In her weekly segment with CP24, Dr. Eileen de Villa, Toronto's medical officer of health, answers viewer questions about COVID-19, including vaccine policies, delta variant, rise in new cases and the latest public health measures.
CP24: The province's chief medical officer of health issued a directive requiring hospitals and home and community care service providers to have vaccination policies. What do you think about this?
De Villa: I think that moving towards a vaccine policy is certainly an important step forward, given where we are. And we know how important vaccines are to our COVID-19 response in terms of protecting ourselves and protecting others around us. I understand that they're putting this forward as a first step. I did not hear that it was the final step. So, I'm looking forward to hearing what else they might do, given the changing circumstances and in response to what we're seeing, particularly their concerns around the delta variant. That's certainly what I heard the chief medical officer of health say, and I think that it is certainly a step in the right direction.
CP24: Furthermore, several companies have come out with their own vaccine mandates. We expect that a lot more companies will follow suit. What are your thoughts on this?
De Villa: It's interesting, and I think it's good to see people make these kinds of maneuvers and make these kinds of policies because I think it speaks to the confidence that people have in respect of vaccines. And when we look at the data, we see that there's good reason to feel confident about the vaccine. And that's not just the data here, locally, in Toronto, or even just in the province of Ontario. It's what we're seeing all around the world that it does make a significant difference to be fully vaccinated in terms of protecting oneself and the community around yourself. So, I think these are good moves. And I think that these are promising signs of the kind of confidence that we're seeing increasingly by the public and business owners in the vaccine and its benefit.
CP24: In the past few weeks, the number of new cases in the province has been rising, and it is being attributed to the highly contagious delta variant. Toronto's numbers have also climbed. How concerned are you about the delta variant?
De Villa: I think that we had all anticipated, and you've heard me say this before, that we would anticipate and we did anticipate that there would be increased cases, in light of people moving around more having more contact, especially when there are still a number of unvaccinated individuals in our population -- some who have who are eligible to get the vaccine and haven't yet gotten the vaccine, and some in our population, particularly the youngest amongst us, who just aren't eligible quite yet for the vaccine, but we're hoping we'll soon have vaccine made available to them as those studies are proceeding. So again, the case increases, not super surprising. But it just reminds us again that there is an opportunity for many people in our population to go out take advantage of the vaccine if they haven't already done so. And for those who have started that course but haven't yet finished and are due as it were for that second dose of vaccine, I can't say enough how important it is to go and get fully vaccinated to protect yourselves to protect everybody else around us, and in particular to protect our children who can't at this point in time, get vaccinated.
CP24: How about breakthrough cases – people fully vaccinated and still getting COVID-19? How are you looking at these numbers right now? Are they of concern? Is the vaccine doing its job in those fully vaccinated that ultimately still get COVID?
De Villa: There is no vaccine on the planet that is perfect. It's just the simple matter of fact. There's no perfect solution to pretty much anything, and the vaccine is no different. However, what we are seeing in terms of vaccines is still very good protection in terms of infection, even in light of the delta variant. But more importantly, what we see is that it still has, thus far, a high level of protection. It provides a really high level of protection for the most serious outcomes associated with the COVID-19 infection. And in fact, when we look at data, whether you're looking at data here in Toronto, you're looking at data from the province or jurisdictions all around the world, the vast majority of those that are hospitalized, particularly with that delta variant of COVID-19 are those who are not vaccinated. So, it speaks to the value of the vaccine to protect us from the most serious outcomes associated with the COVID-19 infection.
CP24: What do you think about the policies being put in place for health-care staff who refuse to get vaccinated but continue to work with vulnerable people?
De Villa: I think that what's really important about putting these policies in place is that at the very least, I should hope that they start those important conversations. And you have heard me say this before, and I will say it again -- this is a healthcare intervention. Getting a vaccine is still a medical intervention. And it's important for people to ensure that they ask their questions and that they have them addressed. I think there's a lot of evidence. I know there's a lot of evidence that speaks to the effectiveness and safety of vaccines. And I am quite certain that when we look at people who have yet to get vaccinated or yet to complete their vaccination, there are a number of them that just have some reasonable questions, and when afforded that opportunity to actually ask the questions in a non-judgmental, very honest and transparent conversation, we have found that, in our experience, people will go forward and get the vaccine. Get your questions answered. But I would just ask that people go to reliable sources of information. Whether it's the Toronto Public Health website, or whether it's the Public Health Ontario website or phone lines that have been established by healthcare providers here in our community, I would strongly recommend that people get their questions as answered but do so by relying on good sources of information, reliable sources of information. I would also ask members of the public to go out and tell people about their vaccination experience. Because we know that friends and family that talk to others about their own vaccine experience and the protection that they feel from the vaccine really help people make those decisions in the right way.
CP24: A viewer asks, "what do you think our situation for the fall and winter is looking like in regard to schools and lockdowns according to the data you have now?" There's that dreaded L-word.
De Villa: I think we can all agree that nobody really wants to see that dreaded L Word come back. It's been a long, hard road over the course of the pandemic. And, you know, to the greatest extent possible, really, nobody wants to see that happen. You know, thankfully, we have the protective benefit of vaccines. But we do know that schools represent an area where people interact and mix with each other, and particularly for those in our community that are under 12 years of age, the vaccine is not yet an option. So, in order to preserve our ability to keep schools functioning well and to avoid any kind of restriction to the greatest extent possible, what we can do is all get vaccinated for those of us that are eligible. The best thing we can do is to get the vaccine. Get fully vaccinated and continue to practice those public health measures that we know make a difference -- masking, distancing wherever possible, moving activities outdoors as much as possible, especially while the weather is still good. These are the kinds of things taken together that can help us avoid that dreaded l word that I know none of us wants to hear about.
CP24: Another viewer asks, "Toronto Public Health requires proof of many vaccinations so that kids can go to school. Why is the COVID vaccine not required and mandated? It seems like a much more serious threat for schools."
De Villa: It's actually not Toronto Public Health that requires information on vaccines. It's provincial legislation. So, we implement the program underneath provincial legislation called the immunization of School Pupils Act. That is the legislation under which we collect information on student immunization, which would be under provincial purview. I would say this, though. We've heard now that we know that only those who were born in 2009 and before are eligible for the vaccine. You have to be about to turn 12 this year or and older in order to get the vaccine. So first and foremost, when I think about what actually will provide for the greatest safety in our schools, it's ensuring that all those who can actually get vaccinated are vaccinated, whether we're talking about students or staff or any other support person within that school environment. Of course, other measures as well -- masking and distancing and using all that good public health advice, including staying home if you suspect you might be sick -- are the things that will actually really support the safest school environment possible. In order to protect our kids, particularly those who can't get vaccinated at this point in time, the more the rest of us actually take advantage of the protective benefit of the vaccine, the safer we'll be able to keep our youngest children until such time if they're eligible for the vaccine. I just can't say that enough. It's so important.
CP24: A viewer says more and more businesses are requesting proof of vaccination from their customers. He asks, "what do you say to those who think this is an infringement of their rights? Or is it our moral responsibility to provide our vaccination status to those we come into contact with?
De Villa: I do think that there is an important conversation that can be had with people around whether they're vaccinated or not. I realized that it may be viewed as intrusive by some people. The viewer question was asking about a moral argument or rights. I don't know that I have any unique expertise in this arena to offer on morality or legal rights and what have you. But I can't say this. We know that the vaccine is effective. It is very effective in terms of protecting ourselves. We see reduced hospitalizations amongst those who are actually fully vaccinated. And conversely, what you see is more illness and more hospitalization and more severe outcomes amongst those who are not vaccinated. We see this in countries the world over. If you're looking at the news out of what's coming from the United States, our neighbours just to the south, they are having some serious challenges in keeping up from a healthcare perspective, whether we're talking about emergency rooms, just general hospital beds, or ICU beds, real challenges around that. So, I encourage people to talk about their vaccination status, to ask others in order to start that conversation to explain to people that you had a good experience with the vaccine or what your side effects were so that people really do understand what the real experiences with vaccines and can match that up with the data that we're reporting from all around Toronto, from around Ontario, from around the world around the effectiveness of vaccines. So, you get a little bit of personal information and some big-picture data.
CP24: A viewer says her daughter works at a sports bar and she is the only worker fully vaccinated. She says her daughter does not feel comfortable with other staff. It also puts a huge risk to customers when handling food and drinks. She asks, will employees of restaurants and businesses that prepare food need proof of vaccine?
De Villa: That's certainly an interesting situation and an interesting question. I don't know that I have a complete answer for it, though. I don't know where the policies will go. We've certainly seen the provincial government put forward some policies and make some recommendations around what workplaces could do in terms of introducing policies. But they've made the first foray. I think it's a good step forward. And I think that there are important questions here. One, there are employee safety issues. And we know that employers have some obligations outside of public health -- employer obligations under occupational health and safety legislation to support safe work environments. And I think that this is one important aspect that employers need to think of and should be speaking to their occupational health leads and consultants about. But in the meantime, I think that to the extent that we are altogether able to encourage people to pursue vaccination, given the kind of protection that it provides, and to really encourage people to take advantage of vaccines, I think that is the greatest thing that many of us can do in our own respective circles and spheres of influence. Certainly, you've heard me speak about it. But I think there is still much more power when each and every one of us speaks to the benefit of vaccines, particularly equipped with the data and knowing that there is the greatest protection provided against hospitalization, against those severe outcomes and allows us to enjoy all these activities that we've missed for so many months now by actually getting more and more of us vaccinated. That's the best advice I can offer at this point.
CP24: But there will be people who will never change their minds about vaccines.
De Villa: I suppose that's true. But from what I've see and when we look at our data here in respect of vaccine, it's actually a very small percentage of people who are very extreme in their perspectives against the vaccine. I think that there are a number of people and that's certainly borne out by the experience that we've had on the ground -- that yes, there are people who are perhaps hesitant, who have questions, who haven't rushed out to get vaccine quite yet. But when afforded that opportunity to engage in real dialogue and do so in a way that doesn't feel like they're being judged. It's reasonable for people to have questions. I only ask that people go and get those questions answered by reliable sources of information, using the best available science. And in our experience, when people actually have that opportunity to ask questions, to engage in dialogue with people that they can really trust and who they know have their best interests at heart, they do start to change their minds and they do go out and pursue the vaccine. That's been my experience over many years of public health practice.
CP24: For those fully vaccinated, what's your message to them when it comes to safety measures, given that delta cases are on the rise.
De Villa: Well, for those who've been fully vaccinated, first, I would say thank you for going out and getting that protection for yourself and for those around you. I would say, though, that look, the best thing to do is actually use all the layers of protection available to us. So, that includes masking and distancing, particularly in those closed environments that are higher risk, and hand washing or hand sanitizing, staying home when you're sick. These are still important measures. So, the vaccine is great, but it's even better and strengthened when we add other measures on top of it. The message continues to be -- look, if you've got symptoms that are consistent with illness, best to err on the side of caution at this point in time. Stay home, get yourself tested if it doesn't improve, and then do the right thing. Protect yourself, protect others.
