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People walk in Bayshore Shopping Centre mall in Ottawa, on its first day open as part of Stage 2 of Ontario's plan to lift lockdowns implemented in response to the COVID-19 pandemic, on June 12, 2020.Justin Tang/The Canadian Press

Some of Canada’s top public-health experts say the country’s focus on wiping out the coronavirus is posing “significant risks to overall population health,” as other priorities take a backseat to the pandemic.

In an open letter to Prime Minister Justin Trudeau and the premiers, 18 health leaders are calling for a more “balanced approach” that protects those likeliest to die of COVID-19 – namely the elderly – while allowing the rest of society to return to something closer to normal.

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“Aiming to prevent or contain every case of COVID-19 is simply no longer sustainable at this stage in the pandemic,” the letter says. “We need to accept that COVID-19 will be with us for some time and to find ways to deal with it.”

Signatories to the letter include Gregory Taylor, Theresa Tam’s immediate predecessor as chief public health officer; David Butler-Jones, the country’s first chief public health officer; Bob Bell, Ontario’s former deputy health minister; Onye Nnorom, president of the Black Physicians’ Association of Ontario; and Vivek Goel, former president of Public Health Ontario.

Canada has been cautiously celebrating its success in controlling the novel coronavirus, particularly when compared with the hard hit United States. Provinces are several stages into their reopening plans, welcoming diners back to restaurant patios and shaggy-haired clients back to salons, with rules around masking and physical distancing often in place.

The country has been reporting fewer than 500 new infections a day since the second week of June, down from averages of between 1,500 and 1,700 a day at the end of April and beginning of May, when new cases peaked.

COVID-19 hospital admissions and deaths are down, too. On Monday, Ontario reported no new COVID-19 deaths for the first time since March 15.

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The Public Health Agency of Canada said the issues raised in the letter have “already been consistently recognized” by the agency and that it continues to “work with our provincial and territorial partners and other stakeholders to address them, both strategically and through a wide range of programmatic and operational activities.”

Critics of the letter’s position say Canada would be foolish to jeopardize its progress by lifting the remaining restrictions too quickly. They argue that reining in the virus is a necessary prerequisite to reviving the economy and improving the well-being of the poor and racialized Canadians who have been disproportionately harmed by both the lockdowns and the virus itself.

“It’s a false dichotomy to say we either tame COVID-19 or we let people get back to work and to school,” said Irfan Dhalla, a physician and a vice-president at Unity Health Toronto who has been encouraging Canada to strive for zero cases. “The places that have been best able to get children back to school and people back to work have been the same places that have aimed for elimination.”

The letter, which reflects views that a few of its signatories have been sharing publicly since early in the pandemic, advocates taking a “risk-based” approach to future surges of coronavirus infections rather than reimposing sweeping shutdowns.

“COVID-19, obviously, is a serious threat to public health,” said Dr. Goel, who helped organize the letter and is a professor at the University of Toronto’s Dalla Lana School of Public Health. “But the measures that we’ve taken also represent serious threats to public health and are increasing inequities.”

Dr. Goel said Canada risks leaving its economy “very hobbled,” if it doesn’t further relax some of its coronavirus-related restrictions. “As community transmission gets lower and lower, we have to start to asking questions like, ‘Do we want to keep restaurants operating at 20- or 30-per-cent capacity, which is what two-metre separation forces them to do?‘”

Amy Greer, an epidemiologist at the University of Guelph, said in an e-mail that the letter struck her as little more than “a bunch of platitudes.”

“I disagree (as do many of my infectious disease and epidemiology colleagues) that we should consider an approach that means we just sit back on our heels and let this play out.”

In response to the letter, Ontario Health Minister Christine Elliott said the province’s cautious approach to reopening has been successful thus far. “What we don’t want to see happen is to open everything up, all of a sudden, and then see the public-health impacts that may come from that,” she said.

On Tuesday, Premier Doug Ford’s government announced it would be extending the province’s declaration of emergency until July 24, in what the Premier’s office said would likely be the final extension.

But the government also introduced a new bill that would allow it to further extend or amend individual emergency orders for up to two years, arguing the province needs flexibility as it continues to respond to the dangers posed by COVID-19.

With reports from Laura Stone and Danielle Webb

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