When will the COVID-19 pandemic be over? Toronto's top doctor answers COVID-related questions
Published Wednesday, November 25, 2020 7:33PM EST
Last Updated Thursday, November 26, 2020 7:33AM EST
Every person in Toronto is at risk of acquiring COVID-19.
A stern warning from Toronto’s public health official on Wednesday after presenting a map that showed almost all of the neighbourhoods in the city meeting the criteria for the province’s red zone for the week of Nov. 8.
“The fact is rates are alarmingly high in Toronto,” Dr. Eileen de Villa said during the city’s COVID-19 briefing.
“These numbers show there’s not much to debate over the need to limit contact between us. You are safest with the people you live within your home.”
While she believes that a fully functioning economy is the best possible thing, de Villa said it cannot function with the current conditions.
“COVID-19 will spread wherever it can. The easier we make it, the worse it gets for people,” she said.
“The worse it gets for people, the harder the hit on the economy.”
De Villa reiterated that COVID-19 is not the cold nor the flu.
She noted that people who do not know that they have contracted the infection may be spreading it for days.
“If you get it, you can’t know how it will affect you until it’s too late to do anything but wait to see what happens,” de Villa said.
“And even if you are willing to take the risk for yourself, no one has the right to knowingly or negligently impose COVID-19 on anyone else.”
The doctor joined CP24 to answer COVID-19-related questions from viewers.
CP24: The owner of an Etobicoke restaurant has now been charged after opening his establishment in defiance of lockdown orders. Why did it take so long for officials to move in and shut down that restaurant? Can you explain the process?
De Villa: It is a rather complicated process. And we are talking about relatively new legislation. The new terms came into place in Toronto on Monday. And the first step with any enforcement is, of course, an assessment by an inspector. For others, it might be a bylaw officer. And in other cases, it might be a member of the Toronto Police Service. It does take time to actually do that assessment. From the perspective of public health, before any order can be issued, especially the kind of order that was needed in this case, you have to have the information, and then the order itself has to be written up. It needs to be done properly. It is, after all, a legal document.
But as we heard yesterday from our Toronto Police Services colleagues, we recognize, and they recognize that there were opportunities to do things better and to do things faster. I think that's exactly what you're seeing here -- a concerted effort amongst a series of different partners to bring a particular situation to appropriate control. I think that that's what the public can expect. We are learning through new legislation and doing our very best. People are working very hard. And that doesn't mean that we can't improve. So, I think you'll continue to see enhancements and improvements in our processes.
CP24: It seems like there could be more protests coming. The premier said he is not going to back down on provincial orders. Are you concerned about people and businesses defying orders?
De Villa: I think that's always going to give rise to concerns for us as public health practitioners, particularly if the nature of the protest is such that it brings large groups of people together into close contact with one another because we know that those are the kinds of circumstances that give rise to the spread of COVID-19. But, let's look at it very objectively. The issue is that yes, there are people who retire, and yes, there are people who are fatigued here in Toronto, but this is an experience that has been witnessed elsewhere in the world. I think what we've also seen elsewhere in the world is that with strong public health measures. With the cooperation and collaboration of members of our community, we've seen that what can happen is that you can bring COVID-19 spread under control and then slowly but surely start to approach life in a manner that's more like what we're used to. And that's really where we all want to be.
CP24: Why weren't the diners at that Etobicoke restaurant charged or ticketed? They also flouted COVID-19 rules.
De Villa: With respect to what actually happens on the ground in an enforcement type situation, all of that rests on the assessment of the inspector, the police officer, the bylaw officer. Whoever is there has to make their independent judgments. And that's what we expect our staff who work in this area to do. I think those questions would be better directed to those individuals. But I can tell you that there is no shortage of commitment on the part of those people involved, whether we're talking about public health, whether we're talking about our colleagues here at the city, who work in the bylaw and those who work for the police service. There is a strong commitment from what I have seen across all parties to make sure that we're doing the best we can to enforce the existing regulations which are there to protect all of us.
CP24: Can you give us your assessment of the auditor general's report about the province's handling of the COVID-19 pandemic?
De Villa: I admit I haven't had much opportunity to even hear the snippets of what the Auditor General said regarding her report. I am certainly looking forward to having the opportunity to review that report. You can well imagine it's important to us in public health, and we're certainly interested in learning, hearing what the perspective was from her office, and making sure that we're putting in enhancements that our goal is to improve always. I will say this. I think it goes without saying that this pandemic has been extremely challenging for all of us. And of course, there's an opportunity to improve. But at this point in time, I think we need together to stay crystal clear and focused on actually bringing the pandemic to control. We need to even focus our efforts on reducing the spread of COVID-19 in our community because we are experiencing very high rates still in Toronto. As much as I'm interested in improving public health practice, not only in respect of the COVID-19 response but public health practice, writ large. But I would like to really focus down on our efforts to control COVID-19 now and to continue the collaboration that we've had with our provincial counterparts and with other medical officers and local public health units around the province.
CP24: The province came out with holiday guidance, asking residents to only celebrate with the members of their household. Are you concerned that people will not be listening to advice from officials when it comes to holiday celebrations?
De Villa: We have seen a number of examples where the people of Toronto have followed the advice. I'm relying on the people of Toronto to heed the call and to really do the best they can to look after their health and the health of the people around them. I don't imagine that there are any of us in Toronto who want to hurt other people who knowingly want to do this. That is just not the way we operate here in the City of Toronto. And it's not what most people aspire to. I think it's important that we continue to put the message out there, that we provide the information that the public needs to have to make good choices for themselves, for their families and our community as a whole.
CP24: How can you tell people not to spend these holidays with family that are dying, when these are our last moments with them? I have followed all of the rules since the beginning. But I can't see my grandfather at Christmas with my kids. I can't know that this is his last Christmas. And we have not spent the time we should have with him. We all know Zoom isn't necessarily grandpa friendly.
De Villa: I really feel for so many people in this city who have confronted these very difficult situations and challenges. And again, depending on the circumstances, each one is unique. There are always certain circumstances where we can find a specific workaround out of compassion for the particular circumstances. We know that that's happened on many occasions over the course of this pandemic. It's my sense that given whatever the specifics are of that circumstance, there may be an opportunity to speak to the people involved, speak to the caregivers and the care providers to see what special dispensation might be provided given the unique circumstances.
CP24: In the first wave, schools were closed, and we waited for months until numbers went down. Why are you expecting by December the 21st that numbers are going to change?
De Villa: I think the issue here is that we've actually found that schools themselves are more reflections of what's happening in the community rather than drivers of what is happening in the community. This is not unique to Toronto. It is, in fact, the experience of many other jurisdictions around the world. Over the course of the fall, since schools have been opened, we actually maintained for several weeks, relatively few outbreaks within the context of schools. That isn't to say there weren't cases. There were some cases. But we're not seeing a lot of transmission happening within school settings. What we do see is that the more COVID-19 there is out in the community, the more likely it is that we see COVID-19 right within the school community.
CP24: In New York, they closed schools because they had a positivity rate of three per cent in the community. Is there a positivity rate in mind that you have for Toronto when you might recommend that schools be closed?
De Villa: At this point, what we're trying to do is really keep the schools open as much as possible. The reason why that's the case is that there are clear advantages for children that go beyond strictly education or academic purposes. For having kids at school, there are lots of good mental health reasons, social health reasons. And for many kids in our community, it is the venue at which they access social services, and in some cases, access to nutritious food. There are many reasons why we want to continue to keep schools open for as long as possible.
There isn't a specific number. It is actually the confluence of factors that needs to be considered. But certainly, the more community spread, the more problematic it is for our schools.
CP24: A viewer asks, I know that we are supposed to celebrate the holidays with only the people living in our household. But what are we to do when we have the kids coming home from university? It's a long holiday, and they can't stay at school. What procedures -- testing isolating -- do you advise that they undertake in order to come home?
De Villa: We know that this holiday advice from the Chief Medical Officer of Health has just emerged. And this is one of those areas that I think requires a little further discussion -- how best should we advise those families who have returning university students coming home? That has yet to be fully worked out. I would stay tuned on that one. We're absolutely having ongoing discussions because we want to make sure that we're providing consistent advice across the province that really shouldn't be all that different from one place to the next if we're trying to reduce risk throughout the province of Ontario with it. Stay tuned on that.
I think we should be considering all the available options. I'm sure that many other jurisdictions have also approached this issue or have had different methods for trying to address these circumstances. I try not to focus on only one or two. Let's look at the available options. Have some conversation here in the province and do what makes sense for our circumstances.
CP24: Can you clarify who we can hang out with?
De Villa: I can appreciate that many of us are frustrated and tired of having to keep apart from people we actually want to be with and that we want to spend time with. But the long and the short of it is right now, given the high rates of COVID-19 infection in our city, the best thing to do is to limit interactions as much as possible. To keep those close contacts limited to those with whom you live. As much as possible, avoid social interaction with people you don't live with because that's the best thing we can do to reduce spread. I recognize that the kids are in classrooms together at school. But there is meant to be physical distancing. There are infection prevention and control measures. I know it's not 100 per cent. It can't be perfect that everybody stays at least two meters or six feet apart at all times. But they are also wearing masks as well, in order to provide for the best protection under the circumstances, recognizing that there is a real value to school. Stay within your household as much as possible. That doesn't mean don't go outside. Go outside, but again, focus those out to activities with those with whom you live. That's the best thing we can do for now. It's not forever. And the more we're able to do it well now, the sooner we will be able to get to life beyond this.
CP24: If most cases come from socializing and parties, why doesn't government implement a curfew?
De Villa: It's not entirely clear that we can say the majority comes from socializing and parties. We know that those are two particular methods that people come into close contact with each other. But there are others. What we're trying to do here and what the provincial government has tried to do, as they enacted their legislation and the regulations and put forward their framework, is to put restrictions in place that limit the likelihood that people are going to come into close contact with each other for prolonged periods, especially in those circumstances that are in closed spaces, and where it might be difficult to wear a mask or to maintain physical distance. It all comes down to limiting social interactions as much as possible. And to the extent that each of us can do that in our own lives, and in the choices that we make, again, the faster we will get to the other side and life beyond all these restrictions and measures.
CP24: A viewer asks, how long will this last when it's all said and done?
De Villa: I can't blame the viewer for the question. I'm sure that's top of mind for many people in Toronto. Look, what we're expecting now is that we have a 28-day period that started on Monday in respect of the lockdown here in Toronto and Peel. What happens beyond that specifically is very difficult to determine in advance. Still, the outcome will certainly be better the more people stick to the public health guidance and advice, and the more people are able to really limit their social interactions with others, stay home as much as possible, only go out for those most essential things and reduce to the greatest extent possible in-person interactions. We've heard from the premier that we should be expecting in the first quarter of next year the arrival of some vaccines, and hopefully, as vaccines unroll and start to get administered, we'll start to see more light at the end of the tunnel.
This interview has been edited.