Three days after Toronto’s top doctor asked the province to intervene to prevent the from spreading further in the city, said he’s unwilling to act.
As Toronto has become unable to even effectively trace the spread of COVID-19, of community spread, Dr. Eileen de Villa, the city’s medical officer of health, is recommending in the city, that people only leave their home for essential trips and that indoor group fitness classes be shuttered.
But saying those sweeping closures and orders exceeded her legal authority as a local medical officer of health, de Villa on Friday called on the province to enact those measures.
On Monday, Ford said the province lacks evidence to respond to de Villa’s request and that he won’t make a “willy-nilly” decision to “ruin” people’s livelihoods.
“If there’s a request to shut down restaurants, I have to sit back and look at evidence,” Ford said at Queen’s Park.
“You better show me real, real good evidence before we do it … I’m sorry I’m not prepared to do that to people’s lives right now. I’ve proven if I have to do it, we’ll do it in 10 seconds. But show me more evidence.”
When asked to respond to those comments Monday, de Villa said the province has “many sources of information” and that Toronto Public Health provides data about all of their cases every single day.
In her letter Friday, she outlined several “critical observations,” including the existence of 169 active outbreaks. Of new outbreaks, 44 per cent — about 18 outbreaks — were tied to restaurants, bars and entertainment venues. She also noted significant exposures, including up to 1,700 people at the Yonge Street Warehouse.
And she compared the city’s current daily cases to earlier counts, saying that when cases tallied 165 per day, the city was essentially in lockdown. On Oct. 1, Toronto had 280 cases, de Villa said.
Dr. David Williams, Ontario’s chief medical officer of health, echoed Ford’s comments on Monday, saying the province will continue to look at the request with its public health measures table, while looking at the impact of existing provincial measures and requesting Toronto Public Health provide “more data to make sure that it supports any further steps so we can handle that.”
Williams said the premier is looking for evidence that patrons have been impacted with illness.
“As of yet we haven’t seen that. We’ve seen outbreaks related to staff during their pre- and post-work time and their activities in the back rooms,” he told reporters when asked to elaborate on Ford’s comments. He said that they have not seen evidence that restaurants generally are contributing to outbreaks in the community.
De Villa said if there are further requests for data “we’ll be happy to provide as best we can.”
said Monday that they continue to work collaboratively with the province, saying he believes they’re acting in “good faith.”
“Sometimes it takes some time to compare notes, to fashion solutions which work both for Toronto and for the rest of Ontario and we will continue to succeed at forging those solutions in a collegial and collaborative way,” he said.
Meanwhile, at Queen’s Park, the premier’s officials repeatedly cited section 22 of the provincial Health Protection and Promotion Act as evidence that Toronto’s medical officer of health already has the power to close restaurants and bars if she so chooses.
That law says the city’s top doctor can intervene where “she is of the opinion, upon reasonable and probable grounds, that a communicable disease exists or may exist or that there is an immediate risk of an outbreak of a communicable disease.”
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On Monday, infectious disease specialists said there is no reason to disagree with de Villa’s recommendations.
“Even with imperfect data we still know that there is transmission in many indoor settings,” including bars and restaurants, said Dr. Isaac Bogoch, a University of Toronto infectious disease specialist.
“The person who has their finger on the pulse and has probably the best access to that information is the chief public health officer of the city … so who am I to argue with Dr. de Villa when she’s saying there’s an unacceptable number of cases associated to bars and restaurants in the city?
“I hope the province listens to her.”
Dr. Andrew Morris, with the Sinai Health System and University Health Network, said he’s also in agreement with de Villa, noting he is not a medical officer of health.
“I actually don’t know what more they would want,” Morris said of the province and available data.
He also noted the directions currently being given to people with bars and restaurants still open are sending “mixed messages.”
“You can go to a restaurant but you can’t have people over to your home for dinner. That doesn’t make sense to a lot of people.”
Asked Monday if she supported a 28-day shutdown in Toronto as requested by de Villa, Dr. Theresa Tam, Canada’s chief public officer of health, said de Villa is in the best position to know.
“At the rate of acceleration and as we’ve heard about, the public health capacity is not limitless — there’s some testing backlogs and some difficulties with contact tracing — then making sure that we reduce contacts and look at restricting those settings where transmission is occurring is really critical to do,” she said. “The speed is of the essence. The faster you reduce this acceleration, the sooner you come out of it. Whatever decision is made has to be made pretty rapidly.”
On Monday, de Villa urged people to cancel plans for Thanksgiving gatherings this year and opt for virtual celebrations, saying missing the holiday this year is better than looking back on the occasion with regret.
Meanwhile, . De Villa said Monday that even with double the number of contact tracers, they would not be able to keep up with the current overwhelming pace of transmission will resume that strategy when possible.
“We have 700 case and contact managers at Toronto Public Health — the most in the country. Infections are rising at a rate that will very quickly outpace conventional case management and contact tracing no matter how many people are deployed to support it,” she said.
“To be frank, I expect we could have another 700 people added to the ranks and still be unable to contact trace with the same reach and results as when infection rates were lower. It’s an indicator of how serious the spread of infection is.”
With files from Robert Benzie and Tonda MacCharles
Jennifer Pagliaro is a Toronto-based reporter covering city hall and municipal politics for the Star. Follow her on Twitter:
