Toronto’s top doctor issues ‘warning to the entire city’ as new cases surpass 200 in single day

Thestar.com
Sept. 28, 2020
Jennifer Pagliaro

As new cases of COVID-19 in Toronto reach the highest point in the pandemic since May, city officials are moving for the first time to shut down establishments that have put members of the public at risk of virus spread.

On Friday afternoon, in a late-scheduled press conference, Dr. Eileen de Villa said there were 236 new cases and the first reported outbreak in a Toronto school with two students infected and more than two dozen isolating at home.

And the medical officer of health, under her own authority, has moved to close four “hospitality-focused” businesses that have flouted public health orders and thwarted investigators, including pressuring employees who are ill to continue working.

“An increase, day-over-day, of this scale is a warning to the entire city,” de Villa said, urging residents to stay six feet apart whenever they can from anyone they don’t live with, wear a mask and wash their hands.

De Villa said “several concerning factors” led to the orders under the Health Protection and Promotion Act, including: Several infected employees working at multiple locations; illegal buffet dining; unco-operative business owners hampering investigative efforts; and staff working while ill and concerns of staff being pressured to do so.

“These factors combined to create a significant risk to efforts to limit the spread of COVID-19.”

With the orders still outstanding Friday afternoon, de Villa promised to update the public on the names and locations of the businesses once orders were served.

The steps taken Friday are the first time the city is acting to close businesses outside of provincial orders after the province claimed bars and restaurants were not to blame.

On Friday, Toronto Public Health posted the first detailed example of virus spread demonstrating how a night out led to at least 20 confirmed cases and dozens of high- or low-risk contacts across three separate bars and how the infection spread from one place to the next.

“A powerful reminder that #COVID19 spreads when given the chance & we all need to take steps for self-protection: here’s a real-world example of how 1 night out in TO led to 20 cases & at least 80 people exposed to the virus who had to self-monitor, self-isolate & get tested,” the tweet said, showing a chart of cases and contacts across the three locations.

Friday’s new case number is the largest single-day total the city has reported since May 22.

According to the Star’s daily count, the city has averaged 167 new cases each day this week, the highest its seven-day average has been since early June.

That average has been accelerating since the city entered Stage 3 or reopening on July 31, and has more than doubled in just the last eight days.

In early August, Toronto was seeing as few as 13 cases reported each day on average.

Like much of Ontario, Toronto was hit hard in the spring by institutional outbreaks in long-term-care homes and hospitals, and by mid-April these vulnerable settings accounted for the largest share of total cases, hospitalizations and deaths.

So far in the fall, the city is not yet reporting a similar rise in new institutional outbreaks. According to city data, the recent spike has been mostly driven by close contact in non-outbreak settings, such as at home, and by untraceable spread in the community.

The numbers account for more than half of the province’s total Friday and came as Premier Doug Ford announced the province would restrict bars open hours and shut strip clubs.

The limit on drinking in bars comes more than two months after the city requested the province make those rules -- ahead of Stage 3 -- to help reduce the risk of virus spread.

On Friday, when pressed by a reporter on why it took so long to implement those measures, Ford said they were being “cautious,” noting an earlier decline in cases.

Meanwhile all but one of Toronto’s health indicators on its online dashboard were yellow or red. Only the percentage of positive test results, at 1.9 per cent, was green.

But Dr. Irfan Dhalla, a vice-president and general internist at St. Michael’s Hospital, tweeted even that number may be troubling, saying other targets are much lower than the city’s 10 per cent -- less than 0.1 per cent or between 0.1 and 1 per cent.

“So, really, there’s nothing green anymore on Toronto’s scorecard,” he wrote Friday.

Asked how the current case count will affect schools, de Villa said the first outbreak was expected and she anticipates more in future.

Two students at Glen Park Public School, near Bathurst Street and Lawrence Avenue West, have tested positive and are isolating at home. As a precaution, a teacher and two classes, with 35 students total, are also isolating.

A total of 28 other schools in the Toronto District School Board were also reporting cases, for a total of 20 infected students and 14 infected teachers. Richview Collegiate had the most, with three infected students.

The Toronto Catholic District School Board reported eight infected students and three infected staff at 10 schools.

Glen Park is the only Toronto school that meets Ontario’s “outbreak” definition of at least two cases where at least one is “linked to a school setting,” de Villa said. That suggests one student infected another, as opposed to schools where all the infected students contracted the virus at home or another setting.

“This (outbreak) definition supports a swift response that will help manage the spread of COVID-19 aggressively,” de Villa said.

The Star spoke to a mother of a 10-year-old girl at Glen Park Public School who was among the children sent home to isolate for two weeks.

“We are still on the fence on whether it is worth getting in a lineup for testing,” said the mother, who did not want her name used.

On Wednesday, she said, parents received information from Toronto Public Health saying there was a case of COVID in the school but weren’t given any additional details, such as the grade level, so they could prepare themselves.

“It was really frustrating. It’s a quite a big school and it would have been very helpful to get more information from Toronto Public Health,” she said.

On Friday morning, a new message from Toronto Public Health was waiting.

“I woke up to an email saying there was a case in her class and she would be isolated,” she said.

“There was definitely a sense of high anxiety among the parents initially. It’s not an email you want to get but you put it in perspective.”

It was “bad luck” that Glen Park ended up with positive cases of COVID, she said. Staff have worked hard to get the students familiar with safety practices like social distancing and cohorting classes.

“They have tried to do everything they can to prevent this. Everything is very well planned out. It’s well organized.
“Here, if they have to go to the bathroom every class has 15 minutes where they can go knowing there won’t be a big group of kids,” she said.

The email that detailed the rules for isolation was soon followed by a message from her daughter’s teacher who said classes would continue on Zoom with two or three sessions held each day.

“It was very reassuring,” the mother said. “They are going to learn a lot about resilience and flexibility from all of this.”

“It is obviously unfortunate but it is not unexpected,” said Ryan Bird, TDSB spokesperson.

“With the numbers continuing to climb in Toronto and elsewhere, we did anticipate that we would have these cases start popping up in our schools among our students and staff.”

Bird said the TDSB continues with “enhanced cleaning multiple times a day” along with requirements for universal masking among students and staff, proper physical distancing and hand washing.

In a statement Friday, Coun. Joe Cressy, the city’s board of health chair, warned the city was reaching a “dangerous tipping point in our battle with COVID-19” and risk of future lockdown.

“Other jurisdictions that have been successful at containing the virus have shown that we need policies that directly respond to the very real risks that we’re facing,” his statement said. “While today’s announcement is welcome news, we still need more proactive actions on the part of all governments -- and we need it now.”

He said that includes boosting testing capacity across the province and the federal and provincial governments working to provide rapid testing options for those in high-risk workplaces.

Elsewhere, officials were being clear about telling people to stay apart.

Quebec Health Minister Christian Dubé asked residents to cancel their gatherings over the next few weeks, including Thanksgiving, the CBC reported Thursday, as the province remains the hardest hit by the virus in the country.