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to stop 4th wave, ontario should re-examine tiered reopening rules

"we haven't really done a proper re-evaluation of those (tiers) since last summer. and what we have done, i think, has been sort of the opposite: expanding our higher risk (activities)."

by: marco vigliotti
despite improving case counts and rising vaccination numbers, experts are warning the ontario government against reopening the province’s pandemic-battered economy too quickly, saying preventing a fourth wave of covid-19 infections requires continued vigilance and patience and, potentially, changes to the tiered reopening framework.
however, doug manuel, senior scientist with the ottawa hospital research institute’s clinical epidemiology program, says ottawa itself is in good shape with daily new case counts falling steadily since reaching record highs earlier this spring. if the city stays on this trajectory, parts of its economy could safely reopen once the province-wide stay-at-home expires may 20, he said.
“at this rate, i think that we could start talking about (reopening) in a place like ottawa, or other places,” manuel said. “it’s looking pretty good to start opening up in some areas.”
manuel advised the provincial government to adopt a “go low and open slow” approach to reopening, focusing on continuing to drive down case numbers while gradually and carefully opening up the economy, with priority given to “high value” institutions like schools. by only reopening when cases counts are low, public health units are in better positions to trace and contain new infections, he said, while opening more slowly would lower the risk of larger outbreaks at higher risk settings — namely indoor places where masks aren’t worn.

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manuel argued that a new, more cautious approach to reopening the economy was needed after ontario’s colour-coded system failed to prevent surges in the fall and earlier this year. hindsight shows that the province shouldn’t have moved ottawa out of lockdown mode in february into the more permissible orange tier  — which permitted indoor dining and fitness — if it hoped to prevent another wide-scale closure of the economy, he said.
“previously, we sort of went from full lockdown to orange, knowing that orange didn’t work in the fall. so why is it going to work in january, february?” manuel asked.
“so, we want to phase in a bit more than we did in the past.”

on april 7 , premier doug ford put ontario back under lockdown, issuing a four-week stay-at-home order and declaring a province-wide state of emergency for the third time since the covid-19 pandemic began more than a year ago. however, just over a week later, ford extended the stay-at-home order for an additional two weeks, until may 20. 

since then, new covid-19 cases in ontario have fallen gradually, with the seven-day average spiking to around 4,400 in mid-april before climbing down to 3,200 in early may. still, case numbers remain higher than during the first or second waves.

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ottawa has seen a faster decline after posting a record setting 370 new cases on april 11 and 15, but the city hasn’t posted over 200 new cases in a day since april 30 and reported only 110 on friday.
unlike previous waves, ontario and canada more broadly are in the midst of a wide-scale vaccination program. ontario has administered nearly six million doses, topping 140,000 a day for the first time this week. residents 40 and older in the province are eligible for the vaccine, as is anyone 18 and older in a designated hotspot. the province plans to expand eligibility to everyone 18 and older on the week of may 24.
manuel said rising vaccination numbers meant ontario had a chance to “get on top” of contact tracing and testing to reduce the “broader transmission … that precedes waves.” but this data should inform how the province phases in its reopening plan, he said, arguing that an evaluation of the tiered system is needed in light of case surges last fall and winter.
“we haven’t really done a proper re-evaluation of those (tiers) since last summer. and what we have done, i think, has been sort of the opposite: expanding our higher risk (activities),” manuel said.
“i think it would be prudent to take a look at what we’re going to slide ourselves into as we start reopening.”

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despite promising vaccine news, yves laberge, a part-time university of ottawa sociology professor, said people must continue to respect public health orders and be “good citizens” to prevent another surge that could put communities at risk. this means practising social distancing, wearing masks and getting vaccinated.
“we can see from the numbers because we know about demographics and we see that we really have to follow the rules,” laberge said.

“the movement … with this pandemic, it’s a bit like in the stock market: it may go up anytime. this is why there was three waves. (just) because it’s going down at some point, doesn’t mean it will never go up again.”

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