While Toronto moved to stage 2 on Wednesday, the city's top doctor says residents need to continue to be careful and learn how to live with COVID-19 safely.
Toronto Public Health reported 73 new COVID-19 infections on Wednesday, bringing the total cases to 14,029. Of those cases, 1,061 have died, while 12, 061 have recovered.
"We also know from the experiences other jurisdictions that we can expect to see an increase in cases as more people are connecting, mixing, and moving around in our city," Dr. Eileen de Villa, Toronto's medical officer of health, said during a news conference.
"And until a vaccine or treatment is available, we must continue to be careful and to take care of each other. We need to keep assessing our local circumstances each week."
De Villa said residents need to keep practicing physical distancing and other public health measures to continue to move forward and not risk losing the progress the city has made to stop the spread of the virus.
The doctor also answered COVID-19 questions from CP24viewers on Wednesday.
CP24: On Tuesday, Toronto Public Health reported the death of a girl under the age of 10 who tested positive for COVID-19. Can you give us more details about that situation?
De Villa: We don't get into personal details or specific details on any given case, just out of respect for the privacy of the individuals involved in the family, who are mourning the loss of a loved one and a young one at that. I can tell you that there are situations where there are other medical conditions that are more relevant, and that are actually in our understanding were more significant and were involved in the death here that you can die with COVID, but not necessarily of COVID. It all depends on the circumstances. I can't get into greater detail than that, but that is our understanding of the situation. We're looking at a death that was with COVID, that COVID was present, but the death wasn't actually due to COVID.
CP24: What do you see in terms of COVID-19 trends when it comes to people under the age of 20?
De Villa: We are seeing as of late more cases amongst the younger age group. We know that younger aged individuals are out and about more often working in the workplace doing essential work, and that creates that risk opportunity. When people are out and about, they're mixing and interacting, which creates the possibility for virus spread to happen. But that's why if we keep good public health measures in place, we can reduce that risk by staying home when you're sick, keeping your physical distance, washing your hands or using alcohol-based hand sanitizer. And if you can't maintain that distance to wear a mask, to protect everyone around you, and if we all wear the mask, we protect each other.
CP24: With Toronto entering Stage 2 of reopening, are we setting ourselves for a resurgence of the virus?
De Villa: We know we've seen this experience in other jurisdictions. Other places around the world are a little ahead of us in terms of the timing of their outbreaks. We know that there is a period you get some decline in COVID-19 activity, as we've seen here. We can't stay closed forever. This is a question of balancing out, protecting ourselves against COVID-19 while at the same time, also restoring all the activities that we need to restore in order to have lives and to take care of the other aspects of health. It's all about achieving that balance. And so that's why we're continuing to emphasize all the things that we know about virus control and limiting spread of the virus. And those are the things I've said over and over again. Those good public health practices -- keeping that physical distance, staying home when you're sick, washing your hands, trying not to touch your face. If you can't maintain that physical distance, please wear that cloth mask. It's the best thing we can do to protect each other.
CP24: As a medical officer of health, what's your reaction to the news of Windsor-Essex being allowed to reopen when just two days ago, it was not given the green light to do so?
De Villa: I don't know the specifics of what's happening in Windsor-Essex as we're pretty occupied here in Toronto. However, I do know the colleagues at Windsor Essex health unit. I know Dr. Ahmed, who is the medical officer of health there, and I have great confidence in his ability to make good judgments and do good public health practice. I have complete faith in my colleagues at the Windsor-Essex health unit. I know that we're eager to create that balance between COVID-19 protections and ensuring that we're able to restart and continue the other aspects of life because that's important for health too. It's a very delicate balance, but it's an important balance that needs to be struck.
CP24: When will playgrounds reopen?
De Villa: I don't know that there's a very simple answer to that. Other than to say that there is an existing provincial order that prohibits the use of playgrounds at this point. And my understanding is that when we look at the provincial reopening framework, they've got playgrounds slated for reopening in stage three, which if we can stick to our public health measures and continue to do all the things that we know are important in terms of limiting virus spread, hopefully, we'll be at stage three sooner rather than later, but it does rest on all of us to get there.
CP24: How can swimming in a pool be safe during the pandemic?
De Villa: As I understand the science, there isn't much that suggests that there's a high risk of virus transmission through the water. The main root of spread when we're talking about COVID-19 is close contact with somebody who has a COVID-19 infection. And when we're talking about close contact, we're talking about contact with the respiratory droplets that come out of their nose and mouth when they talk or sing or cough or sneeze. That's the major risk factor. You can maintain distance if you can maintain distance and stay away as far away as possible from those respiratory droplets. That's what reduces the risk of COVID-19. Hence, you can see that pools with appropriate distancing measures can be reasonable, and they're outdoors. We know that the risk of transmission is much lower when we're in an outdoor setting, lots of air, and air movement.
CP24: What new things have you've learned about the novel coronavirus?
De Villa: We've talked a little bit about understanding and an increased understanding of asymptomatic spread or pre-symptomatic spread. I think we've also understood a lot more around how being in an indoor closed space with close contact are risk factors. That's why, as you see us move into stage two, you see us promoting outdoor types act of activities. Patio dining allows for some degree of restaurant reopening and restoration of regular activity but with reduced risk. Five months ago, we didn't know very much. We didn't even have a name for this virus. I do think that we are still learning more. We still have questions that need answering.
I look forward to seeing what science provides to us, but most importantly, I'm looking forward to having science provide us with treatments and a vaccine for this virus.
CP24: Do you expect physical distancing to continue as we move into stage 3 in a couple of weeks?
De Villa: I think physical distancing is going to be with us for quite some time. I just talked about the need for effective treatments and ideally, a vaccine to prevent COVID-19 infections from happening in the first place. But we know that the vast majority of our population continues to be susceptible to COVID-19. We just haven't reached that level of infection and therefore don't have that level of immunity. That's why I'm looking forward to the vaccine to get high levels of immunity and arrest the transmission of this virus and this disease. Until we get to that point, physical distancing will continue to be part of our lives, part of how we live and co-exist safely with COVID-19.
CP24: Is physical distancing is the new norm?
De Villa: I think that speaks to the resiliency of us as human beings that we figure out how to adapt, and we figure out how to make a good go of it in our current circumstances in our environment. That's what we're asking people to do, not just for themselves, but for the benefit of all of us, so that we can get back to enjoying those aspects of life that frankly we've had to give up for many weeks now.
CP24: Why are gyms in the later stage of reopening when distancing measures can easily be managed? Is there evidence from other jurisdictions that gym opening when public health measures are in place have been associated with COVID-19 outbreaks?
De Villa: Physical activity is fabulous for both physical and mental health. It's not so much about the gym I don't think as it is about the physical activity and that needn't be confined to the gym. I would encourage people to engage in physical activity. Gyms are not an option right now. When I look at the provincial reopening plan, gyms, as I recall, are in stage three. And when we look at what's happening in other jurisdictions, while it's not about gyms, I have seen table tennis clubs in Seoul, South Korea, where they've had outbreaks. And I think the issue is that you're talking about an enclosed indoor space where people tend to breathe heavily because they're engaged in physical activity. You have a closed space, lots of heavy breathing, and that creates the possibility for virus spread. By all means, get out there, enjoy some physical activity. It's good for you to do it outside. The risk of transmission of COVID-19 is much, much lower when you're in an outdoor environment. You've got lots of air, lots of air movement reduces the risk of spreading from one person to the next.
CP24: A viewer asks, I have read that face shields are much better than masks and protect the wearer better, and you can breathe and speak better. They are reusable and would be environmentally better than all the disposable masks that are adding to landfills. Not to mention being disposed of improperly. Why are face shields not being mandated or at least encouraged to control the spread of the virus?
De Villa: There were a couple of different layers in there. For one, it's not entirely clear to me that face shields are, in fact, better than masks. And I assume we're talking about the general public here, so I can appreciate that there are certain circumstances, especially in health care where a face shield is required and other personal protective equipment. But if we're talking about members of the general public, the message is very simple. One, please try and maintain physical distancing. If you can't maintain physical distancing, especially when you are in an indoor space with members of the public outside of your social circle, I strongly recommend that what people do is wear a cloth mask. The good news about cloth masks is that they're not disposable. You're able to wash them. They can be reused. They're much more environmentally friendly that way. And they provide that protection. They help us to protect each other. Uh, as I've said, many times, you know, I wear a mask to protect you. You wear a mask to protect me. This is how we can create a safe environment for all of us from COVID-19. It's the best we can do in the general public to protect each other. I think that it's also environmentally more sound than using disposable masks.
CP24: Many wedding venues are waiting for an announcement from the province on how to proceed with events in September. What is the likelihood of more than 150 people being allowed in one room in September
De Villa: I think it all depends on the setting. My understanding is that weddings can happen right now, but there's limitations around the number of people, particularly in an indoor space. And this is to protect everyone it's to protect all those who are participating in the event. You don't want to have your wedding remembered for being a COVID-19 event. My understanding is with indoor weddings, it's 30% capacity to try to ensure that there is adequate space for physical distancing. In September, our weather is often still reasonable. And so outdoors is a completely different set of circumstances, certainly lower risk, but I don't know what the specific numbers will be then. Sadly, I don't have a crystal ball, and I can't meet those kinds of predictions, but some circumstances will allow for weddings. And it depends on how big the venue is and what's the capacity of the venue.
CP24: If COVID-19 cases continue to appear, will schools still open in September?
De Villa: Our provincial counterparts have asked school boards around the province to make plans and to make plans for different types of scenarios to have a variety of options available. We remain hopeful that we will be able to restart schools. I realized that maybe it's not everybody's favourite activity, but schools play a very important part in the lives of our young people. They have good health benefits over and above the educational benefits. I'm keen to see schools come back. They're important parts of our daily lives for our young people.
This interview has been edited.