Top doctors in Toronto, Peel Region, Ottawa ask Ontario for stay-at-home order to slow COVID-19

Medical officers of health in Toronto, Peel Region and Ottawa urged the province on Monday to impose stronger public health measures immediately, saying a provincial stay-at-home order is needed now to curb COVID-19.

In an April 4, 2021 letter to Dr. David Williams, Ontario's chief medical officer of health, Dr. Eileen de Villa, Dr. Lawrence Loh and Dr. Vera Etches said stricter restrictions are required to "reverse the surge" of cases in their respective public health units.

"A stay-at-home order issued by the province through an Emergency Order is necessary to prevent and mitigate large scale morbidity and mortality and irreparable strain on the health-care system," the letter reads. 

"Stricter lockdowns have been shown to be effective in other countries to control transmission while vaccine campaigns progressed to achieve sufficient population coverage to suppress transmission."

The letter specifically asks Williams to issue the stay-at-home order.

Stronger measures are needed "given the rapid deterioration in local indicators" across the three public health units, the medical officers of health say. They note both Toronto and Peel Region have seen rapid growth in cases even though the regions have been in the grey-lockdown zone of the province's colour coded framework.

In the letter, the three medical officers of health also call for "enhanced" additional safety measures. These are:

• Review all businesses and services defined by the province as essential with an aim to: identify businesses and services that should be removed from the current list of essential services; identify which services in businesses with a large square footage are essential; and implement staffing limits of not more than 50 per cent for businesses and services deemed by review to be essential.
• Impose travel restrictions between regions within Ontario.
• Legislate the emergency provision of paid sick days to supplement existing federal income supports.
• Move schools to online or hybrid learning in situations where school outbreaks in local jurisdictions are significant and the capacity to manage is stretched.

The three medical officers of health ask the provincial government to make "every possible effort" to secure more vaccine doses for the province and to ensure the necessary administration of vaccine doses is in place in areas where they are needed most.

"While continued expansion of vaccine administration remains a critical component of our long-term pandemic response, public health measures are needed immediately to reverse, as quickly as possible, the concerning trends we are seeing in our health units. Given the urgency of the situation, we will make ourselves available to discuss this letter, " the letter continues.

Stay-at-home orders 'turn the curve,' medical officers say

According to data from Ontario's science advisory and modelling consensus table, released on April 1, the following trends are evident, the medical officers of health added:

• The third wave of COVID-19 is here and variants of concern are driving it.
•  Younger Ontarians are being admitted to hospital with COVID-19. The risk of intensive care unit admission is two times higher and the risk of death is 1.5 times higher for those with the B.1.1.7 variant.
• COVID-19 accounts for the majority of people in ICUs and threatens the health system's ability to deal with regular ICU admissions.
• Stay-at-home orders will "turn the curve" and protect the ability of residents to access health care.

Ontario is not alone in experiencing a surge in cases due to variants of concern, the medical officers of health say. They note that the following points were made in an evidence brief from Public Health Ontario, dated Feb. 16:

• Strict lockdowns of larger geographies for at least four weeks have the greatest impact on COVID-19 rates.
• Evidence and experiences from Europe show that any public health measures must be "swift and intense" to slow COVID-19 spread in Ontario communities.
• More restrictions at a level beyond the provincial shutdown and stay-at-home order were necessary to address the growth of variants of concern in other jurisdictions. Such restrictions include the closure of non-essential retail stores and shifting schools to remote learning. "The situation here in Ontario merits a similar response," the medical officers say.
• Measures that apply to all of Ontario should be considered, given the national lockdowns that were implemented to manage variants of concern in other countries.

The Ontario health ministry has not yet responded to a request for comment on the letter.

OMA also calls for stay-at-home order

The Ontario Medical Association, which represents more than 43,000 doctors, medical students and retired physicians, also called for a stay-at-home order on Monday, saying such a restriction is necessary given the "sobering new statistics" being reported every day.

Under such an order, people would leave home only for essential business, such as attending medical appointments, going grocery shopping and exercising outdoors, it said.

The OMA also called for the closure of all non-essential businesses, saying curbside pickup should remain an option. And it called for the immunization of all essential workers, disadvantaged workers, and residents of hotspots.

Paid sick leave, as well, should be made available for essential workers, it said.

The association said every Ontario resident should take the first vaccination that is offered to them.

"I know that everyone is exhausted," OMA President Dr. Samantha Hill in a news release on Monday.

"The last year of living under restrictions, with fluctuating levels of fear, and serious visible inequities, have affected our social, mental and economic health. But right now, we are all in danger," Hill continued.

"We must implement our strictest level of public health measures. The consequences of not doing so could include more people sick and dying than we have experienced thus far; so many so, that doctors could no longer care for everyone."