A Cautious Re-Opening

Toronto’s COVID restrictions ease slightly, starting Monday, as the city moves down a step to the “lockdown” rules that were in place before the middle of January.

The most noticeable change is that non-essential retail can re-open, with masks and capacity limits. Attendance at weddings and funerals goes from 5 to 10 participants, as does outdoor gatherings at distanced events. Libraries will open, but only for computer use and contactless pickup. Veterinary services and pet grooming are allowed.

Most other current restrictions remain in place. Indoor gatherings with anyone outside your household (except for one other person in the case of those living alone) are still prohibited; personal services such as hair salons remain closed, as do restaurants except for pickup and delivery.

The change, which was supported by Toronto’s Medical Officer of Health, followed weeks of greatly improving case numbers in Toronto and across North America.

Toronto’s numbers are now down to a daily average of just over 300 – still extremely high but about two-thirds lower than January’s peak. This is a testament to a much higher percentage of people following public health advice, as well as the immunization of those in long-term care homes.

This appears to have at least postponed the arrival of a third COVID wave, which most experts still predict is likely coming – particularly if restrictions are eased too quickly, if careless behaviour resumes, and if variants of the virus take hold.

Perhaps the best predictor of where things are headed is the reproduction rate – the number of people, on average, infected by each person who has COVID. When cases were skyrocketing that number was above 1.1; when the reproduction number fell to around .8, new cases plummeted. But now we’re back up to 1, despite the vaccine.

That could mean that the progress has bottomed out and that cases will start moving up.

The biggest worry at this point is that the spread of variants, in the short term, will surpass the speed of vaccinations. There are at least three that are highly concerning, which I’ll refer to by the countries in which they were first identified. As COVID information can change daily, what follows is, to various extents, still based on early data.

  1. UK Variant: Estimated to be about 50% more transmissible than COVID classic and perhaps 30% more deadly. The good news is that vaccines seem to be effective against it.

  2. South African Variant: Does not appear to be more lethal but may spread more easily and, in a vaccinated world, is much more transmissible because it appears to evade antibodies produced by vaccination.

  3. Brazilian Variant: The big concern with this one is based on experiences in Brazil, where it appears to have re-infected those who’ve already had COVID. Data is still not available on how various vaccines perform against it.

Of the three, the UK variant is by far the most common in Canada and the U.S. It is the biggest immediate problem although, longer-term, those that are less controlled by vaccines could be the larger concern.

As part of the ongoing superb scientific response to battling the virus, vaccine manufacturers are already working on third doses designed to work against the variants.

In the meantime, until the country is fully vaccinated, we need to do everything we can to slow the spread of these variants before they take hold. The usual precautions, done properly, should still work.