As Manitoba works out its plan to reopen businesses and services shut down to slow the spread of COVID-19, epidemiologists say health officials face a serious challenge in deciding what to do with temporarily shuttered schools.

Reopening schools too soon runs the risk of a surge in COVID-19 cases — but with students stuck at home, many parents won't be able to go back to their jobs if their workplace reopens, said Craig Janes, director of the school of public Health and health systems at the University of Waterloo.

Janes said that's why Manitoba needs to reopen schools early on in its plan to ease COVID-19 restrictions.

"You can't really send people back to work without opening schools and daycare centres," he said.

"One of the first things that any province has to think about is, how do we open schools and do that safely, so that children and teachers can be protected, and then people at home, parents and grandparents, can be protected? It's not an easy thing to do."

On Wednesday, Manitoba Premier Brian Pallister said the province's reopening plan is coming next week.

Manitoba Premier Brian Pallister speaks during a COVID-19 update at the Manitoba Legislative Building in March. (John Woods/The Canadian Press)

Manitoba's plan needs to strike a balance between easing restrictions and keeping the province's COVID-19 curve flat, he said.

"We deserve to move forward and we have to do it thoughtfully and carefully so we don't have a rebound effect."

Manitoba plan will mirror Saskatchewan's

On Thursday, Dr. Brent Roussin, Manitoba's chief public health officer, said changes in the province will be brought in slowly as Manitoba models a reopening plan similar to the one unveiled in Saskatchewan that morning.

That province plans to start a gradual reopening in the next two weeks — beginning with medical services like dentistry and recreational activities like golf, followed by retailers and some personal services, like hairdressing, a few weeks after that.

Through all this, Saskatchewan health officials said they'll keep a close eye on virus transmission patterns in the province. If the data says it's safe to do so, remaining personal services will reopen, along with restaurants, gyms, bars and daycares — but most will still be limited to half their regular capacity.

Saskatchewan's restrictions on areas considered high-risk are sticking around for the foreseeable future, though, meaning classes there will remain suspended.

At a news conference Thursday morning, Saskatchewan Premier Scott Moe said the province will keep a close eye on other jurisdictions that have reopened schools during the pandemic — and evaluate how successful its own plan has been — before deciding whether to start in-school classes again in the fall.

Roussin has said when Manitoba releases its plan, non-essential businesses and daycares will be a high priority for reopening.

Dr. Brent Roussin, Manitoba's chief public health officer, listens as Premier Brian Pallister speaks during a COVID-19 update at the Manitoba Legislature. (John Woods/The Canadian Press)

Steven Hoffman, who teaches global health, law, and political science at York University, said while schools and daycares play an important role for working parents, they're also well-positioned to spread infection.

"They're a place where unique social networks collide in ways that [they] don't often," said Hoffman, who also directs York's Global Strategy Lab.

"That means that there's a unique opportunity for infectious diseases to spread across different populations and groups that don't often share physical space."

He said provinces need to decide where they're willing to take risks as they return to more normal operations. And because some medical services have also been put on hold to slow the virus's spread, schools likely won't make it to the top of that list.

"These are tough choices that governments and public health authorities will need to make," he said. "The only obvious first priority, in my view, is [the] reopening of health care if possible. After that, it becomes really difficult."

Looking to other countries

Hoffman said when Manitoba decides it's time to reopen schools, the province should look to other countries where classes have now resumed — like Denmark, which has reduced its class sizes and moved desks further apart to make physical distancing easier.

Winnipeg-based health policy expert Cynthia Carr said Manitoba should also look at data from countries that have taken different approaches to slowing the spread of COVID-19. In Sweden, for example, people are encouraged to practise physical distancing, but schools have stayed open.

People sit in the sun in Malmo, Sweden, on April 5, as the spread of COVID-19 continues. (Johan Nilsson/TT News/Reuters)

"Can we learn from them? Did they have outbreaks in different segments of society?" said Carr, an epidemiologist with EPI Research. "Do they have a large number of young people [with COVID-19], for example?"

She said it's important that the province is transparent about what data is being used to make these decisions, and shares with the public how health officials are deciding the risks of reopening certain places.

But Hoffman said even careful reopening plans come with risks. And at this point, he's not sure opening Manitoba's schools before summer would be worth it.

"Long story short is that there are options to do it, but they're not easy ones," he said, adding schools could, for instance, focus resources on only bringing back Grade 12 students to finish the year.

"With the end of the school year increasingly approaching, it becomes less and less likely that it makes sense to implement those kinds of intensive processes in order to enable the physical reopening of schools."