What further restrictions should Toronto expect? City's top doctor answers COVID-related questions
Published Wednesday, November 18, 2020 7:20PM EST
Toronto's top public health official is reminding young adults who may be willing to take on the risk of COVID-19 that they are also putting their loved ones in danger.
During the city's COVID-19 briefing, Dr. Eileen de Villa asked parents to talk to their children about taking the virus seriously. The message comes after recent percent positivity figures have been found higher for teenagers between the ages of 14 and 23.
"I know that in these circumstances, as parents, we will want to have said and done everything we could have to help keep our children safe," de Villa said.
"I urge you not to find yourself wishing you'd said something when you had the chance."
The doctor said she understands the urge to want to be with family and friends to forget about the pandemic.
"The need to feel normal is powerful," de Villa said. "But ironically, that need may well be playing the biggest part in sustaining the circumstances we're trying to forget about."
While she and other health officials can impose further restrictions to control COVID-19, de Villa said, "the most effective limits are the ones we set for ourselves."
"So, I ask you again to think about your limits and what that can mean for you and the people around you in the weeks ahead."
Dr. de Villa joined CP24 to answer COVID-19-related questions from viewers.
CP24: What stricter restrictions should we expect to be announced on Friday?
De Villa: I'm not going to get into the details around that because they are part of the act of conversation and discussion that we're having right now with the province and with some other partners in and around the GTHA. These are good conversations that we should be having. And they're important conversations to have if we're meant to control the spread of COVID-19, not just in Toronto but around the province. Stay tuned for that. But at an individual level, for every person who lives in Toronto, the message is actually very simple: do the best you can to limit as much as possible your contact so that it's only with those with whom you live. And if you live alone, we're saving that you know, one or two essential supports, but as much as possible, stay home, reduce your contacts. We know how the virus spreads. So, the more we reduce our contacts with others, the better we will be able to together reduce the spread of COVID-19 and get back to life more like what we were used to before COVID-19 was with us.
CP24: In New York City, for example, they've closed their schools because their positivity rate got to 3%. In Toronto, it's currently 6.2%. Secondly, the province yesterday floated the idea that perhaps extending a winter break might be a good idea. The mayor thought it was a good idea this morning, but then the province today said, we're not going to have to extend the winter break at all. What are you looking at in terms of schools and numbers? And do you think that the schools perhaps should have stayed closed a little longer over Christmas?
De Villa: I'm not really party to the discussions that happened at the provincial level around longer school closures over the winter holiday season. I'm not really sure I'm well positioned to comment on that. But what I can talk about is the experience that we've had here on the ground in Toronto, and yes, we have seen cases of COVID-19 amongst those who are part of the school community.No question about that. But until very recently, we actually had very little by way of active outbreaks. We're hovering quite low within the realm of outbreaks. And I'm going to remind people that the definition of an outbreak, the threshold for calling an outbreak is actually quite low. It's only two cases within a school within a 14-day period of time, where you can at least demonstrate a link to the school in at least one of those cases. It's a very strict definition, and we just haven't seen a lot of transmission happening within the context of schools.
I think that really speaks to the efforts that schools have put forth. School boards and us at Toronto Public Health, along with our school communities, parents, teachers, and students really have worked very, very hard to limit the spread of disease. What we are seeing is that as there is more disease in the community, it does reflect itself in our schools and, unfortunately, as well in our long-term care homes, in our hospitals, in all the facilities and institutions that we have in our communities. That's why we really need to focus on bringing community spread down.
CP24: You've talked about the high positivity rate among teenagers and young adults. How can parents get involved and help share this shape this narrative?
De Villa: This is a difficult conversation to have, as many conversations are to have between parents, and young adults, whether we're talking about teenagers or those who are slightly older than that. And it's a question around supporting our young people to make good choices. And I think that's a reasonable conversation for parents to have with the children. I'm the mother of three teenagers myself. I know how challenging it is to have conversations and how it often seems that teenagers aren't as receptive to receiving advice from their parents. Still, I'm heartened to know, and in my experience, I have found that while it may appear that they're not entirely listening, it's not like they're not picking up some of the information. They do take some of that information in and process it in their own time. I think to the extent that parents can have these honest conversations about how to make good choices in the face of COVID-19 and what it means for your own health and the health of those around you, I think that's a really good conversation you should have. We don't want to say that we didn't have the conversation and regret not having that conversation, knowing what COVID-19 can do.
CP24: A viewer asks, I'm doing everything I am told to do my part to fight COVID-19. I'm not an expert. But how do you explain the fact that you asked me to leave the house for essential needs only, but I can visit a patio for a beer? How do you explain that I can't visit my parents at their home, but I can meet them on a patio? Don't you think this is wrong and you've confused your message?
De Villa: I think we are trying to simplify the message as much as possible. And I would also say this, just because you can do something doesn't mean that you need to. I think it is for each person to really think through what their circumstances are and make reasonable decisions around what they need to do. For example, it is quite possible for some of us to be extremely productive, working from home. It is actually a doable thing. But for many of us in our community, that is not possible. The question is, what circumstance are you in? What are you able to do in your own life and in your own circumstances in order to reduce the spread of COVID-19? We know COVID-19 spreads person to person. It spreads more easily when you're in a closed space and close contact with other people when there's lots of people, especially when you're not wearing your mask, and you can't maintain physical distance. Avoid those circumstances as much as possible, and we will together reduce the spread of COVID-19 in our community.
CP24: A viewer asks, what is the difference between shopping with your family and eating out with your family? One is advised against, and the other encouraged.
De Villa: I would say that the advice is consistent in that the more we're able to reduce the possibility of close contact with others that we don't live with, the better we will be able as a community to reduce the spread of COVID-19 and to reduce its negative impact. If shopping can be done online, then I would do that. That's one very solid way by which to reduce social interactions. Having meals is a necessity of life. Food is something that we all need to partake in. And sometimes, you just don't feel like cooking. I get that. But to the extent that you can either have takeout or delivery, here's an opportunity to reduce the likelihood of interaction with others. That's the strong message to the public -- reduce the likelihood of contact with others, especially those you don't live with. This is how we reduce spread. And this is how we will get past COVID-19 and get to a different point into a different form of life, one more like what we were used to before this was part of our world.
CP24: With the rising numbers in Toronto, have you considered whether or not a state of emergency will be necessary to get the second wave under control?
De Villa: What we're doing now, given the concerning case counts in Toronto and the impact that that has on all of us, especially our hospitals and our health care system, we are in active discussions with the province around what additional evidence-informed measures can be taken in order to control the spread of COVID-19. I would ask that people do stay tuned. We are in active conversations with our partners at the province and with some other local public health units around the province to make sure that we're doing everything we can to limit spread as much as possible. But in the meantime, we still need the public's help to limit social interactions as much as possible and stay home as much as possible because that's a very big support and assistance to any efforts that government undertakes to control the spread of COVID-19.
CP24: A health-care worker at Sunnybrook Hospital says, I listened to the daily pressers. I am deeply concerned that we are not hearing from public health and the City of Toronto about the ongoing crisis of homelessness, lack of affordable housing, lack of support for encampments, and the worsening overdose crisis. Our most vulnerable community members are being deeply affected by COVID-19, and it feels as if they are largely forgotten.
De Villa: Just because they're not mentioned at the daily pressers doesn't mean that they're not thought about. I can assure you that we are constantly thinking about those populations that have been disproportionately impacted by COVID-19. And that includes those who are experiencing homelessness and people who use drugs in our community. In fact, at the Board of Health, we brought forward a report in respect of managing the opioid overdose crisis that's happening in our city and yes, homelessness figures prominently in that as well. There is plenty of activity that is happening. It may not always be overt or obvious, but it's certainly not an issue that's forgotten by any stretch of the imagination.
CP24: In a crowded train or bus, what can transit users do to avoid the risk of contracting COVID-19?
De Villa: For some people where there is an option to adjust times and clearly adjusting times where possible to less busy or less crowded times on the subway, or on the TTC, whether it's a bus route or a streetcar, is obviously helpful. I'm sure, and I know that my colleagues at the TTC are constantly looking at how best to adjust service in accordance with demand, trying to support the ability of people to physically distance on the subway system writ large.
I think the one thing that I can suggest is as much as possible, try to get distance. I recognize that there are probably moments where it's more difficult to do this successfully than others. But to the extent that you can maintain distance, that clearly will help. Wear your mask, try to maintain that distance wash your hands, stay home if you're sick. These are things that we can all do and try to minimize time or adjust time as much as possible to when it's less busy. If windows can be opened or greater distance can be sought, these are the kinds of things that each and every one of us can do when we're on public transit.
CP24: With all that's been said about decreasing the cases, how would sending vaccines to those affected by the virus and the public will help in that goal?
De Villa: That's a million-dollar question. I don't know that any of us has the answer to this right now. In fact, the clinical trials that are being done on the vaccines, we're just getting the reports right now within the last seven days that we've heard about. We don't really know, but we have some early promising preliminary results from two different vaccine manufacturers that show pretty good efficaciousness, with the vaccines up to this point in their testing. But the proof, of course, is in the pudding. We'll have to see what actually comes as some of the studies proceed. We have more time to understand the duration of immunity. It looks good in the short term. The question is, how does it play out in the long term?
CP24: A viewer asks, should masks be two or three layers? What should these layers be made of? Is a coffee filter a good choice for a third layer? Should they be washed in hot water? Or is cold water, okay? Should the water have bleach in it? Should they put it in the dryer? Is it okay to use fabric softener?
De Villa: We know that masks are really important in protecting yourself and protecting others around you. We've heard recent data and advice from the Public Health Agency of Canada that a three-layer mask is better, where one of those layers might be some kind of filtration device. It could be as simple as a piece of paper towel, based on the advice that I've heard from the agency. But there are some really important things about masks. You do want them to be well-fitting, not tight, but close to the face so that you don't get a lot of gapping. You want it to cover your nose, and you want to make sure that you're wearing it above your nose and that it goes underneath your chin so that you get a good fit, and that you're protecting yourself and others around you as much as possible.
I think those are the basics of masks. It should be washed after each use. And ideally in hot water. I think it depends on the material that you're using, but what you're trying to do is to make sure that it is thoroughly clean, and that you're using it as much as possible, that it fits well because these are the kinds of things that each and every one of us can do to reduce the risk. That is over and above, trying to limit your interaction as much as possible with those with whom you don't live. You want to keep your interactions to your household, to your essential supports as much as possible. And when you can't wear your mask as much as possible.
CP24: The city is trying to target the teenage market due to a growing number of cases among their population. The mayor has started making TikToks as a way to reach young adults. When are we going to see you on TikTok?
De Villa: I don't know. I have a feeling that my teenagers may not forgive me if I put myself on a TikTok. I don't know if I have the dance moves of the mayor either. With that said, we must make sure that our young people -- teenagers and young adults -- are aware of what they can do and how important they are in the fight against COVID-19.
This interview has been edited.