Fact or Fiction: Are ‘circuit breaker’ lockdowns going to cut it? Or is it time for #COVIDZero?

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Fact or Fiction: Are ‘circuit breaker’ lockdowns going to cut it? Or is it time for #COVIDZero?
This continuous state of going in and out of lockdown might not save Canada from a third wave. Noor Ibrahim reports. – Feb 4, 2021

Remember that time in the summer of 2020 when many provinces — including Ontario — eased their COVID-19 lockdown restrictions after the daily recorded cases plummeted?

Well, some experts say that might not have been our golden moment.

“We should not have left lockdown when we did in June or so,” said Stacey Smith?, a professor in the school of epidemiology and public health at the University of Ottawa. “Because we cut it short last time — and it seemed like we had an OK summer — that was just a ticking time bomb for September.”

Ontario is currently under its second “circuit breaker” lockdown — a term used to describe a time-limited restriction on public movement until health systems see some relief and then the restrictions ease again.

This form of lockdown does give contact tracers and health care systems time to catch up, provided the restrictions are enforced and people follow the rules. But experts say going in and out of them too soon throws the country in an endless yo-yo strategy of open, close, open, close.

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“We’re actually calling this more of a ‘mockdown’ rather than a lockdown,” said Samir Sinha, director of geriatrics at Sinai Health and University Health Network. “Things were a lot stricter in March because we were really scared. … I think a lot of us were taking it more seriously because we didn’t know what it could do. ”

“Now the fact that people say, ‘Well, it’s a virus that pretty much attacks older people and has a risk of killing them, but not necessarily younger people to any major extent,’ I think a lot of us have now become a lot more complacent,” he said.

According to an Ipsos Poll for Global News in January, 48 per cent of 1,000 participants said they gathered with people outside of their household over the holidays, and 61 per cent of those said they did so without masks.

“There is pandemic fatigue — people do feel stressed out, they get tired of following these public health guidelines,” said Zahid A. Butt, associate professor at the school of public health and health systems at the University of Waterloo.

“The messaging around lockdowns, and what is included in the lockdowns, has to be clear and consistent. If people don’t know what the lockdown means, what they have to do and don’t have to do, then it won’t be successful.”

“This what people do – they say ‘Oh! A boundary! Let me see if I can test it.  Let me push against it.’  That’s very human. So that means we need to be clear about those boundaries,” said Smith?

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Smith? and Sinha say data like that presented in the Ipsos Poll shows that the current lockdown isn’t doing what it is meant to be doing — restricting movement and community contact.

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This means health care systems are overwhelmed, and effective contact tracing –  which Smith? says helped stop the SARS outbreak – has become extremely difficult.

“The problem now with so many cases, is that doing contact tracing is like playing whack-a-mole. You’re trying to knock down an outbreak and its contacts at the same time as you’re in the middle of another outbreak, and another one, and another one.”

Recently, Canada seems to be making a bit of headway.

On Jan. 31,  the country suspended all international flights to and from Mexico and Caribbean destinations until April 30. The federal government has also made it mandatory for passengers to get tested for COVID-19 upon arrival at any of the four designated airports, and to quarantine at a hotel for at least three days at their own expense.

But despite a state of emergency –  international, interprovincial, and intercity travel continues.

“The travel restrictions aren’t as severe as they were (in April),” said James (Jim) Tiessen, director of the master of health administration at Ryerson University. “We’re seeing a number of flights coming in daily from other countries — which is not the case as it was in the spring. Of course, this is particularly troubling given the variants that are particularly emerging in England and South Africa.”

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The variants have proven to be far more infectious — and the culprit behind an “explosive” outbreak in Barrie, where more than 65 long-term care residents have died.

“We realize that some areas (like the Atlantic Bubble) are doing much better than others, and it’s disappointing that we’ve unnecessarily lost so many lives,” Sinha said.

This current state of the country is pushing many to call for a different lockdown approach, and to look outside the border for success stories.

A popular model? The one used in Melbourne, Australia.

In July, Victoria, the Australian state where Melbourne is located, had become an epicentre for the virus.

Then, an independent think tank recommended the federal government move to a “go for zero” approach: for six weeks, residents were only allowed to leave their house to buy essentials, exercise, go to work or give care.

Still, they had to remain within a five-kilometre radius of their homes at all times. Curfews were enacted as well as mandatory isolation periods. Daily caps on arriving international travellers were implemented, and they were forced to quarantine in hotels. Some states closed their borders to each other. Schools went virtual. Child care closed.

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The goal was to bring the cases close enough to zero, in order to enact thorough contact tracing and snuff out the virus.

By December, Victoria had gone a month without recording a single new COVID-19 case.

The catch? All of these rules were enforced.

“Sometimes someone’s got to play the dad,” Sinha said. “So when you don’t give — whether it’s law enforcement or other health officials — the power to actually check and make sure people are doing the right thing, I really think it gives us a toothless process.”

Another catch? Australia had an “exit strategy” — the government was able to provide assistance to those without jobs, to give isolation supports for those who don’t have a space to isolate alone, and to ramp up contact tracing.

But Sinha says that Canada is lagging behind on building its army of tracers, and that essential supports, such as paid sick days and isolation support, have not come through.

Still, experts and front-line workers continue to call for a similar approach to Australia’s — called #COVIDZero — to be enacted on Canadian soil.

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But some argue that simply implementing what happened in another country here in Canada isn’t that easy. Tiessen says Australia’s climate may have made ventilation and congregation outdoors easier.

But Smith? and Sinha say that Australia still has a fairly similar geography and culture to Canada’s, and that if we can’t implement its strategy word for word, we can certainly learn some lessons, especially on how to build our own “exit strategy.”

Many agree that the ramifications of one strict, prolonged lockdown would undoubtedly be devastating on the economy, on mental health, and on education.

But Smith?, Sinha, and Butt all say that taking a short-term, hard hit now will reap fewer losses than the uncertainty of an endless lockdown.

“In the long run – if you look at it – would you want multiple lockdowns all-year round? Or would you want just one, really – I would say – strict lockdown?” said Butt.

Until something changes, Smith?, Sinha, Tiessen, and Butt say cases won’t be coming down low enough to enact effective contact tracing.

It also means, according to Sinha, that the next time we come out of lockdown and up for air, we will be on the brink of getting pummeled by a third wave.

Click to play video: 'Coronavirus: Health experts call for #COVIDZero approach'
Coronavirus: Health experts call for #COVIDZero approach

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