'We're in a reasonable place': Toronto's top doctor answers your COVID-19 questions
Web Staff, CP24.com
Published Thursday, May 14, 2020 7:57PM EDT
Last Updated Friday, May 15, 2020 3:04PM EDT
Following the announcement of the reopening of more Ontario businesses Thursday, Dr. Eileen de Villa, Toronto’s medical officer of health, joined CP24 to share her thoughts about the current COVID-19 status in the city, as well as, to answer your questions and concerns about the virus.
CP24: Do you think that by opening public spaces will push for the second wave to come faster?
De Villa: I think that as services and activities reopen in our city, we will see people interacting more with each other. You’ll have more people moving around, and we will inevitably see more COVID-19 activity. We’ve seen the same experience in other jurisdictions all around the world. That’s why we need to make sure that we’re ready. Whether we’re talking about healthcare, whether we’re talking about public health, we need to make sure that we’re ready to respond to new cases as they arise. It shouldn’t be a surprise to us. And it’s just a question of making sure that we have the resources in place.
And that’s exactly what we’re meant to do, and that’s why the plan to reopen the province is one that takes place in phases. That it’s gradual and that it depends on what’s happening in the community. If, for some reason, COVID-19 activity is going up and it’s too fast, we need to slow down the pace and ensure that we have the resources in place so that we can safely manage the transition.
CP24: Why are we expected to stay in our bubble, but it’s okay to allow housekeepers and maintenance workers into our home or apartment? As a senior, should I not be concerned about so many workers entering my condominium building, especially when they could have been at another location prior to mine?
De Villa: I think the idea is not to have many workers coming in but some workers coming in. And I think we also have to remember how the virus is transmitted. You need to have close contact with the respiratory droplets -- the stuff that comes out of people’s nose and mouth when they cough or sneeze, and that has to enter through your eyes, your nose or your mouth-- for you to get the disease from somebody who’s got the infection. So careful reopening, and staged process – this should minimize the amount of transmission in any given setting so that we can manage it appropriately.
CP24: How do you maintain social distancing in these cases as a nanny and babysitter?
De Villa: So that is more challenging. If you’re going to be doing that kind of work in someone’s household, it will certainly be more challenging. But again, it’s a limited number of people, and it doesn’t change the fact that if you are sick, you should not be out and about or in other people’s homes or having the nanny or the babysitter come over depending on who the sick person is. Ill individuals should isolate themselves and get tested appropriately depending on the symptoms they have and what they think they’re ill with. If we can stick to those rules, which are always good rules to follow, that should minimize risk in that setting.
CP24: What is the probability that weddings scheduled for September through December will be able to happen? Or should couples postpone it or try to wait it out?
De Villa: That’s a tough question. And I can appreciate why people are going to be concerned about that because there are lots of effort and time going into wedding planning. And it takes months to get all the planning organized and booked all the venue. All that stuff takes time. The problem is we don’t know how things are going to unfold. And as we’ve seen with this virus, things change so, so very rapidly. The best advice, for now, is to talk to whomever you have to deal with, whether it’s the venue or the caterer and all those other people to see what kind of flexibility can be put into place with your arrangements. We honestly don’t know where we’re going to be come September or even towards the end of the year. It’s so challenging. I feel for people who are in this circumstance. All you can do is try your very best to deal with your vendors to see what can be done, and what kind of flexibility can be built-in.
CP24: How do you explain emergency homeless shelters where clients just easily going out, spending all day outside where they are not monitored? And also, when they are showing symptoms of COVID, and they decide not to be tested and voluntarily walk out of from shelter without any trace?
De Villa: I can appreciate why that circumstance would give rise to concern. But you know, knowing who the people are that are running the shelters and their involved in the provision of care in those shelters. I know how very concerned they are about their clients and the rest of the community. I know they do their very best to make sure that the appropriate circumstances are in place.
Within the context of shelters, they’ve gone to great lengths to ensure that physical distancing is happening. Remember that making sure that we’re practicing all that good hygiene, handwashing, covering coughs and sneezes and making sure that people who are ill are appropriately isolated. These are all still the kinds of practices that are happening in shelter and it should always be happening. They are also enhancing physical distancing in those settings. I think within the shelter community, everything that can be done in order to minimize the likelihood of spread is being done.
CP24: Is a face shield as effective as a face mask in situations where the physical distancing might be compromised as in a grocery store shopping?
Remember that when we’re talking about non-medical masks or a face covering, that’s not about protecting yourself from others, but about protecting others from your germs. And that’s what’s being recommended in those circumstances, especially in retail environments where you’re not sure you can maintain physical distancing or when you expect that you might get into close contact with other people.
Physical distancing and handwashing are still the best practices to protect oneself from infection and protect the spread. However, sometimes when you’re out there, that just can’t be done. A cloth mask or a face covering helps to prevent the spread of your germs to others.
CP24: What do you think is better in preventing the spread of the virus from you to others -- a face shield or a mask?
De Villa: The mask is the one that prevents the spread from you to others. A shield blocks the droplets from somebody else who might be infected from entering your eyes, for example, which wouldn’t be as covered by a face covering or a mask even if it was a medical type of mask.
CP24: Why are there more businesses reopening, and restrictions being lifted even though daily new cases of COVID-19 are not dropping, especially since the general public is not being tested?
De Villa: Testing is something that the province is in charge of, and I think we should all be pleased to hear the testing is being expanded so that we can make sure that we understand what does virus spread looks like in our community. That’s one of the key points and one of the key pillars under the province’s framework for reopening businesses and restarting activities in the province. I think that that is very important. The other part of the question though is why reopen? And the reality is that we have to actually balance out risks. Yes, there are risks associated with COVID-19 and COVID-19 infection. But there are also risks including health risks associated with keeping our communities and our activities fairly limited as they have been for the past several weeks. And what we’re trying to do is to find a reasonable balance between these two things and to find a way that we can live with COVID-19 safely until we have treatments or a vaccine.
CP24: When we’ll be able to go from a five-person limit to a 10-person limit? When will we be able to see family and spend time together?
De Villa: I can certainly appreciate why people might be asking that question. We all want to be able to connect with our friends and our family again. With respect to the gatherings of the size, going from five to say 10, that is under the purview of the province. It is a provincial order that has limited the size of gatherings to five people maximum. We’ll have to refer to our provincial partners to figure out when do they expect that this might change. But looking at their plan, looking at the provincial framework for reopening the province, I think that they will likely be looking at that in a later phase. And what they’re going to need to see is reducing accounts with respect to new cases.
They’re going to want to see an ongoing decline in the number of new cases. They’re going to want to make sure that there is healthcare capacity and that the healthcare system is able to manage medical conditions, including COVID-19. Public health capacity is going to have to be there, and we’re going to want to make sure that there is testing available for a broad range of people. I think these are the kinds of conditions that we should expect to see. If you look at the provincial plan, it discusses increasing what’s open and what we’re able to do with two to four-week blocks of time in between, depending on how things are progressing within the community. If we can keep up with our physical distancing, I’m hoping that it will be sooner rather than later.
CP24: A viewer says his grandfather is 87 years old, and he lives at a home alone in Peterborough. He says he likes to go up there and stay with his grandfather, do his groceries, cook clean, etc., and make sure he is healthy mentally and physically. He has been following all of the social and physical distancing rules for a month now, and he is worried about his grandfather’s mental health and physical health due to the quarantine and the virus. Do you think it would be okay if he would stay with his grandfather for quarantine, or should he stay in Scarborough?
De Villa: I can appreciate why he would be really worried about his grandfather. And I think first and foremost what I would start with is checking with him through other means. What are we able to find out through the phone and other means? Again, it’s not clear whether this individual uses FaceTime or other video calling methods. Certainly, that’s a reasonable way if there is that method to try to see what is happening in the home and figure out whether there’s reason to be concerned. At this stage of the game, we’re not suggesting that people engage in what I characterize as non-essential travel. If something crucial, something worrisome on the horizon, then I think people need to make reasonable choices for themselves and balance out risks and benefits.
As I mentioned in my previous answer to one of the earlier questions, what we’re trying to do here is to balance out risks and benefits. We know that there are clear risks associated with COVID-19. There are also some risks associated with the existing public health measures and maintaining them for a very prolonged period of time. And the economy has clear health consequences. It’s not just that COVID-19 is the only concern that we have around our health. It’s a question of balancing out. What’s most risky at this stage? What’s most beneficial in this situation? And trying to make reasonable choices in the situation that you find yourself in.
CP24: Domestic service of nanny and babysitter is allowed starting May 19, but a grandparent can’t babysit a child. Why?
De Villa: I’m not sure I would characterize it exactly like that. I think that what we’re looking at circumstances that people are trying to return to work. Our provincial counterparts who released these, this new guidance is recognizing that people need to be able to get back to work. And in order to get back to work, there has to be some form of childcare. It will depend on the circumstances that you have in front of you. And as I said in my earlier answer, one of the things that I think we need to think about is how do we balance out risks and benefits. How do we try to manage the circumstances that we have in front of us?
We know that those aged 70 years or older are at higher risk of severe outcomes associated with COVID-19. There may be younger grandparents around her willing to help out. I think that’s a careful discussion that needs to happen between those families. But it’s all a question of just balancing out the risks.
CP24: Is it safe for children to ride bikes with other kids while keeping their physical distance?
De Villa: In general, what we’re saying is that for people to be outside and to get that exercise to get the fresh air is a good thing. Physical distancing should be maintained. I think the challenge with kids, as a mother of three, is that I know they don’t always stick to the rules as well as intended as they might be. They don’t always stick to the rules. So that’s the challenge. How do you make sure that you’re maintaining that physical distancing? And if it can be done with older kids, that may be doable. But I think again, people need to make good choices, make good judgments based on their unique circumstances. And as we try to live with COVID-19 safely, I think we’re going to be finding ourselves making those kinds of decisions on an ongoing basis.
CP24: Can someone get an antibody test for COVID-19?
De Villa: New tests have to be approved by the federal health agencies and authorities, and there is an antibody test that I believe has just been approved. It’s not clear to me that it’s actually in use anywhere, but hopefully, soon it will be. So right now, I don’t know that that’s actually readily available. We have heard that there is broader testing being made available across the province of Ontario. It’s not antibody testing, yet I think on this one, stay tuned.
CP24: Will the Raptors continue the season from where they left off with playoffs series games when it is safe for them to resume play? And how will the city host Jurassic Park during playoffs with physical distancing measures?
De Villa: When we look at the provincial plan for reopening and restarting activities, having those kinds of large gatherings, which are a lot of fun and a lot of people, that’s something that comes fairly late on in the plan. That would be one of the last things that we would seek to reopen because of the kind of risk that it presents for transmission of COVID-19. I think that would be a fairly late, uh, you know, phase of the reopening plan. As much as we want to be able to capture that kind of joy and excitement again, I don’t think we’re going to be seeing that anytime in the near future, unfortunately.
CP24: Are you comfortable with where we are right now moving forward?
De Villa: Right now, I think we’re in a reasonable place. I do think that we’re in a good space right now. We do need to continue to monitor our data. We know that things are going in the right direction here in Toronto, but we’re going to have to watch, and further reopening is going to depend on what we see in our data.
This interview has been edited.