Click HERE to watch the video townhall.
Summary of Questions and Answers:
Question #1: We are hearing no gatherings outside of the household but we are also hearing that some guidelines do NOT apply to social service delivery. What should we be doing with regards to children in care and their birth families over the holidays? Do we act like a household or a service?
Answer by Dr. Behn Smith: "Because of our overarching goals with COVID, we never want a public health or population health measure to interfere or be a barrier to somebody accessing an essential social service whether that be a shelter or a food bank or medical care. When it comes to household and the services provided by the Ministry of Children and Family Development, each situation is unique. There is not any overarching yes/no or right/wrong recommendation from the PHO. Each situation, each family, each child has a unique circumstance going through their own challenges and need to determine how critical that experience of coming together might be."
"There are so many different forms of family. We have also been inundated with questions from co-parenting families where there are two bubbles coming together and acting as one. There are many circumstances where we are not talking about a nuclear family. In spite of the fact that these bubbles are slightly larger than we might think of initially, we’re still managing to flatten our curve. We’re still doing the right things. I would encourage all of you who are working on a case-by-case basis to come together and recognize that, yes, overall we are trying to limit our social interactions right now in order to keep ourselves in the flat part of the curve. We’re trying to make sure that our interactions are as safe as they can be. We’re staying away from others when we’re sick. We’re maintaining our physical distancing when it’s safe and practical and understanding that in a family situation, that’s not always practical. We are using our frequent hand hygiene. We’re wearing masks if that’s something that’s comfortable for us or something that we can do. Those are some of the layers of protection that can make our interactions safer. If it’s a circumstance where having a virtual visit meets the needs and is not creating additional harms, then that might be preferable for right now. Everything that we’re doing is for “right now”. This is not forever. However, Dr. Bonnie Henry also recognizes that, for some children and families, the attachment and in-person visitation is really critical. Our intention would never be that public orders stand in the way or be something that would create further harm or trauma to children and families who are already experiencing vulnerabilities."
Question #2: Foster parents will be expected to NOT have household gatherings but will they be at risk of getting COVID-19 and if there is an exception made for their foster child to see their family?
Answer by Dr. Behn Smith: "This is correct. The expectation is that we NOT host any social gatherings – that we stick to our immediate household/social bubbles for now."
"Yes, the risk of getting COVID-19 is out there in the community. That is the definition of being in a global pandemic. We cannot predict where the risk of COVID-19. It’s just a part of our community for now. We can all individually decrease our risk as much as possible by keeping our distance, washing our hands, keeping our social bubbles small."
"I totally hear the concern, anxiety and fear when there’s a possibility of a foster child having an encounter with somebody especially that you don’t control their social bubble and you don’t control what they’ve been doing in their day to day life."
"Children under the age of 10 don’t get COVID as often as adults. When they do get COVID, it tends to be milder symptoms and they don’t tend to pass COVID-19 onto others. The idea of a child being the primary risk of transmission (from the data that we have) is pretty low. We can get that risk even lower if, in your planning teams, you go through the guidelines and ask “what are the ways we can even further bring the risk down?”."
On masks and face coverings:
"There is an order around masks and non-medical face coverings in public places. That is an order that’s come under the emergency order under the Public Safety and Solicitor General. It’s not strictly a public health order. It’s an order that applies to people who are over the age of 12 years old. People are exempt from wearing masks in public indoor areas if they have a medical condition that prevents them from wearing a mask or if they’re under the age of 12 or if they can’t put on and take off a mask by themselves. We watched the science closely as it’s developed and evolved over the course of the pandemic and we’ve seen that, as a population measure, masks can reduce the spread of COVID-19. However, it’s still less effective than physical distancing, frequent hand hygiene or physical barriers. All of those things are still better at preventing COVID-19. Masks are added as an additional layer of protection."
Question #3: On not seeing extending family and other adult family members to keep the children in care and foster families safe and as risk-free as possible yet still be expected to do in-person visitations with families outside our bubble (who may not be following the public health guidelines). When is everyone’s health and safety going to be respected?
Answer by Dr. Behn Smith: "This is a challenging time for all of us. We really are needing to balance the risks and benefits. We’re trying to stem the tide of COVID_19 but we’re also trying to mitigate risks for children and families who are experiencing serious challenges themselves and who are more vulnerable to the lack of attachment. We have the benefit of science telling us that kids are in a lower risk group—that they’re not great transmitters of COVID-19 so we hope that with the planning that’s happening in advance of the visit layering in with as many safety interventions and the fact that British Columbians have all stepped up to flatten our curve which brings our collective risk down."
Question #4: How can we plan for safe in-person visits?
Answer by Dr. Behn Smith: "Aside from the interventions already mentioned, what I would flag is the importance of pre-planning between the caregivers and staff members who are all working to support children and families. There are a lot of excellent resources on WorkSafeBC. MCFD also has excellent resources that describe those high-level public health guidelines and recommendations. It’s not always possible or practical to implement every single one of those interventions but the wonderful thing is it is really about layering on. All these different interventions have an additive effect."
Question #5: Should workers limit the number of people at a visit to parents only and what if the extended family are present? How many people are acceptable?
Answer by Dr. Behn Smith: "We don’t have a specific number but we know that the more social contacts, the more likely is COVID-19 to be present or to spread. We would encourage to keep the visits as small as possible."
Question #6: Should we be asking parents and children to wear masks on visits?
Answer by Dr. Behn Smith: "The mask order really only pertains to indoor public spaces, people over the age of 12, people who can wear a mask or people that do not have a medical condition preventing them from wearing a mask. We would not have an expectation that parents and children wear a mask at a visit."
Question #7: On counselling sessions where a counsellor insists that a child in care take their mask off and the foster parent and the child in care are uncomfortable. Virtual counselling is not an option in this case and because the counsellor is seeing many client without masks and there is no appropriate social distancing in the counsellor’s office. The counsellor is, of course, not within the family bubble. What should a foster parent do in this scenario?
Answer by Dr. Behn Smith: "I would reference WorkSafeBC’s website. They have guidelines for counsellors and counselling sessions. It’s an expectation that, for any office, they have a COVID-19 safety plan that’s posted and available. You could certainly ask to look at their safety plan and see if it’s being implemented fully. With the mask order, there is an expectation that a counsellor’s office is considered an indoor public space. There may be exceptions made if the mask is a barrier to carrying out a session. What I would suggest is having a conversation with support workers and really looping back to the counsellor and their COVID-19 safety plan."
Question #8: Why is the planning influenced so much by people’s feelings and opinions rather than the facts of the matter (e.g. COVID data, public health orders, MCFD Practice Bulletins)?
Answer by Dr. Behn Smith: "Public health orders and recommendations are very much influenced and guided by the data which is why classes resumed in the fall because the data says that it’s a relatively safe thing to do. We knew it was the right thing to do and we watched as in-class instructions continued and seeing the school exposures. We’ve seen that that hasn’t created a ripple effect of increased transmissions in the community. We know that it continues to be a good thing for children and families. We continue from a COVID data perspective to really monitor where and how COVID-19 is being spread in the community. Not just based on scientific literature but what really matters is how it’s spreading here in British Columbia. I can absolutely assure you that, if we see in-person visitations as a hotspot, we would absolutely step in. We are evidence-informed."
Question #9: Will foster parents be classified as essential service workers and receive the vaccine early?
Answer by Dr. Behn Smith: "Vaccines started being administered this week. There are a couple of different vaccines that are available. I know there is some hesitancy around vaccines but there have been no short cuts taken in the vaccine development process. The reason that this has happened so quickly is because of unprecedented sharing of scientific knowledge globally and unprecedented resourcing in terms of the vaccine development process."
"Child services are absolutely considered essential. In terms of where that falls in the queue for vaccines, our vaccine planning is really supporting our first two goals of protecting those who are most at-risk of severe COVID and protecting the healthcare system and its functioning. Because the burden of severe illness is right now being carried by the frail elderly, people who are first in line in the queue are going to be the elderly and the people providing care for them. Because children are less affected by COVID-19 directly, I don’t anticipate that foster parents would necessarily be in the front of the line of essential service workers. I cannot say that with 100% certainty because I’m not sitting at the immunization operation centre. We do anticipate that vaccines will continue to flow into the province and the goal will be to vaccinate as many people as possible for people who want it. It’s not going to be mandatory."
Question #10: On youth residential centres and what to do when you’re designated as an essential service and you may have youth in care who are not able to or choosing not to follow population-level health measures.
Answer by Dr. Behn Smith: "We’ve encountered this question many times throughout the pandemic more specifically in mental health settings or psychiatric ward settings. What I would say is there is still a lot of things you can do that are not reliant on that one person. Hand hygiene cannot be underestimated. If the weather permits, maybe open the windows for air circulation. You and the other residents can choose to wear face coverings to provide some layer of protection. You can work with your team to layer as many interventions as you can. Do not hesitate to reach out to your colleagues or public health office to ask for support."
Please refer to the sources below for more information on COVID-19:
