Toronto Public Health aims to resume full contact tracing of COVID-19 cases as indoor dining, gym visits set to restart

With Torontonians poised to resume mingling in reopened bars, restaurants and gyms, public health officials are returning to full tracing of all contacts of everyone infected with in the city.

Dr. Eileen de Villa, the city’s public health chief, told reporters Wednesday the “scaling up” of efforts to identify everyone with the virus, and get them to isolate, is vital as the provincial order halting indoor dining and gym visits expires Nov. 14.

The order expires Nov. 7 for the other hot spots, Peel and York regions and Ottawa. Facing rising daily infection numbers that hit a record 427 on Tuesday, Toronto asked Premier Doug Ford’s government before reopening.

Lifting restrictions will increase mingling and infections, de Villa said, and her goal is to have as many safeguards as possible to prevent a disastrous increase in spread.

“We are working toward resuming full contact tracing in our city,” among other measures, de Villa said, including adding 200 case management and contact staff to the current 700, seeking help from three Toronto hospitals and employing tech tools such as robocalls and text messaging.

Facing a dramatic surge in new infections in early October, Toronto Public Health to aim its staff who interview infected people to discover who they exposed only at high-risk settings such as schools and seniors homes.

But while the city scales up its response, de Villa said the Ontario government must also improve its efforts to protect the residents of Toronto, which on Wednesday saw new daily infections , but also recorded 11 new COVID-19 deaths — the most since June.

“Accessible and available testing needs to be scaled up,” de Villa said. COVID-19 testing, a provincial responsibility, was completed for 28,567 people Tuesday, down from summer levels when people with no symptoms could get tested.

Also, “sick-day provisions should be enacted by the province so that people don’t have to choose between staying home or going to work when they’re sick,” said de Villa.

Mayor John Tory said the city will work with de Villa to ensure Toronto is ready to reopen safely without an infection spike that could trigger a new lockdown.

“We can take the steps, with the resources we will apply as a city and Toronto Public Health, to be ready to open safely and to stay open safely,” Tory told reporters. “I’m confident we can do that — that’s what we have to do.”

De Villa said she won’t hesitate to act if virus indicators suggest that reopening could send COVID-19 spreading out of control.

“If the data tells us we need to do something differently, that we need more measures or we need more time … I will not hesitate to tell the people of Toronto or to ask for whatever is necessary in order to keep the people of Toronto as safe as possible,” she said.

Toronto was ordered into a modified Stage 2 on Oct. 10, during a period of rapid case increases.

Gyms were closed and a ban on indoor dining reinstated, for a period of 28 days.

On Tuesday, the province introduced new guidelines for implementing such restrictions, leading epidemiologists to express concern that the new thresholds are too high.

Under the province’s new guidelines, before ordering restrictions like the ones currently in force in Toronto, the province will look for: a weekly incidence rate higher than 100 infections per 100,000 residents; percent positivity greater than 10; a reproductive rate greater than 1.2; repeated outbreaks in multiple settings, and a health-care system at risk of becoming overwhelmed by the growing number of cases.

Not all of the thresholds need to be met at the same time.

Provincial officials have said that while the guidelines are given a specific weighting, the decision to move any public health unit into a particular level is ultimately based on subjective recommendations made to cabinet by the province’s chief medical officer of health, in consultation with local medical officers of health.

Some of the targets set by the province are so high they’ve never been met in Toronto, even on the worst days of the pandemic.

According to a Star analysis of public health data Wednesday, Toronto is currently reporting an average of about 85 cases per 100,000 residents per week; test positivity of 4.6 per cent; and an effective reproductive number of approximately 1.

Toronto only reported test positivity above 10 per cent for three weeks in March and April, and has never again come near that level. The city’s reproductive number has averaged more than 1.2 only twice — in the early period of rapid exponential growth in the spring, and during a long stretch of steady growth in late summer.

The city has never come close to passing 100 weekly cases per 100,000 residents — that number peaked at 55 in May.

Dr. Isaac Bogoch, an infectious disease specialist at Toronto General Hospital, said he supports the province’s decision to provide clear metrics.

“People need to know what to expect — especially business owners,” said Bogoch. “Where I think it needs recalibration is on some of the metrics.”

Bogoch said Toronto would not be in a modified Stage 2 under the new guidelines. He said the high thresholds set by the province would allow transmission to grow to the point where it would become difficult to rein in again.

“Things will not get better with this as it stands now, and it has the potential to get worse.”

David Rider is the Star’s City Hall bureau chief and a reporter covering city hall and municipal politics. Follow him on Twitter:

Ed Tubb is an assignment editor and a contributor focused on crime and justice for the Star. He is based in Toronto. Follow him on Twitter:

Francine Kopun is a Toronto-based reporter covering city hall and municipal politics for the Star. Follow her on Twitter: