children in high school — and because she’s an emergency physician in the GTA who studies the impact of COVID-19 on cardiovascular health.
“I know that I will take care of kids this winter who didn’t have to be sick. I will take care of them — and their family members — in hallways and chairs after hours and hours of waiting,” she says via email. “And, frankly, there aren’t great treatments in most situations. The best treatment is prevention: a penny of prevention (wearing masks in schools, opening windows, filtering the air) is worth far more than a pound of treatment. If I as a parent knew that I could save my child weeks of coughing, gasping, being in the hospital, being miserable, and potentially even life-long asthma, you can bet I would make sure they breathed in safe air.”
What is Ontario doing to ensure good air quality in schools and buses?
Since the pandemic started, the province has added $29.5 million to its annual budget to support optimized ventilation in schools, spent $450 million on upgrades to the ventilation system and windows, and distributed approximately 100,000 HEPA filters throughout the province.
A spokesperson for the Ministry of Education tells TVO Today via email that “Ontario continues to be the only province in the country since 2022, to mandate that all school boards must post a report on school-specific ventilation upgrades and deliver projects in line with the Ontario Building Code and the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE).”
Joey Fox is chair of the Ontario Society of Professional Engineers' air-quality advisory group. (Courtesy of Joey Fox)
But experts say that these standards and the presence of HEPA filters on their own doesn’t guarantee clean air: it has to be monitored in real time, and staff need to be trained on how to respond to a drop in quality.
“I think that they were considered magic solutions in that if you just simply deployed them, if you bought them and put them in the schools, they would magically solve all the problems,” says James Andrew Smith, an associate professor of engineering at York University and a parent of three kids going to school in Toronto. Speaking from his observations and conversations with other parents in his school district, he says that “most of the time, those HEPA units, even though they’re in the classroom, are unplugged or turned off.”
The ministry has also developed ventilation reports to share with parents. Released by school boards as Microsoft Excel spreadsheets, they detail some of the improvements made each year.
The first tab explains that “school boards are optimizing air quality in schools through improved ventilation and filtration” but does not provide any specific details. The second tab shows how much money the school board has spent on ventilation up to the current school year and how much is earmarked for future spending. There is no clear breakdown of what is being purchased.
The Ministry of Education declined to provide more details on spending.
The final tab has a dropdown menu of all the schools in the school district along with a checklist that states whether new filters were installed, whether the fresh-air intake and frequency of filter changes were increased, how many HEPA filters were purchased, and whether the HEPA filters were deployed. These reports, however, don’t measure air quality or CO2 levels or state whether HEPA units are functional and running.
Jane McArthur is toxics program director at the Canadian Association of Physicians for the Environment. (Courtesy of Jane McArthur)
“There are many spaces that might be fine. But we’re not monitoring or measuring,” Fox says. “There’s no accountability. There’s no transparency. So we don’t know.”
There is also no guidance for improving air quality in school buses, although some regions, like Ottawa, are experiencing driver shortages, which were heightened by the pandemic.
Many of the parents who spoke with TVO Today say they’ve tried to bring these issues to their school administrators, trustees, school boards, and the province — but they feel stonewalled. The Ministry of Education declined to answer whether it’s met with concerned parents and engineers.
Jane McArthur, toxics program director at the Canadian Association of Physicians for the Environment who lives in Tecumseh, says she eventually stopped speaking directly to school administrators and trustees about her concerns. “I fear there is a sort of backlash that my children may experience when their mother is vocal,” she says, adding that there is a “broader culture in which we’re living in right now where the myth persists that the pandemic is over.”
What’s the air quality like in schools and buses?
Most of the real-time data is collected by parents, teachers, and kids who have been measuring CO2 levels daily using small portable monitors. If levels are high, that means you’re rebreathing your neighbour’s air — which could contain various transmissible viruses, including SARS-CoV-2 and the flu.
Such tracking is a cost-effective way to monitor the risk of COVID-19 transmission in indoor spaces, especially since principals are no longer mandated to report infections in schools as of January 2022, unless absences reach 30 per cent of students and staff.
“When you want to prevent people from getting sick, mitigating airborne-disease transmission, you probably want it a little lower, around 700 or 650 parts per million,” Fox says. If the air is passed through a filter, 800 parts per million (which the U.S. Centers for Disease Control recommends) can be sufficient.
Some teachers and parents say they’ve gotten readings showing levels of 2,000 or 3,000 parts per million, as the HEPA filters in classrooms are often unplugged. In buses, the issue is even worse. Multiple parents tell TVO Today they’ve seen CO2 levels that exceed 4,000 parts per million. As students are packed tightly in a small space, buses can create ideal conditions for the spread of respiratory illness. “Given the dynamics of lots of kids in close quarters for an extended period of time in a small airspace without much ventilation, school buses can be considered scarier than classrooms from an infection-control standpoint,” Furness says.
Bus operation is contracted out, although businesses are required to adhere to current standards and guidelines. The ministry declined to respond to questions about buses and air quality.
Fox and other engineers TVO Today spoke with explain that, as buses can’t filter the air, they’d need to rely on students keeping some of the windows open throughout the winter — a trade-off that sees kids breathe in diesel exhaust from the bus rather than unclean indoor air. “I think overall, when you’re weighing the two problems,” Fox says, “I would select windows open over windows closed.”
How can we improve air quality?
The Ontario Society for Professional Engineers has developed tools to improve air quality in schools and buses: they involve monitoring, education, and transparency and have been successfully implemented elsewhere in Canada or around the world.
Fox is urging the province to monitor ventilation by measuring CO2 levels, to make the information available in real time, and to ensure that teachers and staff are trained to help maintain safe air quality. “School boards can make any claims they want, but we have no evidence it is actually being done and whether or not what they are doing is sufficient,” Fox says. “CO2 monitoring, a building-readiness plan, and being transparent about maintenance can ensure systems are working properly.”
The Ministry of Education did not respond to questions about implementing real-time air quality tracking in classrooms, whether staff are trained on how to respond to drops in quality in real-time, and whether there are any plans in place to check up on or ensure that HEPA filters remain plugged in. In an email statement, a spokesperson outlined the government’s investments in ventilation and air quality and stated that “our priority is getting back to basics, with a focus on improving foundational skills including reading, writing, and math, while continuing to make the case to teacher unions to sign a deal that keeps kids in class, without the threat of disruption, for the next three years.”
Ontario School Safety is calling on the province to follow OSPE’s recommendations; install visible CO2 monitors in every bus, classroom, and shared space; form an Indoor Air Quality Maintenance Committee composed of relevant experts and then publish and apply the recommendations of the committee; and provide transparency and updates on progress made.
Many places worldwide have implemented measures to keep students safer in schools. Quebec and New Brunswick have already started measuring the levels of CO2 in classrooms and found that as many as one in three classrooms in Quebec and five in six in New Brunswick don’t have adequate ventilation. Boston’s public-school system developed a real-time dashboard that tracks and shares data about classroom air quality. New regulations in France now require regular monitoring of air quality in schools and daycares, while the Netherlands invested in carbon-dioxide monitors for all classrooms in the country.
Ann Weber doesn’t think it should be a complicated issue. Her two young children have health conditions that increase the risk of complications from COVID-19. “Schools in Ontario ban peanut products because people who are allergic to peanuts have severe responses,” she says. “There are far fewer children who will have a severe reaction to peanuts than to COVID-19, so it seems odd to me that we would treat these two situations differently.”
And experts have a proposed answer for buses: electrification. Last year, Pollution Probe, in partnership with Delphi and the Canadian Partnership for Children’s Health and Environment, released a report with a plan to electrify Ontario’s fleet. “Diesel has been linked to cancer, lung cancer, asthma suffering, but also has been linked to the actual onset of asthma in children,” says Erica Phipps, CPCHE’s executive director, adding that exposure to diesel also worsens test outcomes.
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According to the report, the federal Zero Emission Transit Fund incentive would cover half the cost associated with electrical school buses, and charging stations would also be covered federally, making electric school buses cheaper than diesel-powered buses over a 12-year span. Another report created by the Pembina Institute, a clean-energy think-tank, finds that electrifying 65 per cent of Ontario’s fleet by 2030 would generate 13,000 new jobs and $2 billion for the province. Other provinces, such as Quebec and Prince Edward Island, have already started electrifying their fleets.
“This is absolutely within reach: it is just a matter of the right leadership, the policy leadership, and investment,” Phipps says. “It’s pretty hard to come up with the downside of this fairly simple switch out from polluting diesel to a clean electric school bus.”
What comes next
In October, the NDP put forth Bill 140, Improving Air Quality for Our Children Act. If passed, it would see the province install CO2 monitors in every classroom, report the average CO2 levels measured, and develop an action plan for what to do when CO2 levels get too high. (The bill does not mention school buses.) It has been ordered for a second reading.
The Kingston Whig Standard has reported that Health Canada is currently “developing new indoor air quality guidance for schools in Canada”; a draft of the new guidance is expected to be made publicly available later this year.
Candace McNaughton is an emergency physician in the GTA who studies the impact of COVID-19 on cardiovascular health. (Courtesy of Candace McNaughton)
Ontario School Safety is “pursuing a legal challenge to compel leaders to prioritize school safety over political expedience or popularity.” According to Laing, clean air is an equity issue.
“Schools that are in newer, more wealthy neighbourhoods should not have better air quality than schools that were built decades ago or happen to be in less wealthy neighborhoods,” she says. “Like access to clean drinking water, access to clean, breathable air that won’t make you sick is a human right.”
Right now, the group is asking Ontarians to share how poor indoor air quality has affected their families. “These stories help everyone in Ontario see how important indoor air quality is for everyone, but also help us identify people who would be good candidates to join a group of applicants for the legal challenge against the provincial government,” Laing says.
McNaughton has opted to have her teenagers attend school virtually to reduce risk. “Until things change drastically for the better, my children will continue to attend school online,” she says. “I know too much about the long term effects of COVID to let my children be exposed when there is cheap, easily available technology to prevent infection. I cannot in good conscience — as a mother, physician, and researcher — look at the data and choose otherwise.”
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