Toronto officials outline plan for expected resurgence of COVID-19

Thestar.com
Sept. 1, 2020
Francine Kopun and Ed Tubb

There will be a resurgence of COVID-19 in the fall, health and municipal officials warned on Monday, including the possibility of a wave bigger than the one that peaked in April.

“We know that most of us are not immune to COVID-19 and the virus is still very much circulating out there,” said Dr. Eileen de Villa, Toronto’s medical officer of health, speaking at a press conference from city hall.

She added that how bad the second wave gets will depend in large part on whether people continue to wear masks, wash their hands and practise social distancing.

“We’re getting ready for a resurgence in the weeks and months ahead.”

The city’s COVID-19 Resurgence Plan, announced Monday, outlines how the city will fight the expected second wave of the virus, which has now infected 25 million people worldwide.

Toronto has reported 1,175 deaths.

De Villa said it’s not yet known what that resurgence will look like -- whether it will be one big wave in the fall and winter -- perhaps far larger than the one experienced in the spring, with successive smaller waves in 2021 -- or whether it will arrive in the form of a series of closely spaced, smaller waves that diminish over time, or manifest as a “slow burn,” without a clear wave pattern.

De Villa said that only one per cent of Ontarians have the antibodies that would make them less likely to become ill with the disease. Everyone else is at risk of getting the illness, which has been shown to have unpredictable outcomes in people of all ages, with some reporting symptoms that linger for weeks or months.

Safe, reliable vaccines are not expected before the spring of 2021.

While city and public health officials did not release details of the plans for the fall or the projected numbers for each scenario, another lockdown has not been ruled out, including cancellation of non-essential services and closing parks and other city amenities.

The city says it will return to operating free emergency child care for essential workers if licensed child-care centres are required to close, if the province funds it.

As the weather becomes colder, the city will maintain additional winter space for the homeless and provide enhanced street outreach services.

Additional staff were hired over the summer to conduct contact tracing, a critical component of controlling the spread of the virus.

The city is also looking at setting up a voluntary isolation centre for people who have been diagnosed with the disease but are unable to self-isolate at home.

Civic centres, city hall and metro hall will remain closed for now, said Mayor John Tory, also speaking at the press conference.

Although an increase in the number of infections is inevitable, he said the city’s plan aims to minimize the increase.

“We have learned from this fight so far,” he said.

During the Spanish Flu pandemic of 1918, a second wave in the fall was much larger and more deadly than the first wave, although local officials say that doesn’t mean that will necessarily happen with COVID-19.

De Villa reported an increase of 40 cases in Toronto on Monday. Cases were averaging about 13 a day when the city entered Stage 3 of re-opening on July 31.

According to the Star’s count, reported cases have been rising slowly but steadily on average in Toronto since that week ended on Sunday, Aug. 2.

The seven-day average went up every week in August; last week saw an average of about 33 cases reported each day.

Toronto Public Health also closely monitors the seven-day case average, which is one of several metrics in the city’s dashboard of key pandemic indicators. That dashboard moved from green to yellow earlier this month, indicating the infection rate is no longer in line with the city’s goals.

Despite the increase, the city is still well below its peak infection rate of about 230 cases a day, seen in late May.

Cases have also been rising in the rest of the GTA. Peel, York, Durham and Halton regions have all seen their case averages increase significantly this month.

De Villa reminded residents that COVID-19 spreads easily from person-to-person -- it’s easier to catch than the flu -- and it’s unpredictable.

“There are no guarantees about the kind of outcome you may have if you get it,” she said.

“We still have some questions about kids and how easily -- or not -- they can spread the disease to others.”

She urged people to build one 10-person bubble and stick to it.

Epidemiologist and mathematician Caroline Colijn agreed that what the wave looks like will depend a lot on what actions people take to fight it.

She said she’s concerned about the return-to-school in places, like Toronto, where the virus is continuing to circulate in the community.

She believes that while we need to be re-opening schools, it must be done with extreme caution, and small class sizes will be key to containing the spread of the illness.

It will also be important that parents keep their children home if they show any signs of respiratory illness. Contact tracing and isolation also needs to be conducted quickly in the event that someone becomes ill.

“Our ability to control COVID while shutting everything down was great, but our ability to control it while everything is opening up is less great, and that is the real challenge,” said Colijn.