Toronto’s top doctor reassured residents Wednesday that all vaccines approved by Health Canada are safe, including the Oxford/AstraZeneca vaccine, which has been at the centre of controversy in the past few weeks.

At a news conference, Dr. Eileen de Villa, the city’s medical officer of health, said the vaccines used in Canada went through a careful and thorough review process.

“If the AstraZeneca-Oxford vaccine is what’s in the needle when my turn for vaccination arrives, I will take it happily and without concern,” de Villa said.

“The important thing is to be vaccinated when you are able to be vaccinated.”

Earlier this week, the United States accused AstraZeneca of giving an incomplete view of their vaccine’s effectiveness. The company said it plans to issue an updated data within 48 hours.

Concerns over blood clots after getting the shot have already cast doubts on the safety of the AstraZeneca vaccine. While Health Canada maintains that it is safe, the agency is working on adding a warning to the vaccine.

De Villa said if there are side effects, they usually are mild and will go away after a few days.

The doctor also dispelled information that the vaccines infect a person with COVID-19. She said the vaccines will help the body create antibodies to COVID-19 and give protection when the virus mutates.

“Usually, such mutations don’t amount to much. But sometimes, as with the COVID-19 variants we’re seeing right now, those mutations or changes in the virus can make it easier for the virus to spread,” de Villa said.

“That’s why it’s important to get vaccinated when you can.”

She encouraged people who have vaccine questions to visit the city website or call the Toronto Public Health hotline.

“If you have any doubt, ask – as part of being ready to take your turn to be vaccinated when the time comes, and so you can be confident in this valuable, safe and effective protection.”

The doctor joined CP24 to answer your questions about COVID-19.

CP24: The Ontario government unveiled its 2021 budget this afternoon, focusing on hospitals and vaccines. What did you see in the budget that sticks out to you?

De Villa: I haven't had much opportunity to really get a chance to look at things. But I'm certainly happy to see that there is some funding going towards health. We know that our hospital partners have certainly had a lot on their plates over the course of the last year and have much more to do yet. So certainly, happy to see that. Of course, I think it's important to recognize that when we talk about public health, it's not just about health services or what we do at local public health, it's about all the things in our community that go towards creating health. So certainly, hearing about funds for businesses and funds for families -- all these things contribute to the better experience of optimal health in our communities throughout the province. I'll certainly be looking for those elements in the budget over and above what looks like it is strictly going towards health and health care.

CP24: We are a few days since restrictions in the grey-lockdown zone have been loosened a bit. Outdoor dining has resumed in the city. How are the COVID-19 trends in Toronto going?

De Villa: Our numbers are not moving in the right direction right now. When I look at our indicators, you know, we're seeing our seven-day moving average on new COVID-19 cases going up. We're seeing hospitalizations going up, and we're seeing that reproductive number, that R that we all talk about, that tells us whether our outbreak is growing or shrinking. Unfortunately, that number remains stubbornly above one, which means that our COVID-19 outbreak continues to grow. The thing is, of course, we know what it takes to make a difference here. We know that the more we put distance between ourselves and others as much as we can, this does make a difference. And we know that we want people to have that opportunity to enjoy spring weather because, after a long winter, we all like to get some sunshine and some fresh air. But still really important to keep that distance to try to limit social interactions to the greatest extent possible, really interact primarily with people you live with until we can get more vaccines to get to the other side of this pandemic sooner rather than later.

CP24: There are talks about allowing outdoor fitness and maybe some personal care services to resume as well. Are you concerned at all about the mixed messaging?

De Villa: I understand that our provincial counterparts have been talking about what the future looks like. And I think that that's an important conversation. I think we all need to be concerning ourselves and engaging a good conversation around what safer reopening looks like. That takes time. It takes time to prepare these things. I think it takes time to prepare entire sectors so that they're able to offer services in a way that's as safe as possible. So, I think having good conversations and having those conversations early makes a difference. But I would just note for people out there watching, our numbers, unfortunately, are showing that the outbreak is continuing to grow. For now, the emphasis should continue to be on trying to maintain that distance as much as possible, wearing your mask -- all those self-protection measures. And, of course, getting the vaccine when your turn comes. These are the things that each of us can do to help reduce transmission and to get us to the other side of this pandemic.

CP24: We're hearing that the National Advisory Committee on Immunization may be changing the timing of the second dose again. It is not confirmed, but we are wondering what your thoughts on this.

De Villa: They are an important committee, and they are the key committee that provides all of us across this country with advice on immunization, and they take an evidence-informed approach. I think that's really important. I think what we're seeing here play out is the fact that we're dealing with a new virus about which we're still continuing to learn. And we're talking about new vaccines. Yes, studied and yes, approved for use having gone through these thorough review processes at Health Canada. But at the end of the day, we're still learning about these vaccines as they are new in our toolkit. And so when I see things like changing guidance from bodies like the National Advisory Committee on Immunization, what I see is responsible professional practice—looking at the circumstances, looking at new data and evidence as it comes in and then changing your approach in accordance with that evidence. So, of course, I always look forward to seeing what NACI has to say regarding immunization. And I think it's an important part of the ongoing development of science and our ongoing understanding when it comes to COVID-19 and the vaccines.

We don't know what the guidance is going to say quite yet. And I think I would say this that as we look to the guidance, there's a way to adjust practice in accordance with the best available evidence. I think that when the original guidance was provided, it was to talk about how the dosing or the interval between that first and second dose could be extended up to that point. But the sooner we can get that second dose in, the better it is. This was a method by which to confer the protection of vaccines to as many people as possible as quickly as possible. And it was premised on science that suggested that, in fact, there was good protection provided after a first dose. This is a strategy that has been used elsewhere around the world to good effect. The question is, how much dosing are we getting? How much supply do we have? How do we provide protection to the greatest number of people as quickly as possible? But then how do we make sure that we're also getting that second dose in for those vaccines that are two-dose vaccines in as timely a fashion as possible? The science changes, we just changed our approach in accordance with that.

CP24: There is a new coronavirus variant discovered in India. Have you heard about this, and should we be concerned?

De Villa: I admit I have not seen all the details yet. I've heard in passing about this new discovery in India and I'll be interested in reading more about it. But I will say this, with viruses as they replicate and as they reproduce, they do routinely mutate. This happens all the time with viruses. And many of these mutations turn out to be nothing really to get fussed about, but some of them do. Some of these mutations make for a more transmissible virus. That's what we're seeing right now with that B.1.1.7. We're seeing that compared to COVID-19 that was circulating before, B.1.1.7 is more transmissible and seems to produce more serious illness. It's these kinds of mutations and variants that we're very cautiously monitoring and watching for. I think we'll have to see what is emerging from other countries. But here's the thing about mutations, if the virus isn't being successfully passed from one person to the next, then the mutation doesn't occur. So, the more we can do together to reduce the transmission of COVID-19, the more we reduce the likelihood that these new, more transmissible or worse variants come out as part of that process.

CP24: A viewer asks, how many asymptomatic cases are missed due to the current method of trusting parents who do not want to be isolated or go to the stress of testing their child?

De Villa: That's a tough question because I think by its very definition, if you're asymptomatic and you're not picked up, we have no way of knowing. What I can say, though, is this -- in our experience when I talked to the great people who are working at Toronto Public Health as part of our school health team, what they're telling me is that even for those cases, people that thought that they were asymptomatic, who subsequently get identified as having COVID-19 and when you really get into questioning them and really go through a thorough history to understand, you realize that, in fact, many of them, if not most, have some kind of symptom. It's just that sometimes it's so wild that they didn't think about it or thought it was kind of a nothing. I guess the message to parents and to older kids out there who can manage this for themselves would be to look, even if you think it's kind of a nothing symptom, better to err on the side of caution for now. You might think it's just a, you know, kind of a little sniffle and it's not really something, but in this day and age and given that we're in the midst of a pandemic, best to pay careful attention. Avoid school where possible. Avoid interacting with others if you think that you have a mild symptom that could be COVID-19. It's probably the best thing you can do to help prevent that spread.

CP24: A viewer asks, when are you going to close all factories for 30 days to bring COVID-19 numbers down? The viewer says small businesses have followed the rules, and there are no breakouts, but they still can't open.

De Villa: I think this is evidence of some frustration that's happening out in the community. And I know we're all tired of being in the midst of a pandemic and the many restrictions that come along with that. But I will remind people that when it comes to the regulations and the determination of what's closed and what's open in the different stages of the COVID-19 Response Framework, that is left to the province. They are the ones who are in charge. It is their COVID-19 Response Framework, and they're the ones that make the determinations around what should be allowed for in which levels and what other activities are, are not allowed for in those different stages of the framework. However, again, I can't say it enough. There is so much that actually rests in our hands. We know over the course of the last year and a bit that distance does make a difference. And that continues to be the case, even when we're talking about variants of concern. To the extent that we're able to keep distance and if you have to work in person, following all the infection prevention and control guidance to the greatest extent possible is the best thing that we can all do together to reduce transmission of COVID-19. The only other thing I would add to that is that as your turn comes up to get the vaccine, I would encourage people to go out and get that vaccine. And when we take that all together, that's what will get us to that point where we can start to enjoy all those activities and services and things that we were used to having more freely similar to what they were before there was such a thing as COVID-19 in our community.

CP24: A viewer asks, can COVID-19 be contracted through the eyes? And if the wind blows a droplet on my face, can I contract COVID-19 from that droplet?

De Villa: The thing with COVID-19, we know that it comes from those respiratory droplets and secretions that come from somebody's nose and mouth when they have COVID-19. These are droplets that we all put out there all the time. You can't see them. But they come out of our nose and mouth when we breathe, when we talk, sing, shout, cough -- all of these things. And yes, theoretically, when it enters somebody else's nose or mouth and yes, potentially their eyes, that is a possibility. But it all does rest on you need a sufficient dose. You need enough of the virus to actually enter the system. So, I do say that when it comes to outdoor spaces, if we're talking about being in big open-air spaces, the risk is definitely lowered because even as droplets get put out by somebody, they're diluted because you've got big air volume. So, the likelihood drops significantly. It's not zero, but it certainly drops significantly.

CP24: A viewer says her 88-year-old mother is in close contact with a personal support worker who refuses to get the COVID-19 vaccine. Do you feel that it is right to send unvaccinated people into the homes of vulnerable old people?

De Villa: I don't know that there's a very simple answer to that. I will say this. Obviously, we want as many people as possible to get the vaccine. And we know that health-care workers are one of those essential groups for a vaccination effort because of the nature of their work and the people they care for -- many of whom are quite vulnerable to infection. I do think that it is an important discussion that we need to have. I think that my sincere hope is that for people like this personal support worker in question, we're able to change their minds over time, sooner rather than later so that they voluntarily take up the vaccine. The vaccine is safe. It's effective and it protects oneself, and it protects people around us. This is how we can best protect our community. And I would like to think that health-care workers are interested in advancing the health of the people that they serve and the people around them in every way possible. I think that if individuals have concerns, it makes good sense to ask your health-care workers if they're if they're vaccinated and to explore actually why they may not be as part of advancing that. But I think we have to make choices in terms of what risks we're willing to put ourselves in as patients and our family members as well. It is not a simple conversation.

CP24: If Ontario residents are social distancing, wearing masks washing hands staying safe, why are we still getting 1,500 positive covered results a day? Who are these people? And what are they doing wrong?

De Villa: Well, these people are us. I would say that there are many people for sure who are doing their very best to practice all those is self-protection measures that we've grown so familiar with. But there are circumstances where it's just difficult and we know that with the variants of concern that are out there, particularly that B.1.1.7 variant, that it is more transmissible. It's about 35 to 40% more transmissible based on the studies that I've seen as of late. And so that means it just makes it that much easier for the virus to go from one person to the next, even as they try their very best to practice those measures for self-protection—the measures for self-protection work. Don't get me wrong. They do absolutely work. We know that distance, distance and distance make a difference. But as with everything, there's no perfect and things do happen. All the more reason to stay as vigilant as possible around those self-protection measures and, of course, to get that vaccine when your turn comes up. It's this combination of things put together that actually is what will see us through and get us beyond this phase of the pandemic.

CP24: Where in Toronto do we see the highest number of COVID-19 variant cases?

De Villa: The simple answer to that question is any place where people are together. That's how the virus spreads. I think we have to keep reminding ourselves that it is a person-to-person spread disease. And we know that it comes from the droplets that come out of people's noses and mouths as they talk and speak and breathe. It's all about people together in close proximity to each other, especially in indoor spaces -- not exclusively -- but especially in indoor spaces. That's why the message is consistently and continues to be about keeping that distance, not getting into, you know, social interaction or close interaction with people other than those with whom we live to the greatest extent possible. And when you have to go out and you have that chance of coming into closer contact with people keep that as short as possible and, of course, wear that well-fitting mask. These are the things that actually do make a difference. And that's why you'll continue to hear us say those messages along with the messages related to the vaccine.