With new coronavirus cases daily, experts worry parts of Ontario are reopening too fast

Click to play video 'Infectious disease specialist on staying vigilant about COVID-19 in Phase 2' Infectious disease specialist on staying vigilant about COVID-19 in Phase 2
In this month's Ask The Expert, Dr. Craig Jenne — an infectious disease specialist at the University of Calgary — explains why it's important to continue to keep your guard up about COVID-19 even as the province allows more things to reopen as part of Phase 2. – Jun 15, 2020

Ontario is moving forward with its reopening process, as Toronto and Peel Region are entering Stage 2 on June 24.

Most of Ontario entered Stage 2 on June 12, which includes the reopening of hair salons, restaurant patios and swimming pools. Only the Windsor-Essex region will remain in Stage 1 until further notice, the Ontario government announced on June 22, as Premier Doug Ford said the region has not seen the same level of case decline.

Some experts, however, are concerned that the Toronto and Peel regions have not seen a significant enough decline in cases of the coronavirus, and are worried about public health repercussions as the province moves forward.

Toronto has seen 13,893 confirmed and probable cases, with most the result of community spread or from residents being in close contact with a positive COVID-19 person. Of those cases, 970 are active.

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Read more: Toronto, Peel Region move into Stage 2 of province’s reopening plan Wednesday

Ontario has reported fewer than 300 cases for 16 days in a row now, however the number of cases confirmed on June 23 was the highest number since June 13.

Many of the province’s new daily cases derive from Toronto, Peel and Windsor-Essex, meaning allowing some of these hotspots to enter Stage 2 is not ideal, said Gerald Evans, the chair of the infectious disease department at Kingston, Ont.’s Queen’s University.

“It makes me think there were other considerations that came into play… perhaps that are not based on science,” Evans said.

The need to reopen the economy after months of lockdown to get businesses up and running may be a factor in these regions entering the second stage, Evans said. The opening of other nearby regions, like Durham and the city of Hamilton, might also be a motivation to open the rest of the Greater Toronto Area, he said.

When Kingston entered Stage 2 on June 12, the city had not reported a new case in weeks. That is not the same scenario for Toronto and Peel.

Click to play video 'Coronavirus: Toronto, Peel Region to join Stage 2 of Phase 2 reopening in Ontario, Ford says' Coronavirus: Toronto, Peel Region to join Stage 2 of Phase 2 reopening in Ontario, Ford says
Coronavirus: Toronto, Peel Region to join Stage 2 of Phase 2 reopening in Ontario, Ford says – Jun 22, 2020

While cases in Toronto are going down — 37 new cases were reported on Monday, a decrease of 51 cases from the previous day — dozens of new infections a day still indicates community spread is an issue, he said. Peel Region reported 61 new cases on Monday.

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“I’m concerned. I would have thought they still would have been at least a week or two off before they went to (Stage 2),” Evans said.

Although public messaging continues to stress physical distancing, mask-wearing and handwashing, Evans worries that the further reopening may give the public the impression that these measures are no longer as necessary.

What’s more, businesses may not be prepared to reopen with enough precautions in place, Evans said.

As many businesses were forced to close when the pandemic hit, they will need time to create an environment that’s safe for patrons, so you may not see every door open on June 24 in Toronto and Peel, he said.

Malls a concerning element of the reopening

Ashleigh Tuite, an epidemiologist at the University of Toronto, says she agrees with a tentative reopening of Toronto and Peel region as COVID-19 cases have declined and public health units are succeeding in identifying who is getting infected.

“In terms of the other metrics, hospitalizations have been declining… So from that perspective, it does make sense,” she said.

But Tuite does have some concerns with the elements of the second stage, including the fact that malls and shopping centres are now allowed to reopen.

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Read more: Restaurants are set to reopen, but your meal will come with a side of COVID-19 rules

The Ontario government’s reopening guidelines for malls state that food courts cannot open, stores should limit shoppers at any given time, and screening for COVID-19 symptoms should be done at mall entrances.

If malls reopen, mandatory mask-wearing and keeping distance from others should be in place, said Tuite. Ensuring patrons wear masks isn’t a recommendation listed by the Ontario government under the malls section of its reopening guidelines.

Click to play video 'Coronavirus: Toronto businesses prepare for Stage 2 reopening' Coronavirus: Toronto businesses prepare for Stage 2 reopening
Coronavirus: Toronto businesses prepare for Stage 2 reopening – Jun 22, 2020

“It’s not hugely different from other businesses, but it’s a larger space and there’s potential for crowding,” she said.

“You’re going to have to monitor how many people are going in and out.”

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People going into shopping malls may also do so out of boredom, meaning patrons may linger in spaces longer than if they are going to a specific store for a purpose, she said. Keeping that in mind is important when determining how many people should be let inside a mall, she added.

The safety of businesses reopening

Community transmission levels have declined, which would indicate a lower level of infection in the community, said Thomas Tenkate, director of the School of Occupational and Public Health at Ryerson University in Toronto.

But it can be difficult to uncover the genuine risk levels in regions like Toronto and Peel, as baseline studies and widespread testing haven’t been done to provide a firm answer, Tenkate said.

The purpose of reopening likely has to do more with finances than coming from a purely public health perspective, he said. Reopening more of the economy may also be seen as helping improve the mental health and well-being of a community, which could be another motivation for expanding the opening.

When allowing businesses like hair salons or spas to reopen, their services are based on breaking physical-distancing rules, Tenkate said. In those spaces, wearing masks and providing hand sanitizer will need to occur if those places want to operate as safely as possible.

Read more: ‘You can’t live off 4 customers a day’ — Toronto restauranteur reveals stark reality of reopening

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“If a business puts in place the measures and is very cautious about it and follows through, then that’s as best as you’re going to do versus a lockdown,” he said.

“It’s a bit of a balance.”

But beyond the responsibility of governments and businesses to keep the community safe, the public needs to follow the rules if they want the reopening to continue, he said.

“For all of this to work, there’s an equal responsibility on everyone to follow social distancing as much as possible, washing their hands and wearing masks,” Tenkate said.

“And being very mindful of the potential to transmit to someone else. As members of society, we all have a role to play.”

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

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