Why are we conducting this study?

The Hospital for Sick Children (SickKids) is leading a research study to learn more about ways to support or enhance the safety and well-being of students and faculty, and to better understand the impact of a modified environment and health and safety measures on potential infectious risks.

This research aims to understand what factors need to be considered when implementing mandatory mask use in children and adolescents; specifically, whether the use of masks could potentially lead to behaviours that have been associated with increased risk of infection. We will observe other preventative behaviours (physical distancing and hand hygiene practices) and ask teachers and students to complete questionnaires about various health and safety measures.

Study details

This will be a study simulating return to school for two full days prior to the start of the school year in September. Volunteer students and teachers from elementary and high schools will be recruited to participate in the study on August 19 and August 20 in Toronto.

Students will be assigned to one of two appropriate classes based on the grade they just completed:

  • students assigned to wear masks will be placed in one class;
  • the other class will be for students who will not be wearing masks (Grades 4 and lower) or wearing masks only when physical distancing cannot be maintained (Grade 5 and up).

Classes will be filmed without audio via a secure setup so that the research team can review these videos and collect data on behaviours and mask-use practices. These videos will not be used for any other reason and will not be shared with anyone outside of the study team. All videos will be destroyed once the data has been collected and verified. Teachers will also trial personal protective equipment to compare the use of masks to face shields.

A harmless liquid that lights up when exposed to a special light will be applied to the hands and noses of a small group students in each class to see how this liquid moves around the classroom. This is meant to simulate the spread of infection. Cameras will be used to document how the liquid moves throughout the classroom and among the teacher and other students.

Study updates

September 14, 2020
Researchers and teachers share observations and key learnings from their experiences running simulated classrooms.
Read latest updates

Who can participate?

Please note that recruiting is closed for this study. Thank you for your interest.

This pilot study will be conducted at The Bishop Strachan School and Upper Canada College, in collaboration with Branksome Hall and The Sterling Hall School. Participation, however, is not limited to students who attend the above schools. The study is open to any GTA students enrolled at public or other independent schools who meet the participation criteria. Families may also participate with children/teens of various ages and from different schools. By using broad enrolment criteria, we anticipate the data around masking will be generalizable to other schools. We plan to collaborate further with a broader group of public schools to address additional questions after the start of the school year. Participants must be available on Wednesday, August 19 and Thursday, August 20.

Students

To be included in the study, students must have attended school during the 2019-2020 school year.

Students cannot take part in this study if they:

  • require additional resources or support beyond what can be provided by the class teacher
  • have been exposed to an individual who has tested positive for SARS-CoV-2 in the 14 days prior to the simulation
  • test positive for COVID-19 in the 14 days prior to the simulation
  • have signs or symptoms of COVID-19, as identified on the screening form
  • have travelled outside Canada in the last 14 days
  • have a known hypersensitivity or allergy to the biological indicator (Fluoroscein dye/GloGerm)

Teachers

To be included in the study, teachers must be certified and provide informed consent to participate.

Teachers will be excluded if they:

  • have been exposed to an individual who has tested positive for SARS-CoV-2 in the 14 days before the simulation
  • test positive for COVID-19 in the 14 days before the simulation
  • have signs or symptoms of COVID-19, as identified on the screening form
  • have travelled outside Canada in the last 14 days
  • have a known hypersensitivity or allergy to the biological indicator (Fluoroscein dye/GloGerm)

Frequently asked questions

Generating evidence to fill COVID-19 knowledge gaps is a major priority for researchers around the world and this has led to expedited research to ensure the public is getting reliable, rapid results. The COVID-19 safe school simulation study will have important implications for the start of school, so we needed to use the school space that was readily available before September. This will ensure we can get the results out to the public as soon as possible. We hoped to conduct the study in public schools during the summer. We now are planning additional research studies in public schools in the fall.

The current study is open to any GTA students enrolled at public or other independent schools who meet the participation criteria as well as teachers from both the independent and public school systems.

We believe the results from this study can help inform health and safety measures in public and independent schools. We recognize there are important differences between public and independent schools, and we are working closely with public school teachers to replicate the typical public school environment as much as possible. We also recognize that each physical school environment, even between public schools, vary widely across Ontario. In this study, we are primarily addressing health behaviours of children and adolescents rather than the specific environmental space.

Updated COVID-19: Guidance for School Reopening is a living document that will be updated as new, relevant evidence emerges from around the world. As an academic health sciences centre, we are committed to conducting rigorous scientific research to answer many of the questions we have about COVID-19 and children. The results from this study may help inform future updates to the document.

Similar to other institutions, schools will likely need to adjust their health and safety measures as they progress into the school year, depending on the community spread of COVID-19 and as new evidence emerges. We hope the results from this study will stimulate discussion among education sector decision-makers as they continuously evaluate health and safety measures in schools.

This study has been approved by SickKids Research Ethics Board. It is supported by Toronto Public Health and the Ministry of Education. Ensuring the integrity of research conducted by SickKids investigators is a top priority.

Safety information

  • All children and staff will be tested for COVID-19 at the school 24-48 hours before the first day of the simulation, to reduce the risk of infection.
  • The testing process will occur in a timely manner to avoid crowding.
  • Participants and families will receive information about the necessary steps, should the swab be positive.
  • The swab results will be shared with the appropriate public health authorities and will not be linked to study data. Positive participants will be excluded from participating.
  • While not mandatory, all participants will be asked to self-isolate after getting tested to further minimize the risk of exposure before the simulation.
  • Participants will be completing daily screening to ensure that they don’t have signs or symptoms of COVID-19.

A variety of health and safety measures will be implemented as required by the Ministry of Education, including hand hygiene, cleaning and physical distancing.

During the simulation exercise, we cannot completely eliminate the chance that participants may be exposed to an individual with COVID-19 and develop infection.

Some children may have anxiety upon return to school and/or in participating in the simulations. Mindfulness will be included as part of the classroom teaching curriculum during the simulations and mental health supports will be provided on the school days.

Mask wearing for a prolonged period of time may also be anxiety-provoking or frustrating. A student in the masked class can refuse to wear the mask at any point.

The study team

Principal Investigators

  • Dr. Michelle Science, Medical Advisor, Infection Prevention and Control and Staff Physician, Division of Infectious Diseases, SickKids
  • Dr. Clyde Matava, Anesthesiologist, Department of Anesthesia and Pain Medicine, SickKids

Co-Investigators

  • Laura Alexander
  • Dr. Upton Allen
  • Dr. Samantha Anthony
  • Dr. Catherine Birken
  • Dr. Sean (Ari) Bitnun
  • Dr. Monica Caldeira
  • Stacie Carroll
  • Dr. Eyal Cohen
  • Dr. Ronald Cohn
  • Dr. Mark Crawford
  • Alison Dodds
  • Dr. Jeremy Friedman
  • Jodi Greenwood
  • Dr. Lennox Huang
  • Dr. Daphne Korczak
  • Emily Louca
  • Bryan Maguire
  • Dr. Shaun Morris
  • Giovanna Panzera
  • Dr. Rulan Parekh
  • Rachel Solomon
  • Derek Stephens
  • Laurie Streitenberger
  • Sunayna Vuppal
  • Dr. Catharine Walsh

  • Dr. Doug Campbell
  • Dr. Sloane Freeman
  • Dr. Peter Jüni
  • Dr. Kevin Schwartz

  • Dr. Sarah Khan
  • Dr. Dominik Mertz

  • Dr. Allison McGeer

  • Dr. Laura Bourns
  • Dr. Maureen Cividino
  • Dr. Jessica Hopkins

  • Dr. Vinita Dubey

This study has been approved by SickKids Research Ethics Board and is conducted in collaboration with The Bishop Strachan School, Upper Canada College, Branksome Hall, The Sterling Hall School and the Conference of Independent Schools of Ontario. It is supported by Toronto Public Health and the Ministry of Education.

Contact us

If you have questions or require more information about the study, please email schoolsim.study@sickkids.ca