Toronto’s Medical Officer of Health Dr. Eileen de Villa took some time with CP24 to answer questions about the COVID-19 pandemic. Here are some of the questions and responses.
(Note: Questions and answers have been edited for length and clarity.)
CP24
A record number of COVID-19 cases were reported in Toronto on Wednesday with 1,069 infections. The province also recorded a single-high of 2,923 new infections today. What do you make of these new numbers and these new measures that are going to come next week in the workplace? What can you tell us about those?
Dr. de Villa
This is not the direction that we wish to see these numbers go in. But I think that looking forward to the new year and trying to strike a note of hope and optimism, looking at our experience in the past, this is something that we can actually control. This is well within our reach. We've done it before and we can do it again. And what this requires is a real commitment, real active participation, diligence, vigilance at staying home as much as possible. As difficult as that is, and as much as it goes against the very fiber of our being, especially during the holidays we want to be with our friends and family. But at this point in time, in order to protect ourselves and to protect our friends and family, the best thing to do is to not congregate with them, to stick only with those people with whom you live to the greatest extent possible.
There are some new measures that are coming forward. We do recognize that there continue to be workplaces that are performing essential work, important work, and many of these workplaces are providing the goods and services that we all need in order to continue on with our daily lives. However, that does create the opportunity for people to interact with each other, much of that work needs to occur in person. So, this is our attempt, and certain actions that we believe we can take at this point in time in Toronto, to best secure safe workplaces and to limit the likelihood that spread occurs within those settings. And this has to be done carefully, it needs to be done appropriately and very mindfully around, ensuring that we're doing what makes sense and that we do it in a way that allows for those businesses to function properly so that they can continue to provide those essential goods and services. So, we're being mindful and very careful and that's why you're going to hear from us next week when we have a greater opportunity to make sure that we've dotted all the I's and crossed all the T's and make sure that we're doing the best job.
CP24
Why wouldn't Toronto close elementary schools for 28 days, similar to high schools? Why not try to decrease the risk of infection by closing more schools down?
Dr. de Villa
The decision is one that isn't taken solely at a local level alone and in fact schools and decisions regarding schools obviously involve the Ministry of Education, so that's at the provincial level, and as well will involve the school boards and the schools themselves and school communities. These are complex, difficult decisions to navigate through, and we've had to navigate many of these decisions throughout the pandemic. The challenge of course is that COVID-19 risk and COVID-19 transmission is only one element that needs to be managed. We also have to think about the very clear benefits of in-person schooling for children. And we know that those are significant, they're not to be trifled at and it's not just a question of education. So, it's this balancing of risks and benefits that needs to be taken very carefully, but of course that's something we're always monitoring for, always looking at the data and trying to contribute and provide the best advice to all the parties that are necessary to make that decision.
CP24
Why not shut down everything for two weeks, airports included? Would the numbers go down then?
Dr. de VIlla
So decisions to take major closures as we've observed over the course of this pandemic is something that really does need to happen at the provincial level. We have so much mobility from one jurisdiction to the next that at the very least you want to take decisions of that kind on a regional level because people do move quite a bit back and forth from one city or a town or jurisdiction or region to the next quite frequently. This is how we live in the GTHA. I would suggest that that's the kind of thing that we have discussed and certainly provided some advice to our provincial counterparts, but it is a decision that really rests better in their hands.
CP24
You said so yourself that some people who have tested positive for COVID-19 are not following the rules and are still attending illegal gatherings. Why aren't they getting arrested on the spot and isn't this a criminal offence?
Dr. de Villa
It's not always obvious when people are violating rules, and certainly there is no enforcement team in the world that is large enough to absolutely manage every instance where somebody does not follow the best available guidance or the rules, such as they exist. And I don't think we want that kind of enforcement in our society. I think we do reasonably expect that most people will follow the rules and do care about their own health and the health of those around them. That's what has seen us through the pandemic thus far, and it's what we're going to do to continue out through the rest of the pandemic.
CP24
When someone tests positive for COVID-19 does Public Health advise the employer of the test results, and if not, why not?
Dr. de Villa
When it comes to a positive COVID-19 test actually the first person who informs the patient themselves is the person who ordered the test. With respect to informing employers, one really has to think about privacy here. People do have a right to their own personal health information and, in fact, there are very specific obligations that we have as healthcare providers, it's not just about Public Health but it's for all healthcare providers to ensure that they're doing the best to protect personal health information of the patients for whom they're providing care. If within the context of an outbreak or if there is a public health risk, there are circumstances where we can disclose information in order to control public health risk, but those are very unique circumstances and one actually has to demonstrate that that's necessary.
CP24
How will we know when it's our turn for the vaccine? Will we be advised by our family doctor? Will my family doctor get the vaccine?
Dr. de Villa
The prioritization in the order in which vaccine will be given to different parts of our community is being actively discussed at the provincial level now. And along with that will come to communications methods. As I understand it, there will be vaccine ultimately provided through the regular channels by which vaccine is given and yes that does include family physicians. But for now, I think it's best for people to stay tuned. I know there's lots of interest in vaccine because we're all so very much looking forward to this. But for now, the province is focused on long-term care residents who are at highest risk, high-risk retirement home residents. They're looking at very specific populations right now as they make decisions on who should be next in the prioritization order.
CP24
Could you please consider reporting Toronto's COVID numbers using the same time frame as the province? It's very confusing to hear different numbers, especially when comparing Toronto numbers to those of other health units.
Dr. de Villa
The challenge of course is with different systems, which unfortunately at this point we have relative to the province, through ease a little bit of a differential but I'm hoping that will resolve shortly as we're moving to a different system. But I take that feedback and appreciate that there is some challenge for the public to understand. The issue is is that the numbers are, of course, constantly changing, new cases are always being recorded. And so there is always going to be a little bit of a differential. It just depends on at what point do you actually pull the number from the reporting system, and even just a little bit of a time difference is going to result in a different number because new cases are coming in all the time.
