Premier Doug Ford said he's asked his health experts to give him recommendations on how to safely ease restrictions in COVID-19 hot spots, even as provincial modelling shows case counts are continuing to rise.
At his daily press conference Friday, Ford said the increased restrictions his government implemented have allowed Ontario to avoid the need for "more draconian" measures need in other places, such as France and Spain — but they weren't intended to be permanent.
"I have asked our public health experts to come back next week with a plan to begin to ease restrictions in a way that safely allows businesses to start opening back up after the 28 day period is over," he said, adding "we don't know how long this virus will be with us."
The restrictions, mainly the closure of indoor dining and bars, gyms, and movie theatres, came into effect as of Oct. 10 in Toronto, Peel and Ottawa, and Oct. 19 in York.
Ford said his decision was made based on the modelling information his health experts released yesterday — it showed the growth in new COVID-19 cases is slowing and the province’s trajectory appears to be moving away from the worst-case scenario. Only the worst-case scenario forecast over the next month would see the province's intensive care units reach the level of capacity that would require surgeries to be halted again, the experts said.
However, the experts also cautioned that the super-spreading nature of COVID-19 means that the situation could worsen again rapidly.
The modelling presentation also included one slide that caused an immediate uproar among Ontarians who said it shows the government's decision to shut down some businesses with the modified stage two restrictions wasn't justified.
The Canadian Federation of Independent Businesses (CFIB) and members of Ford's caucus are among those who are angry because the pie charts show that bars, restaurants and gyms were the sources of only a fraction of the total number of outbreaks in hot-spot regions.
"All along, we at CFIB have been asking for the government to provide evidence for any shutdown decisions," said Julie Kwiecinski, CFIB's director of provincial affairs for Ontario. "So yesterday's pie charts, with low percentages for outbreaks for shut down sectors have raised many questions from our members. Our phones have been ringing off the hook."
"Needless to say, struggling small businesses on life support need an explanation from the premier as to why (he) shut them down and took away their livelihood."
The slide consists of four pie charts, one for each of the public health units that have been moved into modified stage two.
The charts show how many known outbreaks occurred in different types of settings from Aug. 1 to Oct. 24. It shows 27 outbreaks — or 14 per cent of the total number of known outbreaks — occurred in restaurants, bars and clubs in Toronto in that period. There were only three in Peel, three in Ottawa and 10 in York, in that sector.
Gyms and sports locations were an even smaller share with six outbreaks — or three per cent — in Toronto, and three in Peel, nine in Ottawa and three in York.
The premier did say the restrictions have been working, but he didn't explain the pie charts. He referred a question about them to Associate Chief Medical Officer of Health Dr. Barbara Yaffe, who said those charts looked much different before the restrictions were in place — at that time, they showed 30 to 40 per cent of outbreaks, particularly in Toronto and Ottawa, were at restaurants or gyms.
The pie charts presented on Thursday included outbreaks during two weeks in October where those businesses were largely closed, but outbreaks were increasing in other settings.
Meanwhile, two other public health experts told QP Briefing the controversial charts don't give an accurate picture of where COVID-19 transmission is happening.
"This is not a snapshot of reality," said Colin Furness, an assistant professor with the Dalla Lana School of Public Health.
"In fact, I think the problem is not what the data is showing here," he added. "The problem is they shouldn't have put this slide in the deck."
The charts only capture outbreaks discovered and declared by public health units — not the proportion of cases stemming from each setting. Outbreaks can be as small as one or two cases, depending on the setting, or large, such as the super-spreading wedding in Vaughan linked to 44 cases.
They also said outbreaks in restaurants, bars and gyms are likely getting missed, as it's far easier to discover an outbreak in long-term care, a school or even a factory, where people either live or return to on a daily basis, said Dr. David Fisman, a professor of epidemiology with the Dalla Lana School of Public Health and a consultant infectious disease expert with the University Health Network. Determining that an outbreak occurred at a restaurant or gym is more challenging because people may not remember and report everywhere they've been and may have no other connection to the other people who were also at that venue, and know that they've also contracted COVID-19.
Furness agreed and said that means transmission in those settings is far more likely to go unnoticed by public health units unless they're superspreader events.
Both Fisman and Furness said this problem is compounded because the public health contact tracing efforts in Toronto and Ottawa have been overwhelmed and suspended. Officials have no idea where 65 per cent of the recent cases in Toronto stemmed from, and 49 per cent of the cases in Ottawa.
Fisman added that better, more specific data exists showing the extent of cases from the settings targeted in the modified stage two restrictions, but it hasn't been openly released by Public Health Ontario.
In a statement, Public Health Ontario indicated it will begin releasing some of that information, in addition to the breakdowns of cases and outbreaks it currently releases on a weekly basis now on outbreaks in health-care and congregate living settings. "Breakdowns will include sectors such as restaurants/bars/nightclubs, recreational fitness, retail, personal service settings ... it will show numbers of outbreaks as well as [the] number of cases," the statement said.
On Friday morning, Ottawa's chief medical officer of health echoed the message that the relatively small number of outbreaks flagged in her city's restaurants and bars doesn't mean that transmission isn't happening there.
"We have many different examples where employees have tested positive, people who have gone to restaurants with their social groups have tested positive, people have been in restaurants while they've been infectious,” Dr. Vera Etches told CTV Morning Live. “Eight per cent are reporting in that 14 days before they got a COVID virus test that was positive, that they were in those environments. So the outbreak numbers aren't the whole picture."
Fisman cited a study by the U.S. Centers for Disease Control that sheds light on that picture. It found studied cases with no known epidemiological link and found those people were three or four times more likely to be bar attendees or restaurant-goers than the general population. He said Ontario should do similar work in Ontario.
Another view shared by all of the public health experts was that restaurants, bars and gyms differ from the sectors with frequent, well-documented outbreaks such as long-term care, schools, health-care, and manufacturing, in that they are not as essential to the functioning of society.
"You don't close the long-term care facilities because they're essential and people actually have to live there and you don't close the schools because the rest of the economy unravels," Fisman said, adding that more precautions should be taken to reduce transmission in schools, especially by lowering class sizes.
Kwiecinski, when told about the public health experts' opinions, said that information highlights another very important concern from her members — poor communication from provincial officials.
"Why put out these fancy colourful pie charts to create an issue without putting asterisks and explanations? Where's the communication on this, the full explanation?" she said.
"How else are people supposed to interpret them other than to say, 'Hey, this is only 3 per cent out of the full 100 per cent, so why did you shut me down?'" she said, adding that the premier needs to be accountable for the decisions he has made.
Her members have more questions for the premier — particularly for details on the $300 million he announced would go toward supporting businesses that have had to shut down, she said. No details of that spending, announced three weeks ago, have been revealed.
They are also asking for the moratorium on commercial evictions to be extended at least until the new federal rent relief program for small businesses is up and running — something the premier confirmed will happen, with forthcoming legislation, at his Friday afternoon press conference.