Toronto's medical officer of health says the city is moving in the right direction after reporting only 14 new COVID-19 cases on Tuesday, the smallest number of new cases "in quite some time."
"Overall, our local COVID-19 cases continue to decline, but it is a slow decline," Dr. Eileen de Villa said during the city's COVID-19 briefing.
"This tells us we need to be vigilant in our measures to make sure we continue to see lower COVID-19 activity in our city."
Toronto Public Health reported 59 new coronavirus infections over the past two days, bringing the city's total to 14,956.
Of those cases, 1,126 have died, while 13,259 have recovered.
De Villa said Torontonians should stay focused to prevent the increase of virus activity so that the city could move forward to stage 3 of reopening.
"I know we are all looking forward to moving to Stage 3. However, for now, I believe that we are at the right place for our city, given our current circumstances," de Villa said.
"In the meantime, we continue to prepare, based on the experiences of other jurisdictions that have reopened ahead of us, so when we do move to the next stage, we know we can do so safely."
Meanwhile, de Villa spoke to CP24 to answer COVID-19 related questions from viewers.
CP24: With reports of passengers testing positive after being on flights, do you think there is any heightened concern about flying? Would you feel comfortable flying at this point within the country?
De Villa: I think everybody has to make their risk assessment and understand why you're travelling, and is the risk worth the reward? I think we all have to make those decisions for ourselves. There are good practices that are being adopted by airlines to try to protect the passengers and the staff. The airlines have no reason to want to create unsafe conditions for their passengers or their crew. But certainly washing hands, maintaining distance as much as possible and wearing a mask are going to be the kinds of things that people can do to mitigate their risk as much as possible. But it does come down to individual decision making.
CP24: Are you surprised to learn about some people not following quarantine laws when they come into this country?
De Villa: That's not a new circumstance, and there are always going to be some people that either flout the rules because they're not interested in following them, but some are going to float them because they don't realize what exactly the rules were. I think we need to try to give people the benefit of the doubt and to give them the reasons why we're asking them to do what we're asking them to do.
I strongly believe in what we have seen here in the city of Toronto: people aren't interested in making others sick. I think when we give people the reasons why we're asking them to take on certain actions, they're more likely to follow those. But from our perspective as public health, when we have put positive cases of COVID-19, we're following them up. And part of that follow-up is to ensure that they're sticking to the rules of isolation that they're minimizing any kind of exposure to others.
CP24: We've heard about the situation in Montreal, where there've been a lot of people out in bars, and now there is a cluster of cases. Did they open too soon? Is this a cautionary tale for us?
De Villa: I think we should be learning and taking the time, learn from the experiences of all other jurisdictions that are either ahead of us in their outbreak or have taken on certain actions ahead of us for whatever reason. There is a lesson to be learned from Montreal. We are seeing this in other jurisdictions as well. But by the same token, we've also seen other jurisdictions that have successfully opened reopened and restored activities, restaurants, and bars and aren't getting that. The question is how we make sure that people are actually following the best advice that's out there -- washing their hands, making sure that they're watching their distance and wearing a mask where that distance can't be matched. We recognize people want to see friends and have some social activity. The real question is, how do you balance that? How do you get the right balance?
CP24: What is your opinion on students returning to school in September with no masks or social distancing as has apparently been suggested by some people?
De Villa: I think that we all appreciate that there is a strong advantage, and there are great health benefits for kids to return to school. The health benefits are not only for the children, but it's for the parents as well. We know that for kids to go back to school, it is an important part of people being able to get back to work. I think there are many reasons that we really need to seriously advance plans on the reopening of schools. That being said, we know that physical distancing and handwashing and where possible wearing a mask are the kinds of actions that can help us minimize the risk to those in schools. We're talking about both students, the teachers and all the other staff that it takes to run schools. As local public health, we're actively engaged. Education is a provincial purview, and it's absolutely for the school boards to work out with the ministry of education. But we have a role as local public health to help provide advice, provide support, and help create those conditions so that everyone can get back to school and do so in a safe manner.
CP24: What precautions would you expect to be put in place to protect educators and students? Classrooms are not very large, and a six-foot distance with 20 students and educators are highly unlikely in most buildings.
De Villa: As you've heard, through the earlier reports, there are still a number of these details that are being worked out. We've heard commitments from the mayor to try and provide space wherever possible, to be able to support our school boards in creating that space for physical distancing. I think there are a lot of options still on the table because we know how important physical distancing is. We know how important hand hygiene is. How do we create the circumstances that allow kids to get back to school for parents to get back to work, but to do so in a way that respects health and safety, both for students and teachers? Lots of work still underway. I don't know that all the answers are worked out, but certainly lots of good options on the table and actively under consideration.
This is a new virus, and we are still learning a lot. This is the first time we're doing this, so we can expect that there'll be little bumps along the way. I do think that as long as everybody puts their best effort forward and that we're really all working together, that's what has seen us through this outbreak so far. And that's what will get us forward in the future.
CP24: A lot of people have been washing and sanitizing their hands since the beginning of March. But on the other hand, I always thought there was sort of a level of dirtiness that we should be putting up with to build up our immunities. Is there a concern down the road that when we come out of this, perhaps when we stop washing our hands regularly, that we will be more vulnerable to other things?
De Villa: I think I've heard those hypotheses that are out there, and they are just that. It's a pretty fancy word for saying theories that have not been proven out yet. Good hand hygiene is good hand hygiene, and there are risks associated with the infectious diseases that can be passed when we don't wash our hands. While living out in the environment, you're going to get exposed to all kinds of things. That's good for our immune systems, and it is part of life, but I don't think that that takes away at all from good hand hygiene. And when we look at the risks and benefits writ large, overall best to wash your hands. Wash your hands with just regular soap and water whenever possible. And if you don't have hand washing facilities and the next best thing is to use an alcohol-based hand sanitizer. That's what protects health best.
CP24: In less than two weeks, thousands of NHL players and staff are going to be arriving in Toronto as we're one of the hub cities. What is Toronto Public Health's role in this?
De Villa: We were involved as Toronto Public Health as were other partners, provincial public health authorities and federal public health authorities. It was a concerted effort and a shared decision. Each of us played our role in bringing the NHL hub city to Toronto, which has some benefits for our city.
It is a bubble. They are meant to stay in their bubble and effectively not present any risk to public health. They need to stay in their bubble. We have monitored and looked at their protocols very carefully to make sure that all is in place to best protect the health of the residents of Toronto. When it comes to testing, their testing is going outside. They're not drawing on local resources to get that testing done. And if there are cases that emerge here in our city light as would be the case for anybody who develops COVID-19 here in our city and is staying here in our city, we will follow up on the cases and the contacts. Again, all to make sure that we're keeping Toronto residents as safe as possible.
CP24: A young viewer asks, where did COVID-19 come from?
De Villa: I think that is still a bit of a question, and I don't know that it has been landed definitively. I wish I could give you the really specific answer, but the best understanding we have now is that this is a virus that came when viruses that come from animals mix up with human viruses and then spread amongst humans. I think we will have to wait sometime before we have the final answer on the question, but when we've got it, I'll be sure to share that with you.
CP24: How come it is not safe enough for family members to be together without social distancing, but it's okay to have waiters, waitresses to serve people in patios where the customers are not wearing masks?
De Villa: I think what we're looking at here is how much time you're going to have to contact people. Generally, when you're sharing a meal with others, there is a significant amount of time spent together at a relatively close distance, and that creates the risk. When it comes to servers, the amount of time you really will be spending in close contact with servers can be kept to a minimum. It's all a question of just trying to manage what's most important and the conditions that are likely to lead to transmission of COVID-19 from one person to the next. It's all about that physical distance and the other elements of handwashing and where possible wearing a mask. Obviously, that's not doable while eating. But certainly, for the components of the meal where you're not actually eating or drinking, wearing a mask, especially when you're in close contact with others, continues to be an important part of protecting oneself and those around you.
CP24: A viewer asks, my workplace has passed a rule that we have to wear a mask upon entering the facility and leaving. Over eight hours wearing that mask in this heat, I read that it's not safe to wear the mask for long times because you are breathing back carbon dioxide. Can accompany force you to wear your mask?
De Villa: I think that when it comes to what is happening within the workplace, that's something that I would speak to your local occupational health and safety representative about. There are employer responsibilities and obligations that employers have to their employees to make sure that they're doing the best to create a safe working environment. And without knowing the details of the workspace, it's difficult to offer that advice, but I do know that there are some very good practices out there. I know that my colleagues at the Ministry of Labour have put out all kinds of advice, both for employers and employees, to create safe working environments for all.
When I think about the circumstances within health-care settings, I can think about surgical procedures. Some of them do last as long as seven or eight hours, some even longer. For the entire surgery, often without breaks, the staff are wearing medical-grade, personal protective equipment to protect themselves and protect others. We know that this happens and that it may be uncomfortable. It's certainly not our regular practice to wear masks for extended periods. But again, it's got gaps. You are getting oxygen. While there may be some discomfort, I do not think there is a significant risk, particularly given what we know from health-care settings and experiences around the world with mask use.
CP24: Are the long-term symptoms being tracked? And do you see any similarities between these survivors? And do people fully recover? If no, does age or other health issues contribute to long-term symptoms?
De Villa: Because this is a new virus, one that we just got to know in January, we are still very much in the learning phase. Those data are being collected. Information on what is happening to individuals as they recover from COVID-19 infection is in the process of being gathered. I have heard those same stories, but I have to admit, I haven't been able to look at them in a very systematic way. Those studies are happening. I know we are all looking forward to understanding more about what the recovery looks like and what it means for us and what it means for health care.
We know that more severe illness happens amongst males who are older than 60 years of age. And those, especially that have pre-existing heart disease or diabetes have more serious illnesses. But we don't know yet what the long-term implications look like and the long-term outcomes because we just haven't had that much time yet with it.
CP24: With news of COVID-19 vaccine trials in Canada, how hopeful are you that a vaccine is on the horizon?
De Villa: It's very difficult to say. Certainly, there are promising trials out there. We know that we are seeing some early promising results. What it looks like in the long-term, again, I think we just have to stay tuned and remain hopeful.
This interview has been edited.