Authorities unsure where Canadians catching COVID-19
“Without being able to do extensive contact tracing, it’s hard to know what’s exactly happening, and without knowing exactly what’s happening, it becomes virtually impossible to have any success stopping this disease by imposing very minimal, targeted restrictions.” Dionne Aleman
University of Toronto
As provinces and cities move closer to a full lockdown to prevent the spike in COVID19 cases, one question remains less than crystal clear.
Where, exactly, is the increasingly rampant transmission of the coronavirus happening? Is it in restaurants and bars, at schools, in factories or mainly in private homes?
The answer would seem to be a crucial piece of information for governments searching for ways to curb the worrying rise in cases.
Meanwhile, the restaurant sector and others are increasingly straining under restrictions that have already shut down thousands of businesses and put hundreds of thousands of staff out of work.
But the publicly available data is limited, and underlying the lack of statistics is another surprising problem. Contact tracing, a key part of the successful strategy against COVID in East Asian countries, has in some areas of Canada been overwhelmed by the sheer number of cases.
In Ontario, the setting where 60 per cent of infections occurred is simply unknown.
“Unfortunately, the hard reality is that we don’t know that much,” said Dionne Aleman, a University of Toronto engineering professor who studies health-related systems.
“Without being able to do extensive contact tracing, it’s hard to know what’s exactly happening, and without knowing exactly what’s happening, it becomes virtually impossible to have any success stopping this disease by imposing very minimal, targeted restrictions.”
Toronto Public Health all but ended its contract tracing work in Canada’s largest city a month ago, unable to keep up with the surge in infections. British Columbia is reporting similar problems.
Aleman questions why governments did not do more to beef up resources at chronically under-staffed public health agencies so contact tracing could keep up with the disease’s spread.
Certainly, there is some data on the issue of where Canadians are contracting COVID-19.
Figures compiled by Ontario’s COVID-19 Science Advisory Table estimated the percentage of virus outbreaks — sometimes defined as two or more people being infected from the same source — in different types of venues.
The largest chunk, 27 per cent, were in long-term care and retirement homes, at 27 per cent, followed by schools and day cares, at 22 per cent. Others included restaurants, clubs and bars, 6.5 per cent, stores 5.6 per cent, and gyms at 3.3 per cent.
Before it ended most contact tracing last month, Toronto Public Health found that 18 of 45 outbreaks during a week in September were in restaurants and bars.
Montreal’s health department also tracked outbreaks of COVID-19. Shops of various kinds represented the largest source – 50 out of a total of 151 – followed by the service industry, including bars, gyms and hotels, with 26 outbreaks.
There have been less precise releases of information, as well. Alberta Premier Jason Kenney told party faithful last month that just three per cent of cases were in restaurants, saying he “did not see any data” suggesting they needed to be closed down.
Dr. Bonnie Henry, British Columbia’s chief medical officer of health, said earlier this week that people could continue to dine out with their core, household bubble.
She said B.C. is not seeing much transmission in eateries that take proper anti-COVID precautions, and they may be less risky than people getting together at home without safeguards.
But Dr. Gerald Evans, head of the infectious disease division at Queen’s University and part of Ontario’s COVID scientific advisory table, said most of the limited data released so far looks at outbreaks, which account for less than 10 per cent of transmission in his province.
And in a stunning 60 per cent of cases, the setting where people contracted the virus is simply unknown, the advisory group says.
Evans points instead to evidence about where people typically congregate for s ocialization.
U.S. data from a Massachusetts Institute of Technology paper indicate that, prior to the pandemic, indoor dining made for by far the largest number of socialization encounters – 13 per cent – followed by fast-food outlets, stores, gyms and other venues. That research did not ascertain how much socializing occurred in private gatherings.
It would be nice to have more data from on the ground in Canada, but those numbers point to where the lockdowns should occur, said Evans.
“We know that when we don’t mandate or restrict things, people will naturally go back to those specific circumstances where they tend to socialize,” he said. “If you look at the States now, that likely accounts for why they are just out of control down there.”
As for the suggestion that most of the transmission is occurring in private homes, “there’s very little data to support that statement,” said the Queen’s professor
But all that is not good enough for the country’s restaurants, which suspect they are being “scapegoated” based on flimsy evidence, with devastating consequences.
About 10,000 restaurants have already closed down permanently, erasing hundreds of thousands of jobs, said Todd Barclay of Restaurants Canada.
Meanwhile, operators have spent an estimated $750 million on measures to protect customers and staff.
Governments should at least release data that separate out restaurants from bars, Barclay said, as his own members’ experience suggests eateries are less responsible for COVID spread than drinking establishments.
“The problem for us is we aren’t getting the information to suggest where it’s happening,” Barclay said. “They’re trying to get out of it and they’re guessing at where they should focus, versus using data to allow them to focus on the areas creating the biggest issues.”