Ontario has unveiled detailed criteria for easing COVID-19 restrictions that will see shuttered businesses reopen in hot-spot areas, but some medical experts warn that loosening rules with cases still rising rapidly could backfire.
Premier Doug Ford announced Tuesday that gyms, indoor dining at bars and restaurants, and cinemas will be allowed to reopen under strict conditions in Ottawa, Peel and York Regions as of Saturday, but Toronto has asked for an extra week to prepare.
Mr. Ford said the new provincial framework, which outlines five colour-coded stages of restrictions, will help the province introduce preventative measures early to slow the spread and avoid lockdowns seen in other countries around the world.
“We will stay on top of the trends to determine where regions stand,” he said.
The same day, Ontario reported a record of 1,050 new cases – with 408 in Toronto, 212 in Peel, 86 in Halton, 76 in York, 57 in Durham and 34 in Ottawa – plus 14 deaths from COVID-19.
Mr. Ford has come under increasing pressure from businesses, as well as his own Progressive Conservative caucus, to explain the data behind his government’s restrictions. Meanwhile, infectious-diseases experts have raised doubts about the province’s ability to get the coronavirus under control while at the same time easing public-health measures.
Andrew Morris, medical director of the antimicrobial stewardship program at Sinai Health System and University Health Network in Toronto, says the province’s benchmarks for reopenings are too loose and provide a “facade of objectivity” for reopening businesses even as cases rise. He warns it will only result in a European-style spike and the need for a harsh lockdown.
“This is not a durable solution,” he said.
Ontario Chief Medical Officer of Health David Williams will make a confidential recommendation to cabinet when he believes any region should change alert levels, but Mr. Ford and his ministers will still make the final decision.
The province put four areas of the province – Toronto, Ottawa, Peel and York – in a modified "stage 2″ last month, meaning indoor dining, gyms and cinemas were closed for 28 days.
Mr. Ford said those restrictions will lift in Ottawa, Peel and York on Saturday at 12:01 a.m., with new capacity limits and restricted hours.
But he said Toronto Mayor John Tory and the city’s Medical Officer of Health, Eileen de Villa, requested an extra week, until Nov. 14, before their reopening begins.
Officials in Toronto, where the growth in infections last month overwhelmed the public-health unit’s ability to trace the contacts of confirmed cases, reacted to the new framework with caution. In a statement, Mr. Tory said Dr. de Villa was reviewing the city’s pandemic numbers, and that his officials would have more to say Wednesday about how, and when, businesses could reopen safely.
Jeff Powis, medical director of infection prevention and control at Toronto’s Michael Garron Hospital, said he worries the province’s new system won’t work without a better system of testing, tracing and isolating patients and their close contacts.
“That’s my biggest concern,” Dr. Powis said. “In the absence of contact tracing, they’re making these decisions in a void of information.”
The provincial framework outlines five classifications for the province’s 34 different public-health units: prevent, protect, restrict, control and lockdown.
“Prevent,” colour-coded green, has the most permissive rules and would include regions with the lowest case counts, positivity rates and community transmission levels, as well as passing grades for hospital capacity and contact tracing. The other levels – yellow for “protect,” orange for “restrict,” red for “control” and grey for a strict lockdown – step up restrictions on businesses and gatherings.
Toronto, Ottawa, Peel and York regions, as well as Eastern Ontario, are to be placed in the “restrict” category.
At that level, restaurants and bars can have an indoor capacity limit of 50, with two metres between tables and a limit of four people at each table. Patrons must wear face coverings when not eating and drinking, and establishments will be required to stop selling alcohol at 9 p.m. and close by 10 p.m. Karaoke bars can also open, but no private rooms are allowed.
Gyms in those regions will also be permitted to reopen with a maximum of 50 people at a time in each facility and increased spacing of three metres between patrons. Cinemas will also be limited to 50 people per facility. Casinos, bingo halls and gaming establishments, as well as performing arts centres, will also be permitted to reopen with limited capacity, but strip clubs remain closed.
Lawrence Loh, Peel’s Medical Officer of Health, said the region is still seeing a significant number of cases as well as the highest positivity rates in the province. “The reality is that our situation in Peel is precarious,” he said.
The NDP called the new system a “complex scheme” that will cause the pandemic to last longer in Ontario, while Liberal Leader Steven Del Duca labelled the government’s plan a “betrayal,” saying it is confusing, weak and leaves behind communities most disproportionately affected by COVID-19.
With a report from Kelly Grant
The Globe and Mail
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