National Post (National Edition)
A little humility from public health officials would go a long way
With COVID-19 case counts at record highs in every province west of New Brunswick, businesses where people congregate are yet again facing an existential crisis: cinemas, gyms, bars and restaurants. The latter two seem to be particularly popular targets. Drinkers and diners have been consigned to ever-chillier patios in Toronto since Oct. 10 — a provision the city ordered extended for another 28 days on Tuesday — and in Winnipeg since Nov. 2.
Since Oct. 1, even the patios have been shut down in Quebec City and Montreal. Where public health officials and politicians have resisted closing restaurants, as in Alberta and British Columbia, they have faced harsh criticism from many in the medical and media communities.
“Show us the evidence” has been a common refrain from bar and restaurant owners: evidence that the virus is spreading widely in conscientiously run establishments; evidence that the people who would otherwise spread the virus in their establishments aren't spreading it elsewhere; any evidence at all.
Generally speaking, they have been left wanting. One of Canada's most famous and prolific outbreaks came from a bar in Quebec City, but karaoke was involved. Drunkenly belting out Éric Lapointe's greatest hits is a rather different epidemiological experience than sitting down for a quiet meal.
Late last month, Ontario released data showing few outbreaks in the province's hot zones had been traced to “restaurants, bars and clubs” — from 2 per cent in Ottawa to 14 per cent in Toronto. But only 16 per cent of cases in Ontario over that time had been traced to outbreaks at all, while 37 per cent were classified as “no known epi link” — i.e., public health officials have no idea where they came from.
Some, no doubt, came from bars and restaurants. Without vastly superior contact tracing there is simply no way to know for sure.
On Tuesday, however, the Toronto's medical officer of health, Dr. Eileen de Villa, declared the hospitality industry shutdown a success. “In the Waterfront Communities and the Island neighbourhood, for the period from Sept. 18 to Oct. 10, the COVID-19 case rate was 275 per 100,000 people,” she observed.
“The temporary restrictions began on Oct. 10, and for the three-week period ending November 8, the case rate had dropped to 49.”
“In Little Portugal, a similar downtown neighbourhood, with a relatively young population and many bars and restaurants, the COVID-19 case rate for the three weeks ending Oct. 10 was 604 per 100,000 people and by Nov. 8, it was 77,” she added.
The Little Portugal case is unnecessarily overstated, as it includes a huge outbreak at a local nursing home. But the neighbourhood had the highest rate of cases among those aged 20 to 40 as well, and the drop is undeniably impressive: There were 28 cases in that age group in the first three-week period, and just two in the second.
This is mostly true across the city, however, and not just in the areas known for millennials and Gen-Zers making merry. City-wide, compared to the three weeks ending Oct. 10, the three weeks ending Nov. 8 saw 14 per cent fewer cases aged 20 to 40, 65 per cent more aged 60 or older, and 135 per cent more aged 80 or older. Of the 46 neighbourhoods where more than 30 per cent of the population is aged 20-40, 33 saw fewer cases overall in the second three-week period. But 13 did not: In one midtown neighbourhood, cases soared by 70 per cent.
It's considerably less than a slam-dunk case, in other words. If overall cases are rising, including among the most vulnerable members of the population, it's fair for restaurant owners to wonder what exactly the point is of shutting them down. And they might also point to Ottawa: Its dining and drinking rooms shut down on the same day in October as the GTA's, and cases have dropped steadily since. If restaurants and bars are such major culprits, why have the two cities' experiences been so different?
I can only imagine the frustration business owners must feel. When cases kept rising after the restaurant shutdown, public health officials said it was “too early” to expect to see positive results. When cases spiked two weeks later, they said it was almost certainly due to ill-advised Thanksgiving gatherings. (Perhaps restaurants could have provided a safer environment?) Two weeks later, they're being told they're still the problem and will have to take another month off.
Dr. Anthony Fauci, the nodoubt relieved head of the White House's Coronavirus Task Force, often stresses the importance of public health officials admitting what they don't know. It would behoove Canada's to take that advice more often. There's nothing disreputable about taking a best guess, so long as they keep in mind the negative effects that shutdowns and lockdowns impose.
With these constantly changing explanations and rationalizations for their preferred anti-pandemic measures, they risk undermining trust in a population so willing to be oppressed that two-thirds of us would support a 10 p.m. curfew if public health officials recommended it, according to Léger's latest weekly poll for the Association for Canadian Studies. That would be some feat.
THERE IS VALUE IN ADMITTING WHAT WE DON'T KNOW.