A member of the province's science advisory table says he thinks it's "just a matter of time" before the province will be forced to revert back to step two or introduce a vaccine certificate program.

"There will be inevitably a moment where step three, especially when we open schools and then especially when the weather gets worse and we need to move indoors more, will not be good enough to have case numbers that are not either challenging for ICU capacity ... or that we see too many outbreaks in schools," said Dr. Peter Jüni, scientific director of the Ontario COVID-19 Science Advisory Table.

"When we then start to see that our case numbers are too high and that we either can't keep schools relatively safe ... or ICUs are too full with COVID-19 patients, there then is a need to revert back to step two for everybody or we start to introduce vaccine certificates and start to distinguish between people who are at risk of ending up in hospital in the ICU, that's the not fully vaccinated, versus people who are not at risk, that's the fully vaccinated," said Jüni, who is also the director of the Applied Health Research Centre at St. Michael’s Hospital's Li Ka Shing Knowledge Institute.

The province entered step three of its reopening plan on July 16, but delayed its exit from this stage giving rising hospitalizations and case numbers. Step three saw the reopening of many indoor venues and activities including dining, cinemas, zoos, aquariums, casinos and bingo halls.

Jüni said while it's difficult to predict when the province might reach this crossroads as it depends on what happens during the next few weeks, he thinks it could become an issue in about six weeks after schools have reopened and once temperatures start to cool.

"When you look at where we are, we are already in exponential growth right now — this means this is just a matter of time numbers will just grow if we continue with our behaviour as we are," Jüni said.

Vaccine certificates could allow the province to put in place differentiated restrictions based on vaccination status, so requiring vaccination for things like indoor dining, gyms or bars and finding solutions like on-site rapid testing for children who aren't eligible for vaccines yet, he said, adding that this kind of measure would also support the economy.

"You're between a rock and a hard place," Jüni said. "Some more restrictions than what we are currently doing, it's inevitable ... we either apply these restrictions to everybody in the absence of a vaccine certificate or we say, okay we're at the point where we need vaccine certificates."

His comments come as Ontario continues to see a rise in COVID-19 numbers, with case counts reaching 639 on Monday and sitting above 600 for the past four days. The seven-day average also reached its highest point in more than two months on Monday at 581 cases.

Earlier on Monday, Liberal Leader Steven Del Duca said the province is "perilously close" to the point where further restrictions through a provincial vaccine certificate program could be necessary.

Del Duca said on Aug. 11 that while he supported a "reliable provincewide standardized certificate" that business owners could decide whether or not to request from patrons, he'd be open to provincially-guided restrictions based on vaccination status.

"If we start to get into let's say dangerous terrain ... then I think we should be looking at every option, which then to me means going a step beyond just empowering businesses and perhaps doing what I believe Quebec is doing to say ... you'd have to demonstrate proof of vaccination before you could enter certain venues or restaurants," he said at the time.

Asked on Monday whether he thought Ontario had reached the point whether the province should mandate restrictions based on vaccination status, Del Duca said "if we're not at that point we are perilously close to that point."

"I think we might be there. If we're not there, we're almost there, and I'd be very open again to using whatever might be available to me to go in that direction to make sure we get through this," Del Duca said.

"If I was serving as the premier in this moment I would want the advice of the science table about whether that threshold had been crossed," he said. "I'd be very open to it in this moment when we see the case numbers starting to climb back up over 700, we hear reports in media about potential projections that are scary."

He said the conversation around vaccine certificates should be revisited once possible projections are publicly released. You can read more about this here.

The science issued a report in July exploring the idea of vaccine certificates, saying that they "may have a practical short-term utility for supporting and maintaining economic and societal reopening" and that it would be useful to have a system in place in case public health measures need to be implemented in the future.

The group said that long-term the certificates could "be useful as verifiable, secure, standardized, and accessible electronic or paper records of immunization."

The table also voiced concerns over different sectors creating their own systems without government guidance, noting that "governments also have a role in defining the settings where vaccine certificate requirements for those accessing services are prohibited (e.g., health care, essential services)."

Several medical and business groups have called on Premier Doug Ford to implement vaccine certificates, as have other opposition parties.

NDP Leader Andrea Horwath has called on the government to put in place a certificate program, noting she agrees with the notion that non-essential activities should be covered by a vaccine certificate.

Green Party Leader Mike Schreiner previously said he supports a vaccine certificate program "to make it easier to regulate access to non-essential services" and that any guidance on how this proof of vaccination is used should come from the province.

The Progressive Conservative government has repeatedly said the second-dose receipt for the COVID-19 vaccine that is currently provided by the province is sufficient proof of vaccination despite concerns over forgery. It has also not indicated any plans to introduce rules around allowing or barring access to activities based on vaccinations status, saying businesses can choose whether or not to ask customers for proof of vaccination.

After the federal government announced on Aug. 11 that it was working with provinces to develop a vaccine passport for international travel that provinces could also choose to use domestically, the premier's office said Ontario businesses would be able to use the federal document as proof of vaccination.

Alexandra Hilkene, spokesperson for Health Minister Christine Elliott, said the province was "pleased the federal government has responded to our calls and support their plan to implement a national vaccine passport for all Canadians. We will work with them on providing the necessary information in a safe and secure manner in order to facilitate the creation of a document that can be used as proof of vaccination for international travel."

Hilkene added that the federal document could be used in the province "should it be required by a business or organization."

Meanwhile, Del Duca also noted that the federal vaccine passports were announced before the election was called and questioned how much progress the federal government will be able to make on vaccine passports during this time.

"Given that the federal government's in caretaker mode, I suspect that nothing significant is progressing on this file from Ottawa, maybe it is, I just don't know about it," he said. "What we have seen in other provinces like our neighbour to the east and Quebec is that they didn't wait for a federal government to talk about international travel, right from the very beginning they showed decisiveness."

Quebec is rolling out a vaccine passport system on Sept. 1, with people required to use it to access gyms, restaurants and other non-essential activities.

"Doug Ford could have literally partnered with his counterpart in Quebec and started this process many many weeks ago," Del Duca said.

Photo courtesy of Dr. Peter Jüni

Science table member says ‘it’s inevitable’ province will reach crossroads — back to step two for everyone or vaccine certificate program

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