Ontario's top doctor is calling on local health units to use their legal authority to enforce the isolation of people who have COVID-19 and people who are close contacts of positive cases.
In a memo to local medical officers of health, Ontario Chief Medical Officer of Health Dr. David Williams told his colleagues they must do more "given the ongoing and increasing incidence of community transmission across the province."
"Given the increasing number of cases, all public health units should implement more aggressive contact tracing and management as we work collectively to flatten the curve," he wrote. "As such, I am strongly recommending that Medical Officers of Health use their authority under Section 22 of the Health Protection and Promotion Act to ensure isolation of cases and contacts of COVID-19."
The legislation allows local medical officers of health to order any people who may have a communicable disease to remain in isolation. Violations of those orders constitute a provincial offence, and can result in a fine of up to $5,000.
At a media briefing Wednesday afternoon, Williams said his memo was intended to prompt local medical officers of health to apply the enforcement provisions of the legislation to any individuals who were flouting their responsibility to self-isolate.
He said there has already been at least one such order issued to someone who had flouted instructions from their local public health authority to self-isolate, but wouldn't give more specific information. "It didn't seem that individual was taking the matter seriously enough, so they wrote a section 22 requiring them to adhere...with the possibility of further legal action and fines," he said.
On Wednesday morning, Toronto's chief medical officer of health, Dr. Eileen de Villa, had announced two "class orders" under that legislation: that all people who have COVID-19, and all people who have had close contact with someone who has COVID-19, are to stay home for 14 days.
Normally, Toronto Public Health would issue orders under the Act individually, as Williams suggested, but de Villa said she believes it is necessary to issue orders to all people who have COVID-19, or are close contacts of people with COVID-19, that they must self-isolate.
The enforcement of those orders falls to Toronto Public Health, said De Villa. She also said those orders mean she is using the maximum legal authority granted to her to act. She said she is also seeking to work with the province to narrow the number of essential businesses and workplaces that are allowed to remain open.
Meanwhile, the province also announced a measure that allows the increased enforcement of the measures it has announced under the Emergency Management and Civil Protection Act, including the shutdown of non-essential businesses. As of Tuesday night, Ontarians can now be required to identify themselves to police and bylaw officers, when those officers are charging them with violations of emergency orders.
At press conference Wednesday, Premier Doug Ford stressed the need for enforcement of isolation measures.
"Right now, today, there is very little separating what we will face here in Ontario from the devastation we have seen in Italy and Spain," Ford said. "Thousands of lives are at stake."
"The actions we take in the next two weeks will be critical, because we know a surge is coming."