The dilemma of back-to-school for the children with chronic diseases

Le dilemme du retour à l’école pour les enfants souffrant de maladies chroniques

Le dilemme du retour à l’école pour les enfants souffrant de maladies chroniques


5 may 2020 11: 15 am


The dilemma of back-to-school for the children with chronic diseases

Stéphanie Marin

The Canadian Press

MONTREAL – The quebec parents will soon have to decide if they send – or not – their children to the primary school and the nursery. In this context of a pandemic of the COVID-19, the decision can be more complex for those whose children suffer from certain diseases, such as asthma. A specialist of infectious diseases at the Montreal children’s Hospital has addressed the issue.

In announcing his plan for the reopening of primary schools and child care facilities – may 11, outside Montreal, and on may 19 for the metropolitan region – the prime minister François Legault has recommended that parents keep them at home with their children if they suffer from “medical conditions”, including chronic diseases, but without more details.

What are these conditions that deserve to avoid the classes and the day care for now?

The answer is neither completely black nor completely white, is it clear from the interview with dr. Marie-Astrid Lefebvre, a specialist in infectious diseases, the Montreal children’s Hospital.

From the outset, she stressed that concerned parents with children suffering from chronic diseases and immune deficiencies should consult a medical specialist who follows their child to have a detailed opinion. Consultations over the telephone and by video conferencing are offered by a lot of doctors currently.

Little children have contracted the COVID-19 up to now in Quebec: according to figures from the ministry of Health, only 0.8 % of the diagnosed cases were young people aged 0 to 9 years of age. There has been no deaths among the quebec children.

But there are still many unknowns about the COVID-19.

The Montreal children’s Hospital has put in a line of small guides to help parents of toddlers suffering from certain medical conditions.

Overall, “for most chronic diseases, it is considered to be safe,” said Dr. Lefebvre, in a telephone interview.

It is safe for a lot of little ones who have lung disease, she said, but not for those who suffer from severe asthma, poorly controlled, and those who take high-dose drug for their asthma, or who have been hospitalized frequently during the past year for this reason.

“These, it is better to keep them at home”.

As to the children with diabetes, “the vast majority can return to the classroom, unless this disease is not well controlled,” says Dr. Lefebvre.

The particular situation of children with cystic fibrosis should also be checked with their doctor. The answer will not be the same for all, and will in particular depend on their lung capacity.

What worries the doctors, it is the children who have cancer, those who have received transplants, including bone marrow, and all the toddlers that are immunosupprimés, that is to say, those whose immune system is very weakened, like those who are doing the dialysis, list-t-it. “It is good to keep them in the house,” judge said she.

The little ones who have a weakened immune system are not necessarily more likely to catch the COVID-19, but are at greater risk of developing serious illness if they are infected, explains the infectious disease specialist, says the specialist.

For children, the COVID-19 is most of the time benign, she says.

But when their immune system is weakened, the infection may be poorly controlled, and there is thus a greater risk of severe complications, such as organ failure. Toddlers are at risk of having to make a stay in the intensive care unit, and needing a ventilator to breathe.

Dr. Lefebvre reminds us that, in the end, the decision of returning to school depends on the comfort level of the parents.

Because it is not mandatory to send children to school, had clarified to the prime minister in announcing his plan for the reopening of primary schools and child care facilities.

On Monday, Mr. Legault added: “there is some anxiety currently in the company, and then me, I understand very well that some parents are not comfortable sending their children to school”.

The recommendations of the experts of the Montreal children’s Hospital for the return to school or day care depending on the medical condition are on their website, in the section “Frequently asked questions COVID-19” or here:

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