Which students qualify for at-home learning? Your questions answered

Parents in Manitoba preparing to send their kids back to school this year have even more questions on their minds than usual, as the province struggles to once again flatten the curve on rising COVID-19 cases. 

A CBC survey asking parents for their top back-to-school questions received hundreds of responses. One of the major areas of concern had to do with at-home learning for children whose health conditions put them at risk of severe consequences from COVID-19.

School divisions will provide remote learning for "for students who are medically advised not to return to in-class learning due to COVID-19 related risk factors," according to the province's back-to-school planning document. 

Doctors across the province are preparing for a flood of sick note requests from parents worried about sending their kids back to school.

Many questions remain, however, regarding what risk factors qualify and how that should be determined.

CBC News reached out to the province, as well as medical organizations and school divisions, to get the most up-to-date information about some of those questions. 

Take our survey if you have any other questions you want answered.

What qualifies a child for remote learning?

Chief Provincial Public Health Officer Dr. Brent Roussin has said it would be difficult to provide a list of health problems that could warrant an exemption to in-class learning. 

A spokesperson for the provincial government told CBC News in a statement that situations where students are granted an exemption "should be rare and limited to children with compromised immune systems or other medical conditions that increase their risk." Parents must consult with a health care provider.

Once an exemption is granted, it would last for the rest of the year or until the spread of the virus is broadly contained and a vaccine or viable treatment is available, the spokesperson said.

In a note on its website advising on requests for workplace or school accommodations, Doctors Manitoba has directed physicians to guidelines published by Shared Health in July, detailing what COVID-19 risk factors could be considered for health care workers.

These risk factors included chronic conditions like lung and heart disease, diabetes, kidney disease, liver disease, cerebral vascular disease (stroke) and severe obesity. It also included people who are immunocompromised, including cancer patients, people who have received organ transplants or people who are taking immune-weakening medications like chemotherapy.

Concerns about mental health conditions like anxiety should be assessed in an in-person or virtual visit, Doctors Manitoba said.

"Doctors will discuss the situation with parents, understand their concerns and the plan for their specific school, but ultimately can only provide a note if there is medical basis for this," said Kier Johnson, a spokesperson for Doctors Manitoba.

The College of Surgeons and Physicians of Manitoba has published guidance for handling requests for school accommodations from parents. They advise doctors that they "are not obliged to provide a medical note of exemption if they deem it is not medically indicated or appropriate for the individual circumstances."

What about asthma or autism?

Many common chronic illnesses, like asthma, or cognitive and behavioural conditions such as autism, would "not necessarily" qualify someone for an exemption, Roussin said at a news conference on Aug. 27. 

He said there are a range of symptoms for those conditions and a medical professional would need to determine the severity of each individual case, and if it warranted an exemption. 

What if a family member is at risk?

The province's back-to-school planning document states that students who can't return to school because of "personal or family health risks factors related to COVID-19 will be supported in remote learning."

As for who would qualify, the province has not said.

Doctors Manitoba says concerns about family members' health conditions are "valid" but "problematic as a rationale" for accommodations. 

"When it comes to a family member's health condition, that would really be a case-by-case issue. It would depend on the health concern or risk of the family member and the risk of the individual to being exposed to COVID," said Johnson.

In addition to the risk factors listed above, other people who would be considered at risk would include people over the age of 60 and pregnant women. 

Do I need a doctor's note to keep my child at home?

Not necessarily. A spokesperson for the province said the small number of children who are immunocompromised are likely already known to schools, but school divisions and independent schools can request a note if needed.

As Roussin said on Aug. 27: "For a decision that would [mean] you can't go to school for an entire year because of a medical problem, I think that should be reviewed by a medical practitioner."

Doctors will be expected to "follow and stay current with what is published by Shared Health and Manitoba Public Health and carefully consider the risks for children and members of their family. Doctors must only provide a note if it is medically indicated," said Dr. Anna M. Ziomek, registrar and CEO of the College of Surgeons and Physicians of Manitoba.

Ultimately, these decisions will be made by Manitoba Education policies, with input from public health officials, Roussin said.

CBC News has requested comment from Manitoba Education but did not receive a response before deadline.

This story was possible thanks to Manitobans who filled out CBC's back-to-school survey. In it, we asked parents, teachers and students to send us their top concerns and questions about the unprecedented school year ahead.