Time to 'up the ante' on following COVID-19 public health guidelines, doctor says

Dr. Nicola Mercer, the CEO and medical officer of health for Wellington-Dufferin-Guelph Public Health, says people really need to start paying attention to who — and how many people — they are socializing with to prevent a second wave of COVID-19.

Cases can go up 'very quickly if people don't respect the number of contacts they have,' Mercer says

Servers deliver drinks to people sitting on a patio at Brothers Brewing in downtown Guelph. (Kate Bueckert/CBC)

A top publich health official in Guelph, Wellington County and Dufferin County says now is the time to "up the ante" to curb the spread of COVID-19.

On Friday, Wellington-Dufferin-Guelph Public Health reported 19 active cases of COVID-19, 11 of which were in Guelph. 

Dr. Nicola Mercer is the CEO and medical officer of health for Wellington-Dufferin-Guelph Public Health. She's concerned about reports of people getting together and socializing in large groups.

David Gooch, works in bylaw compliance in Guelph.

He said bylaw officers responded to 71 complaints for loud parties over the long weekend in the city. 

People going outside their bubbles to large gatherings is concerning to Mercer.

She joined CBC Kitchener-Waterloo's The Morning Edition and spoke with host Craig Norris about the current state of COVID-19 in her area and what she's expecting to see in the coming weeks.

A transcript of their interview is below. It has been edited for length and clarity. You can listen to the full interview at the bottom of the article.

Craig Norris: A report to the board of health this week said that new cases of COVID-19 are "highly probable over the next few weeks or months." So what concerns you about the numbers that you're seeing in Guelph, Wellington and Dufferin counties recently and that trend that's ticking ever so slightly upwards? 

Dr. Nicola Mercer: A lot of this is conjecture and based on now experience with this disease and also the changes that we're starting to see in terms of who is getting the disease.

So early on in this pandemic, the first people that got the disease were primarily other health care providers or the clients of health care providers. So in that case, would be congregate settings, our long term care homes, our retirement homes. So health care workers and the people they were caring with and we saw that and our numbers were quite high and sadly, we did have a number of deaths in that community. 

But as we got better at protecting the people that we were working with as health care providers, as we learnt about the disease and how to protect ourselves, we've seen a different group of people now who are predominantly carrying and getting infected with this disease. And it is definitely younger and it is definitely in our communities now as opposed to in our health care settings. 

And that's a really big change. When I see it in my younger population, and it could be teenagers and young adults, you know, up to 40, they're not the exclusive group that we are seeing it by any means. But they do seem to be driving this right now.

Many of them have very few symptoms, or maybe no symptoms. So they could be carrying this, not knowing that they have it. And they're also the group in our population who are most likely right now to have COVID fatigue and are going out and seeing their friends and are not being as careful about public health measures. 

Relaxing of measures

Norris: And besides the fatigue that you talk about, in my own experience and in speaking with others, things seem to be more lax now. The grocery stores are allowing people to line up or cashiers. There's not the restrictions on people going in anymore. Does this relaxing of some measures concern you when it seems to be happening just as students are returning to school? 

Mercer: Yeah, definitely it does. And I can certainly understand why the listener is maybe thinking that things are getting better. We only have a few cases. Why are we concerned? 

And I think if you sort of take the whole picture, we see things ticking upwards and we have in the province now for a few days. We are very closely monitoring what we call seven day averages, looking at numbers of cases over sort of that week period. That gives us an indication of what's happening. 

But it really wouldn't take very much, Craig, at all for our numbers to double or triple. If people are in the community and they're not being tested because they have mild disease and they're socializing, and this is where I get really concerned. 

People have expanded their bubbles. We have a school bubble, a work bubble, maybe our weekend bubble. They seem to think that they can do all of those things now in these other bubbles, and that's not correct at all. We need to limit the total number of contacts that we come into contact with, not just on a daily basis, but on a weekly basis, a monthly basis. 

This is our new normal. It will not take very much for our cases to go up very quickly if people don't respect the number of contacts that they have. 

Are schools ready?

Norris: Elementary, high schools are phasing in now, staggered starts. Do you feel like schools are actually ready for this, or is this just a case of, look, it's the best we could expect right now? 

Mercer: Well, it's a somewhat difficult question to answer. I mean, I think that we have to recognize that education and learning for our children, for our young adults, are critically important to their mental health and well-being, as well as the long term implications of delaying or deferring schooling are hugely significant for this generation. 

So we have to weigh that risk against the risk of COVID in schools and how to manage that. I do know that schools have really been listening hard to public health and have been doing their best to implement public health measures. We are working closely with them, with assigned nurses to work with our schools, dividing and providing one nurse to a group of schools so they have a consistent contact point. 

It's not easy for them. They're not health care providers. So they're learning health care provider techniques when it comes to public health measures. But I think the most important thing for people to remember is if we don't have COVID in our communities, then we won't have it in our schools.

So we can't just say schools, you do your job and then as parents, as people out in the community, we don't behave or do our job. We want to keep all of our businesses open. So if you're a business owner, it should bother you and concern you if people aren't following public health measures.

We all need to be very mindful of that because we're all interconnected right now. Our schools aren't islands. They function in the broader community.

Feelings of indifference

Norris: People are you know, they're tired. Cases in Guelph, in Wellington County have been relatively low. They may be feeling like this virus, You know what … we're past this, it's not going to impact me. What do you say to those people when a potential second wave is on the horizon? 

Mercer: Well, unfortunately, you won't always know that you're in the second wave until you're looking backwards, and that's when you notice the second wave. 

So I think for people, it's a little bit more of a hindsight as opposed to a foresight. We are trying to predict it in terms of when it will occur. I do believe that we can still avert that. We have the opportunity to change the course of this pandemic if we — all of us, each of us — stop our social contacts, decrease them, go back to the ten most important people in your life and everything else, try and rigorously practice physical distancing or more. 

Wear a mask. Wash your hands. Be very careful. We can change this. And of course, if we do change this, then everybody is going to say to me, why are we doing this? We don't have any cases. Well, we don't have many cases because you're doing all the right things. 

Norris: But what will you be looking for now is, say, in the next 10 days? 

Mercer: Obviously in public health, we do get all the positive cases that get reported to us. I think it's a little bit longer than 10 days because we do use rolling averages, so I'm looking broadly across the province. 

I'm also using my own eyes and ears in terms of my own staff to see what are the behaviours in our population: how can we encourage or change people to follow the right behaviours? I don't want to see people relaxing, especially indoor masking. This is not the time to stop. This is the time to actually up the ante. Our kids are back in school. We have to keep them safe. 

Listen to the interview with Dr. Nicola Mercer:

Dr. Nicola Mercer is the CEO and medical officer of health for Wellington-Dufferin-Guelph Public Health. In this interview, she talks about the current state of COVID-19 and what she’s expecting to see in the coming weeks. 8:02


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