Ontario is preparing to reopen bars, restaurants and gyms in COVID-19 hotspots as it adopts a new, colour-coded framework that lays out what criteria will trigger a change in public health rules on a region-by-region basis.
The framework has five levels, ranging from a green level dubbed "prevent" that comes with minimal restrictions to a grey "lockdown" level that would mean the closure of businesses and the possible declaration of a new state of emergency. Each level is pegged to different public health metrics and has corresponding public health restrictions on a sector-by-sector basis.
The new framework will allow gyms to remain open and restaurants and bars to serve customers inside, with certain restrictions, at all levels short of a total lockdown, which would be implemented in only the most extreme circumstances.
The move is geared at bringing more transparency to the province's process of implementing public health rules, which until now has been a decision made by cabinet based on information presented by the premier's public health advisers that has not always been made public.
That closed-door process sparked an uproar last week when public health officials released a set of pie charts that appeared to undermine the province's decision to implement stronger restrictions in some parts of the province. Moving forward, cabinet will still decide when a region moves between levels, but the advice will be rooted in the publicly disclosed criteria.
The new framework also means that bars and restaurants will be able to resume indoor service and gyms will be able to reopen in Ottawa, Peel and York as of Saturday, as those areas move to the orange "restrict" level, Premier Doug Ford said Tuesday.
Toronto will enter that level of restrictions a week later because Mayor John Tory asked for more time, the premier said.
The three lowest levels — green through orange — roughly correspond with what the province has until now referred to as stage three, with indoor service allowed in bars and restaurants and gyms and cinemas open, officials said. However, there will be some stricter public health measures, such as earlier last calls for alcohol and fewer patrons per table, at the "restrict" level. The red "control" level roughly corresponds to the former stage two — except gyms indoor dining will be allowed to remain open, with further restrictions and a limit of 10 patrons.
Lastly, lockdown corresponds with the former stage one, or the pre-stage one lockdown Ontario experienced this spring.
According to briefing materials, the four regions that were put into the modified stage two restrictions in October — Toronto, Peel, Ottawa and York — were at the orange "restrict" level of the framework as of last week.
However, those regions would also likely have been at the "restrict" level when the modified stage two restrictions were implemented last month, one official who briefed the media said. That suggests those regions would not have faced those restrictions — the closure of indoor drinking and dining, gyms, and cinemas — if the new system had been in place at the time.
Meanwhile, the Eastern Ontario Health Unit was also at the "restrict" level as of last week, while Brant County, City of Hamilton, Durham Region and Halton Region public health units were at the yellow "protect" level and the remainder of the province at the green "prevent" level.
With new data coming in on Tuesday evening and Thursday, the status of the health units will be re-evaluated by Friday, officials said.
The intention is that each public health unit remains at a new level for at least 28 days — or two incubation periods — before it is reclassified, officials said.
To view the restrictions at each level, for each sector, view the briefing deck here.
The announcement came on a day with a record-high number of new confirmed cases — 1,050. It was met with instant pushback from some medical and public health experts who have been critical of the province's handling of COVID-19.
Dr. Michael Warner, the medical director of critical care at Michael Garron Hospital in Toronto, described the announcement as a framework for the economic reopening of the province, "for which the collateral damage is the health and safety of Ontarians."
"You cannot apply an economic framework to control a biological problem," he said.
Warner said he believes the laxer public health restrictions will likely prompt the need for another complete shutdown, causing greater economic damage in the long run. "I'm not aware of any jurisdiction, where that strategy has led to long-term suppression of COVID and sustained economic recovery," he said.
Meanwhile, Dr. David Fisman, an epidemiologist with the Dalla Lana School of Public Health, said in a statement it is unwise to relax closures as the percentage of positive COVID-19 tests continues to rise, the testing system remains dysfunctional and the critical care system is becoming saturated in some areas.
The Ford government's political critics weighed in as well, with Liberal Leader Steven Del Duca calling the plan "a betrayal of Ontarians as we all look for competent leadership."
"Ford is proposing weaker, more confusing measures, even as the province experiences record numbers of new cases and low testing numbers," he said in a statement. "Ford’s plan also leaves behind communities most disproportionately impacted by COVID-19."
Green Leader Mike Schreiner said he welcomes the added transparency to the decision-making process, but is concerned that the public health benchmarks are too high and will allow for widespread community transmission without increased public health restrictions.
"I am curious if these numbers were drawn up by health experts or the premier because a 10% positivity rate looks like a very high bar for moving into the 'control' zone," he said in a statement. "On a day of record case numbers and stalled testing, I am concerned that Ford is forcing public health to take a backseat to the economy, which will hurt businesses if the virus gets out of control."
"I would have more confidence in our ability to safely ease restrictions if the Ford government wasn’t failing so miserably on testing and contact tracing," he added. Some hospitals and health units are teetering on the edge, and we cannot push them to the brink before taking action to curb the spread.
"The bottom line is that good health is good for business.”
In a statement, NDP MPP Taras Natyshak accused the premier of being "behind the ball on COVID-19."
"He chose not to get ahead of the crisis by fixing contact tracing and testing, staffing up long-term care homes, and providing direct support to vulnerable communities and small business owners impacted by the pandemic, because he didn’t want to spend the money. He continues to sit on a pile of unspent COVID response dollars," said Natyshak.
"Ontario needs a data-driven plan with clear benchmarks to help us beat the challenge of COVID-19, but, like the rest of Doug Ford’s playbook, today’s announcement adds to the confusion and shows he’s not willing to spend the money to put stronger public health protections in place."
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