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Ford mused about 'loosening' restrictions in May, but getting Ontario back to normal not that simple

You open up society a little bit and you wait and see,' Toronto epidemiologist says

CBC.ca
April 24, 2020
Lauren Pelley

When will life go back to normal?

It's the question on everyone's minds during the COVID-19 pandemic, and the short answer is frustratingly vague: it could take a year, or two. Maybe more.

The long answer is more complicated, rife with unknowns, and hinging on our ability to stay the course and stay apart amid a crippling country-wide health crisis with no clear end point.

On Wednesday, while chatting with a radio station in Ottawa, Premier Doug Ford mused about "loosening" restrictions by the May long weekend. Speaking to reporters around midday, he clarified that he meant opening perhaps a "trickle" of the economy --not the floodgates.

Even that small glimmer of hope came with caveats, with Ford suggesting any policy changes would be conditional on the health of Ontarians.

"This is the fight of our lives," Ford said in his address.

And while the shuttering of all non-essential businesses back in late March was swift, opening everything back up will take far longer, even beyond a year, epidemiologists predict.

"We need to be cognizant that we still have a ways to go," said Ashleigh Tuite, an epidemiologist and assistant professor at the University of Toronto's Dalla Lana School of Public Health.

Update: On Thursday morning, the province extended all emergency orders until May 6, confirming the continued closure of all non-essential workplaces, public spaces, bars, and restaurants, and an ongoing ban on gatherings of more than five people.

Before governments start lifting restrictions, there needs to be clear evidence the epidemic is fizzling out, stressed Dr. Sumon Chakrabarti, an infectious disease specialist at Trillium Health.

A slowdown of transmission also needs to be coupled with increased testing, he added, otherwise flare-ups could occur.

Tuite said her team has updated their modelling to see what would happen if all public health interventions were lifted at once --a hypothetical mass reopening of society.

The outcome was dire: A rapid increase in cases of the disease, coupled with more hospitalizations and deaths.

"It's a bleak reminder of how impactful what we're doing right now has been," she said, "and also how fragile what we have is."

'There's not a simple recipe for this'
Decision-makers, taking cues from health professionals, seem to grasp the steady, controlled approach required to bring cities back to life.

But what does that actually look like?

For starters, smaller settings and outdoor gatherings are likely to revive long before large concert halls and sports stadiums. And there's good reason to err on the side of caution, since what the experts call "congregate settings" are flashpoints for the fast-spreading virus --evident in the grim death toll at long-term care homes and increasing cases within Toronto's shelter system.

"You open up society a little bit, and you wait and see," said Tuite, adding: "There's not a simple recipe for this."

She explained without a vaccine --which could take a year or more to develop, if ever --or the possibility of organic "herd immunity" where a sizeable chunk of the population has already caught the virus, there will likely be waves of outbreaks in the months ahead.

Those waves, she said, would require careful monitoring. Officials would also likely have to loosen and tighten restrictions to match what's happening on the ground.

A period of calm? Perhaps small gatherings and access to public park facilities would get the green light. A flare-up in the community, sending an influx of patients to local hospitals? Could be time to ramp up physical distancing measures.

With no clear roadmap in place, questions also remain about the ripple effect of bringing people back into workplaces, including more riders returning to public transit, where concerns already exist about drivers and other employees falling ill.

"There are a number of things we need to be looking at before we can really understand what an opening of the GTA area looks like," said Farah Mohamed, senior vice president at the Toronto Region Board of Trade.

"There are things like pandemic-proofing our transportation, making sure that our vital infrastructure is modified so people can actually use it."

'There is no on/off switch'

Infectious disease specialist Dr. Isaach Bogoch, a researcher at Toronto General Hospital, recently discussed the possibilities with CBC Radio's Metro Morning.

"You can envision starting up things like professional sports with empty stadiums. You can think about loosening some restrictions on some places," he mused.

"Could restaurants open, but seat 25 per cent capacity, ensuring that there is appropriate hand sanitizer and space between tables? I'm sure there are creative ways to do this."

More than 80 Toronto health-care facilities, shelters experiencing COVID-19 outbreaks
Speaking to the media on Wednesday, Toronto medical officer of health Dr. Eileen De Villa said she simply doesn't know when any restrictions can be lifted.

There may be certain businesses where public activity is more easily "turned back on," while still allowing people to keep a safe distance from each other, she said.

But for now, Toronto still needs more control over the virus, De Villa continued, adding there's a "delicate balance" between easing measures for the broader community while ensuring residents in settings like long-term care homes are safe and the health-care system isn't at risk of being overwhelmed.

Even so, Toronto has started talking about how to "safely restart the city," Mayor John Tory said.

"We also agreed that there is no 'on/off switch," Tory explained in a statement.

'Too soon to let our guard down': How Canada has avoided a surge of COVID-19 cases in hospitals
In other words, there's no easy fix to the societal shutdown millions of residents are living in.

When it comes to handling what is essentially a new disease, decision-makers don't have any clear guidelines to follow. Other cities around the world are still facing the same uncertainty. And even the latest modelling can't predict exactly when and how Ontario will fully restart daily life.

The only thing that's certain? Getting back to normal will take patience. And time.