Health

What Could Ontario’s ‘One-Dose Summer’ Look Like?

Four Ontario doctors discuss the stay-at-home order, life after vaccination and reopening schools and outdoor recreation.

Members of the fitness community gather for a workout on the lawn of Queen's Park in Toronto on Wednesday, April 14, 2021.

Members of the fitness community gather for a workout on the lawn of Queen’s Park in Toronto on Wednesday, April 14, 2021. (Photo: Frank Gunn, The Canadian Press)

With COVID-19 vaccinations picking up in Ontario, and the weather warming up, people are beginning to wonder what the province’s second pandemic summer could look like. On Thursday, the government extended its stay-at-home order to June 2, with the possibility of reopening schools and a summer filled with outdoor gatherings up in the air. The Ontario Medical Association (OMA) held a virtual panel on Wednesday on why Ontario isn’t yet ready to reopen. Dr. Samantha Hill, cardiac surgeon at St. Michael’s Hospital and Sunnybrook Health Services in Toronto and president of the OMA, moderated the panel of three doctors through the following questions:

Should Ontario end the stay-at-home order?

The OMA, which represents Ontario’s 43,000 physicians, says the province is not ready to lift the stay-at-home order. With more than 2,000 people testing positive for COVID-19 every day, and 1,800 people needing hospital care for the novel coronavirus, doctors recommend that the government extend the lockdown—but ease restrictions on outdoor recreation where it’s safe to do so. “We want the third wave to be the last wave,” says Hill. “Extending the stay-at-home order significantly increases the likelihood that Ontarians can enjoy more freedom this summer.”

What could this “one-dose summer” look like—and what is considered a safe outdoor activity?

Prime Minister Justin Trudeau announced Tuesday that there will be enough COVID-19 vaccines for every eligible Canadian to get their first shot by this summer. He’s hoping “a one-dose summer sets us up for a two-dose fall.”

Dr. Peter Jüni, the scientific director of Ontario’s COVID-19 Science Advisory Table, says that the government should loosen restrictions on outdoor recreation and continue to restrict indoor spaces for the summer. “Outdoor activities are on average roughly 20 times safer than indoor activities,” he says.

The OMA is calling on the province to reopen outdoor facilities like golf courses, basketball and tennis courts to improve people’s physical and mental health.

And Jüni says small outdoor Victoria Day celebrations like backyard barbecues or picnics should also be allowed, but stresses that we need to continue to follow safety measures like congregating in smaller groups, social distancing and wearing masks.

When might we see a reopening of the economy (including music festivals, bars, amusement parks, sports)?

Jüni says the litmus test will be in September and October. He adds that we’d need to achieve an 80 percent complete vaccination rate before considering increasing capacity indoors.

Hill emphasizes that it’s not a question of health versus economy—they go hand in hand. “Nothing obliterates an economy faster than a pandemic,” she says. “Having hundreds of thousands of people dying closes businesses.”

How about reopening schools?

When it comes to easing up on restrictions, Dr. Vinita Dubey, an Associate Medical Officer of Health for Toronto Public Health, wants to see schools open first. (Doug Ford said on Thursday that students would continue with virtual learning for now.) “Cases are on the decline…the modelling shows that if other sectors are still closed and we start with opening schools first, we actually don’t see a huge impact on ongoing spread,” she says.

Ontario schools were closed indefinitely to in-person learning in April due to a surge in COVID-19 cases. Dubey explains that the cases we’ve seen in schools are a reflection of the community. “If we can prevent transmission in the community, we can actually prevent cases from coming into the school.”

She also adds that cases occurring in schools are less likely to spread within a school setting compared to a community or household setting thanks to the safety measures put in place like cohorting students, masking, social distancing and daily temperature checks.

What can we do when we’re fully vaccinated?

Dr. Kumanan Wilson, a specialist in General Internal Medicine at The Ottawa Hospital, says that immunization is an effective weapon against COVID-19: “We’re arming ourselves and eventually we hope to reach a level of vaccination where it’s very hard for the virus to find susceptible hosts.”

As of now, though, there is no clear guidance from the Canadian government about what people can do after being fully vaccinated. According to the CDC, people are considered fully vaccinated two weeks after their second dose. However, Wilson says data has shown that people are relaxing on safety measures right away, which increases the risk of infection. He advises people not to relax on masking or social distancing within those two weeks after their second dose. “Vaccines work best when they’re combined with public health measures.”

How will the COVID-19 pandemic end?

Jüni says COVID-19 will likely become endemic, which means it will continue to exist within areas of the global population for years, similar to the common flu. “We will not eradicate COVID-19,” he says. “It will become like a very tedious influenza.”

This means people will likely need to get booster shots. Wilson adds that a global immunization program (which is how smallpox was eradicated) is key to prevent the virus from further circulating.