From Response to Recovery: Planning for the Next Phase in our Fight Against COVID-19

It was less than three months ago that the first case of travel-related COVID-19 was detected in Toronto. Even before the case was identified, Toronto’s response, led by our Medical Officer of Health, Dr. Eileen de Villa and Toronto Public Health, was underway. Our initial response was swift, persistent, and effective, delaying community spread. 

In mid-March, Toronto moved into the second phase of the COVID-19 response: Mitigation. On the advice of our public health experts, the City of Toronto declared an emergency and implemented the boldest measures we have at our disposal to slow community spread of the virus, including physical distancing. I know that it has been a tremendously challenging time for everyone -- most of all for our front-line workers, who continue to go out every day to keep us safe and healthy, to keep trucks and buses moving, and to run grocery stores and pharmacies.

Earlier this week, Dr. de Villa shared the latest modelling from Toronto Public Health. This data showed that two different pandemics are occurring in our city, which are on different trajectories. For the general population, physical distancing efforts have been largely successful at flattening the curve of community transmission. Our data indicates that we are near the peak rate of increase, and can hope to reach a point shortly where we see fewer new cases each day.

The pandemic trend in congregate living sites is different. It is becoming increasingly clear that COVID-19 preys on poverty. Transmission has surged in areas where physical distancing is nearly impossible, and these sites have become ground zero for the fight against COVID-19. Staff and residents in long term care and retirement homes, shelters, group homes, and supportive housing buildings are at high risk of infection, and fatalities – particularly in long term care homes – continue to rise. These sites are also home to some of our most vulnerable: the frail and elderly, people with cognitive and developmental disabilities, people experiencing homelessness, and mental health or addiction challenges. 

In order to continue to mitigate transmission in the general community, and to help contain outbreaks in congregate living sites, we must continue to physically distance ourselves and stay home. We may have turned a curve, but we are not out of the woods. We will continue to be at high risk for future COVID-19 outbreaks, and overwhelming our healthcare system would still be disastrous. 

At the same time, we need to start planning for the third phase of our COVID response: Recovery. I want to be clear that recovery will not happen all at once. Most of our population still has no immunity to the virus, and a full return to normal life will not be feasible until there is a vaccine for COVID-19. In the meantime, though, we must consider which activities and operations may slowly resume, and which ones we need to continue to delay. Preparing for the Recovery phase means, first and foremost, looking at the challenge through a public health lens.

A new separate recovery planning team has been established within Toronto Public Health. Dr. David Mowat, one of Canada’s leading public health professionals, has joined Toronto Public Health on an interim full-time basis to oversee this recovery planning team by providing public health guidance and direction to inform our recovery. Over the course of his career, Dr. Mowat has served as the Chief Medical Officer of Health for Ontario, the Deputy Chief Public Health Officer of Canada, and the Medical Officer of Health for Peel Region. Our Medical Officer of Health, Dr. Eileen de Villa will continue to oversee all aspects of Toronto Public Health's response, along with Chief Matthew Pegg who is responsible for the City of Toronto's operational response.

Dr. Mowat’s leadership will directly inform the recovery of the entire City of Toronto. The City's recovery team, operating within the City Manager's office, will be led by Saad Rafi, who was previously the CEO of the Toronto 2015 Pan Am Parapan Am Games and served for 24 years in the Ontario Public Service, in a number of Deputy Minister roles. Based on public health advice from Dr. Mowat, Mr. Rafi’s team will determine when and how to resume city operations, while leading engagement with external stakeholders across sectors.

During the Recovery stage, public health data and advice will inform when city services resume operations, and what rules are in place in order to contain any future outbreaks and keep all of us safe.

These decisions range from when to open our parks and libraries, to how to practice safe distancing on the TTC, to ensuring protection for seniors and people experiencing homelessness. The recovery planning team will have to closely consider what the "new normal" needs to be in every aspect of what we do in order to maintain control over the virus and protect our health. Even the design and use of our streets, sidewalks, and bike lanes will have to be reconsidered, in order to facilitate safe physical distancing for pedestrians, cyclists, and other road users. 

I know that the past few months have not been easy. I understand that many in our community want to see a return to our lives before the pandemic. But if we stop physical distancing and open the city right away, we’ll squander all our efforts and sacrifices of the past five weeks.

Now is not the time to ease up. It is the time to stay vigilant, stay committed, and stay home  and continue to reduce transmission and save lives. 

The dedication and sacrifice of each and every one of you has gotten us to where we are today. Let’s not waste it.