Health·Second Opinion

What Canada's top public health officials say about the state of the pandemic and uncertainty ahead

As the country braces for a second wave that threatens to overwhelm hospitals and push Canadians back into lockdown, CBC News speaks to top public health officials about what gives them hope — and concern — in the coming months.

6 months since Canada's first COVID-19 case, key players weigh in on what gives them hope and pause

As Canada braces for a second wave of COVID-19 that threatens to overwhelm hospitals and push Canadians back into lockdown, CBC News spoke to key officials across the country about what gives them hope — and concern — in the coming months. (Ben Nelms/CBC)

This is an excerpt from Second Opinion, a weekly roundup of health and medical science news emailed to subscribers every Saturday morning. If you haven't subscribed yet, you can do that by clicking here.

It may be hard to believe, but it's been exactly six months to the day since Canada's first case of COVID-19 was announced.

Since then, more than 100,000 Canadians have been infected with COVID-19 and almost 9,000 have died — over 80 per cent in long-term care homes.

Globally, cases have now topped 15 million.

Throughout the pandemic, Canada's top public health officials have faced scrutiny, praise and backlash for the choices they've made since that first case was announced on Jan. 25. 

As Canada's health officials brace for a second wave that threatens to overwhelm hospitals and push Canadians back into lockdown, CBC News spoke to key figures across the country about what gives them hope — and concern — in the coming months.

Dr. Bonnie Henry, British Columbia's provincial health officer, says her biggest concerns moving forward are the reintroduction of visitors into long-term care homes, travellers from other provinces and the reopening of the U.S. border. (Darryl Dyck/The Canadian Press)

Dr. Bonnie Henry

British Columbia's provincial health officer has been called one of the most effective public health officials in the world after successfully flattening the curve in the province when it seemed early on it would be overrun with COVID-19.

"We got hit hard and early," she told CBC News in two recent interviews. 

Henry acted quickly to clamp down on outbreaks across B.C. before they spun out of control, taking the province from one of the most at risk early in the pandemic to one of the fastest to reopen safely.

"The timing that we had, the recognition of a couple of big super-spreading events in a conference that was held here and then in our long-term care homes early on — those were the things that we responded to," she said. 

Henry said outbreaks in households in B.C., meat processing plants in Alberta and the accommodations of undocumented workers in Ontario showed how different the experience has been with COVID-19 across the country. 

"It's really hard to compare. There's a lot of differences around timing, around access to tests, around population density and recognition of certain outbreaks early enough," she said. "These are the things that we've all been learning across the country."

To date, B.C. has had just under 3,400 COVID-19 cases and 189 deaths — a response that could have been much worse for a province of more than five million people.

In the coming months, Henry said, she is most hopeful about the reopening of schools in B.C. and aims to have elementary school students back in the classroom full-time in September.

WATCH | Luck, sound decisions helped B.C. avoid worst-case scenario:

Luck and sound decisions helped B.C. avoid worst-case COVID-19 scenario

3 years ago
Duration 6:45
British Columbia avoided the worst-case scenario during the COVID-19 pandemic largely because of its well co-ordinated messaging, sound decisions and a little bit of luck.

"We're also contingency planning," she cautioned. "If we get a major outbreak and lots of cases in the community and things start to get hairy, then we have plans to step back to partial in-class or if needed to full online teaching."

Henry said her biggest concerns moving forward are the reintroduction of visitors into long-term care homes and travellers from other provinces and the reopening of the U.S. border — particularly since B.C.'s first cases were tied to outbreaks in Washington state. 

Henry said she hopes to maintain a "sweet spot" going forward where B.C. can see an increase in activities, travel and socialization in a safe way to prevent "rapidly explosive growth" as new cases arise. 

"We are going to see more cases, and we know that," she said. "We need to make sure that if we do get some spread, which we have seen and will continue to see, that we're able to prevent wide transmission to large groups of people."

Henry said her approach in the coming months won't necessarily be to fully shut down parts of the province in response to outbreaks but instead work to limit spread while remaining open.

"This is going to be for the next coming months, but it's not forever, and we will get back to being together again in the way that we want to be together again — but not right now."

Alberta's Chief Medical Officer of Health Dr. Deena Hinshaw says she's less worried about travel between provinces and is instead more concerned about individuals' actions. (Jason Franson/The Canadian Press)

Dr. Deena Hinshaw

Alberta's chief medical officer of health has faced major challenges during the pandemic after large outbreaks at meatpacking plants across the province led to a spike in cases early on. 

The Cargill plant near High River in southern Alberta was the largest single coronavirus outbreak in North America and led to more than 1,500 people infected and several deaths. 

The province managed to flatten its curve by mid-June, but a worrying rise in the number of cases this week has threatened to jeopardize Alberta's future

As of Wednesday, the province had 1,251 active cases of COVID-19 — the highest total seen in more than two months.

"In some ways, we're a victim of our own success. We have controlled the spread in Alberta relatively well, which means that a lot of people haven't directly experienced the impact of having a loved one with COVID who's become very ill," Hinshaw said in a recent interview. 

"I am concerned that people are perhaps relying too much on their own personal observations in their daily lives and feeling that this is something to not be too concerned about."

WATCH | Dr. Deena Hinshaw warns of pandemic exhaustion:

Dr. Hinshaw warns of pandemic exhaustion

3 years ago
Duration 2:19
Four months into the COVID-19 pandemic, Dr. Deena Hinshaw says officials are worried about COVID exhaustion leading to an increase in cases, the majority of which are Albertans under the age of 40.

Hinshaw said she's less worried about travel between provinces, despite reports of exposure to the coronavirus at house parties in B.C. involving Alberta residents, and is instead more concerned about individuals' actions.

"The challenge is about people really being tired of restrictions and wanting to move on," she said. "Part of what we're seeing is somewhat linked to relaunch having perhaps given people a message that COVID is over — even though we haven't said that."

Hinshaw said that while the danger of increased transmission from reopening further is top of mind, the alternative is that people will go underground to congregate in much riskier settings. 

"It's really about convincing all of our population that they need to be taking these measures seriously," she said. 

"We need to shift how we interact with each other to make sure that we don't get huge amounts of transmission and potentially overwhelm our health-care system."

Dr. Vera Etches, Ottawa's medical officer of health, says the city will need to remain 'vigilant' about outbreaks as Ontario continues to move into Stage 3 of reopening. (Sean Kilpatrick/Canadian Press)

Dr. Vera Etches

Ottawa's top doctor raised the alarm early about the possibility of COVID-19 infections going undetected in the community and the need to act quickly. 

Only four days after Ottawa's first case of COVID-19 was confirmed on March 15, Etches told reporters she believed there were as many as 1,000 cases of coronavirus in the capital.

She's been described as having a "will of steel" and recently warned residents to be prepared to live with the risk of COVID-19 spreading in the community well into 2021 or even 2022.

Etches doesn't pull punches, but she still remains hopeful about the future. 

"We have been able to progressively go back to more activities, and yet our case counts are stable or declining, our hospitalizations are declining, our deaths are declining," she said. 

"So it really is the actions of individuals that has added up to breaking chains of transmission."

WATCH | COVID-19 threat could be present in Ottawa for several years: 

Threat of COVID-19 could be present in Ottawa for several years

3 years ago
Duration 2:22
Vera Etches, Ottawa’s chief medical officer of health, says community transmission could continue into 2021 and 2022, with the virus rebounding periodically in either smaller or larger waves.

Ottawa has had just over 2,300 cases of COVID-19 and 263 deaths. Despite a recent spike in new daily cases, the city reported just 14 on Thursday.

Etches is confident Ottawa will be able to continue to maintain that level of control moving forward but is concerned about what she's seeing south of the border. 

"It is the United States that is one of the most telling stories for us about the ever-present risk of a resurgence. People talk about a fall wave, but it could start in the summer," she said. 

"We're opening up bars, I think it's fair to say that is one of the settings we know has had outbreaks in other places and so that is a risk."

Etches said the city will need to remain "vigilant" about outbreaks as the province continues to move into Stage 3 of reopening.

"In the early days, before people started physically distancing, we saw case numbers double every three days and that could happen again," she said. 

"I hope that people can take a look and see that the virus is still here. I think the language about a second wave as if it's gone, and it might come back, has undermined the reality that the virus is here and it will grow if we let down our guard."

Dr. Eileen de Villa, Toronto's medical officer of health, says COVID-19 cases in the U.S. and even Canadian cities like Montreal linked to the reopening of bars are important lessons for Toronto. (Christopher Katsarov/The Canadian Press)

Dr. Eileen de Villa

Toronto's medical officer of health has guided Canada's largest city through the pandemic with cautious optimism, despite moving slower than other parts of the country. 

But de Villa said the city has used that extra time to understand more about the spread of COVID-19 in order to stop it and prepare for reopening. 

"We're fortunate in the sense that there are a number of other jurisdictions, cities and countries that are a little ahead of us in terms of their outbreaks, and so we have this opportunity to learn from their experiences," she said. "If we want to keep our progress moving forward here in the City of Toronto, we need to be mindful of these experiences."

De Villa said surges in COVID-19 cases in the U.S. and even Canadian cities like Montreal linked to the reopening of bars  are important lessons for Toronto, because people are in close contact and consuming alcohol and can be "less careful" about following public health guidelines. 

But she admits she faces a "balancing act" with giving people a place to socialize safely while avoiding congregating indoors at places like house parties. 

"We are social creatures as human beings, and there is an importance to having social connection through means other than just online," she said. "There is a desire, and it's a very human desire, for in-person connection. The question is, how do we help people achieve that much-needed connection, but to do so safely?"

WATCH | Toronto's top doctor says physical distancing still needed:

Toronto's top doctor says physical distancing still needed as city reopens 

3 years ago
Duration 11:40
Patios, salons, and indoor malls are now allowed to open in Toronto. The moves come as Toronto and neighbouring Peel Region enter phase two of reopening. But Toronto's Medical Officer of Health Dr. Eileen de Villa says public health measures must still be followed. 

De Villa said many of the U.S. states that have seen spikes in cases tied to bars and restaurants had not put in place strict physical distancing or masking measures before reopening and while case counts were still high. 

Toronto has seen more than 15,000 cases of COVID-19 since the pandemic began, with over 1,100 deaths. That number has declined significantly in recent weeks, with just 24 cases reported on Thursday. 

"If the level of COVID-19 activity in the community is low when you start to reopen and still do that reopening in a gradual and cautious fashion, it can be done safely," de Villa said. "I do think it means that you need to be vigilant." 

Looking forward, the reality that Toronto could see a spike in COVID-19 cases isn't lost on her, but she's hopeful citizens will keep up their resolve as the city looks to reopening further. 

"I think people are appreciating, as challenging as the circumstances are, that it does take all of us, and each one of us has to do our part and that we are only as strong as the weakest link in the chain," she said. 

"I do have a lot of faith in the people of Toronto. That doesn't mean perfection, right? As a mother of three, I can tell you that I don't look for perfection, I don't think we can expect perfection from anybody," she said.

"But I do try to look for the strengths that we see in our community and do what we can to build on those."

To read the entire Second Opinion newsletter every Saturday morning, subscribe by clicking here.


Adam Miller

Senior Health Writer

Adam Miller is a senior health writer with CBC News. He's covered health, politics and breaking news extensively in Canada for over a decade, in addition to several years reporting on news and current affairs throughout Asia.

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