Residents need to mitigate risk to keep COVID-19 from ‘roaring back’ as Ontario reopens

With provincial officials aiming to move into Stage 3 of Ontario’s reopening plan as soon as possible, public health experts say residents need to protect themselves and others while shopping, dining, and travelling — otherwise the virus behind COVID-19 could keep “roaring back.”

Right now, many patios and storefronts across the province are already operating, or in the process of opening back up. A shift into Stage 3 could mean another round of businesses open their doors, including all kinds of workplaces and indoor seating at bars and restaurants.

While Ontario Health Minister Christine Elliott still didn’t confirm a timeline on Monday afternoon, she stressed officials are watching the numbers — which included 154 new daily confirmed cases of COVID-19 — hoping to enter the next stage of reopening “as soon as we possibly can.”

On one hand, those expected changes would give residents more “flexibility” in how they live their lives during the COVID-19 pandemic, says Dr. Dominik Mertz, an associate professor in the infectious disease division of McMaster University’s department of medicine in Hamilton, Ont.  

“But at the same time, it gives people more responsibility,” he adds. “It puts the onus back on us, on the people, to make the right decisions for ourselves.”

So what do the right decisions look like in this new normal, where the threat of COVID-19 remains a part of daily life?

Assess your comfort level

“To me, the discussion starts with: What’s considered safe?” Mertz says. “Hardly anything is safe beyond staying in our own room these days. So it goes back to your individual risk assessment.”

Whether you’re planning a night out at a local restaurant or a day trip to a different city, he recommends considering a variety of factors: What level of risk are you willing to tolerate?

How vulnerable are members of your household, based on their age or health risks?

And how active is COVID-19 in the area you’re visiting?

Being outdoors is lower risk than being indoors when it comes to COVID-19 transmission, according to a growing body of reports showing the highest-risk settings. (Laura Howells/CBC)

With those considerations in mind, Toronto-based infectious disease specialist Dr. Isaac Bogoch stresses people should err on the side of caution.

“It doesn’t matter what phase of reopening we’re in,” he says. “The virus is still here and it will come roaring back if we let our guard down.”

For most people, however, staying vigilant may not mean eliminating all risk.

Many health experts acknowledge residents are eager to return to some semblance of normalcy after months of social isolation — so in the long-term, strategies need to be about finding ways to mitigate your likelihood of catching or spreading the SARS-CoV-2 virus.

Avoid high-risk settings

“The key is avoiding the highest risk transmission scenarios which can lead to super spreading events,” explains Dr. Abraar Karan, a clinical fellow at Harvard Medical School and an internal medicine doctor at the Brigham and Women’s Hospital.

Those documented high-transmission events, according to a growing body of reports, have ranged from a choir practice to a crowded call centre — with a clear trend featuring many busy indoor areas.

To steer clear of those high-risk spots, Karan suggests following the advice of Japanese public health officials and avoid the “3 Cs”: Crowds, close contact settings, and close spaces.

Masks are now mandatory in various regions, including large cities like Toronto and Ottawa. (Adrian Wyld/Canadian Press)

Mertz puts it this way: outdoors is better than indoors, and smaller groups are better than large groups. 

That means a bustling indoor mall is likely a far higher risk for transmission then, say, an open-air patio or storefront where people are staying apart from each other.

It’s always key to avoid crowds, Mertz adds, particularly if you have lots of people in a small area, and aim for short contact over prolonged contact with people outside of your household.

“Things like that, you can apply across the board, regardless of the setting,” he says.

Keep a mask on hand

Having a mask on hand at all times also offers additional protection if you do choose to go into riskier settings. 

Indoors, in close quarters, Karan says masks are always a must, with “no exception.”

They’re also mandatory now in public indoor settings in many areas of the province, including various smaller regions and larger cities like Toronto and Ottawa.

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Outdoors, it’s more about gauging your own comfort level, while keeping in mind that lengthy face-to-face contact — like a long chat with a friend — heightens the risk.

It’s a good idea to wear a mask if you’re on a patio with people outside your social circle, and there’s no harm in donning one even in a park where people are staying apart — though, if you do feel like there’s a lower risk, that may be the time to “take a break,” Karan says.

“It ultimately comes down to the level of risk people are willing to take.”

Be cautious while travelling

As more inter-provincial travel starts happening, you also need to keep in mind the bigger picture, whether you’re travelling from an area with higher case counts to a spot with few if any confirmed infections, or vice versa.

In the region of Wellington-Dufferin-Guelph, a mandatory mask policy inside public spaces has been in effect now for weeks, in part due to concern over nearby regions where COVID-19 case counts remain high in comparison to much of the province.

The local public health team is trying to keep the community safe — and open — explains director of community health and wellness Rita Isley.

Experts say it’s crucial to be extra cautious and respectful when travelling to areas with low infection rates. (REUTERS)

Epidemiologist Ashleigh Tuite, an assistant professor in the University of Toronto’s Dalla Lana School of Public Health, says it’s crucial to be “respectful” when venturing to areas with low infection rates. “You don’t want to be the person who’s importing it, so be extra cautious,” she cautions.

Dr. Eileen de Villa, Toronto’s medical officer of health — who is overseeing part of the GTA region that’s proven to be a hotbed for COVID-19 cases — says anyone travelling, whether it’s in a busy city or remote area, needs to just focus on “core public health measures” like physical distancing and hand washing.

Say you’re going on a family road trip, for instance. Bogoch says you’ll probably need to stop for gas, or stand around in a hotel lobby — so be sure to pack masks and hand sanitizer so you can reduce your risk in those settings. 

Log your contacts, travels

Tuite also says as you start visiting more local businesses or travel to different regions, it’s helpful to keep a log of your contacts and pit stops.

If you or a loved one does become ill with COVID-19, those records could help speed up the contract tracing efforts of public health officials, and ensure any other possible cases are identified quickly to stop the spread of the novel coronavirus.

The bottom line, Tuite says, is that reopening more settings will help fuel the spread of COVID-19 — so the onus is now on individuals to keep following public health recommendations to mitigate the risk, and stop infection rates from rising to a level that could require another lockdown.

“We’re going to have flare-ups. We’re going to have increases in cases,” she explains.

“But it’s possible that we can have manageable increases if we have all of these measures in place.”

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