Ontario lurches forward again as reopening begins

Toronto’s not ready. Neither is the rest of the GTA, or the whole Golden Horseshoe, from Niagara to Oshawa and beyond. Big parts of Ontario are reopening. The biggest parts of the province, population-wise, aren’t. And really, thank goodness.

“I know we’re all eager to get things back to normal,” said Premier Doug Ford.

“We need to learn how to coexist safely with this virus,” said Toronto medical officer of health Dr. Eileen de Villa.


That’s what this is about. The good news is that after insisting on a one-size-fits-all approach for so long, the provincial government is using region-specific conditions, less than two weeks after the province’s regional medical officers of health basically staged a public health intervention.

And on Monday Ford, specifically said MOHs and mayors needed to agree to reopen their regions, which would be a huge shift in philosophy, a welcome climbdown, and progress in a province where the pre-eminent public health voice might belong to a premier who bumbles public health advice on the regular.

It was the only way to reopen safely when over 80 per cent of active cases were in the Greater Toronto Area. Now comes the next part, which is, who really knows what the rules are now?

“The underlying message is that behaviourally, we need to continue as we are, in terms of continuing to keep a distance from people who aren’t in your household, and there isn’t strong messaging here in terms of wearing masks, although it’s in there,” says epidemiologist Dr. Ashleigh Tuite, of the University of Toronto. “I think the challenge is, how do you go from (the province’s reopening) document into something we can summarize in five key points so that people can understand and act in a way that protects themselves and protects others. You would hope, in the coming days, that comes out in terms of how to behave.”


Indeed. Stage two Ontario gets to enter the exciting, tentative, possibly confusing and perhaps exhilarating world of the past, and the future. Restaurant and bar patios, drive-in theatres, beauty salons, hairdressers and barber shops, shopping malls (but not sit-down food courts), concerts. Summer day camps, camping, community centres, libraries, museums, galleries, beaches, bus tours, walking tours, swimming pools, splash pads, wading pools. Outdoor team sport practices, and upcoming plans for child care. Remember what it was like to live in the world?


The new world will be confusing, sure. You can have 10 people at a wedding, but churches can open at 30 per cent capacity, so why can’t you get married in a church at 30 per cent capacity? There’s guidance coming on family bubbles, apparently, so how does it work that 10 people can gather, but families aren’t supposed to mix yet? Oh, and this all starts Friday at midnight for the lucky low-COVID regions, so that’s when the 10-person parties start.

“Behaviours will change: we’ve seen it,” says epidemiologist Dr. Nitin Mohan, who teaches public and global health at Western University, and who co-founded a public health consulting firm called ETIO. “Make it a group of five and people will do 10, make it 10 and people will do 15. It’s like driving a car: you’re going to go a little above the limit. So how quick can we respond to any issues, regionally? Our testing capacity, our contact tracing.”

“It’s basic trust: if the public doesn’t trust in the decision they won’t follow the advice,” says Toronto city councillor Joe Cressy, the chair of the Toronto Board of Health. “Reopening means learning to live with COVID. There are going to be outbreaks, there are going to be cases, there are going to be deaths. Reopening means managing risk, and the question is, do we have the criteria and the means to respond when the outbreaks happen?”

That part isn’t as clear. We have hospital space, thank goodness. De Villa said Monday that just 23 per cent of tests in Toronto are being turned around in 24 hours, with 60 per cent as the goal, so contact tracing is not being executed quickly.

But at least she presented specific public health goals for Toronto, and is a voice we should listen to. Because right now, the rest is a mess. Ford says, “(People) can travel. But when it comes to haircuts, I’m hanging in here right until the last minute.” And Dr. Tuite, says, “My epidemiological take is, if you’re in a region that hasn’t reopened, you should stay in your region. But you want really clear messaging to make sure that happens, because otherwise, for the regional reopening to work, it has to be that way.”

So yeah, we’re going to get people travelling for haircuts, and more of them rolling to cottages, or hitting the Airbnbs that have been opened up by the government, for some blinkered reason. Anecdotally, people have just started doing whatever they think is right: going to the cottage, mixing with other families, whatever. Hamilton has seen more cases among young people, which is less worrisome than vulnerable populations, but more COVID isn’t good for anybody.

In B.C., Dr. Bonnie Henry has been an unblinking guiding light. In Ontario, we have … uh … well, good clear public health advice at a provincial level has been like trying to find a small item in your household’s most chaotic, crowded drawer.

 

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