Hospitals are reaching their limits as COVID-19 surges. Nurses are being asked to cancel time off during the holidays. Hamilton has gone into lockdown. And in long-term care homes, residents are dying, once again.
Criticized for not taking swift, strict action to curb the spread of the virus, particularly in the Toronto region, Premier Doug Ford is expected to announce his latest COVID plans on Monday.
The Star asked experts in health care, nursing homes and small business for recommendations for Ford — and the public — on the next steps. Some sent in written comments, others spoke by telephone, their interviews edited for brevity.
Dr. Michael Warner, director of critical care at Michael Garron Hospital
I think surveillance testing in schools in hot zone regions is fundamentally important to ensure that schools are safe and to make sure that when children go home to their families, they are not exposing their families to unnecessary risk.
We need to invest in public health like it is the most important infrastructure project in Ontario. Right now, we are not doing contact tracing to any significant degree in the hot zone region so how could we expect our situation to materially improve?
We need to ensure that the advice that public health physicians … provide to cabinet is made available to the public in an open and transparent way.
The people in my ICU who have been nailed by COVID-19 are people who didn’t have a choice. These are people who live in congregate settings in multi-generational homes. That is all they can afford.
And now what we have over the holidays are people with means and privilege making the decision to congregate in those same settings that poor and racialized people could not avoid. I think that is hypocritical and irresponsible and I think people need to … understand that their actions, even though they justify them as OK, will lead to the spread of COVID-19.
Dan Kelly, president and CEO of the Canadian Federation of Independent Business
Small businesses recognize that we are still dealing with a deadly pandemic and some restrictions are needed to protect their employees and customers. But they want any restrictions to be fair and avoid creating a competitive advantage for some. They also want restrictions to be based on the available data. When government closes small retailers to in-store traffic, but allows the same goods to be sold to giant lines inside big-box stores, they begin to lose the trust of small business owners. When government pushes consumers to use online giants and then reports come out with hundreds of COVID cases among employees at Amazon, they lose the confidence of small business owners.
CFIB suggests a “Small Business First” retail strategy that would allow small firms to serve no more than three customers at a time. And if the province requires any businesses to shut down to protect the public against COVID spread, it needs to ensure that the business is fully insulated from the devastating economic impact. The current provincial COVID support programs are far too limited, with too many exceptions. The province should help the federal government top-up its wage and rent subsidies to 100 per cent for those businesses fully locked down.
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario
We want a complete lockdown.
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All the malls should be closed. The Walmarts of the world should only be open for essential services.
Places of worship should be closed except, I would say, for funerals.
Obviously, the public cannot control themselves. Many are going to the malls. The parking lots are full. Indoor malls are not an essential activity. I don’t see why people need to go from one region to another unless they are escaping the lockdown and bringing COVID to others.
We are also saying that people who live alone, we should consider allowing them to connect with one more house, so they are not on their own.
The lockdown needs to begin on Monday. Every day we delay is a day too many.
Donna Duncan, CEO of the Ontario Long Term Care Association
While the vaccine provides hope to our residents and staff for the future, in order to ensure we have the people to care for our residents today, we must provide homes the supports they need now, including expanded on-site rapid testing, enhanced infection prevention and control, protected rooms to quarantine new admissions and adequate personal protective equipment. And we must all do our part in following the rules, wearing a mask, washing our hands and watching out distance.
Dr. Susy Hota, Medical Director, Infection Prevention and Control, University Health Network
I am encouraged by the arrival of the vaccine and the beginning of vaccination of those who are at high risk. As more vaccine arrives, we can expand the vaccination of front-line staff, residents of long-term care facilities and first responders such as police, fire and emergency management staff, as directed by the province, as all of these people are critical to the ability to keep patients safe. However, we cannot vaccinate enough people in the early stages to stop this pandemic so we continue to ask that people mask, physical distance, wash their hands and tightly limit social contacts.
Dr. Nathan Stall, geriatrics and internal medicine, Mount Sinai
I sound like a broken record, but the greatest risk factor for long-term-care home outbreaks is community transmission.
A hard lockdown is the bluntest tool we have. We need that, given the crisis in our system. But along with that, targeting interventions and tailoring them to specific populations who are at higher risk of COVID-19 makes a lot of sense. That includes things like making testing more accessible, supporting staff with infection-disease paid sick leave and eviction moratoriums.
We are shuffling patients from hospitals that are in bigger crisis to hospitals that are on the brink of crisis. You can only rearrange the deck chairs on the Titanic before the whole ship sinks. To wait another week (before a potential lockdown) when you are talking about exponential growth with the level of community transmission we have right now, it is only going to accelerate and extend the disaster.
Moira Welsh is a Toronto-based investigative reporter for the Star. Follow her on Twitter: @moirawelsh
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