With Ontario beginning to lift COVID-19 restrictions as experts predict we're past the peak of the latest Omicron-driven wave, universities and colleges across the country are preparing to return to in-person learning activities with appropriate safety measures in place.
That includes the University of Toronto, which will resume some in-person learning and activities across its three campuses on Feb. 7.
"As we plan for an increasingly vibrant in-person experience for our students, we want to reiterate our commitment to doing all we can to provide safe conditions for working and studying at our campuses," Cheryl Regehr, U of T's vice-president and provost, and Kelly Hannah-Moffat, vice-president, people strategy, equity and culture, said in a recent memo to the community.
"We remain vigilant about evolving public health conditions and continue to adjust and adapt our plans based on the guidance of our community of experts."
Salvatore Spadafora, special adviser on COVID-19 to U of T's president and senior adviser to the dean of the Temerty Faculty of Medicine, says the reality is that "probably very few things in our society right now are zero risk," but that U of T's 12-step plan to address COVID-19 remains highly effective at limiting transmission in a university setting.
In particular, he cited the importance of vaccines, masking and ventilation - all areas where U of T has robust measures in place.
Spadafora, who is an anesthesiologist, and Alon Vaisman, an infectious disease specialist at the University Health Network and assistant professor in the department of medicine, recently spoke to U of T News about the role each of those three measures plays in reducing risk - and the updates that have been made following the emergence of the Omicron variant.
Masks
Masks continue to be required in all indoor spaces on campus, with the university currently recommending medical masks rated ASTM level two or three.
"These are basically the blue procedure masks you see worn in medical settings and clinics," Spadafora says.
A single-layer cloth mask doesn't provide enough protection on its own, he adds, but may be worn over a surgical mask.
The university is working to make the appropriate masks available, as supplies allow, to U of T community members who are unable to obtain them due to cost or supply chain issues.
As for how they should be worn, Vaisman says masks should fit snugly, covering one's nose, mouth and chin without gaping. High-quality surgical masks can be molded to fit tightly over the bridge of your nose.
"What you basically want to do is make sure [your mask] is flush and there isn't air escaping when you breathe," says Vaisman, who adds that N95, KN95, and high-grade well-fitting medical masks are all reasonable options.
KN95 masks are one-size-fits-all, whereas N95s come in a variety of sizes and require proper fit testing.
"You don't necessarily have to wear an N95 or KN95 to go to class or out in public settings - the most important aspects of mask wearing are that they are well-fitted and can be comfortably worn for prolonged periods," Vaisman says.
While masks in some health-care settings are single-use only, Vaisman says medical masks can often be used more than once in lower risk environments as long as they aren't damaged, moist, or contaminated.
"The recommendation from the Public Health Agency of Canada is to wear a well-fitted mask, so certainly a high-grade medical mask works."
Vaccines
U of T is encouraging all members of its community to get a booster shot as soon as they become eligible.
While infection among fully vaccinated people, or breakthrough cases, can occur with the Omicron variant, studies show that a third dose offers more protection against infection compared to two doses or none.
"Omicron can potentially outpace the vaccine even if you have three doses, but we do know based on recent data that a third dose is still highly protective, up to 70-plus per cent," Spadafora says.
Importantly, a third dose also does a good job of preventing severe outcomes, Vaisman says. A test negative case control study, cited in a Public Health Agency of Ontario report, found that a third dose was associated with a 74 per cent reduced risk of hospitalization two-to-four weeks after vaccination, and a 55 per cent to 65 per cent reduction between five and nine weeks.
To date, 99 per cent of U of T community members are in full compliance with the university's current vaccination mandate after uploading proof-of-vaccination receipts to UCheck, the university's online tool for self-assessments - with most of the remaining one per cent on their way to full vaccination.
UCheck is being updated this week to allow community members to voluntarily upload proof of additional (booster) doses.
Spadafora says he hopes that U of T's Dec. 15 decision to delay a return to in-person learning and activities following the holiday break has given U of T community members the extra time they may have needed to receive booster shots.
For those who still need a boosters, new appointments are being added daily to the provincial booking system and at local pharmacies.
On the St. George campus, the Discovery Pharmacy in the Leslie Dan Faculty of Pharmacy campus is now booking vaccinations for all members of the U of T community, including those without an Ontario health card.
At U of T Mississauga, the province's GO-VAXX mobile vaccine clinics will be visiting in February. U of T Scarborough, meanwhile, is planning to host one or more pop-up clinics in the coming weeks - with details to be posted on the Utogether vaccine page when they are available.
Spadafora also reminded community members to remember to fill out the UCheck self-assessment before coming to campus - and to stay home if they are experiencing any COVID-19 symptoms.
Ventilation
The university has assessed buildings on its three campuses and upgraded all centralized HVAC system filters to MERV 13, or the highest compatible with existing infrastructure. Moreover, demand-control ventilation measures in all buildings (typically in place to support energy conservation efforts) were disabled to maintain consistent in-air flow.
Ventilation systems are turned on two hours before occupancy every morning to introduce fresh air into buildings, a process known as flushing.
In addition, U of T measured air flow in classrooms and set a standard of six equivalent air changes per hour after consulting experts and research on COVID-19 transmission. Upgrades were made as required.
U of T and other universities were among the first organizations to move quickly to upgrade ventilation systems, Colin Furness, a U of T expert in infection control epidemiology, told U of T News and University Affairs last fall.
"We didn't wait for others to say air matters," he said. "The leading voices in Canada are here at the U of T with respect to infectious disease and epidemiology. We consulted our own internal expertise.
"U of T jumped in from the beginning and started prioritizing air and ventilation, which is really smart."
