The Ontario government has updated its screening guidance ahead of students returning to classrooms next week and will no longer include runny noses, sore throats and headaches among the list of symptoms associated with COVID-19.

The screening form was quietly updated on Aug. 27 to align with a new report from Chief Medical Officer of Health Dr. Kieran Moore which identifies a list of common symptoms of COVID-19 that “require immediate self isolation and COVID-19 testing.”

Those symptoms include fever and/or chills, coughing or barking cough, shortness of breath, decrease or loss of taste or smell, nausea as well as vomiting and/or diarrhea.

A total of four symptoms that were previously included in the screening guidance for schools and childcare facilities have been removed. Those symptoms are as follows: sore throat or difficulty swallowing, runny or stuffy/congested nose, headache and extreme tiredeness or muscle aches.

The guidance has also been tweaked to allow the fully vaccinated siblings of children exhibiting COVID-19 symptoms to continue attending classes.

Last winter, they too were required to stay home.

It should be noted that the parents will still be expected to keep their children home from childcare or school if they display any symptoms, even ones not included on the list. The guidance just applies to when they can return.

“To parents I would just say this: there's no such thing as ‘could be coming down with something,’” Toronto’s Medical Officer of Health Dr. Eileen de Villa told reporters on Monday morning after touring a youth vaccination clinic. “If you have even the slightest suspicion that your child is unwell we need you to keep that child at home and apart until it's clear what is giving rise to their symptoms.”

The Ford government initially included runny noses and headaches on its list of COVID-19 symptoms last fall but it changed the guidance in October amid concerns about long lines at assessment centres, only to reverse course again in February during the third wave of the pandemic.

The guidance that will be in place when students return to the classroom next week will require that students exhibiting any of the five COVID symptoms either test negative for the virus or isolate for 10 days.

Exceptions to that policy will only be made for children who have been diagnosed with another illness by a doctor and whose symptoms have been improving for at least 24 hours.

A spokesperson for Minister of Education Stephen Lecce told CP24 that the guidance is simply a “minimum requirement” and that public health units have “the authority to implement additional measures based on local circumstances.”

Toronto Public Health did exactly that during the last school year when it added several symptoms to the list during the second wave of the pandemic but on Monday Associate Medical Officer of Health Dr. Vinita Dubey said that there are not currently any plans to deviate from the provincial policy.

Dubey also confirmed that Toronto Public Health is in the process of updating its own online screening tools to reflect the new list of symptoms.

“Please make a plan, as best you can, in anticipation of having one or more sick kids,” de Villa said Monday. “It's easiest to cope with the unexpected when you've got a plan to deal with it and if you're an employer please make a plan to support your business and your staff if people with sick children can't come to work.”

Toronto Public Health will have more than 100 public health nurses supporting schools as they reopen.

It says that in the event of positive cases impacted cohorts will be dismissed and an investigation will be conducted to evaluate the risk to other individuals.

One pediatrician who spoke with CP24 Monday night said she’s concerned that the new list of symptoms could lead some parents to become lax about getting their kids tested.

“I'm a little bit anxious about it and I'll tell you why. Just a few days ago one of my patients was diagnosed with COVID and her only symptom was a sore throat – and this is not somebody who had been out anywhere other than buying groceries and bringing her child to a park to play,” Dr. Nili Kaplan-Myrthtold CP24. “So no, we are going to need to be pretty diligent about encouraging people to be tested for COVID.”

She said she is concerned that parents might decide for themselves whether their kids have COVID-19, which could lead to further spread.

“I think that we need to be keeping a pretty low threshold for when we want to test kids and adults,” Kaplan-Myrth said. “And again, you know, there's no way that a person can tell clinically that they don't have COVID without being tested.”