COVID-19 transmission strategy backward, says expert

The provincial strategy to incrementally — and often suddenly — impose additional restrictions to try to curb the transmission of COVID-19 is the exact opposite of what is needed to stop the spread, according to one microbiology expert.

“We should have had these increased restrictions and a stay-at-home order perhaps a week or two even earlier,” said Dr. Gerald Evans, a professor and the chair of infectious diseases at Queen’s University, responding to the province’s announcement Wednesday of stay-at-home measures.

“You always want to start your restrictions to reduce numbers when the numbers that are actually present in the community are low. And right now the numbers are really high.”

The problem, says Evans, is that a year into this pandemic, the public is understandably less receptive to accepting severe restrictions. Many are battling serious economic and mental health issues, and lockdowns create real harm. So there’s a lot of political pushback to bringing in measures when the situation seems manageable, he said, even if epidemiological modelling is raising the alarm of what could happen two or three weeks down the road.

“That’s really one of the challenges that we’ve had throughout the pandemic,” said Evans, adding he’s glad he’s not a politician having to make these difficult decisions.

Balancing the science and public opinion is very much a catch-22: restrictions would work better if they’re put in place earlier and kept there for longer periods of time, but it’s harder to get public buy-in for harsher measures when the situation seems less dire. 

“People are really tired of this pandemic,” said Evans. “We’re over a year now with these sorts of things in place and people don’t want to hear about another shutdown, another lockdown, another putting in place of restrictions.

“And that fatigue has really created a lot of backlash, popping up more so than we saw before.”

That public fatigue is likely why the provincial government didn’t bring in a stay-at-home order last week and it imposed the less-restrictive shutdown measures — against the province’s own science experts’ advice.

Top doc says province moved quickly

Despite the province’s hasty escalation of restrictions this week, and the fact that ICU admissions are currently exactly where the province’s own advisors had predicted they would be, Ontario’s Chief Medical Officer of Health Dr. David Williams disagreed with reporters’ characterization that the province hadn’t acted quickly enough.

Williams said that he saw restrictions “as stepping up, much like you would do with a patient. You start with some … you keep enhancing and you move as you need to.”

That’s an incorrect analogy, said Evans. Worldwide experience shows that the longer that strict lockdown measures are in place, the better the pandemic can be controlled.

“And that’s different from the analogy that was used of a patient where you escalate therapy. What we know is, you need to start this therapy intensely at the beginning and then begin to ease things off, not start easy and escalate things up.”

Take the last stay-at-home order from January. Restrictions should have been eased more slowly across the province. Instead, different regions were reopened at different levels of restrictions — orange for Ottawa, and the lax green level for much of eastern Ontario.

A few weeks later, a deteriorating COVID-19 situation moved all those areas to the red zone. Today, Ottawa is experiencing record levels of most COVID-19 indicators, from case counts to hospitalizations.

Still, Evans said this latest push to stop the spread could work if we can hang on.

“Let’s just wind things down, get this under control, get vaccines into people, and then we can avoid all these yo-yo back-and-forth lockdowns and openings.”

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