Front Burner - A practical guide to Canada's slow reopening

Episode Date: May 20, 2020

Across Canada, the economy is slowly reopening. This week, with physical distancing measures in place, restaurants can resume dine-in services in B.C., retail shops with street entrances in Ontario can open, and in some parts of Alberta, you can get a haircut again. But as restrictions loosen, Canadians will be asked to use their judgment to limit the spread of COVID-19. Today on Front Burner, infectious disease expert Isaac Bogoch with some advice on how to navigate those complications.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Pia Chattopadhyay. After about two months under lockdown, Canada is now slowly reopening. The pace of that really depends on where you live.

In provinces less affected by the coronavirus, New Brunswick, Newfoundland and Labrador, and Nova Scotia, now there is a bubble system for families. That means each family can choose another household to spend time with and without physically distancing. There's growing science around the health impacts of isolation. And I think that maybe there's a good argument to be made that Nova Scotians are more social creatures than many other people. In British Columbia, residents are also encouraged to slowly expand their social circle. And this week, restaurants there can actually have diners inside if they follow proper physical distancing rules. I have to say, though, only you know your own risk for your family or for your business and the precautions that you need to take. And in Ontario, where we're still seeing at least 300 new cases a day, retail stores with street entrances can now open.

My friends, today's news is good news. Our efforts are paying off. Today, I've got infectious disease expert and frequent guest on this podcast, Dr. Isaac Bogosh with me. Together, we're hoping we can help you figure out the level of risk you are comfortable taking on as we spend more time outside of our homes. Consider it a practical guide to reopening. This is FrontBurner. Dr. Bogosh, hello. Hey, how's it going? I am well, like you and every other Canadian. We are about two months into this lockdown.

And frankly, I think like you and many others, getting pretty exhausted from the physical, the social isolation. And, you know, we miss the other humans in our lives. the physical, the social isolation. And, you know, we miss the other humans in our lives. And when we reached out to our listeners on social media about their concerns with the various reopenings across this country, this was overwhelmingly what they wanted to know when and how we should be seeing friends and family. And I know that that answer really depends on where you are in Canada, because each province has different rules. But I want to start with you with talking about public gatherings. Can you start off by defining what precisely is meant by a public gathering? Well, that's a great question, because I think a public gathering

means different things in different places. But basically, it means people in general, just means people getting together that are outside of the same house that are meeting together in public. It's as simple as that. Having said that, of course, when you scratch the surface, things can get a little nuanced and it could change a little bit. So in terms of the number of people, the location of the people, these might differ between provinces. Alberta's relaunch strategy recognizes the location of the people, these might differ between provinces. Alberta's relaunch strategy recognizes the importance of the outdoors. Outdoor gathering limits are being increased to a maximum of 50 people.

Ontario easing restrictions, resuming construction projects, seasonal activities, but what will not change is the limitation of gatherings of beyond five people. We have a long way to go. We have a long road to recovery. Okay, and that number, as you say, it's different from province to province, from jurisdiction to jurisdiction, but kind of overall, it is that there should be no more than somewhere between five and 10 people at a gathering.

The expectation is that people will maintain a physical distance at these gatherings, yes? Yeah, that's exactly it. But basically, it's an appreciation that, you know, for whatever reason, perhaps the burden of infection in, you know, a particular province is low enough that it is okay to start meeting people outside of the household, and you can start to get people together. But as you point out, physical distancing measures should certainly be maintained in those gatherings. Okay, I can just tell you in my backyard,

there's no way we could fit 10 people in physically distanced six feet apart because my backyard is in 60 feet. Yeah, yeah, fair enough. I mean, I guess there's going to be, let's put it this way, local adaptation of provincial regulations that are changing with time. I get that we want to have some strict instructions and rigid instructions.

I think we also have to appreciate that some of the public health officials are going through this pandemic for the first time as well. But I guess the thing is, is people really just crave hard and fast rules in the sense that they just want to know what they should be doing and shouldn't be doing. So we'll get more into the specifics, but generally just, you know, repeat. Tell me again what the sort of general ethos of what we're supposed to be doing right now is. So it really depends on which province you are in. It really depends on which province you are in. But if you are in a place, for example, like in many of the maritime provinces, you are allowed to have what they call bubble families,

meaning your household can merge with another household of your choosing and you can have gatherings with those individuals. And in fact, we've seen some really heartwarming moments as they've doubled their bubble, for example, with grandparents. Look who it is! I want to see you. I want to see you. Give me a hug. It's the first time they saw each other and been able to hug each other in six weeks.

If you're, for example, in British Columbia, you're allowed to have gatherings. I believe it is six people. I might be wrong on that number, but there is a set number of people you are allowed to mingle with outside of the family. Small dinner parties or barbecues, even hugs will be okay as long as no one is showing symptoms. We're not prescribing to British Columbians who they interact with and how they interact with them, but people have to make those choices. If infections remain low hotels resorts and some overnight camping would open in June. If you're in Ontario and Quebec those are not yet permitted. I think it's important for people to really look at what's acceptable

in in their province and also appreciate that that might change with time as we move forward through this epidemic here in Canada. You are right about the BC, it's between two and six people. And you're also correct about many of the Atlantic provinces in terms of doubling your bubble. But I need to understand the doubling your bubble a little bit more. So if I lived in one of those provinces, and I have a household of five, which I do, there's five of us, we could then merge with another household of, you know, how many ever people there? Does that mean we don't have to physically distance once our two families get together and merge? Yeah, actually, it does. And it just sort of assumes that both of those families are essentially could be considered,

they could be considered under one roof. The Honourable Blaine Higgs, Premier of New Brunswick. This is an opportunity to visit with a household that could include your parents or one of your siblings or even a close friend. But I want to remind everyone that this is not a free-for-all. Both households must mutually agree to only get together with one another. I'm really interested to watching how this plays out. And I'm in Ontario, very much looking forward to when we're allowed a bubble family

because certainly I think we could use the help. Me too. But if I choose you and you don't choose me back, there goes the guilt and the rejection, doesn't it? So let me ask about extending your bubble to include your family because a lot of us have elderly parents. Some of us have people who are immunocompromised within our very close family network. Is it a good idea to visit your elderly parents to make that part of your bubble at this point of the pandemic? You know, it certainly can be, but I think as like anything else, the answer is it depends. And it depends on a few things. If you're in a place like, I'm just

going to say someplace like New Brunswick, where they're getting, you know, zero to one new cases of COVID-19 per day. And if you're, you know, very careful and not going out and about and putting yourself or your family members or putting themselves at risk of acquiring this in community settings, you know, the risk of acquiring this infection in that family is just extraordinarily small. Of course, it's not zero percent. It's just extraordinarily small. Your family, together with the, you know, the aged parents or, you know, elderly parents or people who might be immunocompromised can sort of put their heads together and say, OK, you know, we're both very, very low risk. We're in a community where there's very little of this

infection. Let's go ahead and do it. But, you know, the alternative might be true as well. It really does boil down to having an honest conversation amongst anyone who's going to be within that bubble about, you know, what are the risks? What are the potential benefits? How does everyone feel about this? And I think collective decision making here is certainly the right path forward. In New Brunswick, Dr. Jennifer Russell, Chief Medical Officer of Health. For some among us, especially the frail and elderly, the anticipation of reuniting with family

has to be weighed against the risk of inadvertently catching the virus. So again, we are still trying to protect people who are immune compromised, people who are older and have comorbid conditions and other health problems. So we really, really have to protect that population. Okay, I got another one for you. No matter where you live, and maybe you want to parse this

between jurisdictions. But this is the other one I have for you. For people who are not allowed to merge households, is it okay, again, at this point to say, have a barbecue in my backyard, without going over the number of people you're supposed to have in a gathering, which in Ontario, I believe is five. And as long as we socially distance, right, the weather's nice, I want to have my pals over. Good idea or bad idea? Allowed or not allowed? God, I don't know, because it's kind of stretching things. I think some people would say not allowed. And then others would say, maybe allowed. Another situation that we hear of too was the, you know, can we all sit in our front yard separated by, you know, two meters and have like a neighborhood, you know, beer and everyone just sits outside. And again, like there's nothing wrong with that. I mean, there's

the example I just gave. I don't think there's anything wrong with that. You're outside, you're separated. And, you know, as we learn more about this infection and how it's transmitted, we realize that the risk of anything untoward happening in a situation like that ranges from zero to negligible. But, you know, with the backyard party, you know, it's certainly not in the spirit of what the current public health restrictions are in a place like Ontario and Quebec. And I think it would be hard to really do, even if you had the space to do it. I'm just not sure it's in the spirit of doing things right. Rob, I'm going to pass this over to the Minister of Health. That is something that we are studying very closely right now, the idea of bubbling,

cohorting, increasing the numbers, because with the warmer weather coming, I know people will want to be getting together for barbecues and other occasions. So say I'm in BC and I want to have a barbecue, and I'm allowed to. Am I letting people come into my home and use my washroom? Am I passing around the bottle of ketchup? I know these sound like kind of mundane, detailed things, but it is the kind of things that each one of us is kind of grappling with, right? Can I do that? Should I do that? What is the risk? Yeah. No, I mean, in general, anytime people are gathering together and sharing high contact surfaces like that bottle of ketchup or even using the same bathroom, the risk is not 0%. It certainly goes up. But if you're in a place like British Columbia, where they're having anywhere from, you know, 10 to 20 or 25

new cases per day in a province of what, a few million, five million people or so, you know, the risk is the community transmission there is so low. The risk is so low. But you still have to be responsible. And I still think the hosts of the party or whoever's having people over should still have hand sanitizer that's readily available. And just so that, you know, people can take additional measures to ensure that they are sure they are healthy and safe. Good afternoon. I'm Dr. Bonnie Henry, the provincial health officer for British Columbia. Keep the group small and consistent. Provide individual servings. So buffets are not something we want to see in the next coming weeks. Space your chairs away from each other so that households are together.

That way you can enjoy each other's company without having the risk. And I think the other thing too is, even though things are gradually reopening, there's still a COVID-19 pandemic. This is not a linear path forward. If there is an unacceptable number of new cases in a particular region, we can certainly expect to see these public health restrictions reimposed. With the easing of restrictions and the added social interaction, the potential for a flare-up in new cases does go up. Every day we can and must do our part to continue to hold the line

on COVID-19. So pause and think about how you are going to keep yourself and those around you safe. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections. So it seems like, in general, a big part of the messaging we're hearing is that the outside, the outdoors is safer, better than spending time indoors. If we are looking at expanding our circle and we can do that safely, then outside is always better than inside. Can we unequivocally say, Dr. Bogosh, that being outdoors is safer than being indoors. Yeah, yeah, I think that's a very, very safe assumption. There's, of course, always, you know,

it's so annoying, but in medicine, there's always going to be an asterisk there. So the asterisk would be, you know, well, if you're outdoors, but you're right up at each other's faces, and someone's infected, yeah, you can still get an infection. But you know, in general, outdoor environments are much safer than indoor environments. And there's also that the difference in depending how much time you spend, not only with in a certain environment, but also with how much time you're spending with other people, right? Like the more time you spend with people in closer contacts, which mostly means indoors, the higher the risk is. Absolutely, absolutely., you know, one of those issues that came up really was,

you know, we kept hearing about jogging or walking on a path or a trail if the trail isn't big enough to have a two meter distance and, you know, you're crossing someone on a path. And, you know, earlier on in the epidemic, I think people were very concerned about that. But I think we know now that, you know, if you're walking by someone, you know, even if they have a rip roaring infection, which they unlikely do if they're walking about outside or jogging, you know, for the very short duration of time that you pass somebody outside, it would just be so implausible to get this infection. Okay, I got a couple more and then I'll let you go, I promise.

Many of our listeners were also wondering about the risks of taking public transit moving forward because they're concerned about how our transit isn't designed for physical distancing, no matter where you live in this country. What is the level of risk there, especially as the economy resumes, more people are being asked to return to work, that means more people will be using transit, no matter where they live. We know what transit was like in many parts of Canada before COVID-19. You imagine people just cramming into, you know, buses or subways. And, you know, that clearly is unacceptable now in the COVID-19 era. But I think transit's really taking a very smart approach by really ensuring that these buses and subway cars are not packed.

And every effort's being made to stay physically distant from one another. Rick Leary is the TTC CEO, and he joins us on the line. We closed the barriers. We blocked off the fare box. We closed the front door, have rear door boarding. We've put signage, trying to keep the physical distancing of our customers. When they're reported, it's up to 15 customers on board. What we do is we dispatch right away, and then the next day, I'll have another vehicle there as well.

I think a smart thing to do in these situations where you're not entirely able to confirm that you're going to be within a, you know, appropriate distance from another person is to, you know, obviously do your best to really practice impeccable hand hygiene. And lastly, I think these are settings where masks may be helpful as well. You know, science is changing, and that's what science is. But early on, you know, the messaging was that children can be these asymptomatic carriers of coronavirus. There seems to be, you know, that evidence perhaps is being challenged a little bit right now. But in any case, you know, I know camps and schools and things are canceled, but extracurriculars, my kids going back to gymnastics in a couple of weeks. Is assessing risk different when it comes to activities that involve kids? Should we think be thinking about it differently? Because they may be asymptomatic? Yeah, it's an interesting point. You know, certainly, they're, it's the data right now is a little bit conflicting. But let's just go with the

assumption and it might be false. But let's just go with the assumption, and it might be false, but let's just go with the assumption that kids may be less susceptible to getting this infection and kids may be less prone to transmitting this infection to others. Again, that might be wrong in the end, but let's just go with that assumption for now. that assumption for now. Even if that's the case, when you get a bunch of kids together, you know, be it in a gymnastics class or in a school setting or at a summer camp, you know, you still risk the possibility of kids transmitting the infection to other kids and really amplifying the infection in any setting where there's a bunch of people clustered together under one roof. And I think we've got to be very careful with kids. Now, certainly we know school is cancelled, you know, in many parts of Canada. Premier Doug Ford confirmed that schools in Ontario

will remain closed for the rest of this school year. I'm just not going to chance it when it comes to our kids. We know that people travel all across this province, and in the summer they even travel more. Why chance it? Although there are some places that are going to go back to school for the remainder of May and perhaps June. Ormstown, Quebec doing something that no child in Canada has done for months. Step into a classroom. Lunch hour is going to be in the class then they will go outside for recess but it won't be a free-for-all. There will be structured recesses. And it's going to be very interesting to see what these schools do

and how they take steps to really prevent infection to be transmitted within schools. Okay, let's end this way. I know you have said this many times before, and other health experts like yourself have also said it, that the key to getting a hold on COVID-19 before a vaccine comes out is testing and contact tracing, because or else we won't have a picture of what's going on really. And they are key factors in being able to reopen successfully. Do we have the means across the country to do both of those things? Some places I think are better prepared than others.

And I think certainly some regions have the testing capability and are able to do contact tracing in a rapid manner. But other places, I think there's room for improvement. I'd also add one other thing to the mix is surveillance. I think surveillance is extremely important. And there's a lot of different ways you can do surveillance. You can test random people. You can do digital surveillance, meaning you can look at using online tools to see who has symptoms. You can test random people. You can do digital surveillance, meaning you can look at using online tools to see who has symptoms. You can use polling. Believe it or not, people have even tested wastewater in different jurisdictions to see if they get a signal. But I think we need to do a better job on a surveillance standpoint. And, you know, using these methods, we'd be able

to rapidly identify areas that may have a small outbreak of COVID-19, and we can jump on that and prevent it from essentially from spiraling out of control into a much larger outbreak. So, as you point out, with increased access to diagnostic testing, with rapid and complete contact tracing, through supporting people who are positive in their close contacts through a 14-day period of isolation, and with quality surveillance, I think we can really be geared up for success as we open up our economies. And I think if we have those in place, the likelihood that we'll need to regress or clamp back down with major public health restrictions just goes down so much. Dr. Bogoch, always good to talk to you.

Thank you. Anytime. So we've been talking about provinces reopening businesses and services and families opening up to one another. But there is one thing that is staying closed for a while yet, and that is the U.S.-Canada border. On Tuesday, Prime Minister Justin Trudeau announced that will be the case for at least another 30 days. that will be the case for at least another 30 days. He said that provinces expressed a clear desire to keep the border closed because of worries that COVID-19 cases would move here. He said the Americans were, quote,

completely open to extending the closure. That's it for today. I'm Pia Chattopadhyay. Thanks for listening to FrontBurner, and we'll talk again tomorrow.