Pushback against shutdown-happy Ontario
Shaky evidence for moves on restaurants
Over the weekend, various politicians from Halton Region, west of Toronto, committed Ontario’s version of treason: They asked Queen’s Park to not — repeat, not — mandate new restrictions on everyday life such as shutting down gyms and indoor dining rooms. And on Monday, Premier Doug Ford agreed.
Halton is seeing considerably fewer cases than Peel, York, Toronto and Ottawa — the four COVID- 19 hot zones where such restrictions were re- implemented three weeks ago. But the decision caused some consternation nevertheless. In part that was because Ford, a politician, dared admit the decision was political: “In Halton it is unique,” he said, “because we have none of the mayors agreeing (with new restrictions), we have the regional chair not agreeing and our MPPS not agreeing.” And in part that was because many public health experts feel the restrictions were reintroduced in the hot zones much too late. “It very much looks reactive, and not proactive,” one told the Toronto Star.
But Halton is being proactive. It’s just asking instead of ordering.
On Oct. 19, regional medical officer of health Dr. Hamidah Meghani “strongly recommended” the cancellation of indoor fitness classes and team sports competitions. And lo and behold, people listened: Youth hockey leagues have returned to practices only, for example. Meghani, like her colleagues in the hot zones, also advised socializing only with people you live with. Instead of demanding dining rooms be closed, however, she extended that principle: “Dine at restaurants with people in your household only.”
This is obvious, intuitive advice that might at least keep a few restaurants and their employees above water. But in Canada, it puts Meghani in the permissive wing of the public health establishment, along with her colleagues Dr. Bonnie Henry in Victoria and Dr. Deena Hinshaw in Edmonton — both of whom have resisted calls from the medical and media establishment to reimpose the most severe restrictions amidst rising case counts.
Despite vast swaths of Ontario being essentially COVID- free zones since Day 1, the province didn’t allow a single restaurant to open indoors until July 17. Quebec allowed dining rooms to open at the end of June, but it has been even more draconian in shutting them back down again: even restaurant patios were ordered closed on Oct. 1.
In an Oct. 2 letter begging the province to shut down indoor dining, Dr. Eileen de Villa, Toronto’s medical officer of health, said her department had considered “requiring individuals to dine in restaurants with only members of their household.” But it concluded that wouldn’t be “enforceable or effective.”
“Unenforceable” evinces a remarkable lack of trust in Toronto’s really very trustworthy population. Toronto’s mandatory-mask rule is officially unenforced on public property. Compliance is very nearly total nevertheless. Restaurants and other businesses have adopted myriad non- binding safety recommendations issued by public health departments. Surely if someone is going to lie about their relationship with their fellow diners, it’s unlikely they are otherwise keeping to their household.
The “ineffective” conclusion is just weird. There is a Chinese study that suggests table- to- table transmission is possible in restaurants — though the tables in question were only one metre apart and in the direct line of fire from the air conditioning. But clearly the major risk of transmission at restaurants is from unmasked people conversing over a meal. This is why Toronto reduced the maximum table from 10 people to six, at the end of September.
It only stands to reason that further reductions, or limiting the household diversity of patrons, would further limit the risk. Down came the hammer instead.
You often hear that “plenty of evidence” supports banning indoor dining. One recent and oft-cited CDC study of 314 people found that 41 per cent of COVID- positive subjects reported visiting a restaurant within the previous 14 days, vs. 28 per cent of the negative cases. But it’s a very small sample size; the question didn’t differentiate between indoor and outdoor; and 59 per cent of the positive cases said at least some of their party hadn’t been following the rules.
Media reports often exaggerate the level of certainty, as well. “In Louisiana,” the New York Times reported in August, “roughly a quarter of the state’s 2,360 cases since March that were outside of places like nursing homes and prisons have stemmed from bars and restaurants, according to state data.”
On the day the story ran, there had been 134,560 total cases in Louisiana; even adding in long- term care homes and prisons, just nine per cent had been traced to any outbreak at all, and 0.5 per cent to restaurants. The Times failed to note that three times as many cases in Louisiana had been linked to bars than to restaurants, or that food processing facilities, “industrial settings” and casinos were all linked with more.
Here in Toronto, you often hear “44 per cent” associated with restaurant- related spread. “Between Sept. 20 and 26, there were 45 active community outbreaks,” de Villa wrote to Queen’s Park on Oct. 2. “Of these outbreaks, 44 per cent were in restaurants, bars and entertainment venues.”
Leaving aside the absurdly broad “restaurants, bars and entertainment venues” category — it includes everything from strip clubs to Morton’s steakhouse — those 45 outbreaks accounted for just 12 per cent of total new cases between Sept. 20 and 26, Dr. Vinita Dubey, Toronto’s associate medical officer of health, confirms.
There were very likely more such cases: Contact tracing can’t remotely keep up with demand. But while it’s understandable many businesses are asking for the evidence to justify closing them down, the simple fact is that it doesn’t really exist. It’s an educated guess. And other educated guesses, like Meghani’s, Henry’s and Hinshaw’s, are valid too.
After all, there are plenty of places where allowing indoor dining hasn’t immediately been correlated with spiking case counts. “We have seen very minimal spread in restaurants where all of the guidance is being followed,” Hinshaw told reporters on Tuesday. In Toronto, the first 40 days of indoor dining saw newcase rates more than double. In Hamilton, Ont., an hour down the road, the new-case rate was lower on Day 40 than on Day 1.
Many American cities have had Toronto’s experience, or much worse. But others in that general neck of the woods have had Hamilton’s experience: Cleveland, Columbus, Pittsburgh, Grand Rapids, Mich., Providence, Detroit and Hartford were all seeing fewer cases 40 days after reopening dining rooms.
Ontario has certainly excelled at achieving the worst of both worlds: Neither permissive enough to satisfy the libertarians nor restrictive enough to satisfy the public health maximalists, with a heavy dose of absurdity tossed in. Over the weekend, the Star reported that a friend of Premier Ford had secured approval for his clear plastic dining igloos, which can be erected on patios in no- indoor- dining zones. How it can possibly be wise to seal people inside an igloo with a potential COVID-19 case, but unwise to allow them into a properly ventilated dining room, has not been explained.
Meanwhile Sam Oosterhoff, Education Minister Stephen Lecce’s 23-year-old parliamentary secretary, is quite rightly under fire for posting photos of himself huddled maskless with roughly 50 others at a restaurant in Niagara Falls. The proprietors claim they repeatedly asked the party to follow the rules, and were rebuffed. Ford’s altogether bewildering response: “He’s doing a great job.”
Good luck to Ontario’s restaurateurs. They’re going to need it.