As It Happens·Q&A

Close dine-in at restaurants and bars before it's too late, urges Toronto doctor

People want to make safe choices to protect themselves against COVID-19, but the Ontario government isn't making it easy, says Dr. Larissa Matukas.

Dr. Larissa Matukas is one of dozens of doctors who signed a letter for tighter restrictions in Ontario

Dr. Larissa Matukas is one of dozens of doctors who signed an Ontario Hospital Association letter calling on the province to close dine-in bars and restaurants temporarily to stop the spread of COVID-19. (Yuri Markarov/Unity Health Toronto)

People want to make safe choices to protect themselves against COVID-19, but the Ontario government isn't making it easy, says Dr. Larissa Matukas.

Matukas, head of the division of microbiology at St. Michael's Hospital in Toronto, is one of dozens of doctors who signed a letter released by the Ontario Hospital Association last week. It called on the province to put tighter restrictions on non-essential businesses such as dine-in restaurants, bars, nightclubs, gyms, theatres and places of worship. 

Ontario Premier Doug Ford announced new rules on Friday requiring bars and restaurants to stop serving alcohol at 11 p.m. and end in-person dining at midnight. Toronto's top doctor Eileen de Villa is also asking city council to require restaurants to reduce their number of patrons, collect contact information and lower music volume to conversation level. 

But Matukas says these measures fall short as COVID numbers continue to rise. Ontario reported 554 new cases of COVID-19 on Tuesday, following a record-setting 700 on Monday. The OHA called Monday for a return to Stage 2, in which only takeout and outdoor dining is permitted.

Here is part of Matukas' conversation with As It Happens guest host Helen Mann. 

Dr. Matukas, what is it like for you as a medical professional to hear from the premier that we are officially in a second wave?

I think that we have been toying with this terminology for a while, and certainly we are seeing this resurgence of cases, and [Monday's] numbers certainly are reflective of what has been going on for the past couple of weeks.

In [a] press conference, Doug Ford announced more than $50 million to recruit thousands more front-line health-care workers. But what didn't you hear from the premier that you would have preferred to hear?

Last week, a group of experts and physicians, along with the OHA, had issued a statement that called for very strict measures to really restrict and temporarily close businesses, particularly dine-in restaurants, nightclubs [and] bars, and we didn't hear any of that.

And whilst there were some restrictions ... with respect to the hours of operation of these businesses, we welcome that, but we were hoping for more.

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The Toronto public health officer, Eileen de Villa, said that the thing is it's not where you go, but what you do when you get there — that you get [the virus] from people, not from places. That sounds like it's supporting an argument against closing down bars, gyms, facilities like that.

I agree with the sentiment that it really is individuals that we are transmitting the virus between. It is not from a location to a person; it's between people.

However, in these establishments, it is very difficult to adhere to those preventative measures to prevent the spread from one person to another. And the reason for that is that you actually need to remove your mask when you are sitting down to eat a meal at a restaurant. You are removing your mask to actually drink your beer or coffee or tea.

You are participating in activities between people who are unlikely to be part of your household, and congregating in an indoor space with many others that have traveled through that same space, or even sitting there with you at the same time. 

I don't blame the businesses for remaining open, because there are policies right now that allow them to do so. And so it really is up to the individual. But if to stay safe requires you to wear your mask and to wash your hands and to avoid piercing your social bubble, then it's almost next to impossible to do that in these types of establishments.

The health minister in Ontario, Christine Elliott ... said that they don't really want to return to Phase 2 unless they have to. So what is your biggest concern in terms of the timing of this? What's the risk if they wait longer and it doesn't happen now?

The risk is that we will continue to see the number of infected individuals rise. And what will start happening is that we will start to see individuals who will not be able to fare through the infection as well as other individuals have. And so we'll start to see increasing in the number of hospitalizations, increasing in the number of those that require intensive care [and] ventilation, and we will eventually see even higher numbers of deaths.

We all need to do our part collectively, as the premier has mentioned, but we also need the government's support in order to help us choose the safer options.- Dr. Larissa Matukas, St. Michael's Hospital 

The Ontario Public Health Officer, Dr. David Williams, said today that this was "an undulating wave" as far as he could see. Does the reluctance to call for more restrictions have to do, perhaps, with not wanting to look like the bad guy?

I'm not sure that I know how to really answer that question. I think that in general, it always takes time to see the effects of public health measures.

The numbers that we're seeing today is reflective of the activities that were happening two or three weeks ago. And we will continue to see, you know, the effects of the current restricted business hours in the coming weeks.

Something tells me that we may not have time to wait to see if those measures are sufficient, given that the number has increased, that there is a strain on our testing system and network, that we're starting to see increasing in the number of hospitalizations with COVID already.

It's really important that we send messages that allow people to make the safer choice and to participate in safer activities, rather than leaving it up to individuals to decide whether or not a particular activity is safe for them.

People line up to be tested for COVID-19 at a testing centre in Toronto on Sunday. (Nathan Denette/Canadian Press)

So do you think that's a problem here, that people are hearing what they want to hear?

I think most people are really wanting to do what the safest thing is. And when they hear that it's OK to go to a bar or a dine-in restaurant, they have no reason to judge or believe that it isn't safe. And so they may not realize that it is an actual riskier activity than, say, dining at home with your family.

I guess the thing is, though, you say temporarily closed, but we've seen a lot of businesses — gyms, restaurants, other things — struggling in recent months and unable to come back. There's a lot of concern about the obvious economic impact of all of this. Is there a way to strike a balance?

That's exactly what we need to see happen.

We do need to consider the costs of the sacrifices that these businesses are taking. And it's imperative that when we look at what the cost of these public health measures are, that they take into account the costs of providing financial relief and support for the businesses that are sacrificing their time to temporarily close.

You know, there'll be people listening across the country that don't live in big cities. They may be in a much better situation than the numbers of cases we're seeing in places like Toronto. But should they be concerned about the second wave?

I think that everybody should be concerned about COVID-19 and the spread of the disease. We should all be adhering to the public health measures that have been advertised and messaged on a regular basis. We all need to do our part collectively, as the premier has mentioned, but we also need the government's support in order to help us choose the safer options.

Written by Sheena Goodyear. Interview produced by Katie Geleff. Q&A has been edited for length and clarity. 

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