Toronto's top doctor is urging residents to keep following public health measures to prevent the spread of COVID-19 variants as the city waits for more vaccines to be delivered.

Dr. Eileen de Villa, Toronto's medical officer of health, reported during the city's COVID-19 briefing Wednesday afternoon that there are 32 confirmed cases of variants in Toronto.

"The variant spread from elsewhere gives us every reason to believe variants will spread here in the same way," the doctor said. "So, in the weeks ahead, let's make decisions about the degree to which we mix with one another to make it harder – not easier – for COVID-19 to spread in any form."

"We do not want to make the situation worse."

Living with COVID-19 is like trying to find the way out of a maze, de Villa said, and vaccines can lead to the exit. While the delay in vaccine supplies is frustrating, she asks everyone to wait mindfully.

"The variants and the vaccines intersect on our way out of the pandemic because one can affect the other," De Villa said.

"We do not want the variant to complicate the role of the vaccine in bringing an end to the pandemic."

Dr. de Villa joined CP24 to answer questions about the COVID-19 pandemic.

CP24: Are you concerned about the timing of reopening portions of the economy six days after schools resume in-person learning?

De Villa: There is reason to be concerned about what sort of approach we take to reopening. And what I said earlier this week was I think it's quite prudent and in fact, I think it's really smart to think about reopening and have really active planning conversations on what safest reopening looks like in the context of the pandemic. Again, we are just opening schools for in-person learning in Toronto and Peel and York next week. We want to have some time to really assess what that looks like and what it looks like, particularly in the context of the variants of concern, which we know are emerging in our communities. I would ask for increased caution and really looking at the data very carefully, giving us some time to assess what's happening so we can do what's best for the entire community, for health, for the economy and life overall.

CP24: Are you considering at all with your power as the medical officer of health to try to restrict the reopening of the economy and perhaps wait to try to get a little more data and see where things move or go?

De Villa: I think that I'm not ready to make a decision in respect of what we should do or whether we should exercise powers. But as I've said all along, and as I've tried to do throughout the entire pandemic, we will take the best available evidence, we will look at our data, we will assess the situation at the time, and make the best decision that really focuses on the best interests of all people in Toronto, whether we're talking about students, families, businesses, people who live in the community. We need to look at the entire picture and understand what's happening in our community to make the best decisions.

CP24: If you were asked to give any guidance of the province on March Break, what are your thoughts at this point with March Break less than four weeks out?

De Villa: With March Break, this is like so many other decisions that we've had to make or that people have had to make throughout the pandemic, very difficult balancing act. On the one hand, even though students in Toronto are just getting back to in-person learning next week, they've still been in school, and that still work, both for the staff and for the students. We all need a little bit of a break when we've been, you know, working hard over an extended period of time. That's just natural.

By the same token, we're just getting back to in-person learning in places like Toronto, and we want to have an opportunity to observe what happens from an epidemiologic perspective, what can we understand of the way virus seems to be moving or not moving within our school community, particularly while we have variants of concern? I appreciate not an easy decision for our provincial counterparts, lots of considerations that need to be thought of, and the ones that I've described are just the public health ones. There are many more considerations, I'm sure for the provincial government, that I'm no expert on. But I certainly don't envy them. None of these decisions are easy to make.

CP24: What is the status of the variants of concern in Toronto? And how concerned are you about them?

De Villa: I think we have to look very carefully at the experiences of other jurisdictions. Other countries around the world are a little ahead of us in respect of the emergence of variants of concern, and we should be informing ourselves based on those experiences. So, whether we're talking about the United Kingdom, or whether we're talking about a, you know, a country like Denmark, they're a little ahead of us in respect of variants of concern. And what they saw was at the outset, you get a little bit of emergence of variants of concern, but over time -- and it doesn't take all that long because we're talking about exponential growth -- before you know it, it becomes the dominant strain. And the experiences from the UK and the experiences from Denmark would suggest that you need to exercise a greater degree of caution, really keep public health measures on very strongly in order to reduce the likelihood of ongoing spread and transmission. I think we should learn from other countries; we should learn from their experiences and not repeat mistakes that have already been made.

CP24: Going back to March Break, is there enough time to make a decision given that there are a lot of variables involved in planning?

De Villa: With so many of the decisions throughout the pandemic, it has been trying to weigh out all these different variables and to make decisions with the knowledge you have at the time, which may or may not be as complete as you'd like it to be. I think that what we have done certainly here in Toronto is that we've looked at the information that we have available to us at the time and made the best decisions that we could in consideration of all those different factors that need to be balanced. That's the difficult work of managing through a pandemic. And I suspect it's something that we're going to have to continue to do over the next several weeks and months.

CP24: The city announced today that it plans to open nine vaccine clinics. It's just missing one thing – the vaccine. How hopeful are you that this plan is going to happen fast enough, given the delay in vaccine supply?

De Villa: I think that there is clearly, a desire for all of us to have vaccine supply issues resolved. And I think there is good news to be had in that through the leadership of Chief Matthew Pegg, and so many other people at the City of Toronto and Toronto Public Health, in concert with community partners, hospital partners, health care providers out there in the community, we're working hard to be ready. So when those vaccine supply issues are resolved, we'll be ready to put needles in arms as quickly as possible and get that level of protection. But in the meantime, what we need people to do is to continue to really limit their interaction with others. The more we're able to reduce the spread of COVID-19 right now, we reduce the impact of the variance, we reduce the health impacts and the strain on our healthcare system, and we give our vaccines the best chance to be effective and to do their work.

CP24: A viewer asks, how are you going to implement the rule about staying in a hotel for travellers who are coming back into the country? How are you going to enforce it?

De Villa: This is a new measure that's been implemented in order to try to limit the spread of COVID-19, particularly from variants. And as it turns out, it's a rule that's been implemented by the federal government. So, as it turns out, I don't have a lot of detail around how they're going to enforce and manage the rule that they've now put into place. But I would sincerely hope this that, you know, as citizens and residents of Toronto, that of course, we're interested in protecting not only our own health but the health of those around us and our whole community, the more we're able to actually follow the rules in respect of reducing the spread of COVID-19, the sooner we all get back to normal life. So, I would ask that people don't wait for enforcement to come along. Let's you know manage ourselves recognizing that the better we're able to do this now, the sooner we get back to life that looks more like it used to before there was a COVID-19.

CP24: A viewer asks, I'm a type one diabetic (high-risk group) and very hesitant to get the COVID-19 vaccine. I understand the people with type one diabetes were not part of the initial test groups. Is it safe to get the shot?

De Villa: For anyone else who has particular concerns around the vaccine, I find the best way to resolve those is to actually have the conversation with your trusted care provider, whether that's your family physician, or in the viewer's case, if there is a specialist that's involved in his care. I think that's the best way to try to resolve the issues. Certainly, if you're allergic to a component of the vaccine or you're too young to receive the vaccine, those are the two major reasons. But we understand, based on the safety and evaluation that was done on the vaccines that have been approved for use in Canada, there's a good reason to actually take on the vaccine. But again, concerns can always be addressed. And in the context of a good conversation and a trusted relationship with your care provider, I find that's usually the best way to address those.

CP24: How will individuals with high-risk chronic conditions be identified? For example, a viewer writes, I'm age 57, with type one diabetes, high blood pressure. My family doctor and endocrinologist are aware that my condition is a high risk, but how will the city vaccination group become aware?

De Villa: This is one of those things that we need to defer to our provincial counterparts. So, the way people will be sequence through and who gets to go for the vaccine at what point and how they will be notified is something that is currently under provincial purview. We'll look forward to hearing those details from our provincial counterparts. But I'm glad to hear that there are people, particularly those who are high risk and have particular medical conditions, who are clearly interested in getting vaccines. So, my suggestion to people is to read up, stay aware. Stay tuned, and make sure that you're ready to roll up that sleeve when your turn comes.

CP24: Can a breastfeeding mom get the COVID-19 shot?

De Villa: At last reading, I believe that there are no contraindications there, meaning that there isn't a reason not to take the vaccine if you're breastfeeding. So, again, good to have a conversation with your trusted care provider. Read up on information around what the vaccines are and how they work, and most importantly, be ready. Stay tuned to find out when it's your turn to get the vaccine, and be ready to roll up that sleeve. We know this is an incredible tool that's available to us in terms of protecting ourselves against COVID-19. And in the meantime, limit your interaction with others. Let's do what we can to reduce the spread of disease in our community until that vaccine turn arrives.

CP24: A viewer asks, what's the point of cancelling or rescheduling March Break when Easter is less than two weeks later? Have you considered attaching March Break to Easter because everyone will get together anyway, just like Christmas?

De Villa: As it turns out, any decision around March Break, to be clear, doesn't fall to us and local public health. That's something more for our partners in education to consider. However, I would say this to the viewer, as much as people love to get together for those special occasions and holidays, including religious celebrations, I would ask, for now, we've got variants of concern on our horizon. And we've seen what they've done in other jurisdictions. They took situations where COVID-19 transmission was actually going down, but because these variants are more transmissible, as they started to spread, you actually started to see more disease, subsequent waves of COVID-19 activity. My plea to the people of Toronto and frankly, throughout the entire province, the best thing we can do, what we all need to do together, really limit our interactions -- distance, distance and distance. This is the best thing that we can do to reduce the spread of COVID-19, reduce the impact of the variance of concern, and allow vaccines to have the best possible effect and best protection for us. And at the same time, all together, if we do these things, we will get back to life after COVID-19 in a faster and more expeditious fashion.

CP24: What are the guidelines from Toronto Public Health to school boards when it comes to students wearing masks? Children need mask breaks, a viewer says.

De. Villa: I think where we get an opportunity to ease up on masks are going to be in some obvious times like eating or drinking something. That's an obvious point, but also when you're outside, and at that point, keeping distance as much as possible allows for that opportunity to have a break. So, that would be our recommendation at this point in time.

CP24: What do you think about wearing two masks?

De Villa: It's all about the fit and where the double mask actually helps to promote that fit, that's a good thing, according to our colleagues at the CDC.

This interview has been edited.