Toronto's top doctor, Dr. Eileen de Villa joined CP24 Live at 5:30 on Thursday to answer COVID-19 questions from viewers and to discuss the current status of the city during the pandemic.
The city has a total of nearly 7,000 COVID-19 cases with more than 500 deaths.
CP24: The messaging from Toronto Public Health has shifted from staying at home to encouraging residents to go outside and keep physical distancing. Why the change in tone?
De Villa: We’ve been talking over the last several days now about moving from exclusively a COVID response focus to one that balances that response with recovery. We have been seeing some promising signs, and we’re still in the early days. We’re not out of the woods yet, but we are starting to see some signs that tell us that we are at their peak period, and we’re hoping to see the peak behind us in the not too distant future. How do we start to learn to live with the virus in our community without always staying at home? Maintaining physical distancing, staying safe, but allowing people the opportunity to try and resume certain aspects of life in our city.
CP24: From a viewer – I wanted to know what percentage of the cases in Toronto is as a result of community spread, and based on the data that you have available, is there any chance that we can maybe see our families anytime soon?
De Villa: We know that at the beginning of the outbreak, most of the cases had to do with travel to other places outside of our city. And over time, that started to change. But I can tell you this, the biggest risk factor for getting a COVID-19 infection is having close contact, especially household contact with somebody who has COVID-19 infection. If you have somebody in your household who has an infection, and you live with them, you’re at really high risk for that. And that’s about 35 per cent of our cases. When I last looked at our data, about 30 per cent of our cases are due to community spread at this point in time. That’s the basic breakdown of cases.
The question now, what about getting together with family at this stage of the game? We’re still pretty cautious about that, particularly for those who are in the older end of the age spectrum. As much as we want to see some of our older family members, our grandparents and the like, they are very, very susceptible to severe impacts and in severe outcomes associated with COVID 19. I’m encouraging people to get outside a little bit to enjoy a little bit of the sunshine, get some fresh air, get physical activity. Good for your body, good for your mind as well. But still to be cautious. We’re not quite out of the woods yet.
CP24: If children are found to be low risk and not getting as ill as other vulnerable groups, can you please explain why they cannot go back to school or attend camps in the summer?
I think there are lots of questions still around what the impact is, what does illness look like in children and young people. In general, we’re seeing that COVID-19 illness isn’t as severe. The most severe outcomes seem to be with those over the age of 70 and certainly those over the age of 80. However, in recent days we’ve been hearing more and more cases of more significant inflammatory conditions. You’ve probably heard some news reports around Kawasaki disease that seems to be associated with COVID-19 infection, so new virus still learning quite a bit about this virus.
So far, it looks like children don’t have severe outcomes or severe illness, but we are starting to learn more and more as we’re seeing more and more cases. We’re going to try to balance things out, trying to balance COVID-19 protections along with making sure that we’re meeting all the other health needs, which include going to school and going to camp.
CP24: My boyfriend and I currently live in separate households, each with other people. Do you see the potential of the concept of a two-house bubble being an option for Toronto residents? I understand that both households would need to agree to this arrangement and would need to be exclusive to each other.
De Villa: I’ve heard this before. Other jurisdictions are doing that. I’m going to guess that the viewer probably has heard of this concept from other places that are already practicing that. I’m hopeful that as we move along in our outbreak and as we start to see signs of improvement, that we will be promoting this kind of activity shortly. For now, we’re still suggesting physical distancing where we’re saying that it’s okay to get outside and enjoy a little sunshine, a little fresh air, maintain the physical distancing. For now, we are slowly getting there, but remember, we’re not out of the woods yet.
CP24: Are we allowed to see our friends as long as we keep physical distancing measures intact?
De Villa: It’s not all that straightforward. And I can completely appreciate why people want to actually connect with their friends. And as great as the technology is, there’s nothing quite like connecting with people in person. I think that maintaining that physical distancing is important.
People should wash their hands if they’re enjoying a snack or some food at wherever they’re out at. But I think you have to keep in mind that there are still provincial orders in place around gatherings of people. And in particular, there are restrictions around having gatherings of more than five people. So that’s just one thing to keep in mind from the provincial perspective. But please, above all, physical distancing and wash your hands and maintain good respiratory hygiene, cover your cough and sneeze and all the good stuff we tell you to do every year.
CP24: Why have we not mandated facial coverings in public, especially in a densely populated city? Many of the countries that have had mandate had this mandate have been able to reduce transmission.
De Villa: Well, we’re certainly not stopping people from wearing masks if they feel that that’s an important thing to do. And we’ve heard already from our partners at the Public Health Agency of Canada that in those circumstances outside where it’s difficult or impossible to maintain physical distancing, that wearing a mask is a reasonable thing to do. But remember that when we’re talking about wearing a nonmedical mask, we’re talking about you preventing your germs from going to other people rather than protecting yourselves from others. So, it’s about preventing your transmission of disease to other people.
I think the one thing that we have to remember though, is that it’s not always possible for everybody to wear a mask. There are some people in our community that have significant respiratory issues already to begin with or have particular health conditions that make wearing a mask difficult. So, it may not be for everybody, but for those who can, if you’re not able to maintain physical distancing, which is still the first and best approach, then wearing a mask is quite reasonable to prevent the spread of disease from you to others.
CP24: A viewer says she has great concerns regarding shops opening with the street front entrance. Will people not want to shop with friends? And once in stores like bookstores, touching books or other items by many hands, is that not dangerous? Shouldn’t everyone wear masks and gloves?
De Villa: Opening of retail stores that will be happening on Monday as per the provincial new directive is only for curbside pickup. So, there’s no actually people quite yet in the stores. So for now, we think that this can be managed. While there are certainly lots of people here at the city that are actively working on this to make sure that we’re prepared and that businesses are ready and that the public knows what’s expected in order to protect themselves and those around them from COVID-19 so that we can do this safely.
I think we’re going to see how that goes. It’ll be a good demonstration to see what the challenges might be so that we can continue to learn and improve constantly. But above all, health and safety are going to be the top priority while we seek to try and bring business back and restart all the activities that we’re used to doing and what we’re used to being able to have in our daily lives.
CP24: Why are they allowing hardware stores to open as long as they follow guidelines? People will walk beside other people, but they won’t open up golf courses. There is no contact with this sport, you can pay online, and other golf courses in other provinces are open.
De Villa: I think there’s good rationale there. You’re quite right. A sport like golf can be played without a lot of contact. I’m going to remind folks that there are a number of the restrictions that are currently under provincial order. The province did allow for golf courses to start to prepare themselves to get ready for an opportunity to open. And the province did release a framework. I hate to speak for the province, but I can tell you that they did release a framework looking at what conditions would need to be in place in order for businesses and other activities to resume in a safe fashion. They indicated that what we’re going to do is look at the circumstances of how well the disease is being controlled. Is healthcare ready as public health ready? What do our data say? And when we have all the conditions that are right, slowly but surely, we can start to add on and resume services in order to try and get our city back and our province back in the case of the problem.
CP24: What’s your advice for people who want to see their moms and give them hugs on Mother’s Day?
De Villa: I think you’ve heard the premier make some very reasonable remarks. He talked about how those 70 years of age and older are more concerned just given what we know about the impact of COVID-19 on those particular individuals. And I think he spoke to the common sense of people and the right that people have to make some reasonable choices around what makes sense for their health based on their understanding of what their health conditions are. So, I think that all makes sense. I would suggest to people that we do have to be careful, particularly for those who are over a certain age and for those who have chronic conditions, and therefore at higher risk. But I can appreciate why people want to acknowledge and recognize their mothers.
CP24: What do you think about Mount Pleasant’s decision to open the cemetery for limited hours so people can visit their mothers?
People want to honour their mothers to acknowledge Mother’s Day of the year. I wasn’t specifically consulted, but I will tell you this, maintaining physical distancing while going out and doing those things that are important in our lives is the key at this stage of the game.
This interview has been edited