The medical officer of health for Niagara says he will go ahead with stronger outbreak control measures in that region’s schools, despite receiving a letter from Ontario’s chief medical officer of health questioning his methods.

On Jan. 14, Acting Medical Officer of Health Dr. M. Mustafa Hirji issued memos directing schools to monitor air quality inside schools and resume dismissal of whole classrooms after the discovery of a positive COVID-19 case.

He asked that any classroom with a reading of more than 800 parts per million of carbon dioxide (an indicator of poor air quality) receive a high-efficiency particulate air (HEPA) filter, regardless of what other air filtration capabilities are present in the school.

A day after the memos were sent, Ontario Chief Medical Officer of Health Dr. Kieran Moore wrote a letter to Hirji expressing “concern” over the direction to implement carbon dioxide monitoring in classrooms.

“I am concerned that these measures will lead to increased harms to the children and youth in Niagara Region and strongly urge you to reconsider your approach in alignment with provincial direction,” Moore states in the letter.

Moore added that the monitoring was not in line with established science.

“We are not aware at present of any correlation between CO2 levels and viral transmission,” Moore said.

Carbon dioxide monitoring is common in other parts of the world as a measure to assess possible risk of aerosol spread of coronavirus.

Its use for risk assessment of COVID-19 exposure is well documented in scientific journals

Niagara Region also requires that classes be sent home for isolation upon notice of COVID-19 exposure for a period of seven days, something the province has dropped.

“You are aware that Niagara is the only jurisdiction in Ontario or Canada to continue this practice in the face of the increased transmissibility of the Omicron variant and that the negative consequences of school dismissal and closure are significant to the mental, social and education wellbeing of children and youth,” Moore wrote in the letter.

Hirji also urged school principals to report all detected cases of COVID-19 in schools for documentation, something that is no longer required by the province.

Moore cited another of Hirji’s requirements, that students who want to forego masks in class must obtain a medical note from their doctor.

“This is being done in direct opposition to provincial guidance that such notes not be required, without consultation with your primary care providers or the Ontario Medical Association and without informing the public that such notes are not covered by the Ontario Health Insurance Plan and would be paid out-of-pocket,” Moore said in the letter.

Niagara Region Public Health spokesperson Alexandra Rankin confirmed to CP24 they received the letter from Moore on Jan. 16 “with his thoughts regarding our local recommendations for school and childcare.”

In response to the letter, Dr. Hirji told CP24 he is going ahead with all stated plans to boost outbreak control and surveillance measures in Niagara’s schools and childcare centres

“We have adapted some of the details of how our recommended measures will be implemented in consideration of the easing workload on our school boards, but will be proceeding with these measures in order to give children, teachers, and other school staff additional protection as we successfully resume in-person schooling,” he said.

Asked why he sent the letter, Moore said he was seeking clarity about the measures, as well as consistency.

“The consultation that we had with his office was basically about the public health measures that are in place and the return to school. We want consistent and persistent messaging across Ontario,” he said.

He suggested public health measures that increased the number of absences beyond what is already expected will occur during Omicron are not what he wants in schools.

But at least one other public health unit is also putting additional measures in place to protect students and education workers.

On Thursday Peterborough Public Health’s Medical Officer of Health Dr. Thomas Piggott said that an online survey is being launched so parents can submit rapid antigen tests results themselves.

He said that should various indicators, including absenteeism rates and the results of the online initiative, demonstrate spread of COVID-19 exceeds set thresholds it could be recommended that unvaccinated students be dismissed for five days to self-isolate.

It is unclear whether Moore signed off on Peterborough’s policy but Piggott said in a news release that it was developed in consultation with his office.

Speaking with reporters earlier in the day, NDP leader Andrea Horwath said that local public health leaders should be commended, not questioned for introducing new safety measures in schools.

“When local public health leaders are stepping up and finding solution to keep children safe when they’re in school, then I say ‘thank you’.”