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Further Guidance on Mask Wearing Limitations and School Accommodations

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Further Guidance on Mask Wearing Limitations

Following Public Health advice, the Guidance for Mask Use in Schools document (adobe pdf 226 KB) released on September 2, 2020, indicates that non-medical masks should not be worn by anyone who

  • is unable to remove the mask without assistance (e.g., due to age, ability, or developmental status)
  • is actively having breathing difficulties
  • is under two years of age

It further states that, “In general, most people with underlying medical conditions can safely wear a mask. There is no evidence that wearing a mask will worsen an underlying medical condition. For example, in most situations, an individual with an underlying lung condition such as asthma or an underlying heart condition can safely wear a mask.”

A medical note from a health care provider for a reasonable accommodation to be made by a school is not required by Public Health or Manitoba Education. However, to accommodate limitations to wearing a mask at school or on a school bus, information regarding the child’s limitations to wearing a mask must be provided to the school.

At the school division or independent school’s discretion, the division or school may request a note be provided by a parent/guardian/caregiver from a health care provider.School divisions shall only grant exceptions to mandated mask wearing for the following specified exceptional circumstances:

  • children under the age of two years
  • children under the age of five years, either chronologically or developmentally, who refuse to wear a face covering and cannot be persuaded to do so by their caregiver
  • people, especially children, with severe sensory processing disorders
  • people with facial deformities that are incompatible with masking
  • people with post-traumatic stress disorder (PTSD) who are triggered by a face covering
  • people with extreme agoraphobia/asphyxia phobia (which is long-standing and pre-dating COVID-19)
  • people with a cognitive impairment, intellectual deficiency, or autism spectrum disorder for who wearing a face covering will cause severe distress or disorganization
  • people with a medical condition unrelated to COVID-19, including breathing or cognitive difficulties or a disability, which prevents them from safely wearing a mask
  • people who are unable to apply or remove a mask without help

If a parent/guardian/caregiver is concerned about their child’s ability to safely wear a mask on the school bus or while at school, they should speak with their child’s health care provider. Public Health advises that inappropriate exceptions to mandated mask wearing have the potential to inadvertently compromise the overall public health measures implemented in schools to mitigate risk to all and to minimize the spread of COVID-19 in Manitoba schools and communities.

If there are limitations to a child’s ability to wear a mask while on the school bus or at school, the parent/guardian/caregiver must provide written notification to the child’s school, specifying the child’s specific limitation with wearing a mask from the list above.

In a case where a student is having active breathing difficulties, the student will be advised to remove their mask and the parent/guardian/caregiver will be contacted to pick up the student to seek medical attention.

For those who would like to use a face shield, it must be done in combination with a face mask. A face shield is not a replacement for a non-medical mask. Masks should have two or more layers of tightly woven fabric, completely cover the nose and mouth, and fit snugly against the sides of the face without gaps. Neck gaiters, buffs, and neck fleeces are not recommended in place of a mask, as they are not designed as a non-medical mask and their effectiveness is unknown at this time.

A mask can be either a non-medical re-useable cloth mask or a disposable mask.

Guidance on School Accommodations during COVID-19

COVID-19 is a new disease. Currently there is limited data and information about the impact of underlying medical conditions and whether they increase the risk for severe illness from COVID-19. Expert groups have provided information on the risks to those with underlying health conditions and have advised that the majority of children and youth, including those with underlying medical conditions, should be able to safely attend school with the enhanced safety measures that have been put in place.

Some children may be at higher risk of adverse outcomes from COVID-19 due to underlying medical conditions, such as immunocompromised states or chronic medical conditions, including cardiac, lung, and neuromuscular disorders.

Children and youth who have medically complex conditions, particularly those with medical technological supports associated with developmental disabilities and/or genetic differences, are also in a potentially higher risk category.

School divisions and independent schools have planned alternative approaches to provide programming to students who are unable to attend school due to a higher risk of severe illness themselves, or due to a family member in the same household having a higher risk of severe illness.

Schools will provide reasonable accommodation based on a recommendation of limitations provided by a health care provider. Parents/guardians/caregivers should have this discussion and then prepare a note outlining the medical accommodation as included in the list above. A medical note may be required and helpful in better understanding the specific accommodation as well as preparing for the safe return of the child to school as per regular school practices in supporting students with health needs (not specific to COVID-19).

As indicated by Manitoba Shared Health, Health care providers “should also consider, and discuss with parents, the unintended consequences associated with not attending school. The benefits of attending school go beyond academic achievement: children and youth rely on schools for physical and mental health services, nutritious food, safety, security, and support.

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