Looking toward the future amid COVID-19, every province has its own lens.
A cautious approach underscores all of the plans so far, but experts are uncertain about which strategies are cautious enough — and whether some plans include more than they should.
“At this point in time, you cannot say which approach is better,” said Zahid Butt, a University of Waterloo professor in the School of Public Health and Health Systems. “One thing is for sure — there is no one-size-fits-all solution to reopening during a pandemic.”
Ontario’s first stage of its reopening plan follows the province’s lowest increase in new virus cases since March. Seasonal businesses, some retailers and medical procedures can restart on May 19 so long as they meet certain criteria and abide by physical-distancing protocols. Some things didn’t make the cut, like hair salons and barbershops. Guidelines on child care and schools are also not included.
Premier Doug Ford has emphasized that businesses allowed to reopen next week should only do so “if they’re ready.”
Held up against Quebec’s reopening plans, there are differences. In some ways, Quebec is taking more of a regional approach. The province accounts for more than half of the country’s COVID-19 cases, with more than 40,000 infections and 3,300 deaths as of Friday.
While schools in the Montreal area will remain closed, other parts of Quebec have been given the green light to reopen. Premier François Legault has left it up to parents to decide whether they want to send their children back but said the situation in Montreal still remains too risky to loosen up measures. A decision on businesses won’t be coming until later in May.
While there’s no “one-size-fits-all” approach, the regional strategy might be more sensible, said Jay Kaufman, a professor in the department of epidemiology, biostatistics and occupational health at McGill University in Montreal.
“It’s rational to have a locally oriented policy approach that focuses on the places where the situation is most acute,” Kaufman said. “A lockdown is a very blunt instrument, with both costs and benefits. But locking down in a place with little transmission means that the costs can outweigh the benefits.”
In Alberta, retail stores, hair salons, museums, daycares and day camps were allowed to open May 14, with restrictions. Unlike Quebec and Ontario, restaurants and cafés are allowed to reopen at half capacity.
The reopenings apply across the province — except in Calgary and Brooks, which will have to wait until May 25 because the two communities have three-quarters of the province’s active cases.
“The virus is affecting provinces differently,” Butt said. “It depends on how population density, population mobility, how the health system is. It makes it far less likely for us to have an effective, co-ordinated response across provinces.”
In Ontario, Ford said he won’t tell any mayor what pace they should go at, leaving some of the reopening decisions in their hands.
Toronto, for example, accounts for more than half of the province’s new infections of COVID-19 as of May 14. In fact, the number of active cases is much higher than when the city first declared its state of emergency on March 23, according to public health data.
The city’s mayor, John Tory, said the denser population plays a key role in how the virus spread. He said he’s fine with the pace established by the Ford government but that he wishes there were more details about why the specific decisions were made and what is on the horizon so the city can prepare.
Looking at a city like Toronto, the regional approach may have offered more benefits, said Butt.
“The advantage is that, if you open regionally and there is a surge in cases, you can just close that region and not the whole province,” he said. “It provides an economic stimulus to that region when it is open, but only once you see it’s working, then you can move on to other regions.”
But there are dangers to this approach as well, Kaufman said. Right now, provinces depend on robust and efficient testing and tracing systems — one he isn’t sure Quebec, or any province, can safely say they have at this point.
Ontario recently admitted to an error in case reporting. The actual number for May 15, when Ford announced the province’s first reopening phase, should have been 345, rather than the 258 previously reported.
“They lack a more co-ordinated, targeted and efficient testing system that would better contain the spread of infection,” Kaufman said. “And for tracing, they’re also deficient.”
Prime Minister Justin Trudeau recently spoke with Canada’s premiers about ramping up testing and tracing capacities as provinces restart. He said the premiers agreed that “coherence” in the approach is necessary across the country and that efforts to improve those tactics are ongoing.
Schools open, schools closed
It’s on the subject of schools that the provinces show the most disparity.
School shutdowns were announced across the country in mid-March. Now, as the school year creeps into summer, questions around whether to restart linger.
It won’t be happening in Alberta during this academic year. There’s no set date on when students will return to class, however it’s included in the province’s second phase of reopening. It states there’s a potential for kindergarten to Grade 12 classes to resume — with restrictions. It could start in time for summer classes.
Ontario has not provided new information about schools, though officials say there may be new information in the coming weeks.
Quebec is resuming school in some regions but not others. Montreal’s schools were previously set to reopen for May 25, but the city did not meet conditions in time to do so safely.
To Butt, there is some logic in the regional-scale reopening of schools. But it will ultimately serve as a test, he said, which comes with risks.
“You might be able to see better what role children have in community transmission,” he said. “We’ve seen children are affected but less affected than other parts of the population. Quebec is really working as a test example of whether strategies like this work or not.”
The subject of schools being left out of Ontario’s reopening plan is problematic, according to Kaufman.
“How is it that golf and animal services take precedence over children?” he said.
Quebec’s decision to keep Montreal’s schools closed also disappointed him.
“Reopening schools should be a much higher priority in Ontario, so as to better balance the risks and benefits to survive this pandemic period with the least long-term damage.”
— With files from the Canadian PressView link »