Covid-19, Ontario, Public health, Public safety, Toronto

Tolerate anti-maskers and anti-vaxxers?

Taxicab in Makati


Sometimes it seems like we all have that neighbour that despite all evidence showing face masks reduce contagion refuses to wear a mask in indoor public spaces citing individual rights, but conveniently ignoring everyone else’s right to live in a secure and safe community. 

Canadian case law is clear: governments are allowed to place reasonable limits on individual rights to protect public health. Furthermore, it is abundantly clear that current restrictions, such as the mandatory wearing of face masks are only temporary measures in consequence of a pandemic. Thus the argument that governments in Canada are trampling over individual rights is a weak one.

This argument becomes even weaker when we compare ourselves to other countries, which require both face masks and face shields to be worn as double protection in public places. In the Philippines, for example, if you don’t wear a face mask together with a face shield you will not get a taxi, it’s that simple. Temperature checks are mandatory before entering a restaurant or shopping mall in its capital Manila. Furthermore, all international travellers must undergo a Covid test at the airport upon arrival to the Philippines. While travellers to Taiwan are required to take a test before departure. By comparison to these two countries, Canadian health measures are both lenient and very reasonable.

Yet some anti-maskers and anti-vaxxers are over-dramatically insisting that public health measures in Canada are authoritarian. As someone who grew up in the Dominican Republic during Balaguer’s civilian-authoritarianism before moving to Toronto, I sincerely doubt they understand what authoritarian measures look like. Seriously, who has been locked up in Canada for not wearing a face mask? Someone did get arrested for obstruction of justice only after receiving repeated warnings and blatantly ignoring public health measures while risking the safety of his customers and employees. The fact that this person didn’t even have a business licence before the pandemic began demonstrates that he is unwilling to follow even the most minimum requirements on a good day. Fortunately, he doesn’t represent the vast majority of small business owners who care about the well being of their clients and workers.

The irony is that both the anti-mask and anti-vaxx movements claim the mantle of freedom, yet by practicing disinformation and engaging in hateful conspiracy theories they have proven to be very intolerant. Caving to their demands will only prolong this pandemic and harm the common good. Thus we should heed Karl Popper’s advice on the limits of a tolerant society and under these special circumstances claim the right to not tolerate these two groups, when they break the law in a manner that compromises public safety. Furthermore, while we respect everyone’s freedom of expression rights; nonetheless, reasonable temporary face mask requirements, which are supported by scientific research, should not be a time-consuming debate in the middle of a pandemic that has cost lives.

On the other hand, we should have a healthy debate on how far do we as a society want to go with requiring proof of immunization, now that vaccines will be available soon. Certainly, mandatory vaccinations are out of the question in Canada thanks to the Charter of Rights and Freedoms. But just like I have to wear prescription eyeglasses to drive a car, shortly I may have to show proof that I have received a vaccine before being allowed to buy tickets to the next Rodriguez concert. In general terms, we have a right to a safe workplace and Covid is a hazard. So, how far should we go with requiring proof of vaccination to ensure workplace safety? Certainly, there might be workers who are unable to receive a vaccine due to valid health reasons e.g. an allergy. But what if a worker refuses vaccination under religious grounds? The answers might be case by case. Regardless, this is an important debate to have right now.

Covid-19, Ontario, Parkdale - High Park, Public health, Public safety, Toronto

Restaurant patio tents must have at least two full sides open

By now you likely know that “the data available so far indicate that indoor transmission of the virus far outstrips outdoor transmission.” Which is a key reason why outdoor dining is safer than indoor dining. As the weather has become colder in Toronto, we have seen patio tents in restaurants become ubiquitous. Which raises the question: at what point does dining in an enclosed tent become as risky as dining indoors?

What does the law say? First, let’s look at the CaféTo guidelines.  Which state:

A tent/structure may be permitted on private property if the following requirements are met:

  • An area that is covered by a roof, canopy, tent, awning or other element, must have at least two full sides open to the outdoors and cannot not be blocked by other walls or physical…

Some might argue that this requirement is just a guideline. However, Ontario Regulation 263/20 RULES FOR AREAS IN STAGE 2 mirrors the above guidelines and states in Schedule 2:

12.  If an outdoor dining area at the establishment is covered by a roof, canopy, tent, awning or other element, at least two full sides of the entire outdoor dining area must be open to the outdoors and must not be substantially blocked by any walls or other impermeable physical barriers.

13.  If an outdoor dining area at the establishment is equipped with a retractable roof and the roof is retracted, at least one full side of the outdoor dining area must be open to the outdoors and must not be substantially blocked by any walls or other impermeable physical barriers.

Based on the above it is a legal requirement for restaurant patio tents to have two full sides open to the outdoors. The purpose of this requirement is to increase outdoor airflow and thus reduce the risk of Covid transmission.

What happens if you see a restaurant that is not in compliance with this requirement e.g. a completely enclosed tent with customers inside? You may want to heed the purpose of this requirement and not dine there due to the risks. If you know the owner, you might want to inform them about these requirements. You also can contact 311 to inform the City of potential noncompliance.

Restaurant workers and owners have been hard hit during this pandemic. I admire their resolve in face of trouble and their use of patio tents to save their jobs and business. As the weather becomes colder there might be a temptation to close the tents i.e. not have at least two full sides open. However, these rules are there to protect us. While there is a case that all levels of government might not be doing enough to help the restaurant industry, that is still no excuse for not complying with regulations that protect safety.

Restaurant patio tents must have at least two full sides open
Covid-19, Ontario, Public health, Toronto

Covid hotspots in the GTA

You may have heard in the news that Brampton unfortunately is a Covid hotspot in the General Toronto Area (GTA). Recent numbers show us that Peel Region has reported 1,180 cases since August 1, 2020 compared to the City of Toronto which reported 1,357 cases for the same time frame. The problem is that Toronto (with 2.9 million) has almost twice the population of Peel Region (with 1.5 million) yet the number of cases is comparable.

These numbers tell us that any Provincial plan to tackle this problem must go beyond blaming a few partygoers and bars. There is a strong case for more and wider testing especially in these hotspots to contain outbreaks. Also, I would like to speak to my fellow Toronto residents and say it is time to become less Toronto centric since many people live in Peel yet work in Toronto and vice versa. Therefore, any solution must consider that Peel and Toronto are in this problem together. After all, we have several Covid hotspots in Toronto as well.

We all need to demand our members of provincial Parliament more testing and improved contact tracing now otherwise we will be looking at the very real possibility of a Covid second wave in the GTA.

Covid cases in the GTA since August 1, 2020
Covid-19, Public health, Toronto

People under 40 account for 65% of recent Covid cases in T.O.

First, here is the good news: back in late July and early August we saw daily reported Covid cases in T.O. drop to the single digits. Furthermore, so far in August, we have been averaging about 18 new cases a day. Now for some disconcerting news, residents under 40 make up 65 % of the cases seen in August, in other words, two thirds.

It might be easy to imagine crowded indoor bars full of young people not wearing masks and thereby pass judgement. However, we all know that several essential workers are under 40. So, it is not clear what is causing this discrepancy between age groups.

Faced with this uncertainty, perhaps the best course of action is education, such as Dr. Eileen de Villa’s recent announcement. Villa reminds us that despite some encouraging numbers we must all remain vigilant as we enter Stage 3. Otherwise, the consequences can be a second wave of Covid.

One key lesson these statistics teach us is that youth does not mean immunity. The fact that in 2 out of 3 cases the person is under 40 means that we all must be careful, regardless of age.

Under40
Daily Covid T.O. cases in August 2020

Covid-19, Mental health, Parkdale - High Park, Public health, Toronto, Ward 4

Mental Health Resources at Parkdale – High Park

While we focus on bringing Covid cases down, let’s not lose sight of mental health, which is equally important as our physical health. Layoffs, lack of social interaction, financial difficulties, strained relationships, and uncertainty have consequences. So, during these difficult times it is only natural to seek help. On that note, here are some mental health resources for those living in the Parkdale – High Park area:

Finally, some insurance plans cover counselling and psychotherapy services. Laid off employees part of a group plan may still qualify for these benefits. For information contact the insurance provider.

In the event of an emergency one should always call 911.

4villages

 

Covid Alert, Covid-19, Ontario, Public health, Public safety, Toronto

The case for Canada’s Covid Alert app

There are five reasons why we should all be optimistic about Canada’s new Covid Alert app:

  1. An Oxford study indicates that Contact Tracing apps have the potential to significantly reduce Covid transmission (noting that half of transmission cases occurred before symptoms were present);
  2. Both, Korea and Taiwan have implemented highly successful Contact Tracing apps;
  3. The low level of virus exposure notifications by some European Contact Tracing apps can be explained by the fact that social distancing measures are still in effect and these apps are still in the early stages of adoption;
  4. The Bluetooth technology used to determine “close contact” might be new, but is continuously improving; and
  5. Apple and Google, which developed the Application Programming Interface (API) used by Covid Alert, prioritized privacy.

Critics of the new app are correct to point out that many essential workers and retired folks might not be able to afford a smartphone to run this app. Nonetheless, these problems can be resolved by implementing new laws requiring employers to provide smartphones to essential workers, just like they are required to provide them with Personal Protection Equipment (PPE). Furthermore, governments should strongly consider providing free smartphones to seniors and anyone who cannot afford them in their efforts to turn the tide against Covid.

Engineers, scientists, and those working with new technologies understand that no innovation is perfect from the get-go. In fact, several iterations may be required to have a successful Covid Alert program. It is not in our spirit to give up when the going gets tough. Otherwise, Canadians would not have invented the electric wheelchair, the pacemaker, or the telephone just to name a few of our innovations.

This blog post is a call to all engineers, programmers, scientists, technologists, and innovation enthusiasts in Ontario to download the Covid Alert app today, and to please help your co-workers, family and friends install it as well. The science says Contact Tracing apps have the potential to significantly reduce Covid transmission. Now it is our turn to use Covid Alert, help improve it, and do what we do best which is to protect the public.

CovidAlert

Covid-19, Public health, Public safety, Toronto, Uncategorized

Preventing a second wave of Covid in T.O.

After months of mostly bad news, the latest Covid figures from Open Data Toronto give us some reasons to be hopeful. In fact, the past two days, we have seen the lowest numbers of daily Covid cases since the start of the pandemic. As relieved as this data might make us feel, it is important to note that the struggle to put an end to Covid in T.O. is not over. Which means that prevention measures, such as: frequent hand washing, physical distancing, staying home if possible, and wearing face masks need to continue for the foreseeable future to avert a second wave.

Furthermore, it was encouraging, but not surprising to see the total number of daily cases drop even further after the TTC and the City made face coverings mandatory. Most notably, daily sporadic cases (i.e. not associated with an outbreak) have been in the single digits the past two days. While there are a number of factors that contributed to this drop, the science is crystal clear, face masks help reduce contagion: https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-how-face-masks-prevent

While some of us might oppose wearing face masks, as a community we are better off when we follow the advice of professionals and the latest science, especially on matters concerning public health and safety.

Together we have managed to lower the number of Covid daily cases in T.O. significantly. However, we need to be aware that other cities, which achieved similar success and rushed to lift restrictions (without implementing reasonable mitigation measures), later found themselves facing a second wave, and consequently had to shut down their economy once more. Until there is a vaccine, or an effective treatment, or a new technology that prevents transmission in a significant way, at least for now, the best methods we have for reducing Covid cases are: frequent handwashing, engaging in physical distancing, studying or working from home (when possible), and wearing a face mask (especially when indoors).

We The North can enjoy the outdoors (e.g. parks and patios) with a warm jacket in the Fall and even Winter, so even though restrictions will be lifted soon, there should be no reason to go to indoor spaces known for their risk of outbreaks (e.g. crowded bars, large parties or packed restaurants). Stay safe and stay hopeful.

Sporadic

Covid-19, Public health, Public safety, Toronto

Face masks are reducing Covid-19 transmission in T.O.

In a previous post we looked at Covid infections for people in their 30’s, since this age group has been affected more by community transmission than others. One of the purposes of wearing face masks is to reduce the number of community transmissions e.g. when we go to shopping, take public transit, get some take out etc. So, the question is: has community transmission of Covid gone down since July 7th (the date when faces masks became mandatory inside public spaces in Toronto)? The answer is, yes. Specifically, if we look at people in their 30’s the number of daily reported cases has significantly gone down. In fact, as of July 8th we are looking at the lowest numbers since the start of the pandemic.

covid-daily-30

 

Covid-19, Public health, Public safety, Toronto

Covid sources of infections in T.O.

Of the approximately 15,000 Covid-19 cases in Toronto, over 70% can be traced to either “close contact” (e.g. residing in the same household with a confirmed or probable case) or an outbreak. “Community” infections (i.e. not due to travel or close contact or a known location) account for almost 15% as per the chart below.

Covid-all

However, sources of infection vary by age group. First, let’s look at the youngest age group, which is 19 and younger. For this group 77% of cases were due to close contact. While outbreaks account for 10% and community transmission for 7%.

Covid-19

Secondly, let’s look at the oldest age group, which is folks 90 and over. For this age group 93% of the cases were due to outbreaks. This information is consistent with the news of several outbreaks in long-term care facilities.

Covid-90

Thirdly, let’s look at a middle-aged group those between 30 and 39 years of age. For this age group 38% of cases were due to close contact, 24% linked to outbreaks, and 17% caused by community transmission. The fact that community transmission is higher for middle-aged groups (compared to the young and the elderly) is consistent with the fact that middle-aged adults are most likely to buy groceries, run errands, go shopping, work in essential services etc. than youths and the elderly.

Covid-30

From the above we can conclude that youths are more likely to get infected due to close contact, while the elderly are more likely to get Covid-19 because of an outbreak. Furthermore, we can also conclude that community transmission is a risk, since people who get Covid-19 due to community transmission are likely to spread it via close contact to their partners, families, friends, roommates and co-workers. Consequently, we all still need to wear face masks outside of our homes, practice physical distancing and wash our hands frequently. Stay safe and listen to the science.

(Credit: this data comes from Open Data TO)

Covid-19, Public health, Toronto

Covid-19 fatalities/ICU by T.O. postal code (under 70 years of age)

The elderly, especially folks in long-term care have been disproportionately affected by the recent Covid-19 pandemic.

In a recent blog post I pointed out the large discrepancy in the number of fatalities by neighbourhood in Toronto.

Some have singled out the concentration of long-term care facilities in certain neighbourhoods as a possible explanation for these discrepancies. Others have argued that some neighbourhoods in Toronto simply have more people.

Let’s explore these arguments by looking at the Covid-19 data for patients under 70 years of age. Since it is unlikely for someone under 70 to be in a long-term care facility.

A look at Covid fatalities for patients under 70 by postal code reveals that certain neighbourhoods have suffered a disproportionately higher number of fatalities:

  • Two neighbourhoods: Weston and Birch Cliff, Cliffside West account for 14% of Covid fatalities in Toronto for those under 70.
  • Two North York neighbourhoods: Downsview and Northwood Park, York University account for 10% of Covid fatalities in Toronto for those under 70.
  • Some neighbourhoods have had only 1 under 70 Covid-19 fatality. While Weston has had 11 under 70 Covid-19 fatalities.
  • Therefore, there is still a large discrepancy in Covid-19 fatalities by neighbourhood that cannot be explained by the concentration of long-term care facilities.

Noting that fatalities are not the only serious outcome from Covid-19, let’s now look at the number of Covid-19 patients under 70 who were hospitalized in an intensive care unit (ICU):

  • The neighbourhood of Weston has both the highest number of Covid-19 patients under 70 who were in ICU, and the highest number of under 70 Covid fatalities.
  • Two North York neighbourhoods: Downsview and Northwood Park, York University had a high number of patients who were in ICU.
  • Some neighbourhoods have had only 1 patient under 70 in ICU because of Covid-19. While Weston has had 12 under 70 patients in ICU because of Covid-19.
  • Weston does not have 10 times more population than these neighbourhoods. In fact, it has a lower population than some of the neighbourhoods with 1 ICU patient under 70. Therefore, population cannot account for these discrepancies.

Both Public Health Ontario and Public Health Toronto need to investigate what exactly is causing these large discrepancies in terms of Covid fatalities and ICU cases by neighbourhood.

Four postal codes in T.O. with the highest Covid fatalities of people under 70 years of age

Postal Code Neighbourhoods Borough Covid fatalities
M9N Weston York 11
M1N Birch Cliff, Cliffside West Scarborough 9
M3N Downsview North York 8
M3J Northwood Park, York University North York 7

 

Four postal codes in T.O. with the highest Covid ICU patients under 70 years of age

Postal Code Neighbourhoods Borough Covid ICU
M9N Weston York 12
M3N Downsview North York 11
M9V South Steeles, Silverstone, Humbergate, Jamestown, Mount Olive, Beaumond Heights, Thistletown, Albion Gardens Etobicoke 10
M3J Northwood Park, York University North York 8

Covid_fatalities_70
Covid-19 fatalities by postal code (under 70 years of age)