After several months of public health restrictions to slow the spread of COVID-19, provincial officials are still holding out hope that people will be able to gather with their extended families over the holiday season but one infectious diseases expert says Ontarians should prepare to spend Christmas differently this year.

Earlier this month, officials urged Ontarians only to gather with their household for Thanksgiving as COVID-19 cases continue to climb in the province and on Monday, Ontario’s chief medical officer of health asked residents in Toronto, Peel Region, Ottawa, and York Region to skip trick-or-treating due to high levels of transmission in those communities.

“My friends, we all know that this isn’t going to be a regular Halloween and the steps we take now will determine what the holiday season looks like this year,” Premier Doug Ford said at a news conference at Queen’s Park on Monday.

“We need to work together this Halloween to protect Christmas and the holiday season this year.”

Last month, Prime Minister Justin Trudeau also suggested that Canadians still have “a shot at Christmas” if we can bring the number of active cases down, comments that were made just before infections began to spike in the country’s two largest provinces.

Speaking to CP24 on Tuesday morning, Dr. Isaac Bogoch, an infectious diseases specialist and researcher at Toronto General Hospital, said he believes some provinces, including Ontario and Quebec, will likely have to impose restrictions on gatherings over the holidays.

“It is a long fall and a long winter ahead and rates of COVID-19 climbed pretty quickly at the end of August and look where we are at now... based on the trajectory we are seeing now, it would not be surprising to me if we are going to have a modified Christmas and New Year holiday,” he said.

“I know no one wants to hear that.”

He noted that the holidays are still several weeks away and it is possible that cases will decline in the hardest hit regions.

“Obviously we need good policy. We need businesses and organizations to do the right thing to create safe environments and we need citizens to do the right thing to make the right decisions,” Bogoch said.

“If we all do our part, we can get case numbers lower and maybe we can have a somewhat… normal holiday season but I think we are going to see some modifications, unfortunately.”

Trick-or-treating can be done safely: Bogoch

Bogoch was one of a number of people who questioned the province’s decision to cancel trick-or-treating this year in the four regions that have been reverted back to a modified version of Stage 2.

At Monday’s news conference, the premier was asked about the province’s logic in keeping patios and dance studios open while at the same time indicating that activities like trick-or-treating are not safe.

In a tweet, Bogoch said the decision didn’t “sit right” with him and said the province should be finding ways to “do things safely rather than cancel.”

“There is a variety of ways that this can be done in a safe manner and I think many people are going to choose to do so,” Bogoch told CP24 on Tuesday.

“You've heard some medical and health leaders say that this can be done safely... there certainly have been some mixed messages. I do think it is important to adhere to the local public health guidelines and I will be adhering to those but of course there are strategies to do this safely.”

The province's top public health doctors have asked people in the four COVID-19 hot spots to spend Halloween with their own household this year and consider activities such as an indoor candy hunt, pumpkin carving, watching movies, and decorating lawns instead of trick-or-treating.

Toronto Mayor John Tory said the city accepts the province’s advice on trick-or-treating this year.

“I'm not a doctor, I'm not a scientist, and I don't know enough to be able to know what is going to be able to contain the spread of this virus and what isn't. I'm satisfied that people have spent the time necessary to try to make the best judgment they can,” the mayor said on Tuesday.

Tory said experts frequently have differences of opinion and the advice from provincial health officials is in line with what the city’s own medical officer of health recommended.

“All of the cancellations of these events... this is painful stuff but in the end it is based on the advice we have from people who are in a position to know what is going to stop the spread of this virus and get this nightmare over with,” he said.

“So everybody has an opinion but we have to rely on the ones that come from the people we have working for us.”

Tory’s comments were echoed by the premier, who said the medical officers of health in all impacted regions agree with the province’s guidelines.

“You can find a few docs that will disagree all the time. We find all the time a certain group of them. If I followed some of the advice that I heard from those same people at the beginning, it would be a real disaster,” Ford said Tuesday.

When asked about enforcement of the guidelines, Ford said officials are relying on the people of Ontario to follow the rules.

“The enforcement is trusting the people of Ontario that we’ve been trusting ever since the beginning of this pandemic. The vast majority of people are listening and going by the guidelines and protocols we’ve set out,” he added.

"If you want to load a whole bunch of kids in a car and drive 30 miles, we don’t have enough police. We can’t be checking every single car, we can’t be checking every single area. If someone has a house party well they are being reckless and they are being careless."