Toronto's medical officer of health answers pandemic-related questions
Published Wednesday, January 13, 2021 7:05PM EST
Last Updated Wednesday, January 13, 2021 8:26PM EST
As stay-at-home orders will come into effect on Thursday, Toronto’s top public health official wants to remind residents that “the pandemic will end, and better times will emerge.”
During the city’s COVID-19 briefing, Dr. Eileen de Villa, Toronto’s medical officer of health, said staying at home for the next 28 days is “absolutely necessary” to stop further spread of the novel coronavirus as the city reported 789 new infections.
De Villa noted that 7,708 cases of COVID-19 and 11 deaths were posted in the last week.
“It’s critical to create greater barriers between ourselves and the virus and to protect the health care system, which we all know now is under great pressure,” she said.
“Distance is the single most important barrier.”
In addition to the issuance of a stay-at-home order, the province also declared a second provincewide state of emergency amid surging COVID-19 cases and record high deaths.
On Tuesday, Ontario’s COVID-19 science table released its latest projections, including more virus-related deaths during the second wave of the pandemic than the first. The latest projections indicate that deaths per day will likely double from 50 to 100 if more restrictions are not implemented between now and the end of February.
“If the projections from the province manifest in the worst case, we should prepare for what that will mean here in Toronto, as we are the country’s largest city, home to density and some neighbourhoods at the highest risk,” de Villa said.
“In that instance, a significant number of higher case counts, hospitalizations and deaths would be right here in Toronto.”
The doctor warned that the belief that there are better days ahead will be tested in the coming months.
“As difficult as the next several weeks may be, in the end, the hard times will pass, the pandemic will end, and better times will emerge,” she said.
Dr. Eileen de Villa joined CP24 to answer COVID-19 related questions from viewers.
CP24: The stay-at-home order will be coming into effect on Jan. 14. There has been a lot of confusion about the rules. What is your initial reaction to the order? And can you tweak some of the rules?
De Villa: I think there's certainly a lot of interest in understanding the details and intricacies of the new orders and what the province is putting into place. And to be quite upfront, I have yet to see the details myself. But when you get past all the details, and when you boil it down to its essence, I think the resounding theme here is please, as much as possible, stay home. This is all about keeping distance. And if there is something that we know, something that we're very certain about that we've learned over the course of the pandemic, it's that actually distance makes a difference. Distance works. The more we are able to stay physically apart from people with whom we don't live, the safer we will all be as individuals and as a community.
CP24: Should we infer or understand anything from the fact that at this point, about seven and a half hours from the deadline, you don't have all the details of the new rules?
De Villa: I think what it speaks to is how very complicated putting together legislation is and making sure that all those I's are dotted, and those T's are crossed. And even then, there are often imperfections. Again, we're all human, and I'm sure they are doing their very best to try to put information out in a rapid but coherent fashion, taking into consideration the many different aspects that one needs to take into consideration. To my mind, I hope it's that they're being careful and thoughtful as they put together these very important pieces of legislation.
CP24: The order comes into effect two days after the province released new concerning projections. What do these projections mean for the city?
De Villa: The projections that were put forward and that gave rise to these new measures were done at a provincial level. But when we think about Toronto, Canada's largest city and the largest city in the province with a very high-density jurisdiction with many neighbourhoods that are at high risk just given the circumstances, we can certainly expect that a goodly proportion of those cases or those hospitalizations, or those deaths, if we find ourselves and the province in the worst-case scenario, it would happen right here in Toronto. That's why it's just so important that people understand and follow the advice to stay home as much as possible. That's what we can do to reduce virus spread.
CP24: In an interview with an infectious diseases specialist, he said the stay-at-home orders do not address the root causes of the COVID-19 spread. He said essential workers in congregate settings with no paid sick leave and no access to regular testing is the problem. If we do not address that, he said we are fooling ourselves. What do you make of his comments?
De Villa: I think he's quite right that there is an important issue that's there. But this isn't an either-or scenario. In fact, it's a both-and. Those of us who have the luxury and the ability to stay home and work remotely should be doing that. And yes, there are many of us in the city who do have that capacity to conduct our business, work from home, and stay home as much as possible. There's no question: many people in our city do not have that luxury, either because of the nature of their work or their financial circumstances where they really cannot afford to lose the income from taking time off work to get tested or to isolate appropriately. We need to make sure that the government, provincial or federal and who are the ones that have the power to do something about this, that they actually provide easy income supports that make it possible for people to do the right thing, which is to get tested and to stay home from work if they become sick with COVID-19, or they suspect that they might be ill with COVID-19.
CP24: How do you convince the government to do this?
De Villa: I think it does take constantly making the case and demonstrating that there is value. At the end of the day, what this really does is it is an investment, and ultimately, I think it pays off and saves in the long run. And I think those arguments will resonate with many people, particularly those in charge of things like the economy and thinking about what we do to best protect business. What we do to best protect business and the economy in this province is to protect the health of the people that are necessary to run those businesses and that underpin that economy.
CP24: A viewer asks, why are ice rinks and skate rental open during a stay-at-home order?
De Villa: I would still like to really see the details before we can comment specifically on what makes sense or doesn't make sense or whether there are opportunities for improvement. But you will hear me say this that regardless of what it says, what we want to do is ensure that people who have that ability to stay home do so to the greatest extent possible. Distance, distance and more distance. This is what actually makes the difference in terms of reducing the spread of COVID-19. People need to go out and get groceries, and they need to go out and get physical activity and get some exercise, both for their physical health and mental health. But in so doing, please do that only with the people you live with if you're going to engage in those activities with other people. And other than that, keep your distance from all other people. That's the simplest thing that we can all do.
CP24: A viewer asks, I understand the order, but what is this outside gathering of five or less? Can I gather at the park with my daughter, her husband, and my granddaughter?
De Villa: It's difficult to really help people understand the details of the orders without actually having seen the details of those orders. But in general, what I would tell people is that look, the simplest thing to do is to really focus that if you're going to interact with other people, the safest, the best thing to do is to keep those interactions exclusively with those people with whom you share a roof --people that you live with. For those who live alone, you may prefer mental health reasons and to avoid isolation, perhaps connect with one other household, and that's it. We're trying to minimize the amount of contact that people have with people outside their household. That's the simple formula of distance, if you will, and it actually does work to reduce COVID-19 spread.
CP24: Does the cold outside increase our risk of getting COVID? Should we now wear masks outside?
De Villa: When it comes to COVID and the spread of COVID, it's certainly like many other respiratory viruses prefer cold, dry air in terms of spread. It's just easier for many respiratory viruses to spread in this kind of weather and these kinds of conditions. That's why this is cold and flu season. When it comes to protecting oneself, the best thing to do, of course, is to stay home, but if you need to be out and about, whether it's going to the grocery store, or the pharmacy or getting outside for a walk or some exercise, the best thing to do is to wear a mask as much as possible.
CP24: A viewer asks, I'm a realtor, and I like to drive around the checkout neighbourhoods and my kids like a change of scenery since we've been at home for months. During all the lockdowns, we like to go for drives and to be clear, we don't get out of the car. Is that okay to continue doing?
De Villa: I'm not sure what the regulations will say. Clearly, the idea is to be home as much as possible and only go out for those outings that are most essential. We're focusing on things like groceries or pharmacy or health care or getting out for some exercise. I appreciate that there probably isn't a risk in the same way when you're in your car. I suppose one way to do that is to perhaps build it in as part of getting to the grocery. If there are some mental health and joy associated with getting there, perhaps incorporating that on the way to the grocery might be one way to try to do that and still stay within what is appropriate. But the notion is, of course, stay home as much as possible.
I think we all have that feeling to a certain extent. And this is hard. There's no question that this is a very difficult thing that we are all going through. It's been a long 10 or 11 months for sure. But hope is in sight, and there will be better days in the future.
CP24: How is COVID being transmitted? A viewer says they are hearing many differing opinions on its transmission. Some people believe it's only possible to contract the virus if directly in contact with someone with the virus. Is it still transmissible on surfaces? Is it airborne?
Also, how does the new variant change the transmission and how the virus is passed on?
De Villa: The understanding now is that it is mostly spread by direct contact with the secretions, the stuff that comes out of people's mouths and noses. When they talk, when they shout when they sing, or sneeze or cough, little droplets come out. And if that individual has a COVID infection, and those little droplets either enter your nose, your mouth or your eyes, that's the primary way in which COVID-19 is spread. There may be instances where it is spread by having the virus on your hands and then touching your eyes, nose, or mouth. But this is not believed to be quite as frequent the route by which COVID-19 spreads. But that doesn't mean it's zero. When it comes to spread, that's why we're constantly speaking about distance.
When we talked about the new variants that have been discovered as of late and spoken about a great deal in the media, the understanding is that it just seems to transmit that much better. Again, the standard route still, but just seems to be more effective, more readily spread from one person to the next, which of course, is made worse by the fact that we're in colder, drier weather, which causes respiratory viruses to spread better in as a matter of time. We understand that it just seems to spread more easily from one person to the next. And there are a number of different theories about why that's the case. I don't know that we have all the answers on that yet.
CP24: There have been more than a dozen cases of the COVID-19 variants reported by the province. Has there been a case of any of the new coronavirus variants in the city?
De Villa: I think that throughout the entire province of Ontario, there's certainly concern around this, and that's quite reasonable. But at the end of the day, we are really focused on people providing fulsome history. So, the fact that we may not know the whole story yet on some of the cases that have been identified, it's often because it's quite difficult to go back over a two-week history and think through who you have been with and where might you have been. If you've travelled, it's fairly obvious. But for others, it's a question of trying to figure out well, what have I done in the last two weeks and who was I with that might have travelled if it wasn't me that travelled. That history to understand where people might have acquired COVID-19 isn't always as simple as it might appear at first blush.
CP24: A viewer asks, children are currently not attending school in person due to community spread and high positivity rates. However, child-care centers remain open at full capacity. And it's not just children of essential workers attending. Are children and child-care centres not at the same risk as children attending school?
De Villa: There is certainly risk with respect to spread amongst children, but I know that they have invested a lot of time and effort in infection prevention and control. And again, it's just a necessity for some people to be able to get to work.
CP24: A viewer asks why medical and dental offices are still operating as if there is no pandemic?
De Villa: I think this comes down to all of us trying to do our best in terms of staying at home and only going out for those essential purposes. There are obviously essential medical care needs and dental care can also be done on an emergency basis. This is really about asking people in the community to stay home as much as possible, only go out for those essential services. And yes, that does include whether we're talking about medical care or dental care. For everybody's safety, the more we are able to stay home and only go out for essential services, the better off we will all be as a community and the sooner we will be able to put COVID-19 behind us.
CP24: Are the Toronto Maple Leafs still considered an essential service, and are they considered safe?
De Villa: I don't know that I can speak to whether they're deemed an essential service or not. But I can say that there are incredibly rigorous protocols that have been put into place for the Toronto Maple Leafs and the other NHL teams that are playing in Canada. Those protocols have been vetted at the local, provincial and federal levels. And the purpose of that vetting was to ensure that they best meet public health requirements and needs and ensure public health and safety.
This interview has been edited.