Ontario has updated its screening guidance for schools and child-care facilities and will once again require that children with sore throats, runny noses or headaches stay home until their symptoms begin to improve.

Under the previous policy, children were only required to isolate if they had one of five symptoms that were commonly associated with COVID-19 – a fever or chills, shortness of breath, a loss of taste or smell, nausea, vomiting or diarrhea or a continuous cough.

But the new guidance, which was quietly updated on Thursday, adds five additional symptoms to the list and requires that the siblings of symptomatic children also isolate at home, even if they are not exhibiting any symptoms themselves.

Under the updated guidance, children will now be expected to stay home if they develop any one of 10 listed symptoms with their return dependent on how soon they get better, which symptoms they had and whether or not they can access testing.

The most stringent rules apply to fever or chills, shortness of breath, a loss of taste or smell or a continuous cough. If a child develops any of those symptoms, they will be expected to isolate for a period of five to 10 days, depending on their age and vaccination status.

That is unless their symptoms have been improving for 24 hours and they have tested negative for COVID-19 on a single PCR test or two rapid antigen tests taken 24 hours apart.

Meanwhile, the guidance is different for children exhibiting other symptoms, some of which are typically associated with the common cold.

The ministry says that if a child has a single symptom from a list that includes a sore throat, a runny or stuffed nose, a headache, extreme tiredness, muscle aches or joint pain and nausea, vomiting or diarrhea they can simply stay home until their condition has been improving for at least 24 hours.

However, if they have two or more of those symptoms, the guidance requires them to either test negative for COVID-19 or isolate for a period of five to 10 days.

Fully vaccinated children and those aged 11 and younger can return to school five days after symptom onset, while everyone else must wait the full 10 days.

The new guidance is stricter than what was in place throughout most of the fall when parents only had to screen their children for five symptoms.

The guidance, however, is not as strict as rules Toronto Public Health put in place last winter which required children with runny noses and other symptoms less commonly associated with COVID-19 to either test negative for COVID-19 or isolate for 10 days.

It should also be noted that there are some exceptions to the new rules. For example, a runny nose is permitted if it is related to “seasonal allergies, being outside in cold weather, or other known causes or conditions.

In-person learning at Ontario schools is currently suspended until at least Jan. 17, though child-care centres continue to operate.