Ontario’s shift to regionally reopen the province has its benefits, experts say, but they’re concerned that messaging about who can do what — and where — might cause issues down the road.
“Not only is a regional plan the right idea, it’s always been the right idea,” said Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto.
“There was never any evidence from any jurisdiction in Ontario to suggest that the entire province should move together.”
The vast majority of the province has been given the green light to move into the next stage on June 12, but the Greater Toronto and Hamilton Area (GTHA) and other regions will need to wait.
Of Ontario’s 34 public health units, 24 will be allowed to reopen things like hair and beauty salons, campgrounds, public swimming pools and splash pads and shopping malls, all under existing public health protocols and restrictions.
The remaining 10, primarily the GTHA and those near the U.S.-Canada border, will need to record an improvement in daily case numbers before moving on.
Furness believes the messaging surrounding Phase 2 has already been muddled and worries it will lead to an exodus of residents from closed regions to open ones.
“I was really disappointed not to hear a strong admonition to say, ‘Don’t do that,'” Furness said. “If you’re a local business outside the GTA, don’t take people from there. Put it on your website. Put it on your voicemail. Put a sign on the door.”
In announcing the second stage, Premier Doug Ford and his provincial ministers indicated there would be no travel restrictions between regions in Phase 1 and regions in Phase 2.
Ford said it’s “fine” if people from the GTA want to visit, say, Prince Edward County for a wine tour or go camping up north. But “you know, when it comes to haircuts, I’m hanging in there,” he said.
Ford never explicitly spoke out against inner-provincial travel amid a regional reopening.
The risk of spreading the virus from a hard-hit region to another still remains despite the staged plan, said Alon Vaisman, an infection control physician at the University of Toronto.
“The regional approach makes sense, but the question is: what elements are you opening up first? Some of the pieces are more easily exposed to people from other regions with higher COVID-19 prevalence,” he told Global News.
Vaisman compared amusement parks and medical clinics. It’s unlikely out-of-towners would make their dentist appointment in an area that reopened, he said, but the reopening of a large park or entertainment space might attract more than just the locals.
At the same time, “someone from Toronto isn’t going to go to Kingston to use a children’s playground.”
“We don’t expect out-of-towners to come in and exploit it,” he continued, “but people are looking to leave, go back to their normal lives, it’s only natural that people from highly-affected areas will want to seek out these experiences they haven’t had in such a long time.”
Drop in cases, but risk remains
What makes matters more complicated is the doubling of limit gatherings.
Social gatherings will be allowed to increase from five to 10 starting June 12. That change applies across the province, regardless of what phase a region is in. Again, the same public health guidelines apply — people should maintain physical distancing, upkeep hand washing practices and stay home if they’re sick.
But the messaging is blurred here, as well, Furness and Vaisman believe.
“If the people who are gathering are effective strangers, does it make a difference if those strangers are in your home or in a coffee shop? It’s probably worse that they’re in your home than the coffee shop because you’re less likely to adhere to things you’re supposed to be adhering to, like keeping distance and not sharing food. It’s opening things up for your family,” said Vaisman.
“Just because the government says you can, doesn’t mean people should be doing it, also.”
The trend in new cases has seen some fluctuation over the last few weeks but has been gradually declining. While the increase in gatherings is feasible in most parts, a place like Toronto isn’t ready, they said.
“Everyone has to understand that this is a give-and-take — if things start to go bad, you go backward,” Vaisman explained.
“It’s not a static back-and-forth, it’s a dynamic process where you make decisions to pull back on certain parts, and go forward on other parts.”
Quebec also chose a regional recovery plan. The province opened retail stores and other businesses in early May, but Montreal — which accounts for more than 26,300 of the province’s 53,047 cases — was exempt.
The city was unable to reopen elementary schools and daycares, as some parts of the province did, and won’t see hairdressers and other personal care businesses restart for another week.
Decision-making on regions unclear
Some of the areas not included in Ontario’s second phase aren’t facing the type of outbreak the GTA or Montreal is, like Windsor-Essex County. It holds 1,066 of the province’s cases as of June 9.
Furness emphasized that Windsor, and all border cities and areas, will always be “risky places” during a health crisis like COVID-19. Health care and other essential workers cross the border daily for work, he said, but on top of that, the situation in the United States isn’t any better.
“I would put Ottawa in the same category,” he said. “It’s not on the U.S. border, but you’ve got a huge amount of international travel because of business and you’ve got border travel between Quebec and Ontario.
“Ottawa is allowed to go into Phase 2, but I would say Windsor and Ottawa have some common analogous risks.”
It’s an interconnectedness that likely also speaks to why Hamilton was included in the exemption from Phase 2, said Ashleigh Tuite, an infectious disease epidemiologist and researcher with the University of Toronto.
“Hamilton is between Niagara — which is having a fair amount of disease activity — and the GTA,” she said. “Given what we know about people and their desire to return to normalcy, that would be tempting, I think, to go get your hair cut in Hamilton.”
It may seem like a “buffer” to stop people from travelling and prevent a spread of the virus, but without the right messaging, there’s an invisible risk, she said.
Tuite, Vaisman and Furness all agree that extra guidance is needed before the second phase rolls out entirely.
“At the end of the day, we’re all autonomous and we’re going to do what we’re going to do,” Tuite said, “but at least having some guidance and understanding about what we should be doing and also why we’re doing it, I think, is going to be really important.”
— with files from the Canadian Press