Dr. Nitin Mohan: “Mandatory testing in some cases is quite beneficial.”

Dr. Nitin Mohan: “Mandatory testing in some cases is quite beneficial.”

Despite some two million Ontario students heading back to school this month amid a global pandemic, the provincial government says there is no scenario in which a student will be required to take a COVID-19 test. The province’s strategy has the support of multiple public health and medical ethics experts interviewed by CBC Toronto, who said Ontario’s decision to forgo mandatory COVID-19 testing in schools is appropriate, at least for the time being.

“Mandatory testing in some cases is quite beneficial. In school-aged children I think we have to be a bit more cautious,” said Dr. Nitin Mohan, a physician epidemiologist and assistant professor at Western University in London, Ont. While Mohan said mandatory testing could, “in theory,” be an effective way to contain the spread of the coronavirus in schools, he said there are many uncertainties that make the reality more complicated. Primarily, Mohan pointed to inevitable false positive results and a lack of research on how the virus spreads among children. Properly screening for symptoms will likely be more effective than relying on test results, he said.

No Canadian jurisdictions have any form of mandated testing for students, and the strategy has not been widely adopted in other countries. While none of the experts expressed outright opposition to the idea of mandatory testing, most said other strategies have a more realistic chance at preventing outbreaks. The prospect of mandatory testing as a form of proactive screening — in which students would be randomly tested regardless of their symptoms — was also described as costly and burdensome by Dr. Peter Juni, a University of Toronto professor and the executive director of Ontario’s COVID-19 science advisory table.

Experts also said there are promising strategies in development that could both prevent outbreaks and also provide public-health officials with information about the prevalence of COVID-19 in schools. Juni pointed to the emerging tactic of wastewater testing, in which health officials sample a location’s wastewater for the presence of COVID-19. Positive test results can signal a possible outbreak more efficiently than individually testing all the people at a given location, he said. An approach like wastewater testing could provide many of the benefits of mandatory testing without the associated problems, Juni said, though he cautioned that it’s not yet clear if Ontario has the capability to introduce it on a wide scale.

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