Has province learned nothing?
Ontario found a formula to reduce cases and has decided to go in a different direction
So March break will be in April, but that’s not the point. Well, it’s the point for some parents, and some kids. We’re coming up on a year of serious pandemic life, and I hope parents and kids are doing OK. We’re all trying to swim.
But moving March break to April 12-16 is just one part of a plan that seems as coherent as an eight-year-old’s first crack at persuasive writing. Thursday, Ontario’s science table said the more transmissible variants are circulating, and we need to reduce transmission to account for them. And the province said it will relax restrictions, which is expected to increase cases, possibly sharply.
It was plainly contradictory. Unlike most students, this province appears to have learned nothing.
“The best bet we can offer from the science is this: if we’re able to push the impact of COVID-19 down further by sticking to public health measures and aggressive vaccination, we can avoid a third wave and hope for a late spring and summer that’s much safer and more open,” said Dr. Steini Brown, the dean of the Dalla Lana School of Public Health and the co-chair of the science table, at a press conference.
“I hope they use the emergency brake when they need to,” said Dr. Isaac Bogoch, infectious diseases specialist at the University of Toronto and Toronto General Hospital, in an interview. “Mobility is a proxy. It’s a good proxy, but it’s just a proxy. But if you start opening up, don’t be surprised if there’s more mobility, and more human interaction. And don’t be surprised if we see a rise in cases, especially with (the U.K. variant) B.1.1.7 circulating.”
If you’re down to the emergency brake, the driving’s going well. The province announced the March break move because of genuine worries about variants, about people travelling, about people congregating together. But Friday the government will announce which of 28 possible regions will exit lockdown, and have the stayat-home order lifted. And schools — whose impact we haven’t determined, though Quebec says they have driven cases since reopening last month — are going back.
So Ontario finally found the formula to reduce cases and the burden on the hospitals and health-care workers, did it for a month, and has decided to go in a different direction. Retail is already opening even in grey lockdown zones, which is expected to increase mobility and contacts; the stay-athome order was the first thing, combined with restrictions, that bent the COVID-19 curve in Ontario since last spring.
But this government’s hunger for short-term economic gains, and tolerance for needless illness and death in exchange, just can’t be helped.
The science presentation was clear. Current measures are working, and vaccination of long-term-care homes — not quite finished, despite the province’s premature say-so, but close — means a reduction in deaths, but not a reduction of the strain on ICUs, because LTC patients don’t usually get there. Variants are expected to make the virus harder to control — Brown said we would need an effective reproductive rate of 0.7, which is lower than now, and which we have rarely achieved in this pandemic — and they are circulating in the community. Dr. David Williams, Ontario’s chief medical officer of health, said that even short interactions could be dangerous now.
“While you might have gotten away with that with the other COVID strain, this new one does not permit that,” said Williams. “You just need a very short contact, and you can transfer it. People say, I just talked to someone for a few minutes, and I don’t know how I got it, but that’s the only way I got it. People are surprised at how rapidly and easily it is transmitted.”
So we’re ... reopening retail, and schools, and lifting stay-athome orders, Monday, or the week after?
When asked by TVO’s John McGrath whether he was missing anything — whether it was fundamentally contradictory for the science table to say transmission needed to be reduced to avoid disaster, while the province moved forward with a move that is expected to push it the other way — Brown said, “no, I don’t think you’re missing anything.”
“The cases will likely rise, given the variants of concern,” said Brown. “The need to keep the (transmission) level down is really, really critical. But there are a number of things that need to be weighed in making these decisions.”
That was a man saying, very politely, that science isn’t making the call here. The hospitals are opposed to the reopening plan. The registered nurses, too. And the doctors.
Oh, and the organization representing the 34 public health medical officers of health signed a letter advocating, again, for the province to implement paid sick leave. According to public health sources, MOHs were given about an hour’s notice last week that the province intended to reopen, and were told there would be additional measures to keep people out of green regions; they just weren’t told it would be up to public health officials to do it themselves.
Meanwhile, York Region has nearly 100 cases of the variant, and their mayors are asking to be moved back to red, not lockdown, so restricted indoor dining and fitness classes can be open; it’s also what the framework would allow, and it’s worth remembering that a more strict framework failed to stop the climb back before the variants arrived. It all seems like the most magical of thinking.
“While we’re going back into the framework, this is not an opening up,” said Williams. “While we can open up some aspects within the framework, we can’t open up writ large. We have to be more vigilant and more careful with our personal contact, or conduct.”
That’s why, as Bogoch more or less put it, the emergency brake is what’s left. North Bay will be the first test, with the variant infecting an apartment building and closing a school there. There will be other tests. Would you want to be in a car driven by Dr. David Williams and Premier Doug Ford that has to be stopped via quick use of the emergency brake, before the cliff ?
I was thinking about something Dr. Ashleigh Tuite, the epidemiologist and modeller from the University of Toronto, said the other day, after the province announced the reopening plan. Vaccines arrive in more supply within weeks. Case counts could keep dropping. We are finally on the right track.
“All of this has been painful, but right now if we just push a little harder, get those case counts down, protect the vulnerable, get people vaccinated, we can get there,” she said. “We’re so close.”
So far, too. Good luck, everyone.