'Our battle is not over': Toronto’s top doctor answers your COVID-19 questions
Web Staff, CP24.com
Published Thursday, April 23, 2020 6:47PM EDT
Last Updated Saturday, April 25, 2020 6:32PM EDT
It's been one month since the city declared state of emergency to combat the COVID-19 pandemic. Following the declaration COVID-19 cases rose to more than 4,000 with 222 deaths.
Toronto's top doctor, Dr. Eileen de Villa, has been leading the city's response to the virus. She joined CP24 Thursday to answer viewer questions.
CP24: First of all, how are you doing?
De Villa: Thanks for checking up on me. I appreciate that. It’s been very difficult. This is an unprecedented global pandemic, and it’s challenging. But I’m grateful. I have a very strong network of friends and colleagues and family, and they keep me going. And I’ve managed to stay healthy.
CP24: We heard about the call for help from the Canadian Armed Forces, and the prime minister now says they’re going heed that call for Ontario. What are your thoughts on this?
De Villa: This is an unprecedented situation, and we know that there are certain homes out there that and certain communities that have had difficulty with this challenge because we’ve not seen anything like this before.This is a public health crisis. The likes of which we have not seen probably since something like the 1918 pandemic – the influenza pandemic in an earlier century. I appreciate that people may need extra help, and particularly in the private long-term care homes sector. We’re very fortunate here in the city of Toronto that the long-term care homes that are run by the city have had their share of challenges just like everybody else with respect to COVID-19. But they’ve been able to pull together resources thanks to redeployments from the city and assistance from healthcare partners and certainly from us at Toronto Public Health, but other homes and other communities, particularly those in the private sector, may not have that opportunity and may not have been able to access those kinds of resources.
So, I think this is a great example of a community coming together. Different levels of government coming together, different sectors coming together, -- united in a cause. And that’s to protect the health of some of our most vulnerable residents in our city and in this province.
CP24: We’ve heard so much about the so-called peak in this virus. When do you believe we are in the peak right now? And how does that look, and when does it start to go on the downslide?
De Villa: Well, what’s interesting about these kinds of things is that you can’t. You can only really tell when the peak is once you’ve passed it. But when you start to see some leveling off, as we have seen with respect to our case counts in our community, we have lots of indications that we are what I would call the peak period. You’re still going to see some days where case numbers go up, and then they go down a little bit and then they may shoot up again. But it does look like we’re getting some levelling off, particularly when it comes to community cases.
CP24 viewer: Since I have been quarantined with my families for the past few weeks and my cousins have been at their homes all this time, which means, we don’t have COVID-19, is it okay if we get together for some fun times?
De Villa: I want you to go out on a play date, but not yet. We all want to get together with our cousins. We want to hang out with our friends, with our family members, with people in our community, our neighbours. But we’re not quite there yet. So, I would say to kids all over and big kids to throughout our city, hang in there, stay the course. The more we’re able to stay physically distancing, staying at home as much as possible and not yet getting together with our friends and family, the sooner we will get our city back, the sooner we can get back to having those kinds of gatherings where we can connect together not just on video or FaceTime but hopefully soon in person.
But in the meantime, to get there faster, we need people to just keep doing the physical distancing. Keep staying at home, play with your siblings at home for now and soon. Hopefully, if we can keep this up soon, we’ll try to get you back with your cousins.
CP24: How will the schools be different once students start school? What safety measures will be in place to ensure students and teachers are safe?
Well, that’s an excellent question, and I think that is still something that is very much are being figured out. We are still trying to continue on with our current physical distancing and public health measures. I can’t state that enough. This is still really important for people to continue to do. We have to stay the course with our physical distancing, our public health measures in order to continue to see good control on the spread of COVID-19 in our community. We are of course eager to make sure that kids get back to learning. I mean, school is a really important aspect of for young people throughout our city and throughout the province. We’re going to have to figure out how do we make sure that teachers and students stay safe. We’ll have to figure out how best do we practice physical distancing because we will expect to see some COVID-19 still circulating in our community, and we want people above all to be saved. So still a lot of unanswered questions and lots of ideas being discussed. And I’ll look forward to having more concrete information to share with the public. And certainly, we’ll be sharing that information with the public in concert with our school board partners and teachers and all the people who make schools run in our city and throughout the province.
CP24: Is there clinical scientific evidence showing that 14 days after testing positive for COVID-19, the person is no longer capable of infecting others with the virus?
De Villa: That’s a really good question. And you know what I’ve told people when we’re asked questions around the virus is that remember this is a brand new virus. It was just identified in early January, and here we are towards the end of April, and we’re still very much learning about this virus. But what we understand so far about the virus is that if you actually acquire the virus from somebody who was infected with COVID-19, what we know is that generally, most people will start to show signs and symptoms within 14 days of having been exposed to that virus.
That’s why we always talk about this 14-day period of time. That’s generally the maximum time from the time that you were exposed until you’re going to start to show symptoms. So that’s our understanding of the virus. We are still trying to figure out lots of things about virus transmission. Scientists are working really hard on these questions, and that’s the challenge when you’re talking about a new virus, we don’t have all the answers yet, so we have to change our approaches. We change our response as we learn more about the virus because it’s been so concerning to learn about potential asymptomatic spread like to not knowing that you could be a spreader when you have no symptoms at all. That’s a real concern. But you know, you can look at it both ways. So, there may, there’s concern certainly, but the issue is that if there are a number of people who get infections and are asymptomatic, that also tells you that there are a number of people who don’t get particularly sick.
So, the real issue here is how do we make sure that those who might be sick but don’t know about it, stay away from those who we know get really serious illness if they get exposed to COVID-19. And based on the data that we have thus far, people who are most sensitive, who tend to have a more severe impact and more severe illness associated with COVID-19 infection or are those older than 70 years of age, those who have pre-existing chronic health conditions and those who have a suppressed immune systems for whatever reason. So the issue for us is how do we make sure that we separate these individuals? How do we best protect those who are most susceptible to serious illness?
CP24: I’ve worked in an essential office which relies heavily on paper files. These files are handled by multiple people during the course of a workday. How can we best protect ourselves and coworkers from spreading the virus? No one is currently infected.
De Villa: I’m glad to hear that there’s a workplace where everyone is well, and I would say keep up the good work. So, what’s the best thing to do? I’ve said this before: wash your hands, wash your hands, wash your hands, try not to touch your face. If you’re going to do that, try to wash your hands in advance.
And if you don’t have access to soap and water, then the best thing to do is to use an alcohol-based hand sanitizer. Cover your cough and sneeze ideally with a tissue. And if you don’t have a tissue, cover it with your sleeve or your elbow. And finally, if you’re sick, stay home. These are the things that we always need to do is this is a good advice we always give to people in public health, in terms of trying to protect yourself from respiratory illness, but especially important when it comes to COVID-19.
CP24: With the warmer weather, will mosquitoes be able to carry the virus?
De Villa: As far as I know, I don’t have any indication around a mosquito-borne transmission of COVID-19. Our understanding is that COVID-19 is spread by the droplets that come out of our nose and mouth. If you’re infected with COVID-19 and you cough, sneeze or talk or sing, little droplets come out of your nose and mouth, and they can spread to other people. So, you have to have contact with those droplets, and they get into your eyes, nose, or mouth. That’s how we spread COVID-19 from one person to another.
CP24: Are there any pediatrics covert 19 cases so far? If there are not, how vulnerable will a child with pre-existing medical conditions be? What are the probability and the severity of them getting the disease?
De Villa: Yes, there are cases of COVID-19 across the age spectrum. What we do notice is that younger people don’t seem to get particularly severe illness. That doesn’t mean it never happens, but on balance, we see the most serious illnesses, those that require hospitalization or, or those that lead to death tend to be in older populations. But of course, there are COVID-19 cases amongst a younger people and yes, amongst children as well. And we’re looking at a newborn right now. It’s got to be nerve-wracking for parents, and mom’s giving birth now, how severe could it be with a newborn being exposed to this virus? Well, I think that will depend on each individual case. I admit I haven’t read that much about newborns and COVID-19, but, clearly, we know that the disease can impact across the age spectrum.
It’s both a very exciting time to be a new mother, but it’s also a challenging time, especially when you can’t physically connect with your entire support network. And any of us who’ve had children know that it really does take a village to raise a child. Unfortunately for now for new moms that that village has to be virtual. Hopefully, they’re feeling that they’re getting the support that they need at this very important and exciting time in their lives.
CP24: Is there any indication of a timeline for the resumption of elective surgeries or procedures?
So, the way hospitals are run, they report directly to the provincial government. So, they have their own administration. But I think when we’re talking about the resumption of activities that are more like what we’re used to, more like what we would call normal for us. That certainly has to be guided by public health inputs. And as I’ve said before, through various talks, there are a number of things that we’re going to be looking for before we actually start to resume regular activities or something that looks more like regular activities in our city. So, we’re going to want to know that the disease is under control, that we’re seeing a declining number of cases for at least a couple of weeks. So, we’re going to want to assure ourselves that we’ve got good health care capacity and good public health capacity should we start to see COVID-19 activity rise again in our community.
CP24: When will we be able to see our children and grandchildren we don’t live with?
De Villa: I’m hoping that parents and grandparents are taking advantage of available technologies and connecting with their families virtually for now. I would encourage them to do that because we need to continue for now public health and physical distancing measures in order that we protect the gains that we’ve made thus far against COVID-19. Our battle is not over. We have to continue these measures, and I will do my very best. We are all doing our very best to try to get us to the point where we can start to connect with each other in person again.
However, in order to get to that time sooner rather than later, we need people to continue physical distancing, stay at home as much as possible. Try to limit your outings only to those things that are absolutely essential. And for now, to connect with family and friends via Skype, via FaceTime, using any video chatting method or using the phone.
CP24: I’d like to know if it’s okay to visit my neighbour or sit outside in her backyard eight feet apart and have a drink for an hour or so.
De Villa: I think that’s actually reasonable. The challenge is, how do you make sure it doesn’t turn out to be a whole street party. And so that’s the tough part. So, if it’s just you and your neighbour, keeping distance, talking to each other from your backyard.
This interview has been edited.