Even with vaccines, health self-assessments remain important, U of T experts say

For nearly a year, the University of Toronto has required everyone visiting its three campuses to complete a self-screening questionnaire to monitor themselves for symptoms associated with COVID-19.

Students, faculty, staff and librarians can complete the process through UCheck, the web portal that guides users through a self-assessment in eight short questions, including whether they have experienced symptoms like a sore throat or cough.

Given that U of T now also requires community members to show proof of vaccination before coming to campus, some may be wondering whether regular self-screening is still important.

The short answer is “yes,” says Professor Sal Spadafora, special adviser on COVID-19 to U of T’s president and senior adviser to the dean of the Temerty Faculty of Medicine.

“One of our best defences against COVID-19 is vaccination,” he says. “However, if you listen to our public health experts or any of our epidemiology colleagues, they all advise that we continue to be very cautious.

“The reason that I believe it is important to be very reflective and self-aware is that there’s the potential for a small number of breakthrough infections in fully vaccinated people.”

A Public Health Ontario report suggests breakthrough infections are very rare. Of more than 11 million people in the province who received at least one dose of a COVID-19 vaccine between Dec. 14 of last year and Sept. 18, 2021, only 19,616 partially vaccinated and 8,264 fully vaccinated people later contracted the illness. There’s also evidence that vaccines reduce the severity of symptoms and the risk transmission and hospitalization.

As of Oct. 4, more than 80,000 U of T students, faculty, librarians and staff have declared their vaccination status and of those 95 per cent uploaded proof of full immunization ahead of the second-dose deadline of Oct. 15. The vaccination and health screening requirements are part of U of T’s 12-step plan for a safe return to campus.

Since vaccines make it less likely that someone will fall seriously ill if they catch COVID-19, Spadafora cautioned that symptoms can fly under the radar and make it possible to unwittingly pass along the virus.

“Even the mildest change – say a sore throat, stuffy nose, headache or just feeling under the weather – could be a sign of a COVID infection,” he said.

When Spadafora experienced a scratchy throat – a possible sign of COVID-19 – he says he immediately went to an assessment centre. A polymerase chain reaction (PCR) test returned a negative result suggesting he was probably dealing with seasonal allergies.

“We’re trying to create a community where we’re all very self-aware, using the health screening tool Ucheck, and creating a culture where all faculty, staff and students and librarians feel supported in taking time away from work or classes to go get tested.”

Susy Hota, an associate professor in the department of medicine in the Temerty Faculty of Medicine and a medical director, infection prevention and control at the University Health Network, agrees that self-assessments remain important – even among the vaccinated – so COVID-19 cases can be detected as soon as possible.  

We can’t be testing everyone all the time, so we need people to recognize when they may have symptoms of COVID-19 and go for a test as soon as possible if they think they do, she says.

Hota adds that it’s important to remember a COVID-19 infection may not always manifest with “classic symptoms” such as a loss of taste and smell.

“We do get quite a few cases that are very mild in nature, especially now that we’re in the post-vaccination era. Sometimes symptoms are a runny nose and a sore throat,” she says.

While Isaac Bogoch, an associate professor of medicine in the Temerty Faculty of Medicine and a staff physician at University Health Network, says self-screening may not be in the same league as vaccines, masks or physical distancing when it comes to stopping COVID-19, he nevertheless notes the importance of a multi-pronged approach.

Another upside: Self-screening may also be helping to usher in a badly needed culture change by making it more acceptable for employees – or students – to take a sick day when they aren’t feeling well.

“There are very few silver linings to this pandemic, but this might be one of them,” Bogoch says.

“Don’t go to work sick.”