Ontario’s COVID-19 reopening is ‘much too slow’ and timing is ‘a bit contradictory,' infectious disease doctor says

Ontario has released its plan for reopening the province and one infectious disease expert is stressing that the pace is slower than needed, even though it's great to finally have a plan in place.

"I think there are certain aspects of it that can be improved, but as a start I think this is good," Dr. Sumon Chakrabarti told Yahoo Canada.

"I think this is much too slow. I think that we have to remember that if you look at this same time last year, especially if you compare what June and July will be, we're actually going to be in more restrictions this year compared to last year... To me that's a bit contradictory because we have significant change here with vaccination."

Ontario will begin to ease restrictions on outdoor amenities on May 22 as a preliminary step, including allowing golf courses and tennis courts to operate, and increasing outdoor gathering limits to five people with physical distancing. The expectation from the provincial government, at this point, is that Ontario will move into Step 1 of the plan on June 14, with the requirement that 60 per cent adults have received their first dose of a COVID-19 vaccine.

Currently, first doses of the COVID-19 vaccines have been administered to over 58 per cent of adults in Ontario.

One aspect of the plan that Dr. Chakrabarti identified as being unnecessarily slow is the requirement that the province must operate in each stage of the plan for at least 21 days. He hopes that when the provincial government takes into account hospitalizations and intensive care unit capacity, and the situation on the ground, that timeframe can be sped up.

"Hospitals and ICUs have not have not fully decompressed yet, so that's obviously something to keep our eyes on," Dr. Chakrabarti said.

The infectious disease expert does not believe Ontario's vaccination level alone should be considered a "blanket benchmark" for reopening stages, stressing the importance of the health systems ability to manage hospitalizations and ICU admission.

"I care the most about hospitalizations, and ICU capacity," Dr. Chakrabarti said. "So if people get COVID in the summertime - it's going to happen, people will get sick - but we're going to easily be able to manage that in our hospitalizations, without restricting the public," he said.

"That can happen at 70 per cent [vaccine coverage], that could happen at 60 per cent, because we have to remember that there's also lots of people in, for example Peel, that have immunity to COVID because they've had COVID. It doesn't really work the best for a blanket, a one size fits all."

Much of the information from the province does not concretely mention how other factors, like hospitalizations, will play into this plan, but Christine Elliott, Deputy Premier and Minister of Health, did say at a press conference on Thursday that the number of new cases, number of people in ICUs and hospitals, the public health capacity, and other indicators will be considered when moving Ontario from one step to another.

Doctors and advocates for Ontario’s children and youth urge our education colleagues to join us in calling on @fordnation & @sflecce to OPEN SCHOOLS. Our kids can't wait any longer. @celliottability @otffeo #KidsNeedSchool #EveryDayCounts pic.twitter.com/IBhdLnkwje

— Canadian Paediatric Society (@CanPaedSociety) May 20, 2021

Concerns around schools being left out of the reopening plan

Following the announcement of Ontario's reopening plan, there have been several questions about why school reopening is not part of any step in this plan.

Good news about #Ontario roadmap to reopen: Clear, staged, first priority for outdoor activities.
Bad news: Goal seems to be to keep schools closed so it's possible to open stores, restaurants and other venues.
More Bad News: "Schools first to open" no longer seems to be a goal. https://t.co/7j7zoWMHWM

— Alex Munter (@AlexMunter) May 20, 2021

In an open letter to the provincial government, doctors and advocates, including the Canadian Paediatric Society and SickKids hospital, are calling for the province to reopen schools immediately, allow summer school to occur in-person and resume in-class schooling in September with routine scheduling.

"With the decrease in COVID-19 hospitalizations in Ontario by over 50 per cent and with more than 50 per cent of adults at least partially vaccinated, the decision to re-open schools at this time will have minimal, if any, impact on the health care system," the letter reads.

"Children and youth have suffered immeasurably over the course of the pandemic. It is time to prioritize their health and well-being."

Dr. Chakrabarti also recognized that schools are a miss in this reopening plan.

"We've heard the mantra, [last to close, first open], and we don't have evidence of that yet," the infectious disease expert said.

"We know that schools are not a source of perpetuation of transmission but when you have a situation when you're at the max of a third wave, like we did a couple months ago, then schools do contribute, so that's why at that time we had to stop them."

He added that Ontario should "aggressively start" thinking about opening schools for the last week of May or first week of June.

"I think having in-class learning, even for that short time, would be such a good thing for kids, as well as their parents," Dr. Chakrabarti said.