More than 500 Ontario doctors are asking the Doug Ford government to keep schools open in January despite the rapid spread of the COVID-19 Omicron variant.

The doctors signed an open letter to Premier Doug Ford, Education Minister Stephen Lecce and Ontario’s Chief Medical Officer of Health Dr. Kieran Moore, saying that government must not use provincial school closures as a means to control the spread of the disease.

“Children and youth have experienced significant harms since March 2020 due to prolonged school closures, and we now must prioritize the needs of children and youth,” the letter states.

“School closures should no longer be a knee-jerk reaction to rising case counts. Numerous jurisdictions have committed to keeping schools open and we need to do the same.”

Premier Doug Ford said on Tuesday that his government will decide whether schools will re-open for in-class instruction in January over the next several days. Across the GTA, most public boards are scheduled to restart on January 3.

Dr. Alanna Golden, a family physician and former social worker in children’s mental health, said she started the open letter to urge the government to keep schools open amid the pandemic.

“They're an essential service. They're essential to students and in order for children and youth to grow and develop, they need to be in school,” she told CTV News Toronto on Wednesday.

“There's nothing inherent about schools that make them dangerous compared to any other setting. Right now, I'm not hearing any discussion or rumblings about societal lockdown, so I can't imagine why we would be talking about school closures.”

The letter signed by individual doctors from across the province lists a number of recommendations on how to keep schools safe, while allowing them to also stay open, including making better and more frequent use of rapid antigen testing.

“Frequent testing (e.g. every second day) of school-based contacts has been shown to be equivalent to self-isolation for control of COVID-19 transmission,” the letter stated. “Two Utah-based “test-to-stay” programs implemented over a four-month period saved over 100,000 in-person instruction days for nearly 60,000 students.”

The doctors painted a grim picture of the impact school closures have had on children and youth, saying their academic, social, emotional, physical and mental health have deteriorated resulting in higher rates of eating disorders, psychiatric illness and food insecurity.

The letter states that the issues children have faced due to school closures are in light of the “little to no COVID-19 transmission occurring in the school setting.”

They also note that while the Omicron variant has been found to be more transmissible, it has not been yet found to be more dangerous.

“People infected with Omicron were 15-20 per cent less likely to attend hospital in the UK and 80 per cent less likely to be admitted to hospital in South Africa,” the letter stated.

“Canadian hospitalization rates of less than one per cent have been observed, with a mortality rate of zero per cent thus far.”

The doctors stated that the province needs to re-write the popular phrase, “schools should be the last to close and the first to open” and replace it with “schools are an essential service and must remain open.”

Infectious Diseases Specialist Dr. Alon Vaisman said on Wednesday that it seems unlikely that schools will reopen by Jan. 3 due to the rapid spread in the community that may result in “tons and tons” of cases among students.

“This may not necessarily last very long. It all depends on how long this wave last and it looks like this wave will come and go very quickly,” he said. “And if we're not seeing the level of morbidity and mortality associated with the disease, then there's less and less justification to keep schools closed.”

“So I think in the near future that will likely be the approach, but I think very quickly after that, there'll be generally pressure and a change in thinking about COVID-19, such that schools are going to likely be opened again or very quickly soon after in January.

The letter received criticism from some epidemiologists, teachers and families across the province, saying the Ontario government has not done enough to keep schools safe.

“Appalled to see physicians doing this. They had months to demand more HEPA filters, N95s for teachers, vaccine mandates. They didn't. They're not even asking teachers be prioritized for a third shot,” Colin Furness, an expert in infectious disease epidemiology from the University of Toronto, wrote on Twitter in response to the open letter.

“Do they not know about airborne, or Long COVID? Do they not know that rapid testing every other day is inadequate and impossible since [Premier Doug Ford] didn't bother buying these?”