Over the past few weeks, most of the new COVID-19 cases were reported among people in their fifties, Toronto's top doctor said Wednesday.
"And that may be related to a number of different things, not the least of which is close contact with people in work environments," Dr. Eileen de Villa, Toronto's medical officer of health, said during her weekly interview with CP24.
"We know close contact is a major risk factor, and the two big sources for close contacts with a case are going to be households and workplaces."
Toronto Public Health reported 121 new COVID-19 cases on Wednesday, bringing the total to nearly 13,000. Of those cases, 955 have died, while more than 10,300 have recovered.
On making masks mandatory on public transit, de Villa said an active conversation is happening on the issue.
"I would stay tuned because that is something that is very much a hot topic of conversation," she said. Mississauga joined Brampton and Ottawa in mandating the use of masks on public transit.
De Villa answered COVID-19 questions from viewers below:
CP24: Toronto Mayor John Tory announced about city offering summer camps and reopening of city pools and other aquatic amenities in the next few weeks. What about playgrounds?
De Villa: All of these things are under the provincial orders and their purview. We're waiting for them to tell us what the plan is. But I can tell you that what's good about this and what we're hearing now is that we're going to be able to enjoy more and more of our outdoor space safely because we know that the risk of transmitting COVID-19 or getting COVID-19 when you're out in the great outdoors is much lower than it is when you're inside. So out in the great fresh air is a great thing.
CP24: We heard about the daycare announcement from the province yesterday. Some aren't so happy about the amount of time that was given for daycares to prepare. Are you comfortable with what the province announced?
De Villa: I think the province announced and provided some guidance. I know that daycare operators and childcare service operators are going to need some time to figure out how to operate in the way that allows for the safe delivery of childcare now that we're living with COVID-19. But I think that these adjustments and the kinds of changes and adaptations that they're going to have to make or going to be experienced across the board. I can tell you that at Toronto Public Health, we're providing advice. We've been working hard with the childcare providers here in the city, who have run our emergency childcare centers throughout COVID-19 or for the last several weeks now.
We have quite a bit of guidance developed, and we're prepared to help our partners throughout the system so that we can get our city back, and that includes childcare.
CP24: People in their 20s, early 30s, got a lot of criticism from a lot of people regarding that gathering at Trinity Bellwoods Park last month. A lot of people suggested we were going to see a large spike in cases, but a report yesterday found that Toronto Public Health has found no link to any spread of COVID-19 through that incident. What do you think that means about either the spread of disease or the dangers of large gatherings?
De Villa: The fact that we didn't see an increase in activity is a good thing. Regardless of what the source was, we don't want to see those kinds of spikes in activity around COVID-19. We know that there is a risk the more you interact with people, especially in crowds, in closed spaces and indoor spaces. We know the risk is definitely reduced outdoors, but that doesn't mean that there is no risk, particularly when you're in close contact with lots of people. The mainstays of prevention of COVID-19 – physical distancing wash your hands, use alcohol sanitizer if you don't have any stay home, when you're sick, try not to touch your face – these are the pieces that are the most important when it comes to preventing COVID-19.
CP24: When will restaurants reopen?
De Villa: We all want to get our city back, and that includes the ability to enjoy the many great restaurants that we have come to enjoy. That is also part of the provincial order. And that should be happening. We hope as things progress in terms of our outbreak and as we start to see more and more improvement in our case counts here in the city and throughout the Golden Horseshoe.
I can tell you as well that at Toronto public health, we've produced some guidance for restaurants and other food premises so that they can start to get themselves ready. They will have to operate in a different way of being in an environment, and co-existing safely with COVID-19 will mean some different practices. Our hope is that our restaurants and those who are in that food industry, in that service industry will pay attention to these guidelines, start to call their workers back so they can start to get things ready. So that when the moment comes, they can just hit the ground running and start offering their wonderful service once again to the people of our city.
CP24: How many restaurants are either downloading that guidance or looking for that advice or calling Toronto Public Health and trying to seek out that information?
De Villa: Well, I haven't necessarily track that, so I don't have the specific numbers. We certainly do watch these kinds of things within our operations because we want to know whether we are answering their questions. Are we providing the guidance that they're looking for? I would encourage restaurant owners to go to our website, take a look at the guidelines. We've tried to make them as, as straightforward as possible, sort of a checklist format. It's not an incredible amount of reading, and it's meant to be useful and practical as you seek your restart your business.
CP24: I would like to know if the current social distancing rules of 10 people together – is that inside or outside social distancing?
De Villa: For the last several weeks, we've been at five. They've expanded to 10, but that's with social distancing as much as possible. I can't emphasize enough how much physical distancing is one of the most important things that you can do to protect yourself and to protect others around you from COVID-19. And again, I would say that in places where you can't reliably maintain that physical distance with people from outside of your household, I recommend strongly the use of a cloth mask or face covering to protect others from your germs.
CP24: When are they going to open washrooms? All the vendors along the waterways are open, and you want us to get out and be active, but we can't find a washroom anywhere.
De Villa: It definitely is an issue, especially if we're going to be able to enjoy the outdoors and the heat that we've all been craving for many weeks. I know that our colleagues at Parks, Forestry and Recreation have been actively working over the last several weeks to open up washrooms as part of their parks and facilities. And my hope is that those amenities will be more readily available now and in the coming weeks, as those facilities are brought back online. It does take some time to get those things going, but I know they're working hard at getting those facilities back up and running again and ready for use.
CP24: Why is it that I can have a massage, which is close up, but not be able to get my toenails cut where the person is at least three feet away?
De Villa: I think I've got it right in that the provincial orders that are being changed and allowing for phase two in those places that are moving towards phase two, do include for the possibility of nail salons to operate. It's just a question of fact worth looking at, at what the province puts out because that is under the changes to the provincial orders that are in place. But suffice it to say the idea is to try to find ways to move forward to reopen safely and restart safely, knowing that COVID-19 is still out in the community. How do we minimize risk? How do we live as safely as possible?
CP24: When will large office buildings with 400 plus employees, as well as being open to the public, be able to reopen fully, to allow staff back in the office to work?
De Villa: What's being encouraged is for those who can work remotely to continue to do that. That way, we can make these adjustments. Learn how to co-exist safely with COVID-19 in our community, in a gradual and staged fashion. This is a new virus, still learning quite a bit about it. I know that we're weary, and we're tired of the many restrictions and all the rules that are coming into play.
But this is about community safety. It's about community health. We ask people for their patience. We know that physical distancing continues to be an important component of protecting ourselves and our community. As we learn how to live with this, and hopefully in the upcoming months get some effective treatments and vaccines, we'll start to resume something more like what we've been used to do in the past and getting back to workplaces and seeing people, our coworkers because I know we miss them.
CP24: I'm very concerned about children, constantly touching sanitizer residue left on frequently sanitized toys and services like tables and chairs and door glass, etc. As you know, little children put so many things, including fingers, into their mouths. And it seems to me that constant contact with sanitizer will not be healthy.
De Villa: We're always concerned, and little children tend to put all kinds of things on their mouths, and we have to be careful of that and constantly watching that. So, certainly, the childcare guidelines provide for an appropriate adult to a child being supervised ratios so that that appropriate supervision can be provided. However, I would also say that the cleaners that are recommended for use within those settings are meant for childcare settings. I think there's lots of information provided in the guidance to childcare settings to ensure that they are creating a safe environment.
CP24: An email from a viewer says, I am 60 years old and use public transit. I have noticed smokers who smoke at the bus or streetcar stops their fingers come in contact with their lips. They then hold onto handles or seats. Does this pose a risk of transmission?
De Villa: I prefer not to see people smoking anywhere. Let's start off with that risk, but with respect to the risk of transmission on surfaces, there's always the chance that that happens. But I will tell you that based on the data that we understand and the best evidence that we have currently on COVID-19 the greatest transmission happens from the droplets, the secretions that come out of people's nose and mouth if they are sick with COVID-19 and they're up close and within close contact of another person. It is possible through surfaces. That's why it's really important that you wash your hands, use hand sanitizer. These are the things that can actually best protect you and avoid touching your face.
CP24: A viewer emailed and said my teenage daughter has been invited to a private pool in a friend's backyard. The pool is saltwater. If they social distance, is saltwater swimming, okay? I'm assuming chlorine is fine given some pay phase two public pools are opening up soon. If swimming is allowed in chlorine and saltwater pools, are there any further tips you can provide so that we follow public health guidelines?
De Villa: I expect swimming is an issue that will come up more and more. And I suppose that's a good thing because it means that we've got weather that's good enough for swimming. Again, a new virus, not a lot of evidence around what happens within pool water and what have you. But we do know that physical distancing is still the mainstay. It's the cornerstone of preventing transmission when it comes to COVID-19. That, along with handwashing, as we've said, or using alcohol-based hand sanitizer, staying home if you're sick, not touching your face, are the main things that we need to pay attention to.
And my expectation is that the science will answer the questions around transmissions for water. But from what I can understand, that's not a significant role. It's really around staying away from people because of the respiratory secretions – what comes out of people's nose and mouth if they're actually sick with COVID-19.
CP24: Do you think we'll get the science soon enough for this summer?
De Villa: I don't know how much science we're going to get that is going be that solid in this short period of time. But I think that we have to think about how much dilution you get when you're in a large body of water like a pool. In the same way that there is a fair amount of dilution that happens when you're outside in the outdoor air. Even if you're near somebody who has COVID-19 infection, whether they know it or not, in the outdoors, there's so much dilution, so much air that the likelihood of transmission, especially if you're maintaining physical distancing is relatively low. That's why it's so important. It's about physical distancing, big air space. Dilution is a major factor here. And I think that would apply in an outdoor setting, which had included the pool.
CP24: As our family cannot be at the cottage altogether this summer, each family is taking turns. While we will all clean high touch services when coming and going between visits, some have suggested that we wait two to three days between each visit to reduce any risk of any potential viruses on services. Is that really necessary?
De Villa: Cleaning the surfaces, especially the high touch surfaces, remains an important component of trying to reduce risk. But it still comes down to hand washing. I think that fundamentally will protect families as best as possible. Over and above physical distancing, we're talking about a family that is all together. Physical distancing, less of an issue here. In this circumstance, cleaning properly, cleaning those high touch surfaces, washing hands, or using alcohol-based hand sanitizer will be the best way to protect oneself. Of course, trying not to touch the face too.
This interview has been edited.