Ontario’s new COVID-19 response framework won’t improve rates of virus transmission: experts

Click to play video: 'Coronavirus: Ford announces new early warning system as Ontario sees new single-day case record' Coronavirus: Ford announces new early warning system as Ontario sees new single-day case record
Ontario Premier Doug Ford on Tuesday unveiled a new early warning system that will replace its current system of modified stages. Ford said a new dashboard available on Ontario's website will allow people to more easily understand where their region is at. With the new system, Ford said Ottawa, Peel and York regions will be shifted to a Restrict level with Toronto remaining where it is for another week. This will allow in-door dining and gyms to reopen with restrictions. Brant, Durham, Halton and Hamilton regions will be moved to a Protect level. – Nov 3, 2020

As Ontario continues into the second wave of the COVID-19 pandemic, the province has released a new framework for determining measures and restrictions on businesses, though many experts say it won’t reduce rates of virus transmission.

The new system, which was announced Tuesday, will go into effect on Saturday and would see hot spot regions that are currently under a modified Stage 2 move to the new “restrict” level, which will allow indoor dining, bars and fitness centres to reopen with limitations.

Ontario Premier Doug Ford said Ottawa, Peel and York regions would move to the new “restrict” level on Nov. 7, with Toronto to follow suit on Nov. 14.

Read more: Coronavirus: Ontario classifies municipalities in new, more targeted COVID-19 category system

Eastern Ontario would also move to the province’s new “restrict” category, while Brant County, Hamilton, Durham and Halton regions would fall under Ontario’s “protect” level, allowing for controls that are slightly more loosened than “restrict.”

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All other regions in the province would fall under the “prevent” classification, which will see “standard measures” in place and the least amount of limitations.

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Provincial framework for reopening blasted by scientists for ignoring science of COVID-19 – Nov 4, 2020

Curbing the spread of COVID-19

While experts believe the government’s new strategy is a nod toward transparency, many don’t believe the new framework will help to reduce COVID-19 transmission. In fact, some say it could even make Ontario’s coronavirus infection rates worse than they are currently.

Dr. Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto’s information faculty, said case counts are going to rise “slowly” and “steadily” with the province’s new framework, and he singled out the holidays as a possible source of new infections.

“I think the Christmas holidays, (when) families intermingle, I think that’s going to be the straw that breaks the camel’s back. … I think we’re going to have to lock down in January.”

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The fact that restaurants, bars and gyms will open in hot spot regions, Furness said, is “absolutely appalling.”

Read more: Ontario reports 987 new coronavirus cases, 16 more deaths

He said Ontario is following Donald Trump’s plan for managing COVID-19. “We’re scaling back testing in Ontario and now we’re opening up businesses.”

For Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital, it’s not clear how effective the new coronavirus response system will be.

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“The way they set these metrics, it would take pretty significant community spread before some measures were taken to restrict spread in the community,” he said. “We do need to recalibrate what those metrics are for imposing public health restrictions. … I think it just gives us a little too much leeway to allow for community transmission.”

Bogoch said lockdowns should be the last public health measure taken by governments, but in the case of Ontario’s new framework, he thinks the threshold for shutting down is too high.

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“I’m not saying we should be locking down,” he added. “I’m saying we should clearly be taking steps to curb transmission in the community.”

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Dr. Anna Banerji, a pediatric infectious disease specialist and an associate pediatrics professor at the University of Toronto’s Dalla Lana School of Public Health, also doesn’t think Ontario’s new response system will help to improve COVID-19 transmission rates.

“It’s opening things up,” she said. “If you open things up, you’re going to increase the spread, but what I think they’re trying to do is reduce the degree that it spreads, but what they need to do is deal with the school situation first.”

Virus transmission in public settings

The Ontario government doesn’t specify or indicate new or additional measures for schools under its new COVID-19 framework.

At a press conference on Tuesday, Ontario’s chief medical officer of health, Dr. David Williams, said schools weren’t mentioned as part of the province’s new system because they were opened up with more layers of protection in place.

“We’ve added more staff at all levels,” Williams said. “We’ve added our public health nurses, (and) enhanced that role as well. There’s PPE and there are various cohorts.”

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Coronavirus: Ontario’s top doctor explains why schools aren’t part of new COVID-19 early warning system – Nov 3, 2020

He said a lot of positive COVID-19 cases in schools have been picked up at home or through community contacts.

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But according to Banerji, not including schools in Ontario’s new framework is a mistake.

“Schools seem to be the blind spot for this government,” she said. “Yes, it’s a school, but it’s also a workplace and business for teachers and custodians.”

Furness paints a picture as to how COVID-19 could spread with Ontario’s new framework in place. For example, he said, people with the novel coronavirus could go out to dinner and infect their waiter.

Read more: Is Ontario’s regional staged approach working amid the province’s second wave of COVID-19?

“The waiter infects the kitchen staff, all those people go and party with their friends who are also 20-somethings — maybe entirely asymptomatic,” Furness said. “They then spread it within their families and so on and so forth. Then, all of a sudden, you have an outbreak in a long-term care home 50 miles away.”

Regardless of the restrictions under Ontario’s new framework, Furness said allowing people to gather indoors without masks will create the “perfect storm” for COVID-19 transmission.

“Regardless of closing times, regardless of restrictions and number of people intended to be seated at tables, regardless of any of that, when you open restaurants and bars to indoor dining, you’re creating situations that COVID will profit from.”

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Clarity, transparency of public health messaging

The Ontario government recently came under fire for sending what critics described as mixed and unclear messaging regarding public health safety measures in the province.

For example, more than two weeks ago, the government announced indoor dance classes could resume in modified Stage 2 regions but maintained that gyms must remain close, prompting confusion amongst the public.

Read more: Ontario’s mixed messaging on coronavirus is leading to distrust in province, experts say

Now, experts say the province’s new COVID-19 response framework is transparent, which is a positive sign.

“We all need to know what are the metrics for reopening and what are the metrics for imposing public health restrictions,” Bogoch said. “They’ve outlined that in a very clear, colour-coded manner, so I think that’s the obvious pro.”

But Banerji said the province’s new system is confusing, with it being detailed in some areas and not in others.

For example, restaurants and bars under the new “restrict” category will limit the number of people who can be seated at a table together to four.

Read more: Halloween on or off? Dance studios but no gyms? Inconsistencies fill coronavirus messaging

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“Are those four people within your family? Are those four people that are just in a group of four people?” Banerji said. “If it’s four people in a family unit, they should be sitting together, but if it’s people who are not part of the same unit, they need to be separated, and so a lot of those details are not in there.”

Furness said the province’s new system appears to be oriented toward businesses — not toward the public. He noted there’s a lot of detail in the plan, which is useful for businesses.

“If I’m a gym and I want to reopen, I need that detail. I need to know what to do,” Furness said. “But for the public, this is a lot of information to take, and none of this seems to be oriented to the public.”

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— With files from Global News’ Jessica Patton and The Canadian Press

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