Niagara poised to move to red zone

Hirji continues to advise against further reopening, but expects the province isn’t listening

Despite the warnings and advice of nearly every major health-care organization in Ontario, the association of public health units and Niagara’s own medical officer of health, the region appears poised to be shifted into the red pandemic zone next week.

Dr. Mustafa Hirji said Wednesday the province is on a path of “relatively aggressive reopening” of the economy — a path that leans heavily upon Ontario’s colour-coded system of restriction zones that failed to stop the second COVID-19 wave that saw hundreds of Niagara residents with the virus die.

For the past several weeks, medical experts have been advising against opening up Ontario’s economy too quickly. Citing the spread of more infectious variants of the novel coronavirus in the GTA and the previous failure of the rainbow restriction system, these experts have urged the reopening be delayed until the infection rate has fallen further and more intensive-care-unit beds are available.

Aside from Hirji and the provincial association of public health units, the Registered Nurses Association, Ontario Medical Association, Ontario Hospital Association and Public Health Ontario (PHO) have all advised the government of

Doug Ford not to reopen just yet.

“To that group, I would also add Ontario’s chief medical officer of health who, just a few weeks ago, said Ontario should get down to 150 ICU patients before reopening,” Hirji said. “That recommendation appears to be something that the province is not following.”

As of Wednesday, there were 287 people in ICU beds in Ontario.

On Feb. 11, PHO released three reopening metrics the province should use to determine if a region can safely reopen. At best, Niagara only meets one of those three measurements.

However, the PHO recommendations are not Ontario policy and Hirji said, going only by the colour-coded framework, the province can justify moving Niagara into the red zone.

An announcement is expected Friday.

Hirji gave his recommendations to the province earlier this week, and continued to advise for a slow, cautious reopening until the infection rate is lower, more ICU beds are free and more vaccines are injected into arms.

Among his concerns is Niagara’s improved but still higher than the first-wave peak infection rate, the number of local outbreaks and the increasing spread of B.1.1.7, or U.K. variant, in the GTA.

There are six presumed cases of virus variants in Niagara. Lab results to confirm the variants have yet to be sent to public health, Hirji said.

On Wednesday, Toronto public health reported its viral reproductive number — the number of people a single infected person can make sick — rose to 1.1 from 0.8. A number below 1.0 indicates a falling infection rate. A figure of 1.0 or higher is a mark of increased virus spread.

The provincial coloured-coded system sets the red zone reproductive rate at 1.2 or higher — a level that indicates infection-rate growth.

By comparison, the PHO is recommending a region maintain a reproductive rate of 0.7 or lower for at least two weeks before reopening.

Niagara’s reproductive number, although improved from the second-wave peak in January, rose this week to 0.8 from 0.6.

Hirji said he is concerned the virus will spread from the GTA to Niagara and, if the region reopens prematurely, an increased virus spread will trigger another COVID-19 wave and a third lockdown, which will do more long-term economic damage than holding off a few more weeks until the infection rate is lower.

If Niagara does move to the red zone next week, Hirji’s orders for restaurants, bars and stores will remain in effect.

Under the red-zone limits, indoor dining must be limited to 10 total patrons at any given time and only a maximum of four people can be seated at a table at any given time. Under Hirji’s orders, those four people must be from the same household or be essential contacts, like a caregiver or a couple that does not live together.

Stores, meanwhile, must enforce proper mask-wearing and two-metre physical-distancing requirements in the stores and lineups, even those outside.

Retail outlets, currently restricted to 25 per cent capacity, can have 50 per cent capacity indoors, based on fire code limits. That means the number of people allowed in stores will vary widely. In a small store, that may mean only a few people, but much larger outlets, such as the Niagara Flea Market in St. Catharines, could see more than 1,000 people inside at a time.

Hirji said the health department could issue orders at specific businesses if COVID-19 spreads there.

When Hirji first issued his orders for restaurants and bars in October — which he put in place because of virus spread among patrons that resulted in outbreaks and increased community spread — local politicians, including Niagara’s regional council, urged him to rescind the order. He did not and, according to public health data, spread in restaurants dropped significantly after the order came into effect.