Toronto’s top doctor says the city is moving in the right direction in the fight against COVID-19 but reminded residents to keep their focus on following public health measures.
“This is in effect like walking a tight rope. A tightrope walker was quoted as saying that the most dangerous part of the walk was “when you have to turn because that is the only moment when you take your eyes off where you’re heading, and that’s when you really risk falling,” Dr. Eileen de Villa, the city’s medical officer of health, said at Wednesday’s city briefing.
“If we lose sight of where we are, we could wind up back where we started – again.”
Toronto Public Health reported 1,055 new cases of COVID-19 on Wednesday. There are currently 1,121 people in hospital, with 242 in intensive care.
De Villa said the city is seeing success in its strategy of vaccinating hot spots in the city. She added that targeting those areas is the “most effective use” of the vaccine.
“We are confident that the current hot spot strategy delivers a double advantage. The strategy not only targets the neighbourhoods and demographics that are at greatest risk of infection but also indirectly reaches into workplaces where it can be easy for COVID-19 to spread, as we know, these neighbourhoods are often home to essential and frontline workers,” de Villa said.
“It sometimes feels contradictory to speak to our success in the delivery of vaccinations, when there are still so many waiting their turn, and while the third wave is still dangerous.
Dr. de Villa joined CP24 to answer your questions about COVID-19, including vaccines and other issues.
CP24: What do you think of the province's paid sick program they unveiled earlier? Is it enough? Will it help?
De Villa: I haven't really had much opportunity to look into the details of the announcement. I don't know that I can give you a complete and total response. I am glad to see some movement in the right direction. We want people to be able to do the right thing, to do the healthy thing, to stay home, get tested if they're sick, or they suspect that they may have COVID-19, rather than showing up at work, feeling ill or potentially spreading disease because they're trying to make a reasonable choice for themselves and their families. People should not have to choose between feeding their families and doing the right thing to protect themselves and our community from COVID-19. I'm looking forward to looking at those details. But I am glad to see some movement in this direction. And every step in the direction towards supporting people doing the right thing is a welcome one. I'll be able to comment later on.
CP24: Do you anticipate that you will issue more section 22 orders to close workplaces with COVID-19 cases?
De Villa: Given the transmissibility of the new variants that we're seeing, I won't be surprised, and I don't think the public should be surprised to see if more of these things happen. But it's certainly my hope that we can work with our employers and organizations, and businesses throughout the city to do the very best we can as a community to try to reduce the spread of COVID-19. That's what this is all about. We're really trying to shut down the virus, not shut down businesses. And we're trying to create safe workplaces so that we can get back to life more like it was before there was a COVID-19.
CP24: A Toronto ICU doctor posted on social media about patients who had received their first dose of the vaccine showing up in hospital. Is Toronto now tracking the number of people who have become infected after they've been vaccinated?
De Villa: This is the kind of information that we would like to collect and make sure that we're keeping track of. Lots of data points here and lots of information that we need to keep on top of. And we want to inform our efforts so that we're doing the best we can in terms of controlling COVID-19. We know that no vaccine is perfect, even with two doses on board. There isn't such thing as a perfect vaccine. But we have seen in the experiences here in long-term care and in experiences around the world that the vaccine is indeed very powerful in reducing the risk posed by COVID-19, both for the individual and the community. So, I would encourage people to have faith. We have lots of evidence that the vaccines are effective in terms of reducing the most significant impacts of COVID-19. But that doesn't mean that they're perfect.
CP24: Last week, the province confirmed cases of the B.1.617 variant that first emerged in India. Are there cases in Toronto?
De Villa: We know that we received word from our colleagues at Public Health Ontario who are responsible for the lab that there are a number of cases in Ontario, including some here in Toronto. This is something that, of course, we're watching with interest. And it just reminds everybody that it's really, really important to keep up those measures for self-protection. We really do want to limit any possibility of transmission, whether it's a B.1.1.7, B.1.617, or frankly, any other variant that may come and enter into our community.
READ MORE: Public Health Ontario reports 36 cases of COVID-19 variant first identified in India
CP24: There are reports that some private religious schools in Toronto are staying open during the stay-at-home order. What is the latest on this? How is this still happening?
De Villa: Some ongoing investigations are being undertaken by Toronto Public Health staff and some other partners who are involved in enforcement and assessment of the conditions that relate to the legislation that's in place. These are complicated issues. I think that many people in the community have certainly raised some concerns with us. What it may look like may not actually pan out with respect to the investigation. So, please know that our concern at Toronto Public Health is making sure that we're doing the very best to try to reduce the risk of transmission of COVID-19, whether it's in a workplace, whether it's in a school, whether it's in a place of worship, or anywhere else in the community. We are undertaking investigations, and I can assure people that we are working with all relevant parties, including legal minds, to figure out what's the best course of action.
CP24: The city announced that it is partnering with Vaccine Hunters, the volunteer group that posts vaccine information on social media. What does this say about the provincial rollout?
De Villa: I don't look at it as having to turn to something. You may have heard through our press briefing today that, in fact, what I think this really speaks to is the innovation that exists amongst the various communities here in Toronto. I think it's a testament to this really great group of volunteers that they have come in and filled a need. They saw a need. They had skills that they could deploy, and they put those skills to good use. They're using social media as a method by which to share important information and to bring some good to the city and bring some good to the community. And for that, I really loved the people at Vaccine Hunters for their excellent work and their contribution to the COVID-19 response.
READ MORE: Toronto partnering with Vaccine Hunters Canada to connect residents with COVID-19 shots
CP24: We've been hearing about side effects like headache, dizziness, etc., after getting the AstraZeneca shot. What is that a sign of?
De Villa: Each person reacts slightly differently to the various vaccines. And we know that with AstraZeneca, we've seen through the reports that there are more side effects, particularly with that first shot more so than the second shot. And with the other vaccines, the mRNA vaccines - the Pfizer and Moderna vaccines - the general reports have been that there are more side effects with the second shot relative to the first shot. So again, just interesting observations with respect to the vaccine. But when you're getting that kind of response, you're talking about training your body to actually mount an immune response. That's effectively what vaccines are doing, teaching your body how to recognize the foe that's COVID-19 and effectively develop that immunity to it. So, not surprising to see people actually get symptoms that are somewhat similar to what you would expect if you got sick. So again, there are some signs to look out for that need follow up but having some degree of feeling unwell and headache, in particular with AstraZeneca, I've heard, these are the kinds of things that you can expect. But if you're seeing things like a headache that's really getting very bad and doesn't seem to be improving, difficulty breathing. Things like that are the kinds of things to seek medical attention. For symptoms that can be managed with a little bit of Tylenol and some rest, those are just your body mounting the appropriate response to a vaccine.
CP24: A viewer says she is in her mid-60s and has cancer. She is worried that she is not adequately protected with only one dose of the Pfizer vaccine.
De Villa: This is a question that's come up for many people. But just to be clear, what the National Advisory Committee on Immunization recommended was that we separate dose one and dose two for a period of up to four months in order to allow for us to use the existing vaccine supply to cover as many people as possible. That's really what's at issue here. There are certain circumstances and a few limited exceptions to that particular rule. And depending on your unique medical condition, those who are exceptions to the rule are actually meant to be called by their physicians and advise that they bring that second dose up. But I think what's really important here is that when they've looked at the studies in respect of the vaccines, they found that that first dose really does confer a significant amount of protection. And that the second dose adds a little bit more by way of protection but that it is reasonable to space those doses, one from the next in order to allow a greater proportion of our population to experience the protection of vaccine, particularly now while vaccine supply still is a bit of a challenge. Hopefully, this will be less and less of an issue over time as vaccine supply becomes more available. And then we will not have to worry about dosing intervals that are that far off relative to what the manufacturer recommends in terms of spacing.
CP24: A viewer says she received her first dose of the vaccine and wants to know whether it means other members of her household are also protected in some way?
De Villa: Everyone getting their dose of vaccine is a boost to protection for that individual. But by protecting oneself, we are protecting others around us. That being said, once you've got your first dose of vaccine, you still need to continue to practice measures for self-protection as much as possible. Different in your household, the people you live with are the people you live with. But even though people are getting vaccines on board, which is a great thing, and I would encourage people to get their vaccine as soon as possible as their turn comes up, we're asking people to continue to keep their distance as much as possible from those with whom they don't live, to wear a mask, a well-fitting mask, if they are coming into interaction with others and to minimize that interaction as much as possible. It's still really important to continue to follow the measures for self-protection right now. And hopefully, over time, as more and more of us get vaccinated, we can start to slowly but surely change our practices. We're watching other countries as they move forward. Some countries, the United Kingdom, in particular, are a little ahead of us in respect of their vaccination and a little ahead of us in terms of their pandemic experience. We're watching how their very cautious moves towards reopening unfold so that we can learn from those experiences ourselves.
CP24: The CDC updated its masking guidance for people fully vaccinated. A viewer wants to know if people with one dose of the vaccine still have to wear a mask when going out for a walk. Is it okay just to wear a shield and no mask?
De Villa: I really appreciate the question. And I understand that the United States has released their guidance. I would just point out, though, that their guidance is in respect of people who are fully vaccinated. So, that means having two doses of the vaccine onboard. This is an important distinction that needs to be made at this point in time. So, for now, I would advise the viewer - the best thing to do is as much as possible wear a mask when you're outside at home. A well-fitting mask that doesn't have a lot of gapping has an appropriate number of layers, ideally, a filter in between two different layers of cloth. That's what protects you as best as possible. Vaccines are not yet perfect. And one dose doesn't mean fully vaccinated when we're talking about vaccines that actually require two doses. We will watch over time. And hopefully, as more and more of us get vaccinated, especially with that second dose, we can start to change over time, carefully. And we're going to continue to watch what happens both in the United States, the United Kingdom and other countries around the world.
READ MORE: Outdoor mask guidance echoes what many Americans already do
CP24: A viewer asks, why did you wait so many months to use your authority under Section 22 to close workplaces when we've known for months that certain workplaces have had outbreaks? Why have gyms and personal care businesses have been shuttered for months when the data doesn't show they've been a significant driver of cases?
De Villa: I think that what we have done is tried to apply the best available evidence to every decision. And at this point in time, there were good reasons to really pursue this course of action with workplaces and try to make them as safe as possible. Optimally, earlier on in the pandemic, a lot of businesses were shuttered, particularly in wave one. And that brought down the transmission over time. We've seen more and more businesses operate. And we certainly have always investigated outbreaks and worked with businesses to minimize risk to the greatest extent possible. And oftentimes, that did mean sending people home. At this point in the pandemic, we made the decision based on the evidence that we have. And our goal is to ensure that as much as possible, we're controlling risk in these settings, recognizing that they're among the few places where people are gathering outside of their homes, given that we are in a stay-at-home order. So, how do we make them safe? How do we continue to allow them to provide the essential goods and services that we all rely on every day while ensuring that workers there are afforded the greatest protection? This we felt was the best course of action at this point in time.
CP24: Final thoughts for this week?
De Villa: My final thoughts for the week are, look, we still have a large number of cases and still many, many people ending up in hospital in an ICU. So, I would just encourage people to continue to follow those measures for self-protection. That's a very powerful tool that each and every one of us has. Other than that, as soon as your turn comes up to get the vaccine, please go out and get that vaccine. That's the second most powerful tool we have. If we use these tools together, we will soon get to the other side of this pandemic and start to enjoy life again, more like it was before there was a COVID-19.
